Version 6.1, July 2, 2020
NAN is a political territorial organization representing 49 First Nation communities within northern Ontario, with the total population of membership (on and off reserve) estimated around 45,000 people. Within NAN territory, many remote communities are only accessible by air for the majority of the year and have nursing stations that serve as their primary source of health care. These nursing stations are supported through the Government of Canada’s First Nations and Inuit Health Branch. Communities with road access will often access health care through services that are a part of the provincial health care system. There are also several First Nation-governed organizations in NAN territory that are involved in regional and local health service delivery.
This complex system results in jurisdictional ambiguity around health care delivery and public health, making NAN territory vulnerable to public health emergencies such as the COVID-19 pandemic. NAN community members lack comparable access to health care as non-First Nations people in Ontario, and a significant number of people in NAN have health conditions, such as diabetes, that put them at risk of serious complications from COVID-19. To decrease risks to NAN communities and to keep NAN First Nations and members safe and supported, a group of medical and field experts is needed to inform NAN’s response to the COVID-19 pandemic.
The purpose of the NAN COVID-19 Task Team (“Task Team”) is to gather and provide vital information to support NAN First Nation members during the COVID-19 pandemic. The Task Team will respond to the needs of Tribal Councils and health care providers throughout NAN territory, including two health authorities (SLFNHA and WAHA), as well as concerns identified by NAN leadership, area Chiefs, and community members.
Work by the Table will inform and support existing local plans and will align with both the provincial and federal response structures to COVID-19.
Overall goals of the table include:
- Decrease illness and death
- Minimize community disruption
- Inform and support NAN leadership and community members
There are two main areas within the scope of the Task Team:
- Addressing specific questions from NAN
communities, Tribal Councils, Chiefs and the NAN Executive.
- Many of these questions will be raised during the Chief’s Calls regarding COVID-19. The Office of the GC has regularly scheduled these calls throughout the pandemic; depending on the phase of the COVID-19 response, they have been scheduled every day, two times a week, and once a week.
- Identifying immediate priorities and issues for
NAN territory during the COVID-19 pandemic. This may include, but is not
limited to, priorities and issues involving:
- Public health
- Acute care
- Primary care
- Critical care
- Community-level care
- Mental health and substance use
- Emergency management (example: critical infrastructure)
- Surge infrastructure
- EMS/community paramedicine
- Scaling community responses up and down
- Poor infrastructure, such as water and housing
- Inadequate health facilities and accommodation for health providers
- Effects of provincial reopening on NAN communities
- Risks of additional COVID-19 waves
The Task Team will consider the best interests and needs of all the people of Nishnawbe Aski Nation, including those living in urban, remote and road-access communities.
4. Task Team Membership
- The Task Team will consist of experts from the fields of public health, emergency management, critical care, nursing, acute care, and mental health and addictions, as well as Elders and Traditional Knowledge keepers.
- The size of the Task Team and the composition of its membership is left undetermined; however, the group should try to maintain a balance between different areas of expertise, as well as the different areas of NAN (i.e. the West, East, and central/road access regions).
- Members are selected either through appointment by the NAN Grand Chief or through the recommendation of one existing Task Team member with the support of the majority of the Task Team.
- The Task Team will have both a Chair and two Vice-Chairs; the Chair and Vice-Chairs will either be appointed by the Grand Chief or selected by the Task Team, through nomination by another Task Team member and with the support of the majority of the other Task Team members.
- Of the two Vice-Chairs, one will represent the
Northwestern region of NAN and one will represent the Northeastern region.
- This can either be through the organization they represent or as a member of a First Nation in one of these two regions.
- Depending on the phase of NAN’s COVID-19 response, Task Team members may be further identified as either Core or Complete Members. These roles are described in greater detail in 8. Meetings and Other Activities.
Chair and Vice-Chair Duties
- Facilitate the meetings.
- Approve recommendations and any other material that is sent to the GC’s office.
- Attend NAN Chief’s Calls regarding COVID-19 as a representative of the Task Team.
- Provide Task Team updates at NAN Chief’s Calls regarding COVID-19.
- Answer questions, when appropriate, from community leadership at NAN Chief’s Calls regarding COVID-19.
- Attend other conferences and meetings as requested by the Grand Chief’s office.
- Attend NAN Chief’s Calls regarding COVID-19 to provide support to the Chair.
- Answer questions, when appropriate, from community leadership at NAN Chief’s Calls regarding COVID-19.
- Assume the duties of the Chair whenever the Chair is unable to do so.
