Provincial Support for Integrated Primary Care (PC) Programs On-Reserve
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1 First Nations Health Services Integration Fund (HSIF) Alberta Region Provincial Support for Integrated Primary Care (PC) Programs On-Reserve September 18 th, 2013 FNHMA Conference Presenters: Kirsten Dupres, Liette Snache & Renee Rebryna
2 Collaboration. Capacity. Health.
3 Collaboration. Capacity. Health. The goal of this presentation is to share our project processes, successes, challenges, and the rationale for embracing the opportunity. We all know and experience. That services are often required that cannot be provided on reserve-off reserve access can pose challenges! Jurisdictional barriers (provincial / federal) exist! It s time to work together toward a common health care vision!
4 Alberta HSIF Primary Care Project Presentation Outline Project Vision & Mission HSIF National Overview HSIF Primary Care Pilot Sites Partnerships & Collaborations Success & Challenges Rationale & Outcomes Q & A
5 Collaboration. Capacity. Health. Collaborative partnerships achieving accessible, coordinated, seamless primary care programs and services on reserve, for and with First Nations communities.
6 HSIF National Initiatives 70+ Projects across the country 5 Year initiative Builds on the previous Aboriginal Health Transition Fund (AHTF) projects Aim: Supporting collaborative planning and multi-year projects aimed at better meeting the health-care needs of First Nations and Inuit Nationally facilitated, regionally implemented, Nation Led
7 HSIF National Goals Improve the integration of federally-funded health services in First Nations and Inuit communities with those funded by the provinces and territories; Build multi-party partnerships to advance health service integration; Improve First Nations and Inuit access to health services; and Increase the participation of First Nations and Inuit in the design, delivery, and evaluation of health programs and services.
8 HSIF Alberta Region 4 Projects Primary Care* Mental Health & Addictions Continuing Care Exploring Partnerships HSIF Alberta manager supports all 4 Each project functions independently but also have intersections of collaboration There are HSIF projects in your region
9 HSIF Primary Care Alberta
10 HSIF Primary Care Project Alberta Region We are successfully establishing partnerships through our Alberta HSIF project Provincial Support for Integrated Primary Care on- Reserve that will facilitate accessible, coordinated Primary Care programs and services on and off reserve. Thirteen First Nations in Alberta (28% of Alberta First Nations) are leading us through our exploration and demonstration of collaboratively working toward enhanced health services. Our project experiences will provide value to all First Nations communities as we break down the invisible borders and work in a coordinated manner to enhance healthcare collectively. HSIF is a national initiative supporting collaborative planning aimed at better meeting the healthcare needs of First Nations.
11 Primary Care Project Structure
12 AB HSIF PC Project Management Committee Kirsten Dupres Treaty 8 (Co-Chair) Joan Yee First Nations Inuit Health Branch (Co-Chair) Bonita Saddleback Treaty 6 Rep Vacant Treaty 6 Rep Mike Day Chief Treaty 7 Rep Margo Sitting Eagle Treaty 7 Rep Liette Snache Treaty 8 Rep Heather Young First Nations Inuit Health Branch Rep Tracy Imai Alberta Health Rep Dr. Esther Tailfeathers Alberta Health Services Rep
13 AB HSIF PC Project Personnel Renee Rebryna Project Co-ordinator Anne Bird PC Facilitator Margaret Kargard PC Facilitator Kim Auger PC Facilitator Birgitta Larson Evaluator Sandra Woodhead Lyons Evaluator Chantale Strang Project Admin
14 Primary Care Project Goals Determine / confirm the need for enhanced access to Primary Care Programs for First Nations in Alberta Pilot the integration of Primary Care Programs onreserve Pilot site / Nation specific goals will guide the pilot projects, and therefore, the project!
15 Basic primary care services Chronic disease management Cancer screening Information sharing agreements Pilot Community Priorities!
16 Where Are We? Alberta Region Treaty No. 6 Treaty No. 7 Treaty No. 8
17 Kee Tas Kee Now Tribal Council Loon River First Nation Lubicon Lake Band Peerless Trout First Nation Whitefish Lake First Nation Woodland Cree First Nation Siksika Health and Wellness Center Western Cree Tribal Council Duncan s First Nation Horse Lake First Nation Sturgeon Lake Cree Nation Yellowhead Tribal Council Alexis First Nation Enoch Cree Nation O Chiese First Nation Sunchild First Nation
18 Welcome to Kee Tas Kee Now Tribal Council Where we are located in the LSL-HAC Map Lubicon Lake Kee Tas Kee Now Tribal Council
19 The Kee Tas Kee Now Tribal Council is comprised of the member Nations of: Loon River, Lubicon Lake Band, Peerless Trout, Whitefish Lake #459 and Woodland Cree First Nations. While there are many similarities between the five K.T.C member Nations, each has its own unique character and features. All are surrounded by a warmth and beauty rich with culture and traditions of the Cree people.
