Building Better Care Together: Advancing Partnerships with First Nations and Inuit Home and Community Care

For more than 25 years, the First Nations and Inuit Home and Community Care Program (FNIHCCP) has quietly demonstrated what is possible when health services are designed by communities, for communities. Grounded in self-determination, cultural values, and local leadership, the program reaches nearly every First Nation and Inuit community in Canada, supporting thousands of individuals and families to receive care closer to home.

Yet despite its remarkable reach and impact, the FNIHCCP remains one of Canada’s least understood health programs. As conversations about reconciliation, health equity, and Indigenous-led solutions continue to grow, there is a unique opportunity to strengthen partnerships between Indigenous home care teams and mainstream health systems.

The story of the FNIHCCP is not one of limitation. Rather, it is a story of resilience, innovation, and untapped potential.

A Foundation Built on Community Strength

When the FNIHCCP was established in 1999, it represented a forward-thinking approach to health care. First Nation communities were empowered to identify their own priorities, assess local needs, and design services that reflected  cultural values and realities.

This local, community-based model remains one of the program’s greatest strengths today.

Across Canada, First Nations and Inuit Home and Community Care teams provide culturally relevant support that extends beyond traditional clinical care. Services are delivered within the context of family, community, culture, and relationships, recognizing that health is holistic and interconnected.

The success of the program demonstrates the value of Indigenous leadership in health care. Local knowledge, cultural understanding, and community governance have created services that are responsive, trusted, and deeply rooted in the people they serve.

The Opportunity Ahead: Moving from Parallel Systems to Partnership

While the FNIHCCP has achieved significant success, it has often operated in parallel with mainstream health systems rather than fully within them. This separation has contributed to challenges related to communication, care coordination, and service integration.

Yet these challenges also highlight powerful opportunities.

Imagine a health system where FNIHCCP home care teams are engaged as active partners in hospital discharge planning. Imagine referral pathways that seamlessly connect provincial, territorial  and Indigenous community-led services. Imagine policies that are co-developed by Indigenous and non-Indigenous leaders who share responsibility for improving outcomes.

These possibilities are achievable when partnership becomes a priority.

Increasingly, the conversation is shifting away from viewing Indigenous and mainstream health systems as separate worlds and there is growing recognition that Indigenous and mainstream knowledge, expertise and healing approaches each have unique strengths to contribute. Together, they can create more effective and culturally safe care experiences for patients and families.

Trust as the Foundation for Change

Every successful partnership begins with trust.

For many Indigenous communities, historical experiences with colonial systems have created understandable skepticism toward mainstream institutions. Rebuilding trust requires more than good intentions. It requires consistent action, transparency, respect, and long-term commitment.

Encouragingly, there are many examples of organizations working together to strengthen relationships through regular engagement, shared decision-making, and respectful dialogue.

Trust grows when Indigenous voices are invited at the onset in planning and policy discussions, rather than after decisions have been made. It grows when organizations take time to learn about local cultures, histories, strengths and community priorities. Most importantly, it grows when commitments are followed by meaningful action.

Creating More Equitable Partnerships

Strong partnerships also depend on recognizing and addressing existing power imbalances.

First Nations and Inuit home care teams bring invaluable expertise about their communities and cultures, and the clients they serve. Their expertise is essential to delivering high-quality and culturally adapted care, yet they are not always fully included in care planning processes.

Addressing this imbalance means investing in Indigenous workforce development, supporting regional leadership capacity, and creating opportunities for reciprocal learning between Indigenous and mainstream providers.

Including First Nations and Inuit home care teams in hospital rounds and discharge planning is an effective and promising approach to strengthen care integration. By drawing on the expertise of all providers, these collaborative practices contribute to better care coordination, and smoother transitions home.

When knowledge is shared and valued equally, everyone benefits.

Navigating a Complex System Together

Another area of opportunity lies in reducing the effects of jurisdictional complexity.

Many First Nations clients continue to navigate multiple systems that operate under different policies, funding structures, and responsibilities. This can create unnecessary barriers during critical moments of care.

Innovative solutions are already emerging.

FNIHCCP Case Managers and Indigenous Patient Navigators are helping bridge gaps between communities, hospitals, and health systems. These roles provide advocacy, education, and coordination while ensuring services remain culturally safe and community-centered.

Similarly, formal partnerships such as memorandums of understanding, shared protocols, and joint policy initiatives can create greater clarity and accountability across organizations.

These practical steps help transform fragmented services into connected systems of care.

A Shared Path Forward

The future of home care in Canada will be strongest when it embraces the strengths of both Indigenous and mainstream approaches.

The First Nations Home and Community Care Program has spent 25 years demonstrating the power of community-driven, culturally grounded care. The next chapter is about building stronger bridges, creating reciprocal partnerships, and ensuring First Nations leadership is embedded within broader health system planning.

Advancing these partnerships is about more than improving service delivery. It is about reconciliation in action. It is about recognizing Indigenous expertise, supporting self-determination, and creating a health system where everyone has the opportunity to thrive.

When trust is strengthened, power is shared, and systems work together, the result is a model of care that is more inclusive, more responsive, and ultimately better for all.