PETER BALLANTYNE CREE NATION HEALTH SERVICES INC.

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1 PETER BALLANTYNE CREE NATION HEALTH SERVICES INC

2 Peter Ballantyne Cree Nation Multi-Community Band 8 separate, distinct communities Majority of the communities are spread through a traditional territory of approx. 51,000 sq. kms in the NE part of Saskatchewan

3 PBCN COMMUNITIES

4 PBCN HEALTH SERVICES TRANSFER

5 PRE- TRANSFER Prior to 1995 all services for PBCN were provided by MSB Early 1990 PBCN began the pre-transfer process with Comprehensive Needs Assessments and Community Consultations being completed in 1991 Part of this process was meant to determine if Transfer was the best option for the community members

6 PRE- TRANSFER Decision to proceed with Transfer was made with the understanding that it would be set up as a separate entity to protect the funding for Health services and ensure sustainability & accountability

7 Peter Ballantyne Cree Nation Closest hospital hours and 1.5 to 2 hours (mainly gravel) Total Population of over 11,000 On-Reserve Transferred Communities population

8 TRANSFER Incorporated under the Non-Profit Corporations Act Health Board was appointed by Chief & Council & mandated as the governing authority responsible for delivering Health Services March 17, 1995 Signing of First Agreement

9 PARTIES TO THE HEALTH TRANSFER AGREEMENT Health Canada Chief & Council PBCN Health Services Inc

10 UNIQUENESS At the time, it was the largest single band transfer in Canada Only Tripartite Agreement First Incorporated Organization to deliver services under First Nations Health Transfer

11 PBCN HEALTH TRANSFER FIRST SECOND: THIRD: FOURTH: FIFTH: (First 10 year Agreement) 20 Years of Transfer

12 Governance Chief & Council Portfolio Councilors Board of Directors Elder Health Committees

13 Peter Ballantyne Cree Nation Health Services Inc. Governance/Authority Chart Second Level Support (PA) Assistant Executive Director - Capital/Maintenance Manager - Information Technology Primary Care & Community Health Manager - Community Health Manager - Home & Community Care Manager - Dietitian - Emergency Response Coordinator/Trainer - Tobacco Control Program Coordinator - Nursing Program Assistant - Maternal Child Health Manager Holistic Health Manager Human Resource Manager Finance Manager - Accounting Clerk - Accounts Manager Executive Assistant-NIHB Navigator - Receptionist PBCN Membership Chief & Council Board of Directors Executive Director Health Directors Chief Health Portfolio Councillors First Pharmacy Plus PBCN Ambulance Health Committees (S.E., D.L., P.N.) Nursing Coordinator Home Care Nurse/Assessors LPNs Home Health Aids Home Living Assistant Elder Coordinator Primary Care Nurses LPNs Nursing Clerk Pharmacy Clerk Diabetes Support Worker Community Health Developers Dental Therapist Head Start Coordinator Dental Assistant Head Start Assistant Program Support Services -Admin. Assistant/Clerk -Janitor -Medical Transportation Clerks -Maintenance -Medical Transportation Drivers -Security -Telehealth Coordinator (PN) -Receptionist Holistic Health Coordinator Holistic Health Developers Family Outreach Workers Youth Workers IRS Workers Admin Supervision Clinical Supervision

14 Peter Ballantyne Cree Nation Leadership - Chief and Council Signatory to the Health Transfer Agreement Ensure compliance, and monitor proper administration of health programs and services as outlined in the terms of the HTA and other affiliated health program Agreements Delegate authority through BCR to the Board of Directors for the administration of health programs and services as set out in the HTA Assign Health Portfolio Councilors to act, along with the Chief, in an ex-offio capacity on the Board

15 Leadership Health Portfolio Councilors Act as liaisons, advisors and political advocates to the Board of Directors on behalf of Chief & Council Oversee the general administration and coordination of health services Act as Trustees for the membership and are responsible and accountable to the membership on overall community health matters Have no vote Permitted to attend all meetings of the Board of Directors, at their pleasure

16 Board is made up of an Elder and 10 Directors representing each of the PBCN Communities They are community members appointed by Chief and Council for 2 year terms Hold the legitimate, corporate power to make decisions for the organization as a whole Responsible to deliver, administer & implement the mandate of the HTA on behalf of the Cree Nation

17 Responsible to approve overall policy direction & financial control to ensure that PBCN Health Services: is legally operated provides effective services and programs administers finances properly & according to the terms of the HTA They are accountable to Chief & Council and are linked to them through the Health Portfolio Councilors Accountable to the PBCN membership through community meetings, health committees, the Audit and the Annual Report

