Home & Community Care Medical Supplies & Equipment Needs/Gaps

1. Home & Community Care Medical Supplies & Equipment Needs/Gaps Gail Gallagher (AFN) & Jeroline Smith/ Eunice Woodhouse (MB.) January 31st 2007

2. Background • FNIHCCP became fully operational during the 2001 - 2002 fiscal year with a $90 million budget yearly. • According to the RMAF the overall vision of the Program is: “The FNIHCCP will provide basic home and community care services that are comprehensive, culturally sensitive, accessible, effective and equitable to that of other Canadians and which respond to the unique health and social needs of FN/I”.

3. Background (cont’d) • The program, is a coordinated system of home and community based health related services, which enable people with disabilities, chronic or acute illnesses and the elderly to receive the care they need in their home communities”

4. Background (cont’d) • The First Nations and Inuit Home and Community Care Program (FNIHCC) developed an evaluation strategy to see if the program was meeting the needs of the communities and was cost effective. • To date, Study #1 & #2 have been completed on the program, and # 3 is currently in the process of an Request for Proposals.

5. Background (cont’d) • Study # 1 determined “in many communities there are now at least basic services in place” . Currently, 96 % of FN/I communities are currently receiving home care services. • Study # 2 revealed there has been considerable progress made in addressing the home and community care needs of First Nations and Inuit communities. However, there is general agreement that there are still some needs that are not being met.

6. Background (cont’d) • People want access to long term care in their own communities that is culturally appropriate and geared towards First Nations and Inuit perspectives and ways of life. • The demand for services to address home care needs exceeds the capacity of the program. • The issues are complex and multi-dimensional.

7. Challenges/Barriers • Basic needs and cost of medical supplies/equipment are not being met. i.e. Home care program has to purchase their own latex gloves/face masks. • Limitations exist in certain basic home care supplies i.e. An approval process has to be followed when ordering certain supplies. • HR needs ie. For annual leave, etc. • High turn over, burn out and stress. • Gaps in communication between different programs because there is no access to patients records.

8. Challenges/Barriers (cont’d) • Sustainability of the home care program. • More demand on the home care program. Ie. Mental issues, special circumstances/issues. • Small and remote communities needs ie. Client that has to travel 6 hours for dialysis services, (3 x a week). • Specialized services are required in these FN communities.

9. In Comparison… • FN Public Health (MB.) uses the blue card system that replenishes basic medical supplies at no cost to the community’s budget. • Versus HCC program that must use budget dollars to purchase their basic medical supply needs. Plus, requires a prior prescription approval process.

10. NIHB Supplies • HCC Pilot sites – 2 regions: Alberta & Atlantic 2003. • The FNIHCCP Framework requires that we be at least on par with the provinces as a minimum standard; currently as things are now with HCC supplies, this is not the case.

11. NIHB Supplies (cont’d) • HCC program does not have a prior approved medical supplies/equipment list. • Daily basic medical supplies are required to meet home care delivery needs and they have too many steps for approval, (if approved at all). I.e. Masks & gowns.

12. NIHB Supplies - Advantages • Having a stock of inventory would decrease the wait time for prescription approval. • The nurse could order supplies without having to go through the physician.

13. NIHB Supplies - Disadvantages • Poor accessibility to medical supply products. • Time consuming paperwork that is redundant because NIHB is doing the same paperwork all over again. We need to streamline needs. • If supplies are more local, then delivery would be quicker (i.e. NIHB warehouse is in Edmonton, Alberta).

14. Recommendations: • 1.)FNIHCC program to have the supplies/equipment available on site. i.e. Blue Card system available to FN public health programs (but not home care programs). • 2.) RNs/HC Nurses be given the transfer of function to order supplies. • 3.) Look at an escalator clause for funding.

15. CONCLUSION: • These medical supply/equipment needs are critical to the enhancement of the home care service delivery for the client’s well being. • Home and Community care programs promote high standards of care by following best practices.

16. MEGWETCH! QUESTIONS????