EXCHANGE CONFERENCE 2017

BUILDING TOGETHER SUCCESSFUL PARTNERSHIPS BETWEEN COMMUNITY AND THE HEALTH AND SOCIAL SERVICES SYSTEM

he Community Health and aux services en langue anglaise, ministère de de Montréal, even though she works almost Social Services Network (CHSSN) la Santé et des Services sociaux. They made exclusively in French for a lawyers’ firm coordinates a Quebec-wide health it clear their involvement is personal, not in Laval, my wife goes out of her way to and social services “Adaptation just professional, in better access in English obtain these services in her mother tongue Program”T designed to enhance the vitality to existing services. at the ‘Jewish’ Hospital.” of English-speaking minority communities in Quebec by increasing access to existing WHAT DIFFERENCE DO ADAPTATION WHY IT’S IMPORTANT health and social services for English- PROJECTS MAKE FOR PATIENTS? Building Together created a better under- speaking Quebecers. Coming to Quebec City from the United standing of the issues facing English-speak- The program is supported by an investment States in the 1990s, Johnson needed medical ing communities and how to address them from Health Canada and has been undertaken care during her pregnancy. through creative programing and adaptation in partnership with the ministère de la Santé et “I was alone,” she remembered to the of services. And it recognized how commu- des Services sociaux (MSSS). An implementation conference “Even though I spoke French nity-system partnerships have an impact. agreement between CHSSN and the MSSS was quite well and all of the health professionals “Every one of you are here to help make concluded to incorporate the projects into that I met were kind, they never connected this happen in a different way, and from Quebec’s initiatives to improve access to health to me.” Her experience left her feeling the bottom of my heart I want to thank you and social services in English through partner- isolated and vulnerable. for all that you do,” said Johnson. ships between local English-speaking communi- Johnson went on to say: “This is how ties and health and social services system. I wish things had gone down: That the local CLSC or the multiple doctors’ offices WHAT’S BUILDING TOGETHER? I contacted had known that the Jeffery Hale The Building Together conference gathered all of served the English-speaking community CHSSN’s partners in Quebec City, November 23 and had sent me directly there. That I had and 24, 2017, to review and discuss the results received prenatal classes and information in and lessons learned from these local initiatives. English to lower the stress level for an already The event highlighted several Adaptation difficult pregnancy. That during my hospital projects that were carried out in 2013–2018, stay I had at least one person on the team considered best practices and priorities for who was communicating with me in English.” new projects in 2018–2023, and encouraged Martin shared his own perspective networking between all CHSSN community on of the importance of wider access in and system partners. English through the experience of his wife, The two day session was co-chaired by an anglophone Montrealer: “Even though Jennifer Johnson, Executive Director of CHSSN, she’s perfectly bilingual, even though she Iannick Martin, Jennifer Johnson & CHSSN President Ron Creary and Iannick Martin, Coordonnateur à l’accès did her studies in French at the Université CONTENTS Robyn Graham & partners from the Montérégie

Encouraging Greater Access to Services Innovative “English-speaking Collaboration P2 in PEI P4 Agent” in Abitibi P6

A Regional Approach with Public Health for an Underserved Evidence-Based Responses Big Results P3 Minority in Estrie P5 to Public Health Challenges P6

Health Canada Invests in Responding to ASD Needs Taking Some of the Pain out Health & Vitality P4 in Laval P5 of Interregional Health Care P7

Photographer: Jacques Boissinot

Pierre Lafleur Dr. Gaétan Barrette & Tania Callendar

A REGIONAL APPROACH WITH One of the biggest teams to take the stage at Building Together BIG RESULTS came from the Montérégie.

