HOSPITAL CHAPLAINCY TASK FORCE REPORT Responding to human need by loving service. Abstract In the Epistle of James, the sick call for the elders of the Church to pray over them and anoint them with oil in the name of the Lord. Submitted by the members of the Hospital Chaplaincy Task Force, March 8, 2016
Contents Chapter 1 : Executive Summary... 2 Chapter 2 : Scope and Methods... 4 Chapter 3 : Responsibilities, Principles & Standards... 5 Chapter 4 : Background Research... 7 Chapter 5 : Organizational Model... 9 Chapter 6 : Educational Needs... 13 Chapter 7 : Glossary... 15 Chapter 8 : Appendices... 16 1 P a g e
Chapter 1 : Executive Summary In providing this executive summary the Hospital Chaplaincy Task Force recommends the full report to the reader and encourages her or him to read to the end for a fuller understanding of the rationale and recommendations presented in this report. To begin, spiritual care ministry is a responsibility that we all share as Anglicans. In the Baptismal Covenant, we promise to seek and serve Christ in all persons, loving our neighbour as ourselves; and the third Mark of Mission calls us to respond to human need by loving service. In the Book of Alternative Services, the ministry for the care of the sick is portrayed as an act of worship, calling us to prayer for the sick and names the actions of touching and anointing and the sharing of our Holy Communion. Like Jesus who consoles us, we are called to console those who are in any affliction. The Hospital Chaplaincy Task Force is proposing that a Diocesan Spiritual Care Ministry be created which is both diocesan and regional in scope. It believes this can be achieved by establishing a Diocesan Spiritual Care Ministry Council that will have responsibility for identifying and recruiting Clergy and lay spiritual care visitors (gather); educating and (in cooperation with the Bishop) certifying them (transform); and commissioning them (send) for ministry in the hospitals throughout the diocese. A significant amount of spiritual care ministry happens in many parishes in our diocese. Building on the strengths of parish spiritual care ministry discovered by the Hospital Chaplaincy Task Force Parish Survey and January Consultation, the recommended Diocesan Spiritual Care Ministry model is based in regional deaneries and is based on a combination of lay Spiritual Care Visitors and clergy Spiritual Care Practitioners. There are at least five models of hospital chaplaincy at work in the Diocese. While there are parishes who visit hospitals, many others visit residential care facilities, extended care facilities and some visit correctional centres. Some parishes are involved in an ecumenical relationship that funds chaplaincy. This report makes recommendation solely for the ministry in hospitals. In the Hospital Chaplaincy Task Force s research and literature review, we discovered the Ministry of Health s new policy framework for spiritual care in the health care system and the Canadian Spiritual Care Association s work on competencies and ethics. Their work has informed our approach to nomenclature in this report and the need for a program of training for both clergy and lay volunteers who are recruited into this ministry. The Task Force learned that Spiritual Care Visitors and Practitioners need to provide pastoral care to patients, certainly; but, there is a significant need to also care for the families of patients and staff in institutions. This report identifies the need to establish an Anglican spiritual care training program and expects that clergy and lay spiritual care visitors will be required to complete the screening in faith, police checks and anti-racism training before certification by the Bishop. This educational component and administrative requirement is one of the tasks of the Diocesan Spiritual Care Ministry Council outlined in the following pages. Start up funding for this new program is required for its establishment and the development of the educational materials. The only anticipated ongoing costs are for ongoing training, certification, gatherings of the spiritual care visitors, etc. These are anticipated to be part of the job description for the part-time Diocesan Spiritual Care Coordinator which is seen as an ongoing expense. 2 P a g e
RECOMMENDATIONS The Hospital Chaplaincy Task Force makes the following recommendations to the Standing Committee on Mission & Ministry Development of the Diocese of New Westminster: 1. That there be established a Diocesan Spiritual Care Ministry that is built around a partnership between the Diocese and the eleven (11) regional deaneries as described below. 2. That Diocesan Council, with the Bishop s consent, establish the Diocesan Spiritual Care Ministry, and on the Bishop s recommendation, appoint a Diocesan Spiritual Care Ministry Council (DSCMC). 3. That funding be found within diocesan resources or trust funds or through tuition fees for the development of an Anglican spiritual care training program, and that lay Spiritual Care Visitors be required to achieve this level of competency before certification is granted by the Bishop. 