Existing models of First Nations health and social services governance in Canada

The situation in Quebec

In Quebec, as in the rest of Canada, government responsibility for the delivery and funding of health and social services for the First Nations and Inuit rests on a variety of legislative and political provisions that stem from the areas of jurisdiction defined in the Canadian Constitution. While the provinces have the duty to structure the organization of health and social services for their entire population, the federal government must ensure the delivery and funding of services provided to the First Nations and Inuit. However, the federal government’s duty in that respect varies according to the agreements signed with specific nations.

The Quebec government offers to the entire population—including to First Nations and Inuit, regardless of their place of residence—complete coverage of services that are insured and offered by the Quebec health and social services system in its institutions.

Generally speaking, in First Nations communities, two federal departments—Health Canada’s First Nations and Inuit Health Branch (FNIHB) and the Department of Aboriginal Affairs and Northern Development Canada (AANDC)—share the responsibility for ensuring the delivery and funding of health and social services. Most band and tribal councils have taken over the planning and operationalization of these services, thereby assuming those responsibilities. However, the federal government continues to oversee services for the communities that have not concluded agreements to take over services.

Over the years, the First Nations of Quebec have made progress in terms of self-government. In addition to the creation of the Assembly of First Nations Quebec-Labrador and regional commissions and organizations, several actions have been taken to improve child and family services:

  • Section 37.5 of the Youth Protection Act: In June 2001, the government added section 37.5 to the Youth Protection Act. This provision allows communities to establish their own youth protection program, which allows for the application of different rules that are adapted to the local culture.
  • Income Security Framework Policy: This framework policy establishes an income security system adapted to the cultural and socioeconomic contexts of communities. It provides greater flexibility in terms of the services offers, the establishment of local regulations and the recognition of clienteles who are often overlooked by government regulations.
  • Implementation of preventive frontline social services: Some communities currently offer frontline services for parents, youths and families to help them with their difficulties. Communities have the possibility of mobilizing their resources and developing their own prevention programs.
  • Agreement with Avenir d’enfants: The FNQLHSSC and Avenir d'enfants formed a partnership in August 2012 to mobilize First Nations communities and organizations around the development of children between the ages of 0 and 5.
  • Agreement with the Ministère de la Famille du Québec: The FNQLHSSC has entered into a transfer of authority agreement with the ministry that will allow it to better support the development and improvement of child care services in non-agreement First Nations communities.