Co-developing distinctions-based Indigenous health legislation

Together with Indigenous partners and the provinces and territories, we are co-developing new distinctions-based Indigenous health legislation to improve access to high-quality, culturally relevant health services.

Current status: Open

The Minister of Indigenous Services publicly launched the engagement on January 28, 2021.

On this page


As indicated in the September 2020 Speech from the Throne, the Government of Canada is committed to walking a shared path of reconciliation with Indigenous peoples and remains focused on implementing the commitments made in 2019.

The Government of Canada acknowledges the challenges faced by Indigenous peoples, including First Nations, Inuit and Métis in accessing culturally safe care. Canada is committed to working in partnership to advance the priorities Indigenous peoples put forward when it comes to health care. The mandate letter for the Minister of Indigenous Services commits to "fully implement Joyce's Principle and ensure it guides work to co-develop distinctions-based Indigenous health legislation to foster health systems that will respect and ensure the safety and well-being of Indigenous Peoples." It is part of the Government of Canada's commitment to address the social determinants of health and advance self-determination in alignment with the United Nations Declaration on the Rights of Indigenous Peoples.

The co-development of distinctions-based Indigenous health legislation is an opportunity to:

What co-development means

Co-development is a collaborative approach that acknowledges the distinct nature and lived experience of First Nations, Inuit and Métis. This approach is guided by:

Co-development will happen in 2 stages:

  1. broad engagement with First Nations, Inuit, Métis, provinces and territories, subject matter experts and other groups to determine the co-development pathway
  2. co-development of legislative options

Learn more about how legislation is developed:


The Government of Canada will engage:


We will work together with Indigenous partners to:

We will also work with the provinces and territories to make sure potential federal legislation:

Principles guiding engagement

  • Engagement will be inclusive, with multiple opportunities and avenues to engage or re-engage.
  • Engagement will be primarily Indigenous-led. Specific engagement plans will be developed by Indigenous organizations and governments.
  • Engagement will take place multilaterally with federal, provincial, territorial and Indigenous organizations and governments.
  • Engagement is not endorsement. All feedback is being sought, whether it is in support of legislation or not.
  • Engagement is not co-development. Engagement will inform a specific co-development process or structure for this initiative, honoured by articles 18 & 19 of the United Nations Declaration on the Rights of Indigenous Peoples.

Engagement approach

In recognition of the right to self-determination, engagement is being led primarily by First Nations, Inuit and Métis Nation partners at the national, regional and sub-regional levels.

ISC is also hosting sessions to complement the First Nations, Inuit and Métis Nation-led sessions. Multiple streams of engagement are underway.

Engagement stream Participants
Stream 1:
Regional engagement
  • Treaty organizations
  • Nations
  • Self-governing Indigenous governments
  • Tribal Councils
  • Chiefs/community leaders
  • Inuit Land Claim Organizations
  • Inuit outside of Inuit Nunangat
  • Métis Nation governing members
  • Community members
  • Indigenous representative organizations
  • Women
  • Elders
  • Youth
  • Health directors/technicians/professionals
  • Survivors
  • Provincial/territorial representatives
  • Service providers
Stream 2:
Targeted outreach
  • Indigenous women's organizations
  • Urban Indigenous organizations
  • Indigenous youth organizations
  • 2SLGBTQQIA+ organizations
  • Métis Settlements General Council
  • Métis outside of the Métis Nation
  • First Nations Health Managers Association
  • First Nations Information Governance Centre
Stream 3:
National engagement
  • Assembly of First Nations
  • Inuit Tapiriit Kanatami
  • Métis National Council
  • Self-governing Indigenous governments
Stream 4: Seeking
Wisdom: Open Dialogue
  • Indigenous academics
  • Indigenous legal experts
  • Traditional Knowledge Keepers and Elders
  • Students
  • Youth
  • Health professionals
Stream 5: Provincial/territorial
  • Ministries of health
  • Ministries of Indigenous affairs
  • Other provincial/territorial ministries
  • Multilateral engagement, where there is interest from Indigenous partners
Stream 6: IHL inbox
  • General public
  • Interested groups

If you feel that there are groups, organizations or individuals missing from the engagement streams above, please Contact us.

About Indigenous health care in Canada

The organization of Canada's health care system is largely determined by the Canadian Constitution. Roles and responsibilities are divided between the federal, provincial and territorial governments. Generally, provinces and territories have primary jurisdiction over the administration and delivery of health care services. Indigenous communities also play an important role in the delivery of health services and programming.

The federal government exercises a role in health care primarily through the use of the federal spending power. For example, the Canada Health Act is Canada's legislation that imposes national standards on provincial health care insurance plans as a condition of accepting a federal contribution to the cost of those plans.

With respect to health care for Indigenous peoples, which include First Nations, Inuit and Métis, the federal, provincial and territorial levels of government share some degree of jurisdiction. Indigenous peoples are included in the per capita allocations of funding from the federal fiscal transfer and are entitled to access insured provincial and territorial health services as residents of a province or territory. Indigenous Services Canada funds or directly provides services for First Nations and Inuit that supplement those provided by provinces and territories, including primary health care, health promotion and supplementary health benefits. The federal role is guided by the 1979 Indian Health Policy's 3 pillars:

  1. special relationship with "Indians"
  2. inter-relationships with provincial and territorial health systems
  3. community development

The term "Indian" is only used when referring to or citing the 1979 Indian Health Policy.

Any federal legislation in the area of health care must be developed in consultation with provincial and territorial governments and with careful attention to the constitutional division of powers.

Learn more:

How to participate

There are 2 ways to participate:

  1. attend an engagement session. Please contact us to learn more
  2. send comments directly by email or mail to the address listed in contact us

Indigenous Services Canada has developed an engagement guide designed for individuals, Indigenous governments, organizations or communities to help guide their engagement sessions and personal reflections regarding the co-development of distinctions-based Indigenous health legislation. You may wish to consult the guide to inform your participation in an engagement session or your direct comments via correspondence. It is not meant to be a restrictive tool and can be used or disregarded at your discretion. Please share your thoughts however you prefer.

This engagement guide contains:

What we're hearing

The national report summarizing feedback received from engagement sessions, What we heard: Visions for Distinctions-based Indigenous Health Legislation, is now available:

Contact us

Indigenous Services Canada
Distinctions-based Indigenous Health Legislation
10 Rue Wellington Suite 1455
Mail Stop 1921C
Gatineau QC K1A 0H4

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