1. Guide to Competency Frameworks
HHR generally refers to the individuals providing health care
including professionals such as physicians, lab technicians, psychologists – some with national but most with education and accreditation within PT jurisdiction
allied health workers such as homecare workers, diabetes prevention
Mix of public service such as hospitals, as well as private service such as chiropractors
Complexity of multiple systems and jurisdictions
No agreed-upon number of health careers

2. FNHM Competencies Framework Project
History
Indian Health Policy (1979) and RCAP recommended to build more capacity in FN communities on health
Announcement on Aboriginal Health Human Resources Initiative (AHHRI) mad at the 2004 First Ministers Meeting with Aboriginal Leaders
AFN’s Chiefs Committee on Health and FNIHB’s Executive Committee made HHR a priority in March 2005
FNHM Advisory set up with nominations from the NFNHTN
In AFN, reports through to the CCOH
Why a priority now?

3. AHHRI
Objectives:
Recruitment, retention and graduation of youth into health careers
Visibility of health careers
Cultural safety of post-secondary health programs
Recruitment and retention of health workers
Supportive and conducive work environments
Research and data on Aboriginals in health careers
Establish standards of practice for allied health workers
ON Anishnawbek Ed. Institute – development of traditional FN mental health curriculum, cultural safety
MB St. Theresa Point – Elders involved in programs to support students and increase FN content into program
AB University of Calgary – inclusion of Aboriginal content into curriculums for medicine, dentistry and nursing
SK Saskatoon Tribal Council – Mentorship coordinator to improve retention of FN employees in STC
QC FN - Cultural adaptation of youth intervention curriculum - and moving program online - for NNADAP workers and mental health workers
NAAF bursaries for students in health
IPAC-AFMC Cultural safety in curriculums for physicians
FN community health representatives and the future of health promotion
Nursing HHR with ANAC
Additional HHR activities:
Home and Community Care accreditation
FASD worker role
MCH job description
Mental wellness teams – 4 pilot projects
Health organization accreditation by the Canada Council on Health Services Accreditation
NNADAP competency framework, accreditation and evidence base.
Provincial/Territorial Initiatives
Collaboration on testing for health professionals immigrating to Canada
Increasing funding for seats in health programs such as medicine and nursing
Pan-Canadian HHR Strategy
Health Human Resource Planning - ensuring we have enough of the right types of health-care providers to meet the needs of Canadians;
Recruitment and Retention - encouraging more people to enter the health-care field and improving working conditions to keep them there; and
Interprofessional Education for Collaborative Patient-Centred Practice - changing the way we educate health providers so Canadians will have better and faster access to the health-care provider they need when they need it, ultimately boosting the satisfaction of both patients and health-care providers.

4. FNHM Project Funded by AHHRI as a national project Activities:
Develop of a national set of FNHM Continuing Competencies that communities may wish to adopt
Identify effective FNHM recruitment and retention strategies
Develop a communication framework
Identify potential opportunities and challenges relating to transition (i.e., adoption of continuing competencies framework)
Identify training and educational needs and opportunities
Establish of a national network of FNHM
Develop an informative website and e-portal for FNHM

5. Activities to Date First Nations Centre at NAHO
Needs Assessment & Environmental Scan of FNHM
Literature review
Regional focus groups
Assembly of First Nations
website
Champion on Canadian Health Leadership Network (CHLNet)
Regular updates to FN HHR Regional Coordinators, NFNHTN and CCOH
Organization of this national forum

6. Key Definition of FNHM Works in FN community or tribal council
Have responsibility for management of health human resources, financial resources, and health programs.
May also provide leadership and direction around resource planning, change management, and health and social program delivery.
May have title of CEO, health director, health coordinator, or health manager
May have the role of manager of a community health facility, health centre, and health programs

7. Vocabulary
A skill is an ability, usually learned and acquired through training, to perform actions which achieve a desired outcome.
A competency is a standardized requirement for an individual to properly perform a specific job. It encompasses a combination of knowledge, skills and attitude utilized to improve performance.
Core competencies are the set of cross-cutting skills, knowledge and attitude necessary to effectively manage a health facility, and its related health and social programs.
Continuing competencies are defined as the competencies required to create a supportive work environment and to effectively adapt to a changing work environment. Continuing competencies are comprised of core competencies, but also include skills such as self-assessment, health human resource planning and change management.
A Competencies Framework is a holistic document of continuing competencies that represents the work and potential in a given job.

8. Ways to discuss a Framework
Numerous ways to think about a Competencies Framework:
Individual – career entry, progression and satisfaction
Organizational – clarification of duties, performance review
Educational – entry-level education, continuing education
Systems – reduce inefficiencies in the system such as wait-times and referrals
Values include economic, people-centred, and/or client-centred
Important to clarify the goal first – what are the problem(s) to address with a Framework?

9. Issues in FN HHR
Issue of “Continuum” of health work paraprofessional to professional
No clear line
Strict regulation of professionals hinders a community-based approach with multi-tasking and taskshifting
Risk of ghettoizing paras into the role, with no ability to move up into a professional role
Jurisdiction and role confusion
PT mandate: post-secondary education, most professional accreditation
Federal mandate: funding for FN health
FN community mandate: balance the needs and the available funds
Status quo versus planning for the future

10. Intent of National Forum
Review and comment on the work done to date by the First Nations Centre
Learn about promising practices and procedures from across the country
Network and build linkages