SIXTH CONFERENCE ON ACCESSIBILITY OF HEALTH AND SOCIAL SERVICES IN THE ENGLISH LANGUAGE

1. SIXTH CONFERENCE ON ACCESSIBILITY OF HEALTH AND SOCIAL SERVICES IN THE ENGLISH LANGUAGE “BUILDING LINKS” A conference of community resources and public partners seeking strategies and models to promote the health and well-being of English-speaking communities in the new reality of Quebec’s health and social services network February 22 and 23, 2006

2. Workshop II Matisse – 7th Floor “SPECIAL INSTITUTIONAL MANDATES IN MONTREAL: WHERE DO THEY FIT WITH THE NEW BOX ON THE BLOCK?” Animator: John Walker, CHSSN Panellists: Michael Udy, Ghislaine Prata, Carole McDonough, Dr. Wendy Thomson, Christine Boyle, Gary Whittaker Representatives of the community’s historical institutions providing second-line specialized services to youth, the intellectually and physically handicapped will discuss the implication of the creation of the new health and social services centres in Montreal. CHSLD Father Dowd, St. Andrew, St. Margaret will address its regional mandate for long-term care for English-speakers. What are the stakes for our institutions in the creation of new health and social services centres in Montreal? How will services be coordinated between first and second line, or across new CSSS territories? Issues of mechanisms of transfers, territorial mandates and relations with community resources will be explored. Also, the question of out-of-region services will be addressed.

3. Carole McDonough, M.A. Executive Director St. Andrew’s, Father Dowd and St.Margaret’s Homes

4. Who are we? CHSLD St. Andrew, Father Dowd and St. Margaret Homes Our three long-term facilities provide a very broad range of personal care, support and health services to people who have limitations that prevent them from participating in every day activities. The people who use long-term care services are usually the elderly, people with disabilities, and people who have a chronic or prolonged illness. There is a total of 300 beds in our three homes. We also have a 33-bed Family Residence Program and a Day program at St. Margaret’s for 110 participants. Together, our three homes have provided some 300 years of quality care to Montrealers. Father Dowd opened its doors way back in 1865; St. Margaret’s opened in 1882 and St. Andrew’s in 1961.

5. Our mandate Since 1992, the homes have been operating under a unified board, comprised primarily of volunteers from the community with the legal mandate to provide services to the English-speaking population (in accordance with Access to Services to the English-speaking population, Régie régionale de Montréal-Centre, 1993). In June 2004, Quebec’s Ministry of Health and Social Services exempted our homes from the round of health-care agency mergers (leading to the creation of the CSSSs). We were given an expanded supra-regional status to serve the English-speaking community of Montreal and surrounding region. The integration into a single legal and administrative unit, effective January 1, 2006, represents the logical next step in terms of ensuring that the homes are able to continue playing a crucial role in today’s fast-changing health-care delivery system, while making optimal use of financial and human resources.

6. Our mandate … With the integration of St. Andrew’s, Father Dowd and St. Margaret’s homes into a single, streamlined entity, the legacy agency is well positioned to fulfill its supra-regional mandate to deliver quality long-term care to anglophones in the greater Montreal area. We also are proud of our long-standing tradition of collaboration with Québec’s French-speaking majority. We have continued to build on that legacy of collaboration, as demonstrated by our active participation in the various health and social service reforms throughout the years.

7. Some alarming facts regarding the state of long-term care facilities in Quebec and specifically for the English-speaking population of Montreal • Long-term care facilities throughout Quebec are chronically under-funded. Here in the Montreal area, healthcare officials estimate that CHSLDs can afford to supply only about 75% to 80% of the level of care they are obligated — legally and morally — to provide. This situation is clearly unacceptable. • The shortage of long-term-care beds for English-speaking clientele is significantly worse than the situation faced by the general Quebec population. • Fact: The average waiting period for admission to one of St-Andrew’s, Father Dowd and St-Margaret’s three homes is in excess of 200 days. This is more than three times longer than the norm for other CHSLDs in Montreal (65 days) and Quebec (57.9 days)!

