Orientation to Pabineau Health Programs & Services
Pabineau First Nation Community Health Center,
1320 Pabineau Falls Road,
Pabineau First Nation, NB E2A 7M3
“Client and family centered care, always caring, always here”
Pabineau First Nation Orientation to First Nation Health Programs &
Pabineau First Nation Health Program Specifics
Our vision, mission and values statement
Vision: “A holistic approach to community wellness focused on the mental, physical, emotional and spiritual well-being of the community members and their families assisting us in building a healthy community”
Mission: “A mutual purpose of creating, maintaining and promoting wellness, culture and respect in a family client centered care facility”
Values: “The Health Center promotes and facilitates Community wellness, culture and resilience in the spirit of family/ client centered care”
Priorities for the 2015-20 Multi Year Work Plan based on community identification
Health Priorities
Social Issues
Diabetes
Self-Neglect
Alcohol & Drug Issues
Smoking
Abuse & Bullying (promoted through Mental health promotion and healing activities)
Lack of Fitness activities
No Nursing home or place of alternate care for seniors
Mental Health
(includes promotion and healing)
Messy yards, garbage and bad roads (addressed through Healthy community activities)
Heart Health (promoted by fitness activities)
Violence / privacy (addressed through Primary Care activities) –
Nutrition – Prevention of Osteoporosis and Obesity (promoted through Diabetes prevention activities)
Getting medication (Addressed through adult care services) –
Chronic Diseases and Self Esteem
Having to ask / beg for necessary help
Emotional and Physical & Spiritual (healing and wellness)
More people using services (through primary care services)
Reproductive Health and Sexual Health Issues
More professionals
Healthy Community, Children and parents
Better promotion of what is available
Communicable Disease prevention & Emergency planning
Relationship between Health Canada (FNIH) and First Nations communities regarding specific proposal interests
FNIHB provides special funding to assist First Nations communities with their specific challenges and to assist in program development that meets their needs.
The process of submitting ‘Expressions of Interest’ is done at the Band level, and FNIHB Program Managers offering the expertise needed in the area of interest (such as health programs offered by FNIHB)are available to answer questions, and provide guidance in the planning phase of a submission.
Once the proposed idea is preapproved by FNIHB, the First Nations Bands are eligible for financial assistance between $ 5,000 and $ 6,000 to develop the proposal.
Health Professionals Working for First Nations
FNIHB provides funding for the health programs, including human resources allotments. Health Canada provides First Nations with an outline of the qualifications that are needed to offer specific services; provide and may participate in the interviews when First Nations hire staff; and suggest bench mark salaries and benefits.
First Nations Band is the employer and signs an agreement with FNIHB to provide the administration and management of the health programs and accompanying human resources. According to FNIHB, the financial contribution by Health Canada is sufficient to provide the services.
First Nations Bands have expressed inadequate funding to provide the health services and that the trained human resources needed is a challenge within the funding allocated by FNIHB.
It has been recommended that the smaller First Nations communities be assured the Equivalent of a full-time community health nurse position. They are often the pivotal person on-reserve that navigates health services to the Health Network or other health and social services.
In Pabineau First Nation the funding to meet this recommendation is not filled.
Appendix B
Summary of Programs offered by the
First Nations and Inuit Health Branch of Health Canada
Children and Youth:
Aboriginal Head Start On-Reserve Program - provides early childhood/preschool intervention that supports the development of the physical, intellectual, social, spiritual and emotional well-being of First Nations children from birth to 6 years of age, and their families living on-reserve.
Canada Prenatal Nutrition Program-First Nations -the goal is to improve maternal and infant nutritional health for pregnant First Nations women, mothers of infants, and infants up to twelve months of age who live on reserve particularly those identified as high risk; includes First Nations women of childbearing age living on-reserve.
Fetal Alcohol and Spectrum Disorder (FASD) Program - addresses a number of health problems that are associated with alcohol use by mothers during pregnancy. Objectives: to reduce the number of babies born with FASD; and support children who are diagnosed with FASD and their families to improve their quality of life. Program clients: First Nations on-reserve, children from age 0 - 6, and women of child bearing age.
