Jordan's Principle remains in limbo

Lett, Dan

doi:10.1503/cmaj.081756

Cited by 4 publications

(6 citation statements)

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“…A key difference between the context described in this paper and the emerging context in BC is the high level of commitment and investment by the provincial government, the Health Authorities, Health Canada, the First Nation Health Authority and First Nation communities to joint planning and decision‐making and to reciprocal accountability in terms of outcomes (First Nations Health Council; First Nations Health Authority ). There is potential for service level and system decisions to shift focus from jurisdictional boundaries to bridging jurisdictions using a collaborative model informed by Jordan's principle to better serve First Nations' needs (Lett ).…”

Section: Discussionmentioning

confidence: 99%

“…Services not prescribed by the Canada Health Act, but provided by the provinces as a matter of policy, may or may not be extended to First Nation peoples, based on official or more localized interpretations of policies (Lavoie et al ). The division of responsibility appears relatively neat, but federal‐provincial jurisdictional ambiguities have been repeatedly reported for nearly five decades (Booz Allen Hamilton Canada Ltd. ; Lavoie, Forget and Browne ; Lett ) and create barriers to accessing care.…”

Section: Current Policy Frameworkmentioning

confidence: 99%

“…First Nation engagement in health services planning and delivery has increased the visibility of federal decision‐making and increased the possibility for “push backs,” contesting decisions understood as unjust and arbitrary. Such push backs can be public, and result in national and international embarrassment (Lett ).…”

Section: Current Policy Frameworkmentioning

confidence: 99%

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Negotiating barriers, navigating the maze: First Nation peoples' experience of medical relocation

et al. 2015

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This study documents the policy framework that shapes First Nations' experience of relocating to access medical care. We analyzed policy documents and government websites, interviewed individuals who have experienced relocation, family members, healthcare providers, health administrators, and conducted two focus groups with government representatives. Federal and provincial program managers interpret policies, make decisions on eligibility, to extend or deny coverage. Decisions are shaped by shrinking budgets, fragmented program coverage, and jurisdictional confusion. Provider advocacy can help, but also perpetuate perceptions of arbitrariness and distrust. National policy renewal is required to redress this issue.Sommaire : La pr esente etude documente le cadre strat egique qui façonne l'exp erience de d eplacement des Premières Nations pour avoir accès aux soins m edicaux. Nous avons analys e des documents de politiques et des sites Web gouvernementaux, interview e des personnes qui ont dû d em enager, des membres de ces familles, des prestataires de soins de sant e, des administrateurs de services de sant e, et avons men e deux groupes de concertation avec des repr esentants gouvernementaux. Les gestionnaires de programmes f ed eraux et provinciaux interprètent les politiques, prennent des d ecisions relatives a l'admissibilit e, pour accorder ou rejeter la couverture. Les d ecisions sont dict ees par des compressions budg etaires, une fragmentation des champs d'application de programmes, et une confusion d'ordre juridictionnel. Les activit es d'intervention men ees par les prestataires peuvent aider, mais elles peuvent egalement perp etuer des perceptions de proc edure arbitrale et de d efiance. Un renouveau de la politique nationale est n ecessaire pour redresser cette situation.

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Section: Discussionmentioning

confidence: 99%

Section: Current Policy Frameworkmentioning

confidence: 99%

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Negotiating barriers, navigating the maze: First Nation peoples' experience of medical relocation

et al. 2015

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“…The lack of such guidelines continues to create denials and delays in access in other areas where jurisdictional confusion prevails (Jordan's Principle Working Group, 2015;Lavallee, 2005;Lett, 2008). Additionally, since dispensing fees can only be accessed for drugs dispensed, advocacy that yields no viable option for coverage is not compensated (Interview 3).…”

Section: Theme Three: the System Depends On Pharmacist Goodwill In Prmentioning

confidence: 99%

Defined by 0.11%: Policies delimiting access to prescription drugs for First Nations people in British Columbia

Wale

Lavoie

2015

IJIH

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The Non-Insured Health Benefits (NIHB) program is a federal program that funds prescription medication, as well as other primary healthcare benefits, for First Nations people registered under the Indian Act and for Inuit. NIHB policies have been developed within the Canadian political realities of ambiguity in interpretation of historical legal obligations, patterns of cost shifting onto provincial governments, and a move towards chronic disease management. This study critiques the ambiguities embedded in NIHB and provincial pharmaceutical benefit policies for First Nations people in British Columbia. British Columbia's Fair PharmaCare and PharmaCare Plan C provincial prescription programs are compared to NIHB. We conducted a review of these policies and completed our understanding by interviewing three pharmacists to better understand decisions surrounding the dispensing process. Four themes surfaced from our analysis: discrepancy between policy and practice in terms of federal versus provincial responsibility; restrictive processes of access to coverage; a system dependent on pharmacists' goodwill when NIHB denies a claim; and NIHB policies at times being at odds with pharmacists' clinical judgment and business compensation. Our findings suggest the existence of an ethnically differentiated social contract that perpetuates rather than diminishes barriers to care for First Nations people. KeywordsIndigenous, health, British Columbia, prescription, auditor, federal, pharmaceutical, medication, policy Authors Emily R. Wale, BHSc (Honours), (867) Dr. Lavoie played an advisory role in research design and analysis, and the primary role in article development and revisions for publication. She particularly provided expertise with regard to the interface between pharmaceutical policy and Indigenous medication services.

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“…Attempts to legislate Jordan's Principle were also made at the provincial level. In Manitoba, concern over slow and informal implementation of Jordan's Principle led to the introduction of Private Member's Bill 203 in 2008(see Bill 203, 2008Bourassa, 2010;Lett, 2008a). Bill 203 (2008) focused on health and social services, defining a jurisdictional dispute as "a dispute between the federal government and the provincial government or a government agency that is responsible for paying for the health care or social services required by a child" (Definitions section, para.…”

Section: Legislative Efforts To Define and Operationalize Jordan's Prmentioning

confidence: 99%

No Jordan’s Principle Cases in Canada? A Review of the Administrative Response to Jordan’s Principle

Blumenthal

Sinha

2015

iipj

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Jordan’s Principle is a child first principle intended to ensure that First Nations children do not experience delay, denial, or disruption of services because of jurisdictional disputes. This article describes the development of a federally-led administrative response to Jordan’s Principle and recent legal challenges to this administrative response. We identify seven major conceptual issues that currently prevent realization of the child first approach at the heart of Jordan’s Principle and may also introduce new inequities for First Nations children. Through content analysis of legislative, administrative, and judicial documents related to Jordan’s Principle, we demonstrate the complexity of policy making processes affecting Indigenous peoples in Canada, and in other countries (like the U.S.) that have similar structural frameworks.

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Jordan's Principle remains in limbo

Cited by 4 publications

References 0 publications

Negotiating barriers, navigating the maze: First Nation peoples' experience of medical relocation

Negotiating barriers, navigating the maze: First Nation peoples' experience of medical relocation

Defined by 0.11%: Policies delimiting access to prescription drugs for First Nations people in British Columbia

No Jordan’s Principle Cases in Canada? A Review of the Administrative Response to Jordan’s Principle

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