4. That the DSCMC partner with Vancouver School of Theology or the Canadian Association of Spiritual Care to develop this Anglican spiritual care training program. 5. Where Clergy do not have the first unit of CPE or equivalency, and they wish to be part of the Diocesan Spiritual Care Ministry, HCTF recommends that funds should be found to make this possible from diocesan resources or trust funds and from the parish and regional deanery where the clergy is resident. 6. That individuals, both clergy and lay, who participate in this Diocesan Spiritual Care Ministry be required to comply with Screening in Faith, Sexual Misconduct and Anti-Racism training policies, with full police record and vulnerable sector checks being required; and it further recommends that Spiritual Care Visitors who are selected by the DSCMC to participate in this Diocesan Spiritual Care Ministry be licensed annually by the Bishop; and it further recommends that these Screening in Faith policies be updated to include these ministry positions. 7. That the DSCMC work with the Health Authorities to educate their health care staff about the benefits of spiritual care and the role and work of spiritual care workers. 8. That the DSCMC establish criteria for selection of spiritual care workers and be responsible for the recruitment of suitable candidates for this Diocesan Spiritual Care Ministry and the establishment of an interview and selection process for the candidates. 9. That the DSCMC establish a budget to include the creation of a Training program/curriculum development, the paid half-time position of Diocesan Spiritual Care Coordinator to support the Council in its work, and a budget for annual expenses of the program. 10. That job descriptions be developed for clergy and lay Spiritual Care Visitors that will include competencies similar to those established by Canadian Association of Spiritual Care (see Appendix I & II). 11. That in addition to the sources of funding recommended above, that the Diocese establish this Diocesan Spiritual Care Ministry as a priority for funding requests through annual gifts of money from individual Anglicans, parishes, grants from appropriate foundations, and ecumenical and health authority partnerships. 12. That the Diocesan Spiritual Care Ministry be implemented in 2017 after the DSCMC has been established and done its initial work of organization, recruitment and training. 3 P a g e
Chapter 2 : Scope and Methods The scope or mandate refers to the terms of Reference for the Hospital Chaplaincy Task Force (HCTF) which comes from the Standing Committee on Mission & Ministry Development (MMD) of the Diocese of New Westminster. HCTF s task is to investigate whether hospital chaplaincy is considered by parishes and the diocese to be urgent and important, and to identify particular hospitals and other health care facilities where chaplains are needed. If HCTF determines that there is an urgent need, it is to create and recommend to MMD an annual budget for Hospital Chaplaincy Ministry that includes: (1) Remuneration, for hospital chaplains; (2) an education framework, such as Clinical Pastoral Education (CPE) training of hospital Chaplains, volunteers, and parish-based clergy; (3) a method for coordination of the work, by defining and recommending to MMD how the coordination of the ministry might be integrated into the administrative framework of the Diocese; (4) sources of funding, by recommending ways in which this ministry could be funded from the Diocesan budget beginning in 2018; and (5) Gift-Raising, by identifying potential sources of funding for Hospital Chaplaincy Ministry from: Individual Anglicans, Parishes, Diocese of New Westminster, Ecumenical partners, and other sources such as Health Authorities, and the Provincial Government. Other Terms of Reference are: (6) To assist the Diocese in extending the funding of the current part-time Hospital Chaplain Ministry (The Rev. Liz Hamel) by St. John Shaughnessy that ended at the end of 2015, and (7) To coordinate its work with the Diocesan Assessment Task Force. The membership of the HCTF included The Rev. Louie Engnan, (St. Michael Surrey), Ms. Louise Hadley (St. John Shaughnessy), Mr. Glen Mitchell (Diocese of New Westminster, HCTF Chairperson), The Rev. Paul Richards (Holy Trinity White Rock), The Rev. Christine Rowe (St. Mary Kerrisdale) and Dr. Rod Underell (St. Matthew Abbotsford). HCTF s work began when it was founded in October 2015. Its report is expected by March 1, 2016. The HCTF has focused on research into the ways and means of hospital chaplaincy by conducting a parish survey, a diocesan-wide parish facilitated consultation, interviews with Spiritual Care Leaders in health authorities, online research, and the receipt of correspondence from individuals who have worked in this ministry throughout the diocese. Members have discovered and read a significant number of relevant documents and some of these are referenced in the appendix of this report. In addition, the HCTF held twelve meetings between October 14 th, 2015 and March 7 th, 2016 to do its work. With this report, the Hospital Chaplaincy Task Force concludes its work. In doing so, the members of the Task Force wish to offer their thanks to all those who contributed to our work and who made this report possible. These include parish clergy and others who completed surveys, participants in the January consultation, individuals who wrote emails or commented in conversations, health authority employees who offered expertise and/or documentation and diocesan staff members who were very helpful. 4 P a g e