Maternal and Child Health Program - the goal of this program is to support pregnant First Nations women, new parents, and families with infants and young children, who live on reserve, to reach their fullest developmental and lifetime potential.
Chronic Disease and Injury Prevention:
Aboriginal Diabetes Initiative (ADI) –is administered through contribution agreements established by FNIHB regional offices; and initiated in response to work plans submitted to cover community based, tribal council or regional level activities. Each region has a partnership process established to ensure that First Nations are part of the management and implementation of the ADI programs in their region.
Communicable Disease Control:
Air Borne Diseases – Tuberculosis - to reduce the incidence of the disease in First Nations communities; funding of community-based research projects on control and prevention of TB infections in First Nations communities. Program clients: First Nations people living on-reserve and Inuit in Labrador (Nunatsiavut).
Blood Borne Diseases and Sexually Transmitted Infections – HIV/AIDS – the program provides HIV/AIDS education, prevention and related health services to First Nations on-reserve; the overall goal of this program is to work in partnership with First Nations and Inuit communities to prevent HIV/ AIDS transmission and support the care of those impacted by HIV and AIDS. Program clients: First Nations Bands; First Nations and Inuit Associations and Tribal Councils.
Vaccine Preventable Diseases (VPD) – Immunization – FNIHB has developed and implemented a Targeted Immunization Strategy (TIS) for children under the age of six living on-reserve; expected outcomes are to improve coverage rates for routine immunizations, reduce VPD incidence, outbreaks and deaths, and the development of an integrated immunization surveillance system.
Appendix B (cont)
Summary of Programs offered by the
First Nations and Inuit Health Branch of Health Canada
Environmental Public Health Research:
Environmental Public Health Program (EPHP) - raises awareness of environmental public health hazards such as water, food and vector borne illnesses including health problems associated with indoor air quality, mould in housing and pest control (investigation of infestations and eradication of pests).
Environmental Health Research -the program carries out laboratory and field studies, research, monitoring and surveillance; and predictive modeling efforts, in the context of risks posed by environmental contaminants (chemical, biological and radiological) to the First Nations people and Inuit.
Mental Health and Addictions:
Brighter Futures Program -to improve the quality of, and access to, culturally appropriate, holistic and community-directed mental health, child development, and injury prevention services at the community level to help create healthy family and community environments.
Building Healthy Communities Program – is designed to assist First Nations communities (which include individuals and families) and territorial governments in developing community-based approaches to mental health crisis management. Activities include assessments, counseling services, referrals for treatment and follow-up treatment, aftercare and rehabilitation to individuals and communities in crisis.
Indian Residential Schools Resolution Health Support Program -provides access to mental health, transportation services and emotional support services for eligible former Indian residential school students through the Health Canada regional offices.
National Aboriginal Youth Suicide Prevention Strategy -supports a range of community-based solutions and activities that contribute to improved mental health and wellness among Aboriginal youth, families, and communities.
National Native Alcohol and Drug Abuse Program Community-based program -provides prevention, intervention and aftercare and follow-up services in First Nations communities.
National Native Alcohol and Drug Abuse Program – Residential Treatment – a national network of 50 treatment centers operated by First Nations organizations and/or communities that provide culturally appropriate in-patient and out-patient treatment services for alcohol and other forms of substance abuse.
Youth Solvent Abuse Program - is a community-based prevention, intervention, after-care and in-patient treatment program that targets First Nations youth who are addicted to, or at the risk of inhaling solvents.
Primary Care:
First Nations and Inuit Home and Community Care Program– provide home and community care services that are comprehensive, culturally sensitive, accessible, effective and equitable to that of other Canadians. It is a coordinated system of home and community-based health care services that enable First Nations and Inuit people of all ages with disabilities, chronic or acute illnesses and the elderly to receive the care they need in their homes and communities.
Appendix B (cont)
Summary of Programs offered by the
First Nations and Inuit Health Branch of Health Canada
Oral Health Care (OHC) - The program is comprised of three elements:
Support to the National School of Dental Therapy;
Provision of oral health/dental therapy services to First Nations and Inuit; and
The Children's Oral Health Initiative (COHI).