heir presentation, “Partnerships Promoting Access to To achieve this, the program currently funds 20 community HEALTH MINISTER GAÉTAN BARRETTE Services for English-speaking Clients,” was an impressive health and social service networks (NPIs). & ADM PIERRE LAFLEUR ENCOURAGE account of how deeply and effectively community-based These networks sensitize local and regional authorities to the groups can work with the health and social services challenges and realities facing their community members and have systemT to improve health and social services care for English- built hundreds of partnerships to improve access to health and social speaking people. services in English. They are key players in helping local health au- GREATER COLLABORATION “Our goal is to increase access to health and social services thorities and programs connect with English-speaking communities. based on the needs of the community, increase availability of Myriam Tessier, Agente de liaison pour l’accès en langue anglaise, He recognized that issues and challenges varied widely across health and social service information in English and be the leaders CISSS de la Montérégie-Ouest, explained their region’s success this Both the Minister of Health and Social regions but insisted, “Ensemble nous sommes plus que séparés — of change in our community,” said Pauline Wiedow, Executive way: “Le secret dans nos CISSSs, c’est savoir à qui parler.” Services, Dr. Gaétan Barrette, and MSSS this is something on which we can build a better Quebec Director of Montérégie West Community Network, one of the Assistant Deputy Minister Pierre Lafleur spoke for everyone.” NPIs partnered with the three Montérégie CISSSs in the effort. WHO FUNDS THESE PROJECTS? Pierre Lafleur,Sous-ministre adjoint — Direction générale de la “We are really excited to showcase the strength and the Since 2003 the Federal Government has supported the vitality of at the Building Together conference, praising coordination réseau et ministérielle, ministère de la Santé et des collaboration in Montérégie,” added Robyn Graham, Project Official-Language Minority Communities in Canada through a series progress to date and encouraging wider Services sociaux, spoke in the same spirit but focused his remarks Coordinator, Assistance and Referral Centre. of five-year funding programs. Health has been identified as one on the need for even greater collaboration and looked forward of the key determinants of strong, vital communities and Health and deeper partnerships. to increased partnering. WHAT’S AN NPI? Canada invested over $120 million in French-speaking communities “When we’re at the Ministère de la Santé, we’re often very The Networking and Partnership Initiative (NPI) is a CHSSN outside of Quebec and more than $40 million in English-speaking e are there for you,” said the Health Minister simply far away and being in contact with an organization (such as the program designed to support Quebec’s minority English-speaking communities in Quebec over the past five years. and directly in his remarks. “I feel it is an absolute CHSSN) that works directly on the ground is invaluable to us.” communities in improving and maintaining access in English to That investment includes support for the 20 NPI community- necessity to be the minister for everyone.” “This special relationship we have with the CHSSN is extremely the full range of health and social services. This initiative is funded based health networks across the province as well as adaptation Dr. Barrette recognized the historic commitment important to me,” he continued. “We developed our partnership under Health Canada’s OLMC program offering and CHSSN is the partnerships like the one in Montérégie. Central to the success of Wof the English-speaking community to excellent health care institutions: with quite pivotal and important projects. The planets are aligned designated recipient of the funding in Quebec. NPIs is our program implementation agreement with the Quebec “What you built in the past — your institutions, your foundations, your re- for a very big 2018.” The program supports the capacity of Quebec’s English- Ministry of Health and Social Services. NPIs fully respect provincial lationship with the health care network — is to be protected, maintained.” speaking communities to ensure their vitality through cooperation jurisdiction in health and social services. and partnership with the health and social services system.

2 CHSSN EXCHANGE CONFERENCE 2017 | CHSSN.ORG CHSSN EXCHANGE CONFERENCE 2017 | CHSSN.ORG 3 HEALTH CANADA INVESTS Sally Scott IN OFFICIAL LANGUAGE 28 ADDITIONAL MINORITY COMMUNITY HOURS PER WEEK HEALTH & VITALITY OF SERVICE