Chapter 3 : Responsibilities, Principles & Standards ANGLICAN CARE OF THE SICK From The Baptismal Covenant (BAS p.159): Celebrant: People: Will you seek and serve Christ in all persons, loving your neighbour as yourself? I will, with God s help. Blessed be the God and Father of our Lord Jesus Christ, the Father of mercies and the God of all consolation, who consoles us in all our affliction, so that we may be able to console those who are in any affliction with the consolation with which we ourselves are consoled by God. 2 Corinthians 1:3-4 Anglicans respond to human need by loving service (third Mark of Mission) and our responsibility for the sick is based on Jesus constant concern and care for the sick. In the Epistle of James, the sick call for the elders of the Church to pray over them and anoint them with oil in the name of the Lord. From the early days of the Church, the worship leaders would go to the sick who were unable to attend worship; Justin Martyr spoke of the early Christian practice of taking communion to those absent from the Christian community. But a Samaritan while travelling came near him; and when he saw him, he was moved with pity. He went to him and bandaged his wounds, having poured oil and wine on them. Then he put him on his own animal, brought him to an inn, and took care of him. Luke 10:33-34 The Book of Alternative Services names two important principles of this ministry and care of the sick. First, we are to provide it so that the sick are not reliant on the faith-healers and wonder-workers about; second, this ministry is an extension of the Church s basic act of worship, the Eucharist, where we celebrate the community of wholeness with the sick, and the Trinitarian God in whom we believe. This rite, Ministry to the Sick, is the work of the Clergy and the Laity as set out in the Book of Alternative Services (p.551-558). The full rite is based in shape and pattern on the Church s Sunday liturgy and consists of reading and proclaiming of the word; intercessory prayer, culminating in prayer for the sick person with actions of touching and anointing; and the sharing of holy communion. Come to me, all you that are weary and are carrying heavy burdens, and I will give you rest. Take my yoke upon you, and learn from me; for I am gentle and humble in heart, and you will find rest for your souls. For my yoke is easy, and my burden is light. Matthew 11:28-30 5 P a g e
PRINCIPLES & STANDARDS IN THE HEALTH CARE SYSTEM There are three substantive sources of documentation which set out the principles and standards sought in the British Columbia health care system. One is the provincial government s Ministry of Health which, in 2012, issued a report, Spiritual Health: A Framework for British Columbia s Spiritual Health Professionals. A second source is the Canadian Association of Spiritual Care which describes itself as a national multi-faith organization dedicated to the professional education, certification and support of people involved in pastoral care and pastoral counselling. A third source is the well-developed program of Clinical Pastoral Education (CPE) that has several educators in the diocesan area who have been interviewed by the HCTF members. The Spiritual Health: A Framework for British Columbia s Spiritual Health Professionals (Appendix II) is a significant document that sets out the policy framework for spiritual care in British Columbia s health care facilities. It defines spiritual health care as an aspect of health care that focuses on addressing spiritual and religious needs that arise in response to an illness or injury. Spiritual health care is also applicable in situations involving upheaval, moral distress and natural disaster. Spiritual health professionals operate throughout the continuum of care, in such places as acute care hospitals, palliative units and residential care homes. They tend to the multicultural and multifaith needs of BC s pluralistic population, as well as liaising with local communities and building rapport with their local faith leaders. The report describes the current spiritual health infrastructure as inconsistent throughout the province with qualifications and staff complements varying considerably. Some acute care facilities require a master s degree and clinically certified specialists, while others employ local clergy with no clinical training or spiritual health education. In most areas, SHPs utilize volunteers or visitors from local denominational and faith groups to augment services with faith-specific care. The report sets out specific nomenclature for spiritual health professionals (Practitioners, Leaders and Clinical Educators) and Visitors which are from spiritual, religious and cultural groups. The Canadian Association of Spiritual Care (www.spiritualcare.ca) describes itself as a national multifaith organization