Terms of Office
- There is no set term of office for members of the Task Team. It is anticipated that membership will be determined by the duration of the COVID-19 Pandemic and the other duties and responsibilities of the Task Team members.
- If a member of the Task Team is unable to continue as a member, they must inform the Task Team by contacting the Chair, both of the Vice-Chairs, and Coordinator.
- The Task Team and/or the Office of the Grand Chief must make every attempt to identify a new Task Team member who would offer similar expertise to that of the departing Task Team member.
Chair – Mae Katt, Nurse Practitioner
Dr. Mike Kirlew, Family Physician, Weeneebayko Area Health Authority
Lynne Innes, Nurse Practitioner, CEO and President, Weeneebayko Area Health Authority
Dr. Jane Philpott, NAN Special Advisor on Health
Dr. Claudette Chase, Family Physician, Sioux Lookout First Nations Health Authority
Michelle Gervais, Emergency Management Consultant
Michael McKay, Director of Housing and Infrastructure, Nishnawbe Aski Nation
Georgina Lentz, Director of Health Transformation, Nishnawbe Aski Nation
Barney Batise, Traditional Knowledge Keeper
Teri Fiddler, Traditional Knowledge Keeper
Helen Cromarty, Traditional Knowledge Keeper
Eric Goodwin, National Incident Management Team Chief, Team Rubicon
Janet Gordon, Chief Operating Officer, Sioux Lookout First Nations Health Authority
The Task Team will also seek to include:
Additional Emergency Management specialists
Members on Leave:
Dr. Natalie Bocking, Public Health Physician, Sioux Lookout First Nations Health Authority
The expected outcomes of the Task Team are recommendations to the NAN Grand Chief that fall within the Task Team’s scope. Some examples include suggested public health guidelines during the COVID-19 pandemic; requesting advocacy from NAN regarding critical care equipment funding; or identifying the need for more clarity about the First Nations and Inuit Health Branch PPE ordering process.
These resolutions will be communicated in writing to the Office of the Grand Chief. The Office of the Grand Chief will then determine whether and how to act upon the Task Team’s recommendations.
Through working within its scope, the Task Team or one of its Working Groups may respond to a question, priority, or issue in such a way that a recommendation is not the appropriate outcome. Instead, another item (including, but not limited to, proposals, guidelines, guidance documents and/or protocols) is the more appropriate response.
When this occurs, the Task Team or Working Group should be guided by the primary principle of strengthening existing programs and services and not creating new systems.
The Task Team or Working Group should seek feedback and input on the item from Health Authorities, Tribal Councils, and communities. The length and scope of this process should be guided by what is appropriate and reasonable considering the urgency of what the item seeks to address.
6. Working Groups
From time to time, Task Team members may identify an issue in NAN territory during the COVID-19 pandemic that is of such complexity that the most efficient way of addressing it is through the formation of a Working Group.
This Working Group is to be time-limited and have clear objectives. Either the Chair or Co-chair of the Working Group will be a member of the Task Team. Working group members can be sought from outside of the Task Team, but membership in a Working Group does not constitute membership on the Task Team.
The Task Team member who is chairing or co-chairing the Working Group should establish this Working Group’s timeframe and the Group’s specific objectives prior to the Working Group’s second meeting and present these to the Task Team.
Once its objectives are met, the Working Group should be dissolved.
7. Decision making
The Task Team will always work towards consensus, while respecting the autonomy of NAN communities, Tribal Councils, and organizations. The consensus of the Task Team only reflects the recommendations of its members; it is unlikely to speak to every need in a territory as diverse as NAN.
When the Task Team is unable to reach consensus, the Task Team will forward the recommendation supported by the majority of its members. The Task Team will also note that there are differing opinions on this recommendation and share the recommendation that is supported by the minority of the Task Team.