20 Partnerships include: Primary Care Network (PCN) Peace Region, Slave Lake Region Alberta Health Services (AHS) Non Insured Health Benefits (NIHB) Health Services include: Physician Services Nurse Practitioner Services Mental Health Services Home Care Coordinator / Nurses, Health Care Aides Indian Residential School (IRS) Resolution Health Support Workers Maternal Child Health Advisor & Home Visitors National Native Alcohol and Drug Abuse Program (NNADAP) Wellness Consultant Community Health and Immunization Program (CHIP) in 3 of 5 communities Home Care Reporting System (HCRS) RAI Homecare Community Health Programming / Nursing Pre/Post Natal Programming Alberta Health Serbvices (AHS) Cervical Cancer Screening Telehealth Services / Clinical Carts Non Insured Health Benefits (NIHB) Medical Transportation Programs / Referral Services Programs Drinking Water Safety
21 Welcome to Siksika Health Services Siksika Nation is located approximately 100 km east of Calgary and is the second largest (geographically) reserve in Canada
22 Long history of creating partnerships including: Memorandum of Understanding (MOU) with Alberta Health Services Nike Radiology Consultants Associated Calgary Laboratory Services Family Medicine Program at the University of Calgary Calgary Rural Primary Care Network Alberta Health Technologically advanced: Successful Telehealth programs Emergency Medical Responder (EMR) Community Health and Immunization Program (CHIP) Geopraphic Information System (GIS) Siksika Health Services was a Keynote speaker earlier today!
23 Siksika Health Services
24 Welcome to Western Cree Tribal Council Duncan s Horse Lake Sturgeon
25 Western Cree Tribal Council is made up of three Cree Nations; Duncan s, Sturgeon Lake & Horse Lake First Nation, who work closely together in the area of health. Each nation has its own health centre and staff and often shares resources in an effort to provide much needed programs and services.
26 Partnerships include: First Nations Inuit Health Branch Alberta Health Services Alberta Health Primary Care Network (PCN) Horse Lake Fetal Alcohol Spectrum Disorders (FASD) Network Non Insured Health Benefits (NIHB) Treaty 8 First Nations of Alberta Other Tribal Councils and First Nations Organizations Health Services include: Physician Services Diabetes Choice Program Alberta Health Services (AHS) Women s Health Mobile Clinic National Native Addictions and Drug Abuse Program (NNADAP) Home Care Public Health Nursing Services Prevention and Health Services Prevention and Health Services Community Health Representatives (CHR s) Medical Transportation Coordination / Delivery Community Dental Health Practice Visits Enterostornal Therapy Telehealth Equipment
27 Welcome to Yellowhead Tribal Council Enoch Cree Nation Alexis Nakota Sioux O Chiese First Nation Sunchild First Nation
28 YTC First Nations; Alexis, Encoh, Sunchild & O Chiese are collaborating with the Rocky Mountain House/Westview Primary Care Networks and working together to realize a shared goal of increasing and improving access to essential primary care services, such as chronic disease prevention / management, and population health promotion within YTC communities.
29 Partnerships include: Westview Primary Care Network Rocky Mountain House Primary Care Network Non Insured Health Benefits (NIHB) Health Services include: Physicians Services Nurse Practitioner Services Midwifery Mobile Clinic Community Health Representative (CHR) Telehealth Equipment Cancer Cervical Screen Community Dental Health Practitioners Medical Transportation
30 Collaborative primary care services & programs Partnerships, linkages, coordination, planning, communication, collaboration Formal policies & procedures Culturally relevant care & services Proactive health promotion, disease prevention Education, support programs Right programs / services, at the right time by the right provider!
31 family Care Clinics (FCCs) / satellites data sharing agreements (formal / informal) discharge planning increased use of technology Netcare, telehealth local primary care network (PCN) involvement physicians / nurse practitioners patient navigation / case management / referral diagnostic / screening services
32
33 Project Management Partnerships Kee Tas Kee Now Tribal Council (KTC) First Nations and Inuit Health Branch (FNIHB) Alberta Health Services (AHS) Alberta Health (AH) Primary Care Networks (PCN s) Treaties No. 6, 7 & 8 First Nations (AB) Pilot Sites / Communities Others as we progress..
