The NIHB program was established as Health Canada’s national, medically necessary health benefit program that provides coverage for benefit claims for a specified range of drugs, dental care, vision care, medical supplies and equipment, short-term crisis intervention mental health counselling and medical transportation for eligible First Nations people and Inuit.
 

Non-Insured Health Benefits Navigator

The FSIN staffs a Non-Insured Health Benefits Navigator to help support First Nations communities and individuals when refused or denied health benefits under their constitutionally protected rights. The FSIN continues to advocate on all received client calls requiring advocacy support.
 

AFN/FNIHB Joint Review

The Assembly of First Nations (AFN) and the First Nations and Inuit Health Branch (FNIHB) have undertaken a Joint Review of the Non-Insured Health Benefits (NIHB) Program with the following objectives:

• Enhance client access to benefits;

• Identify and address gaps in benefits;

• Streamline service delivery to be more responsive to client needs; and,

• Increase program efficiencies.

 

The NIHB Joint Review began in September 2014 after concerns were raised by First Nations, leading to advocacy efforts by First Nations leadership and the AFN.  The review is guided by a Steering Committee made up of members from the Chiefs Committee on Health, the National First Nations Health Technicians Network and the National NIHB Navigators Network.  The Steering Committee has equal representation from First Nations and FNIHB staff, including two Assistant Deputy Ministers with the authority to make program changes. The NIHB Joint Review is expected to be completed in 2017 and a final report with findings and recommendations will be presented.

 

Kāhui Tautoko Consulting Ltd (KTCL) has been contracted by the AFN to undertake this review.  KTCL is a consultancy based in Vancouver, BC, specializing in First Nations health and community development projects and has undertaken NIHB reviews previously. The objectives of this review are to determine:

• What processes are used to access these benefits and how effective these are;

• What challenges or barriers there are accessing these four benefits including awareness of what is available;

• If the NIHB program is meeting privacy and cultural needs; and

• The strengths and opportunities for improvement of the NIHB Program.

 

One of the current processes within the Joint Review is the operational benefits review which involves a series of community site visits that will consist of interviews with First Nation communities across the regions in Canada.  The communities that have been selected by STAG based on criteria of geography, nature or level of contribution agreements, diversity of health services and needs, are the Onion Lake Cree Nation, Sturgeon Lake First Nation, Sakimay First Nation, Hatchet Lake First Nation, and Standing Buffalo First Nation.

 

National Non-Insured Health Benefits Working Group:

NIHB Navigators from several regions in Canada meet, along with AFN Technicians to present and discuss regional issues and challenges and work collaboratively to present recommendations to the Joint Review Process.

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At the last National NIHB meeting the following issues were presented as an update:

• Jordan’s Principle

• Medical Transportation

• Accommodations for clients in urban areas

• Escorts are provided to clients

• Ambulance fees

• Drugs – the NIHB Drug List

• Dental care

• Vision Care

• Medical Supplies and Equipment

• Short Term Crisis Intervention Mental Health Counselling

 

NIHB Navigators will be presenting the following recommendations to the AFN Health Technician group, for their input into the Joint Review. It is important to note that further recommendations will be presented before the end of the Joint Review process, based on the community interviews that are being conducted by a contractor hired by the AFN.   Health Technicians will be provided with information pertaining to the six communities that will be contacted in Saskatchewan and the process for identifying them based on criteria and specific parameters. Other discussions for recommendations were to have more Navigators hired in regions, and there were diverse opinions about the type of Navigators that each Region would require. For example, cancer care navigators, disability navigators, appeals navigators. Recommendations to AFN Health Technician Working Group:

• Dental centralization – propose that the centralization of dental and orthodontic pre-determination centre be moved back within the regions.

• Appeals – develop proposals to hire navigators to deal with appeals specifically.

• Cancer Care – develop proposal for cancer care Navigator to deal specifically with Cancer Care services in Saskatchewan.

• Meal Vouchers – proposal to develop loadable cards for NIHB Clients so they can have a choice for meals. This is similar to gift cards; instead, they will be for food purchases.