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Canadian Paediatric Society

Jordan’s Principle

Jordan’s Principle was designed to ensure that First Nations children do not experience delays, disruptions or denials of services ordinarily available to other Canadian children. It is a child-first principle named in honour of Jordan River Anderson, a First Nations boy from Norway House, Manitoba, who was born with complex medical needs and languished in hospital while the federal and provincial governments argued over who would pay for his at-home care. Jordan died before ever spending a day in a family home.

Because responsibility for First Nations children’s services is often shared among federal, provincial/ territorial and First Nations governments, accessing certain services can be challenging. Funding disputes between federal and provincial governments, or between federal departments, are not uncommon, and can result in delays that unfairly affect children’s health and well-being. Jordan’s Principle requires the government of first contact to provide the service, and then resolve the funding issue. As such, Jordan’s Principle is a mechanism to help ensure children’s human, constitutional, and treaty rights.57

Although Jordan’s Principle was passed unanimously by the House of Commons in 2007 and adopted by most provinces and territories, its implementation has been limited and inconsistent. A 2015 research report58 found that jurisdictional confusion among provincial, territorial and federal governments still results in First Nations children being denied care, and that Jordan’s Principle is not being applied. 

The Jordan’s Principle Working Group—which includes the Assembly of First Nations, Canadian Paediatric Society, Canadian Association of Paediatric Health Centres, UNICEF Canada, and an academic research team—has called on federal and provincial governments to work with First Nations to implement a governmental response consistent with the vision of Jordan’s Principle advanced by First Nations and endorsed by the House of Commons in 2007.

The Truth and Reconciliation Commission (TRC) recognized that Jordan’s Principle is critical not only to equity but also to the larger effort to redress the legacy of residential schools. The TRC called for full implementation of Jordan’s Principle in its 2015 report.59

In a 2016 ruling,60 the Canadian Human Rights Tribunal (CHRT) described how the federal government’s narrow interpretation of Jordan’s Principle—relevant only to children with complex medical conditions under the care of multiple service providers—along with complex and time-consuming processes, accounted for the government’s report of no cases meeting the criteria for Jordan’s Principle. It ordered the Department of Indigenous Affairs to "cease applying its narrow definition of Jordan’s Principle and to take measures to immediately implement the full meaning and scope of Jordan's Principle." While focused on a case against the federal government, the CHRT ruling highlights an interpretation of Jordan’s Principle shared by many provinces and territories.

Three months after the initial decision, a subsequent ruling61 again ordered the federal government to “immediately implement” Jordan’s Principle, specifically to:

  • include all jurisdictional disputes, both between federal government departments as well as between the federal and provincial/territorial governments;
  • include all First Nations children, not just those children with multiple disabilities;
  • ensure that the government agency of first contact pay for the service without the need for policy review or case conferencing before funding is provided.

The Canadian Paediatric Society surveyed all provinces and territories about their definition of and practices around Jordan’s Principle.62 While not all provinces responded, the feedback that was received indicated significant discrepancies in the interpretation and implementation of Jordan’s Principle. Along with other members of the Jordan’s Principle Working Group, the CPS recommends a governmental response that is consistent with the vision of Jordan’s Principle advanced by First Nations and endorsed by the House of Commons.

Province/TerritoryHighlights of provincial/territorial response to Jordan’s Principle
British Columbia

No response at time of publication.

Alberta

Expressed support for Jordan’s Principle in 2008, but did not describe how this works in practice.

Saskatchewan

Limits Jordan’s Principle to “all First Nations children with intensive health care needs.” Reports three “potential” Jordan’s Principle cases as resolved through case conferencing protocol.

Manitoba

First province to announce an agreement to implement Jordan’s Principle (September 2008), although no resources have been dedicated to the process. Reports that “informal case conferencing” has minimized impact of jurisdictional disputes, but did not provide the number of cases addressed in this manner.

Ontario

Applies Jordan’s Principle to children with “complex medical conditions” but reports no cases to date or “any jurisdictional disputes between Canada and Ontario that have been resolved by reference to Jordan’s Principle.”

Quebec

No response at time of publication.

New Brunswick

Tripartite agreement (First Nations’ Chiefs of New Brunswick, province, and federal government) reached in December 2011, which includes “public services” such as health care, child welfare and other social services, and special education. The document includes a dispute resolution process, as well as communications material for the public in four languages. New Brunswick reports that two potential Jordan’s Principle cases were resolved.

Nova Scotia

No response at time of publication.

Prince Edward Island

No response at time of publication.

Newfoundland and Labrador

Reports that programs and services are provided by the government “consistent with Jordan’s Principle while waiting for funding decisions from another source.” But the province “has not implemented the jurisdictional dispute mechanism of Jordan’s Principle.”

Yukon

Has not formally adopted Jordan’s Principle, noting “Yukon’s health system funds services on a universal basis for all Yukon residents and does not distinguish between First Nation and non-FN, nor does our insured program embody a ‘child-specific’ lens.”

Northwest Territories

Has not formally adopted Jordan’s Principle, noting that “NWT has a single health and social services system that does not have separate health and social services for on-reserve First Nations children and families, and does not differentiate between the provision of any health or social service based on ethnicity.”

Nunavut

The population of Nunavut is approximately 85% Inuit. “The Government of Nunavut is interested in any discussions regarding the inclusion of Inuit children under the protections of Jordan’s Principle.”

Endnotes

  1. The Jordan’s Principle Working Group, 2015. Without denial, delay, or disruption: Ensuring First Nations children’s access to equitable services through Jordan’s Principle. Ottawa, Ont.: Assembly of First Nations: http://www.afn.ca/uploads/files/jordans_principle-report.pdf (accessed May 20, 2016).
  2. Ibid.
  3. Truth and Reconciliation Commission, 2015. Calls to Action. Winnipeg, Man.: Truth and Reconciliation Commission.
  4. First Nations Child and Family Caring Society of Canada et al. v. Attorney General of Canada (for the Minister of Indian and Northern Affairs Canada), Canadian Human Rights Tribunal, 2016 CHRT 2, T1340/7, January 26, 2016.
  5. First Nations Child and Family Caring Society of Canada et al. v. Attorney General of Canada (for the Minister of Indian and Northern Affairs Canada), Canadian Human Rights Tribunal, 2016 CHRT 10, T1340/7008, April 26, 2016.
  6. Canadian Paediatric Society. Unpublished data, April 2016.