First Nations and Inuit Home and Community Care Program - Annual
Report 2002-2003
The Regions
Ontario
Fast Facts
Population: 77,879
Average Population per Community: 628
Number of Communities Eligible for Funding: 124
Number of Communities Funded: 121
% of Needs Assessments Completed: 94%
% of Communities with Submitted Plans: 90%
% of Communities in Planning Implementation: 86%
% of Communities with Access to Service Delivery: 56%
% of Population with Access to Service Delivery: n/a
2002/03
The Region
The most populous province in Canada is also home to the greatest
number of First Nations people on reserve. The Region is home to
approximately 18% of both communities and First Nations/Inuit population
served by the Program. More than two-thirds of communities in Ontario
are small, with a mix of communities going through Tribal Councils
or running programs independently.
In addition to the regional coordinator at First Nations and
Inuit Health Branch (FNIHB), three area coordinators remain with
the program. A support person at FNIHB was added to the team, primarily
to transpose data from the Service Delivery Reporting Template.
There is also a nurse advisor who works with communities in the
north-western part of the province.
FNIHB continued to work with the Chiefs of Ontario and the five
PTOs, which include:
-
Association of Iroquois and Allied Indians
-
Grand Council Treaty #3
-
Independent First Nations
-
Nishnawbe-Aski Nation (NAN)
-
Union of Ontario Indians
Overview: 2002/03
By the end of March 2003, sixty-eight (68) communities in Ontario
were in full service delivery, with 30 more prepared to begin service
delivery in early 2003/04. That compared to 13 in service delivery
at the at the end of 2001/02. After four years of assessments,
planning, and the early stages of service delivery, there was a
stronger knowledge base and understanding of the Program reported
among workers.
With the Program more fully entrenched, communities were better
able to understand the different processes, stages and the corresponding
requirements. Communication was improving as networking increased
and Program staff from all levels looked at ways of addressing
issues and challenges.
The Ontario Region conducted a program review for 12 First Nations
that had been in full service delivery for over a year. The evaluation
addressed processes and outcomes (e.g. Were they delivering the
essential service elements? ). The review indicated that the overwhelming
majority of communities were doing extremely well. While a couple
of communities encountered issues with liability insurance, they
were able to be put back on track. The review was conducted by
a consultant who had experience in both home care and with First
Nations. A final report is scheduled for 2003/04 and will be widely
shared.
As communities moved further along and gained more and more experience
with the Program, there was evidence of the momentum building,
with more staff and better infrastructure in place to provide services
and more people receiving care. At the same time, community leaders
increasingly understood the Program and its benefits.
Training
Due to a relatively high budget variance for 2002/03, communities
were invited to submit proposals to receive up to $10,000 for training
initiatives. The application involved using a template from the
Training Handbook. Many communities applied and received these
funds for training that focused primarily on training of personal
support workers. In total, over $900,000 from the budget variance
was earmarked for training.
Training provided in 2002/03 included:
- First Nations Health Studies Program
- First Response
- Food Handlers Certificate
- Food Care for Caregivers
- Gerontology -- Multidiscipline Post-Diploma
- Grief Recovery Certification Program
- Home and Community Care Orientation Protocol
- Health Science Leadership/Management
- Improving Health Care Management in Aboriginal Communities
- Senior Fitness Instructors Course
- Supporting Persons with Dual Diagnosis
- Total Quality Management/Quality Assurance
- Wise Use of Medications in the Home
- Workplace Hazardous Materials Information System
- Workplace Health Promotion/Bereavement Support
- Wound Care
Case Management
- Through the Chiefs of Ontario and McMaster University, a case
management program was adapted to First Nations culture and two
6-day sessions were conducted in December 2002. In total, 137
people graduated and all communities had at least one individual
attend.
Service Delivery Reporting Template
- Service Delivery Reporting Template training was provided
to communities in service delivery. Additional training is anticipated
as a requirement for other communities not in service delivery
and for additional changes that might occur with the template
if an overhaul is done on it.
- Training was conducted in Ottawa and a helpline was subsequently
provided. The funding variance was used to purchase computers
for all First Nations that did not have the appropriate hardware
and/or software. Even with the training and equipment, a number
of problems were encountered with the reporting template.
Capital Projects
While the majority of the variance was used for training, part
of it was apportioned for capital projects for items such as office
furniture, Hoyer lifts, and specialized beds. As with training,
communities applied for this supplementary supplies and equipment
funding.
Partnerships and Linkages
Partnerships and linkages improved during the year as awareness
increased of the Program, its goals, and its scope. There was an
increased realization that, when partnered effectively, everyone
from staff to clients to communities benefited.
Chiefs of Ontario and Provincial/Territorial Organizations
( PTOs)
Ongoing discussions and planning continued with the Chiefs of
Ontario and the five PTOs. The Peer Review Committee evolved into
an advisory board capacity as the program moved from planning into
service delivery.
Provincial Ministry/Community Care Access Centres
Memorandums of understanding were done at the local level with
the provincial Ministry of Health/Community Care Access Centres
(CCACs) on issues such as referrals and support. The province operates
43 CCACs across the province for all Ontario residents.
Work was undertaken to get the various funding organizations
together for discussions. At the provincial level these included
CCAC and the Ministry of Health and Indian and Northern Affairs
Canada (INAC) and Health Canada at the federal level. One initiative
was looking at coming up with one expenditure and one information
report across all funders.
Educational Institutions
In addition to the case management course provided through McMaster
University in Hamilton, partnerships were established with other
educational institutions that provide personal support worker training.
Other Health Canada Programs
Collaboration and discussions occurred with some other Health
Canada Programs on both a local and regional level such as the
Aboriginal Diabetes Initiative, Office of Nursing, and the eHealth
group. Discussions were also held with Community Health to investigate
mentoring and support between Home and Community Care (HCC) nurses
and Community Health nurses, particularly in the area of personal
support worker supervision.
Environment Health
One issue that came out of the program evaluation was the need
for more education on issues related to environmental health through
Workplace Hazardous Materials Information System (WHMIS) and Sharpes
disposal program. These included such issues as how to ensure that
all dressings, soiled supplies and syringes were disposed of appropriately.
Indian and Northern Affairs Canada ( INAC)
Linkages with INAC were minimal on both a regional and local
level. A tripartite with Health Canada, INAC and First Nations
is in place. The Ontario Ministry of Health administers homemaking
services on reserve but INAC supplies the funding.
Victoria Order of Nurses (VON)
Some communities in Ontario worked with the Victorian Order of
Nurses (VON) in the provision of home care nursing services.
Resources Developed and Distributed
The following resources were developed and/or distributed to
Ontario communities during the 2002/03 fiscal year:
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