First Nations and Inuit Home and Community Care Program - Biannual Report 2000-2002

Regional Overview

Quebec

Quebec Region Profile

In the Quebec Region, First Nations communities account for 85% of the Region's First Nations and Inuit population. The 38 First Nations communities represent 10 First Nations. The largest community is Kahnawake, near Montreal, which has a population of over 7,000 on the reserve itself.

Approximately 15% of the population served are Inuit in Inuit communities in the Nunavik Region. Within the fourteen Inuit communities, four have populations over 1,000 with the others as small as 125 people.

Structure

An integral part of the First Nations and Inuit Home and Community Care (FNIHCC) Program in Quebec is ongoing collaboration with the First Nations of Quebec and Labrador Health and Social Services Commission (FNQLHSSC) and Nunavik Regional Board of Health and Social Services (NRBHSS). These two organizations play vital roles in the planning, implementation, and monitoring of the program.

The Inuit communities are linked with each other through the NRBHSS. With the exception of the nine Cree communities, the other First Nations communities operate the program independently.

Committees were struck early in the process to establish funding distribution processes to communities. Approximately half of the communities in the province are considered small and isolated.

Program staff held daily communications with partners and communities. In addition to a regional coordinator at First Nations and Inuit Health Branch (FNIHB), there was also a contribution officer and part time nurse in 2000/01. In 2001/02, a home care nurse specialist was hired and an administrative support position was filled.

At FNQLHSSC, a home care technician position worked closely with FNIHB and provided support to communities throughout the process.

About Nunavik

The Region of Nunavik lies north of the 55th parallel in the province of Quebec. Nearly 8,000 Inuit call Nunavik home and live in 14 communities. Kuujjuaq is the Regional administrative centre with a population of approximately 1,500 residents.

With a lack of roads connecting the communities, the primary method of transportation between them and the south is via air and marine vessels.

Source :http://www.tapirisat.ca

About the FNQLHSSC

The FNQLHSSC is governed by a Board of Directors elected by the General Assembly. The Board of Directors is vested with all the responsibilities granted to in by the General Assembly of First Nations of Quebec and Labrador. The Board of Directors is accountable to the Chiefs of Assembly of First Nations of Quebec and Labrador and to the General Assembly.

The mission of the FNQLHSSC is to:
Improve the physical, mental, emotional, and spiritual wellbeing of First Nation and Inuit individuals, families and communities in respect of their local autonomy and culture. By helping the communities that with to initiate, develop and promote comprehensive health and social program and services as designed by First Nation and Inuit organizations recognized by our First Nations and Inuit.

Source: http://www.csssnpql.com

About the NRBHSS

The Nunavik Regional Board of Health and Social Services is responsible for the administration and delivery of health and social services to residents of the Nunavik Region.

Program Overview: 2000/01 and 2001/02

By the end of 2001/02, almost all communities in Quebec had undergone needs assessments, planning and were in service delivery. Annual meetings with community representatives began early in the program.

Service delivery plans were peer reviewed and evaluated by committee, with representatives visiting some communities to discuss the plans and areas of potential enhancement. By the end of August 2001, all plans were approved.

While one community was in full service delivery by the end of 2000/01, by the end of the following year five communities were in full service delivery. The remaining communities had approved plans and were in the process of implementation, working towards full service delivery.

Training

In Quebec, as in most other Regions, the training emphasis was on training home support workers, with less emphasis on training for nurses. In terms of number of positions funded by the program, tracking data shows that the number of personal care workers in the province was 431 prior to the program. Training plans indicate that this figure would increase to 488 through program funding. For home care Licensed Practical Nurses (LPNs), the figure would increase from 1 to 13 in the province and the number of Registered Nurses (RNs) for home care would increase from 20 to 57.

This was a challenge for the Region's communities, as the standard of training in Quebec requires 960 hours of training for home support workers. In most other Regions, this time is in some cases a third of the time required in Quebec. Not only do these additional hours impact training funds but it is also more difficult to have people outside the community for such a long period of time, particularly when the program funding does not provide for replacement funding for people who leave for training. Training programs are often required for English and French because of the mix of language usage among communities. Despite these challenges, at least one person in each community received training as a home support worker. In Nunavik Region, ninety people received training within the 14 communities and 30 Inuit received home care support worker certification.

In 2001/02, a two-day training session was held in Quebec City to teach workers how to use equipments provided such as glucometers, hydraulic lift for patients, and how to get assistance for technical support. Health directors, nurses, and home care workers also received computer training to assist them in their programs and documentation.

Partnerships

In Quebec, the primary partnerships developed during the two years were with the First Nations of Quebec and Labrador Health and Social Services Commission (FNQLHSSC) and Nunavik Regional Board of Health and Social Services (NRBHSS).

Program Linkages

Across the country, Regions linked with other federal agencies and programs, where possible. In Quebec, one of the primary linkages was with Indian and Northern Affairs Canada (INAC). The two organizations worked closely together on projects, including the development of common reporting mechanisms for communities.

Resources Developed/Distributed

In 2001/02, with the assistance of a consultant, the Quebec Region created a spreadsheet to be used as a tool for communities to report data on the program. The spreadsheet was so helpful it was adapted to become a National reporting template.