Historical Milestones

The program context can be better understood if its history is set out in terms of events that served as milestones in its development. These milestones are listed below.

• In fiscal year 1975-76 the National Native Alcohol Program (NNAP) was established as a 3-year pilot project jointly administered by DIAND and the Department of National Health and Welfare. It was subsequently extended until a Treasury Board submission calling for a permanent program achieved Treasury Board approval in 1981/82.
• The renamed and fully conceptualized, permanent National Native Alcohol and Drug Abuse Program (NNADAP) was established in fiscal year 1982/83. Health Canada assumed full responsibility for the program. In its first two years, the program primarily funded on-reserve NNADAP prevention projects.
• In 1984/85, resources for a national treatment program component of NNADAP were committed by the Federal Government.
• By the late 1980s, the program was well established, and several years of evaluative activities ensued, undertaken as collaborations of First Nations and Inuit organizations, Health Canada and independent researchers. Arguably, the most influential of these evaluations was a study undertaken in 1989 by the internationally respected Addictions Research Foundation (ARF). The ARF study was highly critical, finding confusion among workers regarding the definition and mandate of their roles and responsibilities as community workers, under-skilled staff in both prevention and treatment, underdeveloped pre-care and aftercare/outpatient follow-up services, and weak linkages between community dimensions of the program and in-patient treatment programs.
• Several subsequent evaluations at the regional level confirmed the findings of the ARF. However, the upgrading recommended in these evaluations was generally delayed. This delay appears to be a direct result of the conjunction of two facts, specifically (1) the concept of Regional First Nations' coordinating bodies that might eventually evolve into Regional policy-making authorities never fully materialized and (2) in the face of a new policy direction, as expressed in the Health Transfer Initiative, MSB increasingly withdrew from playing an assertive, "hands on" role at the service delivery level. Consequently there were few "pushes" or "pulls" towards change.
• In 1989, the Federal Government established the Health Services Transfer Initiative, which sought and, in many cases succeeded, in transferring administrative and program revenues, and management and delivery authority, for programming directly to First Nations, either individually or collectively. This initiative provided the basis for long-term (5-year) agreements. It also further reduced the capacity of a regional authority to dictate standardized policy, especially regarding prevention programs, which were folded into individual health transfer agreements.
• In the early 1990s, MSB's treatment centre funding formula was established. The formula was focussed entirely on in-patient programs, using an annual budget per bed space as a base allocation, then adjusted by size (to reflect economies of scale) and costs associated with additional transportation costs of material purchases (i.e., remoteness indices). Critics of the formula believe that the formula has been disadvantageous to smaller centres and, when upward adjustments to correct for these financial limitations have had to be made, they must be drawn from Regional budget envelopes. In some instances this has meant that, in effect, the larger centres have subsidized the smaller centres. The limitations of budget allocations for smaller centres were made all the more obvious when youth solvent abuse treatment centre funding came on stream, amounting to substantially greater per bed space allocations.
• Also in the early 1990s, new funding was provided for community programming initiatives in the areas of family violence prevention and intervention, community mental health, early childhood development, injury prevention, programs to support the care of healthy babies, and solvent abuse intervention. This initiative can be seen, in part, as growing out of the call in the original NNADAP proposal for NNADAP to "leverage" and work together with other complementary programs to mount primary prevention strategies. It should also be noted that the programming made possible by this funding was also a response to many years of recommendations made by NNADAP workers themselves.
• In October, 1993, The First Nations and Inuit Community Youth Solvent Abuse Survey and Study, funded by Health Canada, was completed. The study led to the establishment of several solvent abuse treatment centres for youth across the country under a new MSB program entitled the National Youth Solvent Abuse Programs (NYSAP)
• In the mid-1990s, MSB funded the establishment of National and Regional Prevention and Treatment Standards for NNADAP. However, subsequent evaluations indicated that the voluntary pursuit of standards-upgrading had been relatively slow. In various aspects of programming, services continued to be below par with the standards guidelines.

• In 1996, the Report of the Royal Commission on Aboriginal Peoples (RCAP) was completed. As the Royal Commission stated in its final report, before the renewal of the relationship can begin, "a great cleansing of the wounds must take place." The third volume of the report, Gathering Strength, focussed on social policy.