34 Establishing Partnerships Identified: Gaps in services / communication Key Nation health staff & leaders Key executive partners (decision-makers) Existing relationships / partnerships (to build on) Reached out to: Service providers that Nations utilize Executives in province Sandwiched from front line to executives
35 Barriers & Challenges Identification of appropriate contacts and persons Establishing relationships Jurisdictional boundaries Funding and governance models Knowledge gaps (reciprocal both ways) Geographical & travel Resourcing & time Short timeframe of project
36 Strengths & Assets Determination to enhance health of First Nations communities Willingness & motivation of all Commitment to fostering change Priority for Nations Quick wins for Nations Relationship building Alberta vision Patience Teaching people about First Nations communities and their strengths Commitment to future sustainability Perfect timing & environment for collaboration!
37 Examples of Success! Alberta Health Services (AHS), Alberta Health (AH), Primary Care Network (PCN) engagement & partnerships Nation level priority definition and plans Netcare initiation in Nations Alberta Health (AH) Health Information Act (HIA)- Privacy /Security information & plans for First Nations Submission of 3 Family Care Clinics (FCC) Expression of Interests (EOIs) Increased use of telehealth e.g. tele-dietician Plans for clinics - women s health and cancer screening Patient navigation, discharge planning, medical transportation
38 How did we get there Our Efforts & Perseverance! Achievments to Date...
39 Project Achievements to Date Terms of Reference Primary Care Proposal Project Scope & Governance Inventory of Primary Care Services On/Off Reserve Health Services & Programs Booklet now online! Draft Project Charter Draft Stakeholder Engagement & Communications Strategy Critical Mass Study (Resource Requirements) Project Tracking and Reporting Processes Primary Care Facilitators (PCFs) (3) 4 Pilot Sites / Nations (13) Project Evaluation Team (2) Primary Care Facilitator (PCF) Pilot Workplans / Reports Project Knowledge Dissemination Health Co-Management (HCOM) Pre/Post Evaluation: Logic Model & Performance Measurements Baseline data collection complete in all Nations!
40 How did we get there Collaborative pre-project planning & proposal Engagement of partners from project conception - to date Strong team with the right people Tracking & monitoring of all aspects Nation-led priorities and foundation Commitment to First Nations health Patience, perseverance and hard work!
41 Project Knowledge Dissemination HCoM Health Co-Management Established in 1996, Health Co-Management (HCoM) was formed to be a proactive mechanism to address health issues for First Nations communities in Alberta. The main goal for Co-Management is to increase the participation of First Nations in assessing, planning and managing programs and services that are funded or offered by Health Canada, First Nations Inuit Health Branch (FNIHB) in the Alberta Region. Co-Management acts as an advocate for First Nations health interests on behalf of the Chiefs of Treaties 6, 7 and 8. All HSIF Alberta Projects share information on the HCoM website: HCoM Link to the HSIF Primary Care Project:
42 Project Evaluation.. HSIF PC Project Access Database Access Database was created for the HSIF Primary Care facilitators to enter Pilot specific strategies, priorities, tasks, risks and achievements.
43 PC Priorities from Now until 2015 Nation and provincial collaboration (Nation-led) Nation priorities into actions Relationships and partnerships strengthen & build more Realistic short term goals with future sustainability plans Risk assessment & management plan Measurable outcomes & final pilot evaluation Project Lessons Learned manual to share
44 PC Rationale Why are we doing this. Healthcare services interfacing with Province Break down invisible borders Increased access to primary care Improved, integrated and coordinated primary care services Formalized stakeholder partnerships Sustainability of pilot sites (from beginning) Health Nations!
45 PC Anticipated Umbrella Outcomes Formalized partnerships and strategies that will benefit ALL interested First Nations in Alberta Lessons learned and resource manual that will serve to share the project experiences and processes Implementation of primary care project model in other Alberta Nations opportunity with desire
46 What can you take away from this presentation Time is right to break down barriers Don t boil the ocean take small, realistic steps Dedicated group of people can make real change Anything is possible with a vision
47 Coming together is a beginning. Keeping together is progress. Working together is success.
48 QUESTIONS?
49 Contact Us. Kirsten Dupres: Liette Snache: Renee Rebryna: THANK YOU!
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