In collaboration with the First Nations University of Canada, OHC delivers a two year diploma program to train dental providers to deliver basic clinical, preventive dental care services and health promotion programs and strategies in First Nations communities. The oral health/dental therapy service providers including salaried dental professionals and contract service providers deliver and manage a broad range of oral health activities including prevention, oral health promotion and basic restorative services. The majority of restorative dental services are provided through Non-Insured Health Benefits rather than through the Oral Health Care.
Community Nutrition -Nutrition expertise is provided to support First Nation achieve optimal levels of nutritional health and is in place at the national and regional levels to provide advice, promotion and education focused in nutrition-related health and social issues.
These issues include: chronic diseases, dental health, specific nutrient concerns, food security, traditional foods, etc. as they apply through the life cycle in a population health and health determinants context.
A variety of levels of activity related to capacity building, advocacy, surveillance and research also fall within the purview of community nutrition.
This service is provided by the Union of New Brunswick Indians (UNBI). Diabetes Educator provides monthly visits to Pabineau First Nation.)
A nutritionist sponsored by Sobeys provides onsite visits ½ day/month where (3) clients are booked for individual consultations
Health Facilities Construction, Operations and Maintenance -FNIHB requires health facilities from which to provide health services; the program can include the construction, repair, renovation and replacement of health facilities such as: nursing stations, health centre, and health stations, health offices and National Native Alcohol & Drug Abuse Treatment Centers and, staff accommodations in isolated locations.
Health Governance and Infrastructure Support:
Aboriginal Health Human Resources Initiative(AHHRI) – in 2005, was allocated $100 million over five years from the Federal Budget; goal is to lay the foundation for systemic change in health human resources, ensuring that First Nations, Inuit and Métis people have access to the health care providers that they need both now and in the future. The majority of funding for the AHHRI flows through national and regional contribution agreements and contracts with a variety of organizations, institutions, associations, agencies, universities and colleges as outlined in the First Nations and Inuit Health Branch's Health Governance and Infrastructure Support Authority.
Aboriginal Health Services Accreditation –
Supports Aboriginal health services as they apply national standards to improve the quality of health care; supports First Nations organizations to engage in the accreditation process and use standards of excellence in the areas of leadership and partnership, information management, human resources, environment and direct health service delivery.
E-Health Solutions - provides funding to e-Health Solutions to support the programs within the First Nations and Inuit Health Branch in the selection, deployment and support of e-Health infrastructure to ensure that First Nations communities are connected and informed.
Appendix B (cont)
Summary of Programs offered by the
First Nations and Inuit Health Branch of Health Canada
Health Careers Program -is intended to increase awareness of health career opportunities and foster an interest in health science studies in Aboriginal students; provides contributions to support Aboriginal participation in education leading to careers in the health field.
Health Consultation and Liaison -two types of funding are available for health consultation and liaison: Base Funding aims at supporting and maintaining core capacity of Canadian national and regional Aboriginal organizations to participate and lead consultation and liaison processes; Project Specific Funding for health consultation to address health priorities is available for Canadian Aboriginal organizations as well as non-governmental organizations and associations.
Health Facilities and Capital Program -supports the construction, acquisition, leasing, operation and maintenance of nursing stations, health centers, health stations, health offices, treatment centers, staff residences, and operational support buildings. These facilities allow Health Canada to offer health programs and services to clients; also supports the acquisition and repair of moveable assets, including equipment, vehicles, and furniture.
Health Planning and Management -supports First Nations planning and management of health programs and services; funding supports community health planning and the development of health services and programs delivery model and its requisite infrastructure at the community, regional or national levels.
Health Research and Co-ordination Projects -provides funding to support Aboriginal health research and co-ordination projects including community, regional, national and international initiatives, that will contribute to enhancing knowledge related to Aboriginal health (including health human resources).
Security Services for First Nations and Inuit Health Branch Health Facilities – supports the establishment of a safe and secure workplace environment for nursing staff providing services in nursing stations and other health facilities on reserve land across the country. This funding is provided for the recruitment, training and retention of security guards by First Nations communities. In addition, the funding is complementary to the physical security funding provided through the Health Facilities and Capital Authority.
