Overview of the health and social services governance process

The health and social services governance process was created to make strides towards improving the offer of and access to services, both locally and regionally, by implementing a model of governance that is adapted to the needs and realities of Quebec First Nations.1.


To that end, the process has two objectives:

  • Reinforce the local and regional decision-making capacity of First Nations communities and organizations with respect to the governance of health and social services in terms of existing programs, sectors and initiatives;
  • Renew the partnerships between First Nations and government institutions, in accordance with a model of governance adapted to the needs and realities of Quebec First Nations.

Governance in health and social services has been a key, long-held concern for First Nations, whether in Quebec, in the other regions and territories in Canada or elsewhere in the world. It also forms an integral part of the mission of the Assembly of First Nations Quebec-Labrador (AFNQL), to which the First Nations of Quebec and Labrador Health and Social Services Commission (FNQLHSSC) reports to. In addition, governance in health and social services is the first of five strategic orientations set out in the Quebec First Nations Health and Social Services Blueprint, 2007-2017: Closing the gaps... Accelerating change.



The process has three focus areas:

Focus 1: Information gathering and research

Fuel the reflection of First Nations communities and organizations by providing a theoretical framework.

Focus 2: Consultation, coordination and experience sharing

Mobilize local leaders to build a model that is acceptable to all parties.

Focus 3: Communication, monitoring and evaluation

Ensure the project makes good progress and that knowledge is passed on to First Nations communities and organizations.




Process phases


The process’s three focus areas have been translated into a four-phased process that will end on March 31, 2016. 

Phase 1: Portrait of the situation - 2014 

The FNQLHSSC takes an inventory and conducts an analysis of the approaches taken to effect change in health and social services governance elsewhere in the world in recent years.

Completed activities:
  • Creation of new partnerships
  • Inventory of existing models
  • Analysis of the legal situation of Quebec First Nations
Phase 2: Your opinion - 2014-2015 

Community decision-makers are called on to formulate their opinion on the current governance structure.

Completed activities:
  • Meetings:
    • February 2014
    • July 2014 
    • January 2015
    • July 2015
  • Formulation of the vision, values and principles to guide the process 
Phase 3: The options - Fall 2015 

One or more governance models are developed, based on the information collected. The Chiefs, local managers and health and social services workers are consulted during the elaboration of the models.

Upcoming activities:
  • Development of proposed models and meetings with the health and social services directors and directors general
Phase 4: The choice - Winter 2016

The First Nations speak, and choose one of the models developed. The First Nations will select, in their way, the governance model that is best adapted to their needs.

Upcoming activities:
  • Finalization of the chosen model and meeting with the Chiefs to proceed with the model’s adoption in principle
In keeping with the governance model chosen and according to the interests expressed by the First Nations, other actions could be taken, such as performing a feasibility study, undertaking negotiations with the federal and provincial governments and drafting a transition plan.


Process coordination


The FNQLHSSC will oversee the process’s coordination. In order to support and fuel the reflection of First Nations, several committees have been created to bring different sets of expertise to the table and help collect the necessary information and knowledge to develop the relevant governance model.




1. The process particularly targets non-agreement First Nations of Quebec.