committed to the professional education, certification and support of people involved in pastoral care and pastoral counselling. It provides educational programs for lay persons and clergy who are preparing to become chaplains, pastoral counsellors, ministers, priests, or community based pastoral care workers. It has established a Code of Ethics and Professional Conduct, (Appendix I) and Competencies for Spiritual Care (Appendix III) that are rich documents that the HCTF has drawn on in its thinking. Readers are asked to refer to these appendices for a fuller understanding of the ethics and competencies involved in spiritual care work. CPE courses are offered through both Providence Health Authority (St. Paul s Hospital) and Vancouver Coastal Health Authority (Vancouver General Hospital). In both cases, the Vancouver School of Theology serves as the institution for registration and academic credits. Both programs are approved by the Canadian Association of Spiritual Care. Learning occurs through direct experience, use of reflective tools, didactic sessions, dialogue around cases in an interfaith peer group, as well as individual supervision. 6 P a g e
Chapter 4 : Background Research The population in Metro Vancouver and the Diocese of New Westminster is an aging one. In part, this is because the large cohort of baby boomers is reaching retirement age; this region is also a popular place to retire. In addition, our region hosts three major highly-specialized hospitals (VGH, St. Paul s and Royal Columbian) and two provincial hospitals (BC Children s and Women s) that serve patients from the entire civil Province of British Columbia. Thus, spiritual care needs are increasing and thus, there is an increasing need for this form of pastoral ministry. There are twenty-eight (28) hospitals in the diocesan geographic area and many more care and residential facilities that have primarily seniors populations. 1 PARISH RESEARCH HCTF conducted a Parish Survey that identified a significant body of work conducted by parishes in hospitals and other chaplaincy efforts. The survey was answered by 32 parishes (49%) who are all actively engaged in hospital and other forms of chaplaincy work. 2 Parishes who did not respond may also be engaged in this work. The HCTF is very encouraged by the number of lay volunteers involved in spiritual care work: 23 parishes have lay volunteers and 9 do not. Lay involvement ranged from a low of 1 to as many as 15 and the total number of lay volunteers identified is 123 in these 23 parishes. 21 parishes reported having trained lay volunteers although the survey did not ask for elaboration on the meaning of training. Lay volunteers contribute from 1 to 20 hours per month and seem to work about 4-6 hours per month on average. The richness of this resource is one rationale for the regional/lay/clergy model of spiritual care proposed below. 2 parishes, ecumenically, share the costs of a part or full-time chaplain and don t directly visit hospitals referred to below in more detail in the chapter (5) on Organizational Models. Clergy (priests and deacons) have a wide range of hours; they reported as low as 1% of their time to as much as 60% working in hospital chaplaincy; although most clergy report spending between 5-10% of their working time. Eleven parishes have a second clergy person whose visits range from 1 to 50% of working time. Three parishes reported having a third clergy person who also visits, ranging from 5-15% of working time. DIOCESAN-WIDE CONSULTATION On January 23 rd, 2016, twenty-five individuals attended a diocesan-wide facilitated consultation on hospital chaplaincy at the Diocesan Centre in Vancouver. Attendees learned about the terms of reference of the HCTF and the results of the parish survey work; they heard a talk about spiritual care by Spiritual Care Practitioner and Leader, Dr. Philip Crowell, the spiritual care team leader at BC Children s Hospital and BC Women s Hospitals & Health Centre. Participants contributed their ideas towards a framework for a diocesan-based spiritual care program. Several important themes evolved from this planning work. To be effective a diocesan-wide spiritual 1 Chaplaincy is not restricted to health care facilities as there are 13 correctional centres, at least a dozen public post-secondary institutions and the Mission to Seafarers operates two centres in the region. 2 28 visit senior care homes, 24 visit Extended Care Facilities and 6 parishes spend time at Correctional Centres. Other sites visited by spiritual care teams in parishes include hospices, hotels, hostels, homes, assisted living and aging in place residences. 7 P a g e