Supplementary Health Benefits:
Non Insured Health Benefits Program (NIHB)
The NIHB Program provides a limited range of medically necessary health-related goods and services not provided through private insurance plans, provincial / territorial health or social programs or other publicly funded programs. Some benefits include: prescription drugs, medical transportation, dental, medical supplies and equipment, vision care and crisis intervention counseling; NIHB is available to Registered Indians and recognized Inuit in Canada. A brief outline of services is provided in Appendix C. Non Insured Health Benefits (NIHB)
Appendix C
N.B. Prior Approval for use of Benefits should be done by recipient as there are a lot of restrictions.
Land and Water Transportation:
Scheduled and chartered airlines
Road and air ambulance
Meals and lodging
Escort and/or interpreter services
Travel to the nearest health clinic or hospital to receive health services not available in your home community, or not covered by provincial or territorial travel assistance programs.
Dental:
Diagnostic services (examinations, x-rays)
Preventive services (cleanings)
Restorative services (fillings)
Endodontic (root canal treatments)
Periodontics (treatment of gums)
Prosthodontics (removable dentures and fixed bridges as an alternate benefit; dentures every 8 years)
Oral surgery (removing teeth)
Orthodontics (straightening teeth)
Adjunctive services (additional services like sedation)
Medical Supplies and Equipment:
Bathing and Toileting Aids
Cushions and Protectors
Environmental Aids (Dressing and Feeding)
Miscellaneous Supplies and Equipment
Lifting and Transfer Aids / Mobility Aids (Walking Aids, Wheelchairs)
Ostomy Supplies and Devices
Urinary Supplies and Devices (Catheter Supplies and Devices, Incontinence Supplies)
Audiology (Hearing Aids and Supplies)
Wound Dressing Supplies /Orthotics and Custom Footwear
Oxygen Therapy
Note: Lifeline set up and/or fees are not funded by NIHB
Pressure Garments and Pressure Orthotics (Compression Device and Scar Management)
Prosthetic Benefits (Breast, Eye, Limbs)
Respiratory Therapy Benefits
Non Insured Health Benefits (NIHB)
Appendix C
N.B. Prior Approval for use of Benefits should be done by recipient as there are a lot of restrictions.
Vision:
Eye examinations (you should get approval for this ahead of time, in case this is not insured in your province or territory);
Eyeglasses that are prescribed by a vision care provider;
Eyeglass repairs;
Eye prosthesis (artificial eye);
Other vision benefits depending on your specific medical needs and according to the agreement negotiated with the association of your province or territory.
Crisis Intervention Counseling:
Short-term crisis intervention counseling may be provided by a recognized professional mental health therapist when no other services are available to the recipient.
The initial assessment; development of a treatment plan
Fees and associated travel costs for the professional mental health therapist when it is deemed cost-effective to provide such services in a community.
Crisis intervention counseling must be provided by therapists registered with a regulatory body from the disciplines of clinical psychology or clinical social work, in the province or territory in which the service is provided. In exceptional circumstances service providers from disciplines other than clinical psychology or clinical social work may be considered.
Payment of NIHB outside of Canada:
Will cover the cost of privately acquired health insurance for approved students or migrant workers and their legal dependants;
Transportation benefits are medically referred and approved for treatment outside of Canada by a provincial or territorial health care plan;
Eligibility – a student following a course of post-secondary training or education from a recognized institution; a migrant worker; a legal dependant or a student or migrant worker.
Drugs:
Prescription drugs that require a prescription from an authorized prescriber;
Drugs that are listed in the Drug Benefit List (generic) – website
http://www.hc-sc.gc.ca/fnih-spni/pubs/drug-med/drug-med_list/list-a_e.html
Over the counter (OTC) drugs and selected health products i.e. multivitamin for children up to 6 years old, prenatal and postnatal vitamins for women who are pregnant or breastfeeding between 12 and 50 years old;
Drugs which have a quality and frequency limit i.e. an individual is eligible to receive a 3-month supply of smoking cessation products renewable 12 months from last prescription.
Chronic renal failure patients- eligible to receive a list of supplemental benefits not included in the NIHB Drug Benefit List required on a long-term basis i.e. epoetin alfa products, calcium products, special multivitamins and select nutritional supplements. Prior approval is required for the majority of prescriptions.