8. Meetings and Other Activities
The activities of the Task Team will be dictated by circumstances of the COVID-19 pandemic. There are five phases of Task Team activity, with criteria for these following phases:
Task Team Response Phases
|Protect and support (Phase 0)||Any active case(s) in a NAN community or several new cases in urban hubs in NAN territory (Thunder Bay, Timmins, Sioux Lookout) AND/OR High level of concern from leadership or NAN executive for health system capacity, public health capacity, or community readiness in NAN territory. AND/OR Determination by GC AND/OR Determination by Task Team|
|Phase1||Limited new cases (<1-2 per week) in urban hubs in NAN territory AND/OR Medium level of concern from leadership or NAN executive for health system capacity, public health capacity, or community readiness in NAN territory. AND/OR Determination by GC AND/OR Determination by Task Team.|
|Phase2||No new cases in urban hubs in NAN territory, consistent 2-4 week decrease in the number of new COVID-19 cases in Ontario. AND/OR Low level of concern from leadership or NAN executive for health system capacity, public health capacity, or community readiness in NAN territory. AND/OR Determination by GC AND/OR Determination by Task Team.|
|Phase3||No active cases in urban hubs in NAN territory, the number of new COVID-19 cases in Ontario has continued to consistently decrease, new cases in MB and QC have shown a consistent 2-4 week decrease. AND/OR No concerns from leadership or NAN executive for the health system capacity, public health capacity, or community readiness in NAN territory. AND/OR Determination by GC AND/OR Determination by Task Team.|
|Phase4||No active cases in urban hubs in NAN territory, limited number of new cases (<10/day) in each of ON, MB or QC. AND/OR ON and MB, have moved to phase 3 of their reopening plans, QC has moved to phase 6. AND/OR Most NAN communities have moved into phases 1-3 of their reopening plans. AND/OR Determination by GC AND/OR Determination by Task Team|
Task Team Activities
Purpose and Description
As the risk of COVID-19 to NAN Territory is relatively low in Phases 3 and 4, it will be more efficient for the Task Team meetings to consist of only a Core Team during those phases. This allows for flexibility in scheduling and reduces the burden of participation on all Task Team members. Core Team Members may rotate in or out depending on their availability. During this time, the Core Team’s focus may shift to supporting communities as they recover and restart. Members of the Core Team can provide strategic-level support during this phase, including the review and analysis of a community’s pandemic response and facilitating relationships that would address gaps and inefficiencies in that response. The responsibility of the Core Team is not diminished from that of the Task Team in Phase 0; however, it will be a smaller and more agile team.
It is not expected that the Core Team will be activated until there are no active cases in NAN communities and no active cases in urban hubs in NAN territory. At that point, the risk of COVID-19 to NAN will be low.
However, it is important to note that a low risk of COVID-19 does not mean no risk; both NAN staff and the core team should remain vigilant throughout phases 3 and 4 and closely monitor the COVID-19 situation, especially as the province reopens and seasonal factors change, increasing the risk of additional waves of the virus.
Along with a NAN Lead, the Core Team will be comprised of one representative for each of the following areas of expertise:
- Health Transformation
- Traditional Knowledge
- Public Health
- Mental Health and Substance Use
- Clinical Care
- Emergency Management
Task Team members can volunteer themselves for Core Team membership in their area of expertise. In the event that two or more members wish to participate as Core Team members in the same area of expertise, they may alternate participating as Core Team members at meetings.
The Chair and the Vice-Chairs will be selected from members of the Core Team.
- NAN Lead: Michael McKay
- Health Transformation Lead: Georgina Lentz
- Traditional Knowledge Keeper: TBD
- Public Health Lead: TBD
- Mental Health and Substance Use Lead: TBD
- Clinical Care Lead: TBD
- Emergency Management Lead: TBD
When the Core Team is activated, it is expected that the following members will attend NAN Chief’s Calls regarding COVID-19 whenever possible:
- Public Health Lead
- Mental Health and Substance Use Lead
- Emergency Management Lead
The following duties are expected of all Core Team members:
- Attend scheduled meetings of the Core Team whenever possible.
- Answer questions from NAN Executive, leadership, and community members to the best of their ability.
- Monitor the COVID-19 situation provincially, nationally, and internationally and assess for risk to NAN territory.
The complete team comprises all members of the Task Team (see p. 3) who are not part of the Core Team.
- Read and review any communication from the Core Team, including meeting reports.
- Be prepared to ramp up Task Team activities, as indicated by the circumstances of the COVID-19 pandemic.
9. Support for the Task Team
- The Task Team will be supported by a Coordinator.
- This Coordinator will be a NAN staff member.
- The Coordinator is not a member of the Task Team.
- Drafting agendas for Task Team meetings
- Writing and/or reviewing briefing reports from Task Team meetings.
- Drafting recommendations and other documents for the Task Team.
- Organizing meetings.
- Maintaining records of the Task Team.
- Logging questions from the Chief’s Conferences.
- Logging emails directed towards the Task Team.
- Drafting responses on behalf of the Task Team.
The Task Team must keep accurate records of all matters that come before it. The Task Team Coordinator will maintain copies of its briefing reports for a period of at least 2 years from the end of the COVID-19 pandemic.
These terms of reference may be amended by consensus of all Task Team members at a Task Team meeting.
Signature of Chair Date
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