care program needs to be regional in nature, based in Regional Deaneries or Archdeaconries so that the delivery of pastoral care is distributed, close to those in need. People who work in this program, both lay and clergy, need to be recruited and trained to care for patients, their families and the staff of the institutions served. There needs to be a partnership with institutions and other denominations. Training of institutional staff about the importance of pastoral/spiritual care is seen as important; and there needs to be strong and effective communications between the regional team and the institution. There is a need for patients to have access to sacraments, prayer and the clergy are to have a presence in these institutions. Spiritual care is characterized as a ministry that is interdisciplinary and holistic. Finally, there is a need for financial support to establish the regional system, the training of people, and then maintaining it into the future. HEALTH AUTHORITIES The British Columbia health care system is organized into regions called health authorities (HA). Within the Diocese of New Westminster boundaries there are five of the seven health authorities found in the province. These include the newest health authority, First Nations HA (http://www.fnha.ca/) that has responsibility for providing indigenous health care. Its mandate is province wide. It upholds traditional and holistic approaches to health and self-care and strives to achieve a balance in mental, spiritual, emotional, and physical wellness. In the future the HCTF suggests that the regional model proposed below will need to establish a broader relationship with the First Nations HA and the Indigenous Justice Ministry of the Diocese. Fraser HA (http://www.fraserhealth.ca/) includes a major trauma centre (Royal Columbian Hospital) and several other significant hospitals in Surrey, Delta, Langley, Abbotsford, Chilliwack, Maple Ridge, Mission and Coquitlam. It has recently re-established a Spiritual Care Department after having eliminated this program in 2010. Providence HA (http://www.providencehealthcare.org/) is responsible for the Roman Catholic hospitals in the City of Vancouver and has a well-established spiritual care program and teaches CPE for which Vancouver School of Theology grants credit. The Archdiocese of Vancouver employees two full time Roman Catholic priests at St. Paul s Hospital to serve the spiritual care needs of patients. Provincial HA (http://www.phsa.ca/) has a province-wide mandate and includes BC Children s and Women s Hospitals, and the several cancer-related agencies and facilities. There is a well respected spiritual care team at BC Children s and Women s Hospitals. At Vancouver Coastal HA (http://www.vch.ca/) the major trauma hospital is Vancouver General and its region includes hospitals on the North Shore, UBC, Richmond, Squamish and the Sunshine Coast. It has a long-standing spiritual care program and teaches CPE for which Vancouver School of Theology grants credit. In addition to these hospital facilities, the health authorities also operate extensive extended care and residential care facilities within the diocesan boundaries (except for Provincial HA). 8 P a g e
Chapter 5 : Organizational Model This chapter recommends a model for implementing a diocesan-wide spiritual care ministry developed by the HCTF following consultation with the diocesan family and the appropriate provincial health authorities. Because the HCTF heard that this ministry is important to a wide variety of parishes, both large and small and geographically diverse, it believes there is significant diocesan energy and will for, and to do, this work. The model builds on the strengths that exist in the diocese parishes now, and creates a way to live out our Baptismal Covenant and our Christian responsibility to care for those in need the sick, their families and the staff of institutions. This will be accomplished by formalizing and regionalizing the parish model reported in the parish survey above, and providing it with a supportive structure at the Diocesan level. The benefits of this model include building on existing parish strengths. It creates a regional model which builds relationships across parishes and provides spiritual care ministry in a more holistic way to the region s hospitals. This spiritual care ministry is more intentional and creates a model of discipleship for individual lay people who are called to this work. With further training and proper screening of participants, the level of delivered expertize in spiritual care will also increase and more effectively ensure that the ministry is protected from ill-prepared caregivers. Currently, only three identified institutions (VGH, Langley and Chilliwack) have formal part-time service. The new model will significantly increase service for the Anglican patient community, their families and the staff of institutions. Diocesan-wide leadership is needed to make the recommended model work. This work is described below, followed by a full description of the model itself. It is important to say that there are forms of existing pastoral ministry throughout the Diocese that can be continued and not required to cease their work because a new model is established. Those identified by the HCTF are described below in the Current Chaplain Models section with our comments. For this regional model to work the Diocese will need to appoint a Diocesan Spiritual Care Ministry Council (DSCMC) consisting of people with expertise and experience in spiritual care ministry. The Council will have the following responsibilities: in partnership with the Bishop, using the well-known model of ministry called Gather-Transform-Send, it will