Province of New Brunswick
Appendix D
Province of New Brunswick – Department of Health (Mental Health and Addictions Services, Public Health Services and Primary Health Care Services, and Policy and Planning Division - Federal, Provincial and Territorial)
A consultation process was initiated with key stakeholders in the Department of Health, including Mental Health and Addictions Services, Primary Health Care Services and Public Health Services. The individuals consulted are responsible for the planning of services, and assuring the programs are available to all New Brunswickers who require them. It is the mandate of Vitalité and Horizon Health Networks to coordinate and manage the health and social services offered in their mandated regions, respecting provincial program guidelines. See Appendix D for a brief description of the programs.
In order to have a participative mechanism in place with First Nations people, provincial working groups were formed with the mandate to improve relationships between the First Nations Bands and the Government of New Brunswick.
Examples of Bilateral and Tripartite Agreements or working committees / working groups are:
H1N1 Influenza (Tripartite Agreement – Federal (Health Canada) / Provincial (Department of Health) / First Nations Bands;
Mental Health Strategic Team – Representatives from Department of Health / First Nations Bands representatives; Terms of Reference – Health Center and Mental Health (February 2017)
Primary Health Care Advisory Committee - Representatives from Department of Health / First Nations Bands representatives;
Communicable Disease Prevention Management Advisory - Representatives from Department of Health / First Nations Bands representatives; and
Transfer Agreements between Health Canada (Federal) and Government of New Brunswick.
The Government of New Brunswick also managed to undertake a significant challenge, hiring a consultant, Mr. Robert Stanton, on behalf of the Government of New Brunswick will undertake tripartite negotiations with the Government of Canada and New Brunswick’s First Nations to develop an agreement for Jordan’s Principle.
The following observations were identified:
The delivery of health services is a shared responsibility, belonging to federal, provincial and Band level governments;
The First Nations people share responsibility to participate and be proactive in their wellbeing ;
Working in partnership with First Nations people, a collaborative and participative approach is necessary;
Ensure that residents living on-reserve have access to the same services that are available to all New Brunswickers.
During the consultative phase of the AHTF Pabineau First Nation/ Madawaska Maliseet project discussions with Pabineau and Madawaska Maliseet First Nations, as well as 12 of the 13 First Nations in New Brunswick showed commonalities in gaps in services that were expressed throughout the province. (Statement by Wanda Pinet, consultant for the PFN/MMFN – AHTF project)
The Department of Health is responsible to ensure that health services are available to all residents of New Brunswick, including residents living on-reserve. It is understood that the Government of Canada, through FNIHB and INAC work in collaboration with the Government of New Brunswick to facilitate the implementation of federal programs on-reserve, and that the Government of New Brunswick facilitate access to services on and off-reserve.
Services offered on-reserve by the Department of Health are often negotiated with the First Nation community in question; not all First Nations communities benefit from the same services.
Gaps in Services
Mental Health and Addictions Services
An area of concern discussed by First Nations was the absence of Mental Health and Addictions Services (counseling) for many First Nations communities.
As outlined in Appendix B, FNIHB provides the following services in the areas of Mental Health and Addiction which is primarily categorized as educational, prevention focused, emergency counseling:
Fetal Alcohol and Spectrum Disorder (FASD) Program – educational;
Brighter Futures Program – prevention and educational;
Building Healthy Communities Program – emergency counseling;
Indian Residential Schools Resolution Health Support Program - restricted ;
National Aboriginal Youth Suicide Prevention Strategy –prevention and education;
National Native Alcohol and Drug Abuse Program Community-based program – prevention and education, referral;
National Native Alcohol and Drug Abuse Program – Residential Treatment – in select First Nations communities; and (access only)
Youth Solvent Abuse Program – emergency counseling
Grassroots information
“Mental Health and Addictions Services are not available on-reserve in Pabineau or … Most First Nations does not have funding for specialized Mental Health and Addiction counseling services on-reserve. The NIHB provides funding for Mental Health crisis services (up to 12 hours); and the National Native Alcohol and Drug Abuse Program offers primarily screening and referral services.
There are 6 First Nation facilities that offer treatment services in New Brunswick.
