Health Funding Arrangements 101

What is a Health Funding Arrangement? (formerly known as Contribution Agreement) Legal agreement between a community/tribal council/First Nations representative organization/NGO/treatment centre and Canada to support the delivery of health programs and services for First Nations in Alberta. Includes: Schedules Program plan (where applicable) Notices of budget adjustments Amendments Series of contributions. 2

Contributions A Contribution is used to transfer monies from federal government to organizations or other levels of government to further government policy and the departmental objectives. Contributions are: subject to performance conditions specified in a funding arrangement to be accounted for and is subject to audit. The recipient is required to report on results achieved. 3

Objective of the new Funding Arrangement framework Assist and support First Nations and Inuit Communities to access funding to provide health programs and services. 4 Principles of the framework Programs and Services are funded in accordance with the mandate of First Nations and Inuit Health Branch. Recipient will have control over management and administration of their health programs according to their capacity and readiness.

HFAs: Then and Now 5 Then (pre ) “Contribution Agreements” Multiple types Carry-forward request letters required Audit required for flexible and block only Set funding: 3 years maximum Now “Health Funding Arrangements” (HFAs) 1 type with multiple funding approaches No carry-forward request letter required Audit required for all funding approaches Set funding: 5 years maximum Funding approaches can be changed within the life of the agreement without terminating the agreement.

Funding Model Names ThenNow “Transitional Funding Model”“Flexible Funding Model” “Flexible” or “Flexible Transfer Funding Model” “Block Funding Models” 6 Certain programs have set funding, despite being held within more flexible funding arrangements (e.g. NIHB Medical Transportation and Indian Residential Schools). Modified to be in line with the Directive of Transfer Payment and with other Federal departments that enter into agreements with similar recipients. Set funding remains the basic funding approach.

What does this mean for Communities? Simplified and flexible funding arrangements Single agreement for all FNIHB Programs Greater program and financial flexibility Streamlined reporting based on programs clusters Non-Insured Health Benefits (NIHB) retains existing requirements (i.e. set funding). 7

Assessing Readiness: What funding model for whom? 8 Working with a community to assess its readiness to undertake the health planning process is a critical first step before selecting a funding approach. FNIHB looks at the recipient’s strengths and weaknesses in financial and program management and other circumstances. “Risk” is a key consideration: assessed through the General Assessment tool. Contributes to decision-making about: the type of plan required from the recipient; the selection of a program’s funding approach; and the level of monitoring required.

Set Funding Arrangement Foundational funding arrangement. First Nations delivers programs based on the Program Plan which is provided by FNIHB. One (1) to five (5) years in duration. No carry forward of funding, all funding must be expended within the fiscal year. Any unspent funding at year end will be considered as a recovery. First Nation may re-allocate program funding before March 31 st with a written request via letter or to the Zone Manager. 9

Flexible Funding Model Two (2) to five (5) years in duration. First Nations delivers programs based on a Multi-Year Work Plan. The Multi-Year Work Plan is a living document; work plans must be updated to reflect changes. Annual year-end program reports as per “program cluster” performance indicators. Funds can be redirected among components within authorities as long as mandatory programs are delivered. Allowed to carry forward from year to year but must be spent before Funding Arrangement expires. 10 Pre 2015–16, Flexible Funding Models were called “Transitional Funding Models”

Block 5 to 10 years in duration. The Community Health Plan (CHP) must be developed by the First Nation for the duration of the Funding Arrangement. The multi-year CHP is a living document and must be updated to reflect changes over time. Funds can be redirected among components within authorities as long as mandatory programs are delivered. The First Nation is responsible for any surplus or deficits. 11 Pre 2015–16, Block Funding Models were “Flexible” or ”Flexible Transfer Funding Models”

Re-allocation of Funds First Nations may re-allocate any funding within a Set Arrangement among health programs and services within the same program cluster (red boxes) with FNIHB-AB’s approval. First Nation may re-allocate any funding within a Flexible Arrangement among health programs and services within the same program cluster (blue boxes). First Nation cannot re-allocate any funding out of Non-Insured Health Benefits and Indian Residential School programs, but can allocate in based on identified priorities.* *This applies to all arrangement types. 12

Carry Forward Communities can carry forward any funding that is not spent (excluding Set Funding) into the next fiscal year for the total duration of the Funding Arrangement. Remember: Then (Pre-2015–16): No “carry forwards of carry forwards” Carry forward request letter required. Amount requested is not necessarily approved. Now (Post-2015–16): Any carry forwards must be spent before end date of arrangement. No carry forward request letter required - unexpended funding plan for arrangements and beyond. Carry forward amount determined through your audit. 13

14 Zone Manager: Jack Kennedy Contact Information Program Liaison Officers: Rose Leclair (Treaty 6 West) Darlene Peacock (Treaty 6 East) Claude Sound (Treaty 7) Denise Gugel (Treaty 8 NPTC & ATC) Cheryl Watson (Treaty 8 WCTC, BHC, T8) Candace Oliver (Treaty 8 LSLIRC & KTC) Monica Michel (NGOs) Thank you!