identify and recruit Clergy and lay spiritual care visitors (gather); educate and certify them (transform); and commission them (send) into the hospitals throughout the diocese to do this work. DSCMC will have oversight over the system, a coordinating role, and organize regular evaluation. Its membership needs to be representative of the regional nature of the model itself. A significant role for the Diocese will be to work with the DSCMC to coordinate and seek agreement with/from health authorities about the potential effectiveness of this model. A further role of the Diocese is to certify people who have been trained for this work as described on page 551 of the Book of Alternative Services ( it is sufficient that the [lay] minister be authorized (by the diocesan bishop) to undertake this ministry). Finally, the Diocese needs to work with the Council to find the resources to establish the model, develop training and evaluative resources, and provide for the administration requirements of the Council s work. 9 P a g e
The HCTF recommends this Diocesan Spiritual Care Ministry model be built as a partnership between the Diocese and the eleven (11) regional deaneries. Each would have certain accountabilities and responsibilities as outlined here. The Regional Deanery Spiritual Care Ministry team consists of at least two Clergy with at least one unit of CPE or equivalency and a number of lay Spiritual Care Visitors who have been trained and certified after participating successfully in the Anglican spiritual care training program. Clergy and lay Spiritual 10 P a g e
Care Visitors are assigned one or more health care institutions 3 that are within the regional deanery boundaries. See the list supplied below. The clergy and lay persons are licensed by the Bishop, in a similar way to Eucharistic Ministers however they will be required to have more formal training in spiritual and pastoral care. This model requires that there be a volunteer Spiritual Care Coordinator position established in each deanery. This person will be responsible for coordinating the spiritual care team activities based on the needs identified by the hospital involved with its region. The diocesan responsibilities and accountabilities in this model are several. HCTF recommends that Diocesan Council, with the Bishop s consent, establish the Diocesan Spiritual Care Ministry, and upon the Bishop s recommendation, appoint a Diocesan Spiritual Care Ministry Council that will be comprised of clergy and lay people who have expertise in spiritual care. This Council will have the responsibility and accountability to establish a partnership between the Diocesan Spiritual Care Ministry and the health authorities regarding hospitals. The Council will establish the regional deanery aspect of this ministry, create the Anglican spiritual care training program, recruit clergy and lay Spiritual Care Visitors, write job descriptions, offer regular Anglican spiritual care training program seminars, arrange with the Bishop for certification of successful applicants, approve regional deanery ministry work plans and conduct regular evaluations. The HCTF recommends that the Diocese establish the paid part-time position of Diocesan Spiritual Care Coordinator to support the DSCMC in completing its work. HOSPITALS/HAs SITUATED IN DEANERIES 1. Golden Ears: Mission Memorial Hospital, Ridge Meadows Hospital, in Fraser HA 2. Granville: Vancouver General Hospital in Vancouver Coastal HA; BC Children s Hospital and Sunny Hill Health Centre for Children, BC Women s Hospital and Health Centre, BC Cancer Agency (and related services), in Provincial HA 3. Kingsway: St. Paul s Hospital, Mount St. Joseph Hospital, Holy Family Hospital, in Providence HA; 4. North Vancouver: Lion s Gate Hospital, in Vancouver Coastal HA 5. Peace Arch: Surrey Memorial Hospital, Jim Pattison Outpatient Care and Surgery Centre [satellite of Surrey Memorial Hospital], Peace Arch Hospital, in Fraser HA 6. Point Grey: UBC Hospital in Vancouver Coastal HA 7. Richmond & Delta: Richmond Hospital in Vancouver Coastal HA; Delta Hospital, in Fraser HA 8. Royal City & South Burnaby: Royal Columbian Hospital, in Fraser HA 9. Sea to Sky: Squamish General Hospital, Sechelt Hospital, Gibsons Health Unit, Powell River General Hospital, Whistler Health Care Centre, in Vancouver Coastal HA 10. Tri-Cities & North Burnaby: Burnaby Hospital and Eagle Ridge Hospital [while Eagle Ridge is a satellite of Royal Columbian Hospital, we have suggested spiritual care needs at Eagle Ridge be met by the Deanery in which it is located], in Fraser HA 11. Valley: Chilliwack General Hospital, Abbotsford Regional Hospital and Cancer Centre, Langley Memorial Hospital, Fraser Canyon Hospital (Hope), in Fraser HA 3 Hospitals at first, but the DSCMC may ultimately include facilities devoted to hospice and residential care facilities and correctional centres as the ministry has capacity in the future. 11 P a g e
