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The Assembly of First Nations (AFN) National Chief Perry Bellegarde is pictured in Toronto on Monday, July 17, 2017. Bellegarde said on Tuesday, Feb. 13, 2018 that Ontario has not fallen back on the excuse that Indigenous health care is a federal responsibility and is instead leading the way among provinces in spending to improve outcomes for First Nations people.Christopher Katsarov/The Canadian Press

The Ontario government is preparing to announce that it is keeping a two-year-old promise to inject hundreds of millions of dollars into First Nations health care and that cash is now flowing to culturally appropriate initiatives including palliative care, primary care and mental wellness.

First Nations leaders say more money is still needed to bring the standard of care provided to their people to the level that is enjoyed by other Canadians. But they give credit to Ontario for breaking down jurisdictional barriers, both with the federal government and with Indigenous communities, to improve a system that has been rife with failure.

Perry Bellegarde, the National Chief of the Assembly of First Nations (AFN), said on Tuesday that Ontario has not fallen back on the excuse that Indigenous health care is a federal responsibility and is instead leading the way among provinces in spending to improve outcomes for First Nations people.

"They are basically going beyond the reserve boundaries and saying 'hey, health care is a right of everybody. We don't care if you live in Toronto or you live in Attawapiskat, we are going to provide resources to you,'" Mr. Bellegarde said.

Isadore Day, the Ontario Regional Chief of the AFN, said Ontario is also demonstrating that, despite its traditional control over health-care delivery within provincial boundaries, Indigenous communities in the province are being allowed to decide how their medical dollars are best spent.

"I am not overly excited about the level of investment," Mr. Day said. "I am optimistic that this is that first substantial step towards recognizing the relationship."

In May of 2016, the Ontario government said it would spend $222-million over the next three years to enhance health care in First Nations communities. The plan was to provide culturally appropriate care delivered largely by Indigenous people themselves.

On Wednesday, at an AFN meeting in Toronto, Health Minister Eric Hoskins will announce that major aspects of that promise are being met.

In December, Ontario provided $55,300 to each of the province's 133 First Nations to improve access to culturally appropriate home and community care.

The province has paid to create or expand 16 Indigenous primary care teams across the province.

It has trained hundreds of palliative care specialists who will work in First Nations communities.

It will soon announce the sites of 34 new Indigenous-led mental-health and wellness programs that will employ more than 100 mental-health workers and incorporate cultural teachings.

And, in the coming weeks, it will announce the establishment or expansion of 10 Indigenous-led healing and treatment centres.

These initiatives come at a time when the expected lifespan of First Nations people is five to seven years shorter than for non-aboriginal Canadians.

Mr. Hoskins said in an interview on Tuesday that health care is too important to let jurisdictional issues get in the way of delivery.

"You know the disparity in this province and across this country with regard to health outcomes when you compare First Nations communities and individuals and families with non-First Nations – the high rates of suicide, the high rates of diabetes and heart disease," he said. "So we all simply need to work together to reduce and eliminate those differences."

The way Ontario is doing that, he said, is to develop a system of health care for reserves that is planned and run by the First Nations themselves.

Alvin Fiddler, the Grand Chief of the Nishnawbe Aski Nation, which includes 49 First Nations in northwestern Ontario, said the province's efforts have been encouraging although they came as a direct response to a declaration of a state of emergency in health care that had been issued by his organization.

But there still needs to be an immediate investment in mental-health supports for Indigenous youth and children in Northern Ontario who are at risk of taking their own lives, Mr. Fiddler said. "We need to look at changing the current funding structure," he said, "so that we can maximize the resources to meet the communities where they are most needed."

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