First Nations in B.C. have joined PharmaCare

For years, health staff and political leaders working in First Nations communities in B.C. have felt strongly that bringing health services closer to home, from Ottawa, was the best opportunity for better services, designed by our people, for our people.

On Oct. 1, First Nations in B.C. joined the PharmaCare program for prescription drug coverage, marking another milestone of transformation for health-service delivery.

Through a unique partnership with the B.C. Ministry of Health and PharmaCare, the First Nations Health Authority has created “Plan W” (Wellness), a fully paid plan that will take over as the first payer of eligible drug benefits prescribed to the health authority’s 143,000 clients. This means that for clients, no longer do claims have to be approved and processed in Ottawa — approvals begin in the doctor or nurse practitioner’s office when the prescription is written.

Accessing health-care benefits from the same provincial systems as other British Columbians supports integrated services and relationships between First Nations peoples and their providers, resulting in more coordinated care. Pharmacists and prescribers are more familiar with PharmaCare, so we have an opportunity for improved alignment with existing provincial practices and standards.

Four years ago, when the FNHA was preparing to transfer health services from Health Canada’s First Nations Inuit Health Branch B.C. region, the First Nations Health Council participated in dozens of meetings with the many working areas of the federal program to make sure we got it right.

This included executives within the Non-Insured Health Benefits program — the department responsible for pharmacy, dental, vision, medical supplies and transportation, and other services for First Nations and Inuit communities in Canada.

We also met with the company that processes medical claims in these areas for First Nations peoples on behalf of the benefits program. At this meeting, three gentlemen in suits began a sales pitch. They told me how happy the pharmacists are with the program. They told me how happy the dentists are with the program. I asked how satisfied are the 140,000 people we represent? They couldn’t tell me.

The NIHB program has many challenges that First Nations and Inuit across Canada have been open and vocal about for many years. These challenges have also been well documented by the media and include multiple steps for approvals of medication and decision-making in Ottawa, far from home.

In 2006, the B.C. government signed the Transformative Change Accord. With this accord, B.C. committed to provide the same health services to First Nations as are available to other British Columbians. This significant change is part of the transformation of health-service delivery that was started by our leadership so many years ago.

For many years and often still today, First Nations health delivery is like a land of solitudes, with distant partners not meeting halfway to make these changes together. Today, with the help of the First Nations Health Governance Structure in B.C., driving a First Nations-specific agenda, both federal and provincial governments are reorganizing with an eye to addressing policy gaps and jurisdictional barriers.

Driven by First Nations priorities, we are able to overcome the policies that have hurt rather than helped our communities. A good example of this was the regulation change by the province of B.C. in March 2017 that removed the barriers for First Nations to join the PharmaCare program.

First Nations leaders gave seven directives to guide the work in health for their people. One of these included a directive to improve and revitalize the noninsured benefits program. There might be challenges ahead, as there always are with momentous change, but the health authority is committed to seeing this work through, and the health council to overseeing the work of our health authority.

Owning our own health and wellness journey is what this work is about. As part of this provincial change, we encourage First Nations peoples to have a conversation with their healthservice provider about their medication and what this transformation might mean for them and their families.

Visit the health authority website to find out more fnha.ca/ pharmacare or call the First Nations Health Benefits team at 1-855-550-5454 with any questions.