  This report included major sections on the importance of a new Aboriginal healing strategy. It emphasized that, to be effective, such a strategy would have to place a major emphasis on not only the individual but also the Aboriginal family and community systems. The importance of an Aboriginal health strategy grounded in a holistic approach, and supported by a human resource development strategy, social housing and cultural renewal, was also a major theme in Volume 3 of the RCAP report.

• In 1997, also growing out of and as a follow-up to the RCAP report, an implementation framework entitled Gathering Strength: Canada's Aboriginal Action Plan was produced. The plan began with a Statement of Reconciliation through which the Government of Canada formally acknowledged and expressed regret for the historic injustices experienced by Aboriginal people.

  The statement included an official apology for the victimization of Aboriginal people in residential schools through physical and sexual abuse. It made a commitment to assisting in community healing to address the profound impacts of abuse at Residential Schools. The Action Plan set out the following four basic objectives to guide the Federal Government's efforts to translate its declared intentions into actions:

  1. A Commitment to Renewed Partnerships. One objective is for the Federal Government to build a renewed set of partnerships with Aboriginal people, other levels of government, and the private sector. An especially significant aspect of this statement of renewal is the emphasis given to the importance of Aboriginal input into the design, development and delivery of programs affecting their lives and communities. Another is an emphasis on restructuring Federal Institutions in a way that will reflect renewed and more symmetrical relationships in policy development and administration in which Aboriginal people are full partners.
  2. Strengthening of Aboriginal Governance Capacity. Another objective set out in the Action Plan gave recognition to the need for strong, accountable and sustainable governments and institutions. The document stated: "This means ensuring that Aboriginal governments and institutions have the authority, accountability mechanisms and legitimacy to retain the confidence and support of their constituents and of other government institutions, to govern effectively. It committed the Government of Canada to working closely with Aboriginal people to enhance their capacity to govern and to enlist provincial and territorial governments in partnerships that will help make this ideal a reality.
  3. Creating New Fiscal Relationships. Through the Gathering Strength Action Plan, the Government of Canada also made a commitment to working in partnership with Aboriginal governments and organizations in developing a new fiscal relationship that will provide more stable and predictable financing, is accountable, and which maximizes the internal generation of own-source revenue.
  4. Supporting Strong Communities, People and Economies. The Action Plan also committed the Federal Government to working closely with and providing tangible support to Aboriginal people in their efforts to improve the physical and social infrastructures of their communities. It also made a commitment pro-actively supporting healthy communities through an administrative transfer strategy to enhance community control and a program strategy to address priority service gaps in such areas as mental health and solvent abuse. Also of relevance to substance abuse and addictions programming was through the creation of an Aboriginal Health Institute, a Headstart program and a human resource development strategy.
• Throughout the 1990s, increasing numbers of First Nations entered into Transfer Agreements, most of which included NNADAP funded program and personnel funding.
• In 1996, the General Review of NNADAP was initiated. The mandate of the national review was to determine the overall effectiveness of the program; to guide the development of strategic recommendations to strengthen programming; and to support the more effective application of the program at the community level. A formal report describing the findings and recommendations of the Review was completed in 1998.

• In early 1998, the Aboriginal Healing Foundation was established, at least partially as a response to the Royal Commission on Aboriginal Peoples. The Foundation's mission is to encourage and support Aboriginal people in building and reinforcing sustainable healing processes that address the legacy of physical and sexual abuse in the residential school system, including intergenerational impacts.

  Residential school abuse was identified in the RCAP report and several other studies as having a significant influence on the disproportionate levels of substance abuse and addictions in First Nations and Inuit communities. The Foundation funds projects submitted by Aboriginal organizations, groups and communities (including communities of interest) which are designed to:

  1. promote healing within the community
  2. empower Aboriginal women
  3. develop and enhance the capacity of traditional and professional Aboriginal care-givers to promote healing in their communities
  4. intervene in current personal or family problems caused directly or indirectly by residential school abuse in order to restore balance in the future
  5. record and share the history of residential school abuse in order to honour the suffering and learn from that history and to avoid the repetition of similar abuse between parents and children.