18 Health Committees Health Committee Representatives: Board Members Health Portfolio Councilor Elder Youth Rep ((between 13 & 17) Members at large

19 Recommended by local HPC and approved by Chief and Council through BCR for 2 year terms Have no legal Authority Provide advice to the HB, HDs & Program Managers on: - matters pertinent to improving health services in their community, - guidance on local health concerns, - local policy direction and - approval of community projects and budgets. Play an important role in the selection and hiring of community health staff (no termination authority)

20 Peter Ballantyne Cree Nation Health Services CENTRAL OFFICE

21 CENTRAL OFFICE Overall administration and management Consultation and technical support Program planning and coordination Clinical supervision of Professional Staff Capacity development and training Financial control and reporting Capital Assets and Inventory control Human Resource Management All Funding and Agreements are managed through Central Office

22 Relationships Accountability - Communication PBCN Membership Health Centers Health Committees PBCN HEALTH SERVICES INC. Board Chief & Council

23 PBCN Membership * C & C Community Meetings * Health Specific Community Meetings * Annual Program Report & Audit * Focus Groups/Surveys for input into Service Delivery Planning Chief & Council * Report at C & C Quarterly Meetings * Annual Meeting * Written Annual Program Report & Audit * Board Meetings through HP Councilors & Chief Health Committees * Participate in Interviews * Work together on approval of community annual budgets & program plans * Provide Annual Orientation * Annual Meeting * Report/participate in HC Meetings as requested/required PBCN HEALTH SERVICES Board of Directors * Program Reports at Quarterly Meetings * All policies, budgets, Agreements etc.

24 RELATIONSHIP WITH HEALTH CENTERS BUDGETS * Operational - Work with HD-HC Health Board * CB Programs Project Teams Health Committee COMPLAINTS * All complaints are in writing * Directed to HD * Next step ED * Board of Directors PBCN Health Services Central Office PLANNING & PROJECT TEAMS * Established for each target group * Draft annual program plans &budgets * Hold focus groups with target group HUMAN RESOURCES * Personnel Policies * Interviews

25 THEN & NOW

26 THEN & NOW Year Transfer Nursing & Community Health Developers Clerical NNADAP O&M including Janitorial & Maintenance MCCAR SET AGREEMENTS Physician/Dental Travel Medical Transportation Clerks Communicable Disease Control Brighter Futures Home Care Nursing Prenatal Nutrition AGREEMENT 10 Year BLOCK All Programs other than those under NIHB & IRS SET AGREEMENTS Physician & Dentist Travel Dental Therapy Specialist Travel MT Clerks Van Based MT Indian Residential School Program

27 Transferred Communities Population THEN & NOW 1995: 2, : 6,788 Change: 4,096

28 THEN & NOW CAPITAL BUILDINGS & AFFILIATES Primary Care Centers with attached Nursing Residences 1 Community Health Center 3 Primary Care Centers 2 Community Health Centers 2 Affiliate Centers Ambulance Center & Residence 3 Family Wellness Centers (AHS) 33 Residences for Professionals & Visitors Central Office Building (PA) Currently planning either a youth center or Drop In Center for 3 communities

29 THEN & NOW Human Resources Transfer includes: First Level those services offered directly in the community Second Level administration, coordination, training & technical support provided from PA Central office Management Direct Service Delivery Admin & Program Support Total FTE

30 Human Resources

31 ACCOMPLISHMENTS & SUCCESSES BUSINESSES & PARTNERSHIPS PBCN Ambulance PBCN Pharmacy

32 ACCOMPLISHMENTS & SUCCESSES CAPACITY BUILDING CORE TRAINING LPN NORTHERN MENTAL HEALTH & ADDICTIONS HEALTH DIRECTORS EMERGENCY & TRAUMA RESPONSE

33 ACCOMPLISHMENTS & SUCCESSES EMERGENCY RESPONSE AMBULANCE HORIZONTAL TRANSPORTATION VEHICLES EMERGENCY & TRAUMA RESPONSE TRAINING First Aid/CPR Instructors First Responders Emergency Medical Responders Numerous Trauma Response Nurses Training

34 ACCOMPLISHMENTS & SUCCESSES TECHNOLOGY TELEHEALTH PBCN DATA COLLECTION SYSTEMS REMOTE PRESENCE Pediatric Trauma Specialist Physiotherapy Specialist Follow-up Ultrasound Dermatology

35 OTHER INITIATIVES IN PROGRESS Home Hemo-Dialysis Point of Care Lab Testing Primary Care & Chronic Disease Re-Design Mental Health & Addictions Strategy

36 Thank - You

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