The treatment facilities are managed by the First Nation Bands, and professional staff is hired by the Bands.” (Discussion notes from a PFN/MMFN Meeting July 2010 in St Quentin, NB)
“There has been discussion between the Community Mental Health Centre (Child and Adolescent Program) to offer services at the Pabineau Health Centre.
The local Mental Health is engaged with Pabineau First Nation Health as an outreach location where their services are provided.
… New Brunswick Mental Health and Addiction Services will offer educational, information and promotional sessions to the community.”
“On reserve service is what best meet the need and comfort of the community”,
This service is official by means of a Term of Reference signed between Pabineau First Nation and Vitalité (Mental Health Section) – January 17th 2017.
Discussion notes from a PFN/MMFN Meeting July 2010 in St Quentin, NB)
Romanow (2002) had made a recommendation concerning mental health services stating:
“Home Mental Health Case Management and Intervention Services should immediately be included in the scope of medically necessary services covered under the Canada Health Act”.
“Many First Nations have stated they would like to have services that have the following characteristics:
Use of a more holistic approach;
Team oriented and culturally sensitive;
Allow the First Nation Health Centers to be referral sources to government treatment centers and community based services;
Access to a crisis team for consultation and intervention as needed;
Explore alternative treatment and intervention mechanisms in order to meet First Nations mental health and addictions needs (telephone, technology – video conferencing);
Development of culturally sensitive resources for the treatment of acute and long term addiction;
Implement monitoring mechanisms for prescription drug abuse.”
Pabineau First Nation will access other First Nation facilities and other provincial Mental Health services - as needed.”
“Currently, there are no facilities and no provincial legislation that are sensitive to the needs of women in New Brunswick. It would be important that existing treatment facilities and community based addiction services be sensitized to the special needs of women and addiction, and include cultural influences in treatment.”
Reference: Discussion notes from a PFN/MMFN Meeting July 2010 in St Quentin, NB)
Methadone Management Treatment
Another area of concern is the access to Methadone Management Treatment Clinics available to First Nations communities or accessible in the nearby communities. The services are presently offered in Fredericton, Moncton, Miramichi, Saint John, with some physicians offering the treatment in their offices, and dispensed through local pharmacists. Unfortunately, “in Pabineau First Nation and … anyone needing Methadone treatments and counseling must travel between for daily treatment ranging from one trip per day for the daily dosage, up to once every 2 to 4 weeks to see a physician for follow-up.
In Pabineau, community members can obtain Methadone from Shopper’s Drug Mart.
The prescribing physician is from the Miramichi.
The clients from Pabineau First Nation on Methadone have been surveyed and are not interested in an on-reserve service. (April 2017)
Many First Nations communities identified the lack of nearby access to treatment, including transportation issues as factors affecting their compliance to treating their addictions.” Reference: Discussion notes from a PFN/MMFN Meeting July 2010 in St Quentin, NB)
The Government of New Brunswick clearly supports the implementation of the Methadone Management Treatment for opiate users in their Provincial Guidelines, stating that Methadone is cost effective. “The estimated yearly cost for treatment in Canada is approximately $6,000.00 including the cost of medication, urine testing and physician, nursing and counseling staff…..while the untreated opiate user can cost society on average $49,000.00 per year… “
“When addressing the length of time needed for Methadone treatments, the Department of Health states ‘Clinical experience and knowledge suggests that stabilization tasks take around 18 months from the time that the individual actually starts in recovery”
Reference: Methadone Maintenance Treatment Policies and Procedures for New Brunswick Addiction Services, Government of New Brunswick, Department of Health, February 2009).
The NIHB places restrictions on the amount of money paid for medical transportation, and specifically restricting travel coverage for Status First Nations to a maximum of 4 months.
RECOMMENDATIONS:
That FNIHB review their transportation and funding guidelines for medical transportation in areas of health treatments, taking into consideration medical intervention practices related to specific health concerns (Methadone treatments);
Establish Tripartite Forum with the Department of Health, including the Vitalité Health Network, FNIHB and First Nations to provide more appropriate and timely access to mental health and addiction services;
Mental health and addictions services available through the Vitalité Health Network can offer services on-reserve. An evaluation of needs for each First Nation community can be completed @ the Health Centre.
