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

Regional Overview

Pacific

Pacific Region Profile

Population: 63,416
Average Population per Community: 311
Number of Communities Eligible for Funding: 204
Number of Communities Funded: 191
% of Needs Assessments Completed: 72 %
% of Communities with Submitted Plans: 69 %
% of Communities in Planning Implementation: 58 %
% of Communities with Access to Service Delivery: 40 %
2001/02

The Pacific Region (British Columbia) is home to 204 communities, the highest number for any Region. Most communities are small and many are isolated. With the average community size at 311, the Region's communities tend to be significantly smaller compared with other Regions.

Structure

A partnership was established with the First Nations Chiefs' Health Committee (CHC) for theFirst Nations and Inuit Home and Community Care (FNIHCC) Program. Communities/collectivities were assisted with their needs assessments and service delivery plans, plans were peer reviewed, and a Regional joint steering committee was struck.

Two home care nurse advisors were hired. One worked out of the First Nations Chiefs' Health Committee (CHC's) offices and the other from First Nations and Inuit Health Branch's (FNIHB) regional office. As well, funding provided for one home and community care regional coordinator and an administrative support position. Recruiting was also underway for a second home care nurse advisor at Health Canada's First Nations and Inuit Health Branch (FNIHB) that would serve the southern communities. The CHC hired a second person to work on the FNIHCC Program, a development advisor who assisted communities with the development of needs assessments and service delivery plans along with the two home care nurse advisors. Working groups, such as the Non-Insured Health Benefits (NIHB) Working Group, were struck.

Program Overview: 2000/01 and 2001/02

The coordinating team helped increase awareness of the Program in communities and increase the number of communities who completed needs assessments and service delivery plans. The result was more communities in full service delivery. With a greater awareness of community services and with the access of funding for home care programming locally, more First Nations people across British Columbia had access to Home and Community Care services. As staffing on the BC Home and Community Care team increased, there was an increase in the number of band contacts made, a challenge with 204 bands in the province.

The combination of many small, isolated communities presents a unique challenge to build capacity among First Nations communities to assess, plan, implement, maintain, and monitor a Home and Community Care program. Despite these challenges, almost three-quarters of communities completed needs assessments by the end of 2001/02 in British Columbia. In addition, approximately 40% of communities were in the service delivery phase. This represented 51% of the First Nations population in the province, indicative of the fact that larger communities tended to reach service delivery phases sooner than smaller communities. By the end of 2001/02, over 93% of communities had accessed Home and Community Care funding.

Training

The increasing number of communities accessing FNIHCC Program funding during this period resulted in increased capacity in First Nations communities in British Columbia. Coinciding with this was increased training and work opportunities for First Nations people because of this program funding. Communities identified a variety of training opportunities for home support workers and home care nurses and a variety of partnerships and training models emerged.

According to program tracking data, in BC the number of personal care workers was fewer than 10 prior to the FNIHCC Program. Training plans indicated that this was scheduled to increase to 267 through FNIHCC Program funding. Both formal and informal types of training were provided.

Formal training provided included training for certified home support workers, (personal care aides) and, Home Care Nursing training, and training for Peer Review Committee members.

• Bands/collectivities worked together to provide home and community care as well as training for home support workers.

• In several cases, larger communities helped smaller communities by offering space for training when available. The FNIHCC team also prepared and reviewed scope of work for personal care aides and disseminated to communities.

• In some communities "laddering programs" were developed whereby students trained to be home support workers could then go on to become Licensed Practical Nurses (LPNs) and then (Registered Nurses) RNs.

• Program representatives from both the CHC and FNIHB took the Home Care Nursing Training from the University College of Cariboo in Kamloops. The training took place over six weekends during an eight-week period and provided the program staff more knowledge about the more technical aspects of a home care program and how it rolls out in a provincial system. The college modified the curriculum to make it specific to First Nations communities providing both theoretical and practical perspectives. The two-week practicum at a regional (provincial) health authority proved very beneficial to the program representatives.

Informal training provided to communities included initial training sessions to introduce the program in several locations in BC and presentations provided to individual communities/collectivities in their own communities.

Partnerships

Following are examples of partnerships fostered during the first two years of the program.

First Nations

• A strong partnership formed with the First Nations Chiefs' Health Committee (CHC), particularly through the CHC Home Care Nurse Advisor.

• BC Aboriginal Network on Disabilities Society (BCANDS) was contracted to mail out several hundred copies of the home care video to First Nations bands across Canada.

• Three First Nations bands/collectivities were involved in the development of a home care video that was distributed Canada-wide.

Provincial

• There was increased awareness of the Province's "Continuing Care" program and opportunities for linkages with the FNIHCC Program at the community level.

Educational & Training Institutions

• A partnership emerged with the University College of the Cariboo in Kamloops for Home Care nursing training specific to First Nations environments.

• First Nations educational groups developed and conducted training of home support workers.

Program Linkages

Across the country, Regions linked with other federal agencies and programs, where possible. In BC, this included:

Indian and Northern Affairs Canada (INAC) (DIAND)

• Work was done on how to link theIndian and Northern Affairs Canada (INAC) Adult in-home care program with FNIHCC at the community level.

Human Resources Development Canada (HRDC)

• A presentation was made to the ARDA's of BC regarding training requirements for Home Support Workers to raise awareness of the program and the need for an increase in financial support for these students.

Within Health Canada

• Linkages were made with the Corporate Services Branch to assist with the building of space for FNIHCC Programs in First Nations communities throughout BC.

• Discussions were held with NIHB program representatives, in part, to determine equipment and supplies clients would be eligible for under the NIHB program. Discussions also took place regarding NIHB partnering with Veterans Affairs Canada (VAC) to share an equipment depot providing new or refurbished equipment to home and community care clients. Equipment for VAC clients is relatively extensive and this unique solution helps to maximize usage and cost-effectiveness through reuse following refurbishing.

Resources Developed/Distributed

Following are some of the resources developed or distributed within BC during this period.

• A home care video was developed in partnership with three First Nations communities/collectivities. The videos were cultimately distributed nationally to all bands in Canada by BCANDS.

• A service delivery plan tool kit for communities was shared with all communities who were working on completing service delivery plans in 2001/02. It included "best practices" examples of actual communities who had completed plans, using these communities' permission. The took kit was in print format and included a summary of community needs assessment, program goals and objectives, foundation to address changing needs, Capital plan, linkages, referral process between agencies, outline of resource needs, job description qualifications, orientation plan, team relationships, appropriate liability insurance, implementation strategy and timelines, evaluation (3 components), fiscal responsibilities, program quality assurance, accountability to community members, budget with sample budget, training plans, partnerships, information and data collection.

• Presentation materials (i.e. overhead transparencies) were reviewed, revised, and updated on an ongoing basis for usage with communities and other federal government agencies.

• Three manuals were developed and distributed to communities within the province and made available to other Regions. They included:

  • home support worker policy and procedure manual;
  • home care nursing policy and procedure manual; and
  • orientation manual for home care nurses and their supervisors.