CURRENT CHAPLAIN MODELS The HCTF has identified five functioning models of hospital chaplaincy within the diocese. These are described below. 1. Parish Model: The parish survey describes this model in detail in Chapter 4 above. Rectors and other clergy, supported by lay volunteers, conduct hospital visits (and a variety of other locations). Some lay volunteers are trained. This model is the basis of the HCTF s recommendations in this report. 2. Part-time Model: The Rev. Liz Hamel is employed part-time as a Hospital Chaplain at Vancouver General Hospital. The funds for this work, in the past, have come from the Parish of St. George Vancouver and St. John Shaughnessy. Currently, in 2016, funding is provided by the Anglican Church Women and parishes on Vancouver s west side. The HCTF suggests that this model continue until the proposed model is established and at work. In the future, the spiritual care model at VGH could be folded into the broader Diocesan Spiritual Care model proposed in this report. 3. Langley & Chilliwack Model: At these hospitals, funding is provided by a partnership among ecumenical congregations. In Langley, in partnership with Fraser HA and the Langley Memorial Hospital Foundation, a Spiritual Care Practitioner works part-time (6 days a month). There is a Spiritual Care Advisory Committee comprised of representatives of the funding churches (including St. Andrew Langley) that raise the salary and Fraser HA pays the benefits. Chilliwack has a full-time hospital chaplain which is funded by a coalition of near-by ecumenical churches including St. Thomas Chilliwack. HCTF imagines that this model will continue and it also imagines there may be room for Anglican Spiritual Care Visitors to add to the work of the current practitioner. 4. BCC/WH Model: At BC Children s and Women s Hospitals, The Ven. John Stephens, Archdeacon for Vancouver, is on call one weekend per month to supplement the existing staff structure at BCC/WH. This model can continue, but as above, it could benefit from the addition of Anglican Spiritual Care Visitors when the diocesan/regional ministry is established. 5. Lion s Gate Model: Lions Gate Hospital and North Shore Hospice serves the north shore and wider. There is a full time spiritual care chaplain, who works closely with the local Christian denominations, other faith leaders and First Nations leaders to care for patients, families and staff. There is a weekly Eucharist in the Chapel, supported by lay Anglicans and led mostly by Anglican ministers from the local churches. Some local ministers are "on call" to support the Chaplain as appropriate. There are volunteer visitors who work with the Chaplain. 12 P a g e
Chapter 6 : Educational Needs Clinical Pastoral Education (CPE) is defined in the Ministry of Health Spiritual Care Framework (MOHSF) document as the branch of Supervised Pastoral Education (SPE) intended to help learners achieve and consistently demonstrate the competencies required to provide spiritual care in a multi-faith context. It is an experience-based approach to learning which combines the practice of care with peer group reflection under the leadership of a qualified teaching supervisor. It is a form of education which is based in clinical practice. In BC, anyone who takes CPE at an approved centre receives graduate-level credit through the Vancouver School of Theology. At Providence Healthcare Authority CPE is training designed to help develop the skills required to provide care which is centered around issues of faith, meaning, values and connection. While the HCTF does not recommend that all lay Diocesan Spiritual Care Visitors be required to study CPE, some level of education is required by lay persons in the model proposed. It recommends that funding be found for the development of an Anglican spiritual care training program, and that lay Spiritual Care Visitors be required to achieve this level of competency before certification as a Diocesan Spiritual Care Visitor is granted by the Bishop. HCTF suggests that this funding should include tuition fee payments from lay volunteers as a demonstration of their commitment to this pastoral ministry. HCTF recommends that the Diocesan Spiritual Care Ministry Council (DSCMC) work in partnership with Vancouver School of Theology or the Canadian Association of Spiritual Care to develop this Anglican spiritual care training program. These lay Diocesan Spiritual Care Visitors will continue to be classified as visitors in the Ministry of Health Spiritual Framework (MOHSF) system which means they can only visit patients who are Anglicans. Clergy who are recruited to the Diocesan Spiritual Care Ministry should have at least one unit of CPE or equivalency or in pursuit of this education. Once completed, they would be recognized by MOHSF as Spiritual Health Practitioners which would mean they could visit any patient in an institution. While this may seem unlikely in the normal course of events, the HCTF has heard testimony demonstrating that this is sometimes the case. For example, at the January Consultation the need for presence by clergy was deemed very important to demonstrate our Anglican commitment to this work and to provide an option for the sick or family or staff who are in need of urgent spiritual care by a clergy person. Where Clergy do not have the first unit of CPE or equivalency, and they wish to be part of the Diocesan Spiritual Care Ministry, HCTF recommends