(First meeting with Marie Paulin, Chief David Peter-Paul, Pat Roy and Laura Mae Sewell (Dec 5th 2011)
The TOR is finalized and was signed by Vitalité and Pabineau First Nation January 17th 2017
Public Health Services
Public Health Services from the Government of New Brunswick are not offered on-reserve due in part to jurisdictional issues. FNIHB provides nursing services through its program to each First Nation community. As stated previously, FNIHB has identified 4 areas in which First Nations are responsible for the delivery of mandatory programs. One program refers Communicable Disease and Control involving immunization and communicable diseases.
The Community Health Nurse is responsible for many community programs, is the link between other health professionals (i.e. physicians off reserve) and health and social services in the community. There are also administration tasks such as the provision of a multitude of monthly, quarterly and yearly reports submitted to government agencies; participation in regional, provincial, and Atlantic meetings to maintain training and assure ongoing educational requirements related to public health and nursing practices.
FNIHB subsidizes Pabineau First Nation funding to pay 9 hours per week for Community Health Nursing.
The gaps identified in public health services are and alternatives:
There is a limited sexual health service for youth that include prevention, education and information. Services offered by Public Health (Vitalité Health Network) are not available on reserve. i.e. sexual health programs, sexual health counseling, prevention of pregnancies, and medical exams); but can be accessed at the local High School level
Update: every Tuesday AM – a PH Nurse is available in the nursing office of Bathurst High School and has advised that FN students are welcome to benefit from this service by making an appointment to “see the nurse”
In Pabineau First Nation the Community Health Nurse can provide Sexual Health counselling, education and information.
In consult with a visiting nurse practitioner the treatment of STI’s and the prescription of birth control methods are available. The PFN – HC does not have samples for free, except for condoms provided by “Healing Our Nations”.
E-Medical Data Base: There is no access to the provincial Client Service Delivery System (CSDS) in Pabineau First Nation. The PFN HC nurse records the vaccines in a single entry immunization electronic record that is readily transferable to the Public Health Department upon request and parental consent.
PFN residents are not marginalized and are treated as all patients and babies and receive Initial Assessment under the Early Childhood Intervention Program /upon parental consent the assessment is faxed directly to the PFN Community Health Nurse.
There is no written agreement to collaborate the reporting of communicable diseases on-reserve or off reserve, and is subjected to discretion of the Public health nursing office.
For Pabineau First Nation, the regional PH office reports CDC incidents and the “on” reserve Community Health Nurse treats the referral according to Provincial protocol for STD follow up and feed back.
Vitalité Hospital Network provides a (1) day /bi-monthly Nurse Practitioner visit to Pabineau First Nation to provide primary care. The service is fully utilized.
As of September 2016, the Nurse practitioner holds 2 clinics/ month.
Diabetes Program: assessment, intervention and outcomes are extremely successful due to collaboration of multidisciplinary team and the commitment of the CBDW.
Pharma Save has recently offered Methadone dispensing in Pabineau First Nation. The logistics have not yet been worked out. The clients are not interested.
Health and Social Services under the
Province of New Brunswick jurisdiction
Department of Health services shared or available to Pabineau First Nation:
Clients and Families (Healthcare System, Health Services and Home Care – share responsibilities with the Department of Social Development);
Addiction and Mental Health Services (Addiction Awareness, Gambling, Mental Health and Suicide Prevention come under the NNADAP worker’s mandate)
Other Health Care Services (Health Emergency Management Services, Hospital Services, Organ and Tissue Donation, Rehabilitation Services);
Medicare
New Brunswick Cancer Network (NBCN Home, Benchmarks, Wait Times, Epidemiology, Other Cancer Agencies, Pediatric Oncology, Prevention, Research, Research and Clinical Trials);
Office of the Chief Medical Officer of Health (Public Health) - Communicable Disease Control Disease Information, epidemiology and surveillance, and Immunization program; Health Protection : Public Health Act, Air and soil: Air quality, Arsenic, Radon; Food Safety; Land Development; Smoke-free Places and Tobacco Control; Water Quality and Testing; Population Health: Baby Friendly Initiative, Early Childhood and Pregnancy, Healthy Eating, Healthy Learners Program, Sexual Health;
Primary Health Care Services (Chronic Disease Prevention and Management, Community Health Centers, Injury Prevention, Inter professional Collaboration, and Tele care;
*** Though Health Canada identifies the availability of these services from the province ci is a fact that cultural sensitivity is missing
Province of New Brunswick – Department of Health (Medicare)
New Brunswick Medicare has established a list of services that is available to all residents of New Brunswick, including all residents living in First Nations communities (on-reserve). Medicare has drastically reduced its coverage over the years to all NB residents, and many restrictions exist (www.gnb.ca/0394/coverageIn-e.asp ).