8. The long wait for admission not only puts our clientele at unacceptable — and unnecessary — risk. It also puts even more of a strain on our finances and our overworked staff because, by the time they eventually do gain admission, residents typically need considerably more care then when they applied many months earlier. • Given the demographics of an aging population — particularly in respect to the English-speaking community — it is clear that we have an increasingly vital role to play in the continuum of care that must be recognized and funded accordingly. • In its three-year plan for 1995-1998, the former Montreal Regional Health Board committed to increasing the number of beds in facilities meeting the needs of the English-speaking community by approximately 1,800 from 2,700 beds to 4,500. However, only about 400 new beds were actually delivered. • In 2002, only 3,092 long-term-care beds were available to meet the needs of the English-speaking community — still a long way from the 4,500 promised back in 1995. And there has been little or no improvement since.

9. CATCHMENT AREA Father Dowd St. Andrew’s St. Margaret’s Total (three residences) Family Res. (RTF) Grand Total CSSS de l’Ouest de l’Ile 2.9% 5.1% 3.8% 3.7% 0% 3.5% CSSS de LaSalle et du Vieux Lachine 4.3% 0% 1.3% 2.1% 16.7% 3.0% CSSS Sud-Ouest-Verdun 1.4% 2.6% 8.8% 4.8% 25% 6.0% CSSS Cavendish 24.6% 71.8% 25.0% 34.6% 41.7% 35.0% CSSS de la Montagne 43.5% 20.5% 48.8% 41.0% 0% 38.5% CSSS du Nord de l’Ile et St-Laurent 7.2% 0% 5.0% 4.8% 0% 4.5% CSSS d’Ahuntsic et Mtl Nord 2.9% 0% 1.3% 1.6% 8.3% 2.0% CSSS Petite Patrie et Villeray 2.9% 0% 0% 1.1% 0% 1.0% CSSS Jeanne-Mance 1.4% 0% 2.5% 1.6% 0% 1.5% CSSS de St-Léonard et de St-Michel 2.9% 0% 2.5% 2.1% 0% 2.0% CSSS Lucille-Teasdale 4.3% 0% 1.3% 2.1% 8.3% 2.5% CSSS de la Pointe de l’Ile 1.4% 0% 0% 0.5% 0% 0.5% Out of region 2.3% 0% 7.4% 5.1% 0% 4.8% Catchment area: The chart below presents the catchment area of our clientele based on the twelve newly created entities in Montreal (Annual Report 2004-2005)

10. Statistics 2004-2005 • 63% of the residents in our three institutions come from their homes in the 12 CSSS of Montreal • 24.5% from hospitals (acute care or psychiatric) • 6.4% from other CHSLDs of Montreal • 2.7% from Rehabilitation Centres; • 5% of our residents come from outside Montreal;

11. CSSS (more significantly from): de la Montagne Cavendish Associated CHSLDs AQESSS CH: St. Mary’s, MUHC Rehab: Constance-Lethbridge Agency Networking

12. Partnerships to date…..

13. With CSSSs: • Invitation to participate in CSSSs discussion groups for the development of their «projet clinique» • Ad hoc discussions for exchange of services

14. With associated CHSLDs • Recent disbanding of the «Regroupement des CHSLD » • Comprised of 8 public non-merged CHSLDs in Montreal (with linguistic, cultural and other specificities)

15. With AQESSS • At the provincial level: • a seat on their Board of Directors representing associated CHSLDs in Quebec

16. With AQESSS-Montreal • At the regional level: • a seat on the Board of Directors of AQESSS-Montreal representing associated CHSLDs of Montreal

17. With other health establishments • Previous partnerships continue • Health and medical services • Rehab. • Much more can be developed

18. With the Agency • Decisions made mostly in collaboration with CSSSs with the exclusion of associated CHSLDs: • Future orientation of services for the elderly (PPA) 2005-2010 • Reduction of beds • Access to services for the English-speaking population • Increase admission criteria (with budgetary implication) • Regional admissions • Etc.

19. Feelings of isolation • Bulletin: Direction Réseaux • Recent publication on Partnership (!)

20. Thank you!