that funds should be found to make this possible. For clergy, this needs to be considered a form of diocesan ministry and they should have the moral and financial support of their parish wardens and council for this work. The HCTF recommends that job descriptions be developed for clergy and lay Spiritual Care Visitors and Practitioners that include competencies similar to those established by Canadian Association of Spiritual Care (CASC) (see Appendix I & II). These include self-awareness, spiritual and personal development, multi-dimensional communication, documentation and charting, brokering diversity, ethical behaviour, collaboration and partnerships, leadership and research. In addition, further competencies that should be required include an understanding of First Nations and the needs of other cultures, demonstrated openness towards ecumenical and inter-faith relationships, 13 P a g e
and an understanding of the pastoral care needs of health care workers. These job descriptions would also be framed in core relational values including respect, empathy, faith affirmation, connection and vitality. Key core practice values will also form part of the ideal job description including competence, ethical-conduct, self-care, responsibility and accountability. Many who will be served, patient, family, staff, will be in a vulnerable place because of their physical or emotional distress. HCTF therefore recommends that individuals, both clergy and lay, who participate in this Diocesan Spiritual Care Ministry be required to comply with Screening in Faith, Sexual Misconduct and Anti-Racism training policies, with full police record and vulnerable sector checks. HCTF further recommends that these Screening in Faith policies be updated to include these ministry positions. Because HCTF has discerned that individuals need to have the proper orientation towards this ministry, it recommends that the Diocesan Spiritual Care Ministry Council establish criteria for selection of spiritual care workers and be responsible for the recruitment of suitable candidates for this Diocesan Spiritual Care Ministry and the establishment of an interview and selection process for the candidates. HCTF recommends that the Diocesan Spiritual Care Ministry Council work with the Health Authorities to educate their health care staff about the benefits of spiritual care and the role and work of spiritual care workers. This will help health care staff understand when spiritual care might be needed. 14 P a g e
Chapter 7 : Glossary Aging in Place: Where an older person continues to live in their home for as long as they are able; and they may have services and support to enable this. Assisted Living: Seniors live independently in institutional facilities that help with some of the needs of daily living such as meals and cleaning. Clinical Pastoral Education: is interfaith professional education intended to assist clergy, candidates for ministry, lay volunteers, and spiritual care workers to develop a spiritual care identity as well as appropriate skills in the delivery of spiritual care. Residential Care: Where an older person lives in an institutional residence that provides meals and full care, rather than living in their own home Spiritual Care: Spiritual care providers are often intimately involved within the wider framework of the health care team and the family of the patient. Though spiritual care involves prayer and sacrament, it is even more about sharing a journey, both with the patient and with the family, in which deep listening fosters reflective openness - emotionally, morally, spiritually and intellectually. Spiritual care is always about inviting and attending to the patient s own narrative and reflections, and always carries with it an element of conversational moral and ethical discernment. In all of this, we are called to walk together, listening and talking, without being prescriptive, but enabling patients and families to make the best decisions they can within the context in which they are living, and within the best possible support systems. 4 Spiritual Health Care: an aspect of health care that focuses on addressing spiritual and religious needs that arise in response to an illness or injury; it is also applicable in situations involving upheaval, moral distress and natural disaster. Trauma: an injury to living tissue, often serious and/or a disordered psychic or behavioral state resulting from severe mental, emotional stress or physical injury. 4 The Anglican Church of Canada, February 3, 2016, in a submission to Canada s Special Joint Committee on Physician Assisted Dying, page 3. 15 P a g e
Chapter 8 : Appendices Documents referred to in the report s chapters that are important to the background rationale of the recommendations. For example, these useful documents are attached as appendices to the report. I. CASC Code of Ethics II. Spiritual Care Framework III. CASC Competencies for Spiritual Care IV. VGH Memorandum of Understanding re denominations V. Revised CPE Brochures, Providence Health Care VI. Position Descriptions, VGH Hospital Chaplain and two from Fraser Health Authority 16 P a g e
17 P a g e HOSPITAL CHAPLAINCY TASK FORCE REPORT