It is important to verify with the attending physician or contact Medicare directly if a person has questions concerning the benefits covered.
First Nations people who are registered Indians (Status) have access to the Non Insured Health Benefits (NIHB) plan which is provided by First Nations and Inuit Health Branch (FNIHB). There are many gaps in the provisions of the NIHB program.
Non status and non-aboriginal people do not have access to NIHB.
They are not eligible, even if they qualify for social benefits with the Department of Social Development in the FN community
The Department of Social Services has a Special Needs section for which social clients may benefit based on assessment of need.
Non status and non-Aboriginal residents living on-reserve must move off reserve in order to receive the provincial benefits. Any medication payment can be considered by the band on a one-to-one basis. It’s an internal decision
Informing First Nations and Health Care Providers of Health Services
First Nations People
There are different formats and strategies to keep the community informed:
Media and technology strategies: Radio, television; Newspaper, newsletters; Website link between the Health Network and First Nations websites;
Booklet/ information sheets describing health services could be available for reference at the Health Centre ; poster is in inner hallway and @ entrance
Information packages for specific groups (Cancer survivors, smoking cessation etc.);
Community strategies: Committee meetings; Community meetings; Primary Health Care Groups (diabetic teaching sessions, healthy aging, women’s health);
Single Entry Point: A resource person @ the Main Entrance Reception who assists in directing a client to the proper service.
Health Center Face Book page for the specific purpose of advisement – managed by certain employees
Letters, mail-outs, phone calling and word of mouth, reminders listings
Service Providers of Health Services (Aboriginal and Non-aboriginal)
Many projects are part of the Health Center diversity for community engagement and participation.
Events providing an opportunity to meet Health Network and First Nations Health Care providers in the respective Zone;
Working groups within areas of interest i.e. Public Health with the person providing public health and/or mental programs on-reserve;
Orientation of new Health Network employees with a presentation by a First Nation person in the respective Zone explaining information about their culture and services;
Orientation could include a visit to the First Nation Health Centre, promoting opportunities of collaboration and understanding;
Since 2014 Vitalité Hospital Network applied for and got a grant (HSIF) to start a process of providing their employees education about Aboriginal Culture. The project attained its objective and the promise of sustainability is going forward funded by Vitalité as of the current year 2016-17
Since 2011 we have entered a partnership with the Faculty of Nursing from UNB – whereby select students participate in the life of the community and the Health Center activities.
Students have attended in groups of (3). In 2012 we had 4th year student, and again this year (winter 2017) – for the 2nd time a 4th year student did his 6 week clinical providing us with a Men’s Wellness project and pamphlet on Men’s Cancer prevention.
The Nursing students usually attend for a total of 160 hours and during that time have to meet standards of performance and duty as outlined by the UNB Nursing Faculty.
When the UNB student completes the term hours a theme legacy remains with the Health Center
UNB will be closing its faculty in Bathurst this year.
Pabineau First Nation is home to the NB – FN FASD Liaison Social worker from the FASD Centre Excellence. She is an employee of Vitalité and works from her home base in Pabineau First Nation. This provides us frequent and easy access to services.
Pabineau First Nation Health team is committed to the mandate for the newly organized ISD program. A FN person from the Band office Department of Education is on the Steering Committee at the Administrative level. The Health Team of Pabineau provides the internal structure for the ISD program at the band level
The Pabineau First Nation Health Team identified an employee as the lead for the Jordan Principle Fund.
We now have a slogan for our health services
“Client and family centered are, always caring, always here!”