Objectives

The main objective of the Adult Care program is to assist First Nations people with functional limitations (because of age, health problems or disability), to maintain their independence, to maximize their level of functioning, and to live in conditions of health and safety. There are three components to the Adult Care program: in-home care, which provides homemaker services; foster care, which provides supervision and care in a family setting; and institutional care, which provides services in Types I and II institutions. Type I is residential care for individuals requiring only limited supervision and assistance with daily living activities for short periods of time each day, and Type II is extended care for individuals requiring some personal care on a 24 hour basis, under medical and nursing supervision. Individuals requiring more intensive levels of medical care (ie. Types III, IV and V) are considered the responsibility of health authorities.

Background

The DIAND Adult Care Program is one component of Social Policy & Programs, which include Child & Family Services, Social Assistance, Children's Programs, Family Violence Prevention and other social services that address individual and family well-being. It is a complementary initiative to Health Canada's Home & Community Care Program, as well as some aspects of Non-insured Health Benefits.

The Adult Care Program is consistent with the federal government's general policy to provide First Nations people on-reserve with access to services which are comparable to services provided by the provinces to other Canadians. A 1984 Memorandum of Understanding between DIAND and Health Canada sets out the respective areas of responsibility of each department. Although DIAND does provide funding for institutional care, in 1988 a moratorium was placed upon the construction of new on-reserve personal care homes, placing greater emphasis on in-home care.

The Adult Care Program is primarily directed to serve the needs of the elderly. In 1997-1998, the program assisted about 700 First Nations people residing in institutions located on- and off- reserve, and provided in-home care for about 5,100 individuals in their own communities.

Eligibility

Adult Care services are provided to registered First Nations individuals living on-reserve, who have functional limitations because of age, health problems or disability and who require care. The program is administered by First Nations officers who assess the financial and social needs of the client.

Key Initiatives

In 1996, a joint working group on a Federal First Nations Continuing Care Strategy was established to examine overall effectiveness and coordination issues between Health Canada and DIAND programs.

In 1998, the joint working group was expanded to include First Nations and Inuit. The scope of work involves development of an overall framework on continuing care, organized in three components: home care, institutional care, and continuing care.

Health Canada's Health Transition Fund funded 9 pilot projects focussing on home care. The projects are intended to provide evidence for home care delivery models, information on approaches to coordination and integration of services, and validation of the First Nations and Inuit Home Care framework noted above.

The 1999 Budget provided funding for the development and implementation of a First Nations and Inuit Home & Community Care Program, which will build upon the in-home component of DIAND's Adult Care Program, and a First Nations Health Information System.

Over the 2000-2001 fiscal year, DIAND will continue to respond to Adult Care/Continuing Care issues through four streams of activity:

• Continue to work with Health Canada to identify and develop a national approach aimed at achieving a single-window delivery system that covers the full spectrum of care.
• Participate in the joint working group on Continuing Care as it develops the Institutional Care framework, and oversee the conduct of research to help inform the development of the framework.
• Participate as a member of the Health Transition Fund Steering Committee to help ensure successful evaluation of the home care pilot projects
• Participate as a member of the National Joint Steering Committee, National Technical Advisory Committee, in the planning and development of the First Nations and Inuit Home and Community Care Program.

Contact Info:

For further information on the Adult Care Program in your community, contact the DIAND regional office nearest you:

Other Links:

Health Canada: First Nations & Inuit Home & Community Care Program

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