First Nations and Inuit Home and Community Care Program - Annual
Report 2002-2003
The Regions
Saskatchewan
Fast Facts
Population: 52,168
Average Population per Community: 621
Number of Communities Eligible for Funding: 84
Number of Communities Funded: 83
% of Needs Assessments Completed: 99%
% of Communities with Submitted Plans: 99%
% of Communities in Planning Implementation: 99%
% of Communities with Access to Service Delivery: 98%
% of Population with Access to Service Delivery: 97%
2002/03
The Region
For 2002/03, the Saskatchewan Region shifted from a developmental
model to a service delivery model. While area program staff had
focused more on the planning and community development aspects,
the positions in 2002/03 concentrated more on home care nursing
expertise and the associated support for service delivery. Staff
included one full-time coordinator at the Federation of Saskatchewan
Indian Nations (FSIN) and three full-time area coordinators, one
each for the northern, central, and southern districts.
Except for the Regional Coordinator position through First Nations
and Inuit Health Branch (FNIHB), all of the other positions and
personnel changed. While in 2001/02 there had been funding for
six full-time positions including a clerical support position,
this was reduced to three positions in 2002/03. The three home
care nursing practice advisors were all part-time - one in the
north, one in the central region, and one in the south. Although
they were divided into the north, central and south, they focused
on third level support.
Formed in the early 1990s, the Saskatchewan First Nations Home
Care Working Group remained active. Created through FSIN, in 2002/03
the group was primarily comprised of home care staff throughout
the province. The self-directed group continued to meet monthly
with approximately 30 individuals in attendance at each meeting.
Overview: 2002/03
Programs were in full service delivery in Saskatchewan, along
with increased service delivery in communities that had begun offering
services in the previous year. Essentially, communities offering
services in both 2001/02 and 2002/03 began to see programs become
more fully entrenched over the course of the fiscal year.
Despite the reduction in the number of regional positions providing
communities support for the Program, three quality nurses were
recruited successfully to work on a part-time basis. At the community
level, the program attracted more and well-qualified staff, which
aided in serving more clients. In the south area, for example,
86 clients received care at the end of 2002/03, up from 18 during
the same period one year earlier.
Clients were able to access services through a systematic system
of referral, assessment and planned care, providing better accessibility
for all people on reserve. Services expanded beyond basic care
and in many cases included health promotion. Intra and interregional
nursing groups continued to meet and address program issues in
the different parts of the province.
However, some communities, particularly in the north, experienced
a large turnover in staff.
Most communities across the province had dedicated home care
nurses, although community health nurses continued to play a dual
role in smaller communities. They often had to cover both community
and home health nursing areas.
A key success during the year was being able to assure that all
communities had direct nursing consultation and support at the
second level (i.e. Tribal or 2nd level through FNIHB). By the end
of 2002/03 all Home and Community Care (HCC) nurses had some connection
to professional support that they could call upon and support their
practice. In the central and southern areas, there were some communities
that were unable to provide nursing consultation and support for
home care nurses. A system was developed whereby these communities
could receive support for a fee that was included in the contribution
agreements. For example, in Fort Qu'Appelle a nurse provided part-time
practice advisor services but also offered hands on day-to-day
contact with five communities.
Training & Conferences
As in all regions, this was the first year funding from National
was not specifically allocated for training and capital projects.
Some communities were unable to address ongoing training needs,
particularly for training of new home health care aides and in
the provision of ongoing training for workers.
Service Delivery Reporting Template (SDRT) Training
- Two Training sessions were held for the Service Delivery Reporting
Template. The first was in June 2002 and over 80 community representatives
attended. In March 2003, three sessions were held - one each
in the north, central, and southern areas. Communities were again
invited to send at least one representative.
Logic Model Workshop Training
- The National Evaluation Team provided training on logic model
and other aspects of evaluation for approximately 30 community
and regional program staff.
North
- Two conferences were held in the north, one for home care
nursing and one for home health aides. Various training programs
related to nursing education were facilitated through area post
secondary institutions. The northern area continued to look at
ways of offering ongoing training for home health aides.
Central
-
Workshops on a variety of topics were provided to workers
in the central area including Leadership Management Supervision,
Policy Writing, IV Therapy, Assessment, TeleHealth (through
Battleford Tribal Council and Dr. Tobe) and Wound Care (through
Convatec).
-
Home Health Aide training and a home health aide refresher
program were provided, the latter through a partnership with
the Saskatchewan Indian Institute of Technology.
South
-
In the south, start-up training dollars from previous years
resulted in the graduation of home health aides, with at least
one certified home health aide being the result in each community.
Charting, foot care, and back care training were also provided
to home health aides.
-
A diabetes education program was provided to health workers.
Registered nurses received training in wound care, HIV, foot
care, and fetal alcohol syndrome.
-
Wellness clinics were held monthly and foot care workshops
were provided for members of the public in several communities.
Partnerships and Linkages
Indian and Northern Affairs Canada (INAC)
Work included working towards joint reporting. A joint financial
form was created while a data/statistics form is still in progress.
Home Care Working Group
The working group shared information and addressed regional on-reserve
initiatives such as charts, policies, and procedures.
First Nations
Networking among First Nations representatives in the Saskatchewan
Region continued as workers linked with other health care workers,
communities, Tribal Councils, and organizations.
Community leaders, clients, and families became increasingly
familiar with the Program and how it differed from the previous
system. Communities were designing programs that met their own
specific needs, involving members of the community and collaborating
with other departments in the community such as education and other
areas of health care, all with the support of band leaders.
Regional/Provincial Health Authorities
Linkages with service accessibility from health authorities were
initiated and a partnership with the provincial home care program
continued to augment some of the First Nations and Inuit Home and
Community Care Program (FNIHCC) program goals. Communications with
local physicians were reportedly enhanced for improved continuity
of care for clients.
Diabetes Dream Project
The Battleford Tribal Council (BTC) in central Saskatchewan has
been involved in diabetes research through a home care team in
conjunction with a Toronto hospital.
Education
Partnerships continued with educational institutions such as
the Saskatchewan Indian Institute of Technologies (SIIT) and the
Saskatchewan Institute of Applied Science and Technology (SIAST)
in providing culturally appropriate training programs. There were
also linkages made with Continuing Nursing Education in the province.
eHealth Solutions Team
Toward the latter part of the fiscal year, linkages were made
with eHealth both nationally and regionally, most notably for data
collection support. Training was provided in March 2003 and hardware
was provided where essential. eHealth set up the computers and
the Service Delivery Reporting Template was pre-installed.
Non-Insured Health Benefits (NIHB)
Linkages in the region with NIHB included presentations and meetings.
Aboriginal Diabetes Initiative
The two programs investigated ways of ensuring continuity of
diabetes education and care for clients.
Community Health
Collaboration and communication was built with community health
nurses and community health representatives in several communities.
Resources Developed and/or Distributed
Chart Review Process
A significant undertaking in 2002/03 was a Chart Review Process,
which included revising all basic chart forms and the development
of a Charting Guidelines booklet. Because the charts had been developed
years earlier, a significant update was overdue. The Home Care
Working Group put together a volunteer committee to look at this
and hired a consultant through regional resources. Copies were
developed and distributed to all programs throughout the province.
Policy Manual
Work was undertaken on revising the FNIHCC policy manual. The
second draft of the policy manual was distributed for review with
the goal being to finalize during the 2003/04 fiscal year.
Nursing Procedure Textbook
An appropriate textbook was sourced and recommended.
Pamphlets
In the south, questionnaires and pamphlets developed locally
about the program were distributed.
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