truly am inspired by the great work that is being done by the NPI network in partnership with the health and social services RESPONDING I system,” said Sally Scott, Director of Health Care Programs Dr. Mélissa Généreux within the Strategic Policy Branch at Health Canada in her remarks TO ASD NEEDS to the conference. “I’ve had the chance to speak with many of you at this IN LAVAL conference, to learn more about your networks and the services PUBLIC HEALTH that you provide and the important things you are doing to support THE CHALLENGE the anglophone community in Quebec.” FOR AN UNDERSERVED As in other regions in Quebec, an increase in the number of people CHSSN’s Adaptation projects are funded by Health Canada with diagnosed with Autism Spectrum Disorder (ASD) has been apparent approval by the MSSS according to a protocol that respects fully MINORITY IN ESTRIE in Laval. Despite best efforts by CISSS de Laval to reduce the wait time Quebec’s jurisdiction in health and social services. for access to services for all in need, English-speaking children with “I look forward to our ongoing collaboration and the Dr. Mélissa Généreux, Directrice de santé publique de l’Estrie, ASD (6 – 18 years old) were waiting longer to receive their first services opportunity to continue ‘building together’,” concluded Scott. presented an outstanding example of how a partnership in comparison to the same French-speaking age group. between community and health system players can have a positive impact on people in need. THE COMMUNITY-SUPPORTED RESPONSE Regional health authorities became concerned about Working with the local English-speaking NPI, AGAPE, the CISSS worrying results in the 2012 Québec Survey of Child developed a response that began in 2015 and cut those waiting times Development, especially for children in kindergarten. to the same level as those experienced by francophone families. Significant gaps in the general development of English Catherine Parent, Éducatrice spécialisée with the CISSS de and French-speaking children were identified. Laval, and Évelyne Delma, Chef de service réadaptation, CISSS de Laval, presented the results of the project: “Promoting Social Skills SPOTLIGHT ON he Government of Prince Edward Island WHY PRINCE EDWARD ISLAND? WHO TOOK THE LEAD? Development Among English-Speaking Youth Aged 6 to 18 with T adopted a new French Language Services The francophone community in PEI, like There is a long tradition of community-health system Autism Spectrum Disorders or Intellectual Disabilities.” OFFICIAL LANGUAGE Act in 2013. Health and social service were English-speaking Quebec, is an Official partnerships in the Estrie so, in collaboration with English- With Adaptation funding, the CISSS de Laval was able to add MINORITY COMMUNITY an immediate priority but the government Language Minority Community. The speaking community partners including the Townshippers’ an additional educator who provided 28 additional hours per week needed to create a framework for planning community receives support for knowledge Association, Phelps Helps, and the Eastern Townships of service with a specific mandate to provide services for English- ACCESS TO SERVICES and delivering services and programs that development and adaptation-type programs School Board, Dr. Généreux’s team took the lead and started speaking children and youth. Since then, all English-speaking children would include both user and provider and health and social services efforts through to investigate. and youth on the waiting list have received services within the IN PEI information. Health Canada. Quebec’s health and social “We took the initiative because we were wondering mandated delay. Elise Arsenault, French Language Analyst services system and its English-speaking why such differences exist?” said Généreux. “Was it due to The project also piloted the use of innovative teaching materials Elise Arsenault for PEI Health, was at the conference and gave communities can learn from what other language or cultural barriers? Was it due to socio-economic to encourage clients’ social skills in group settings. a talk entitled, “Improving French Services in jurisdictions are doing, such as PEI’s efforts vulnerability? One thing is certain — we felt that such the Prince Edward Island Health Care System.” in capturing the language variable and their inequalities were unacceptable so we needed to better “As an indicator of the demographic focus on the language of the user/patient understand them in order to take appropriate action.” health of the community, French first language in offering patient-centered care. education is experiencing a lot of growth in WHAT’S THE IMPACT? PEI in part because of increased immigration,” WHAT’S THE PROJECT THERE? A comprehensive report that describes the health status and explained Arsenault. “In health and social • To improve access to better, more accurate well-being of the English-speaking people in the Estrie region; services, addressing language barriers reduces information on Acadian and francophone • 16 recommendations addressed to the Direction de santé the risk for the users and the service providers, health system information use; publique, the CIUSSS de l’Estrie — CHUS and to other it enhances the quality of the care and patient • To identify health care providers’ linguistic partners; safety, and also helps the government plan capacity leading to more effective use of • A community-focused Regional Committee chaired French language service delivery in a more available resources and to safer, higher by the CIUSSS de l’Estrie — CHUS; evidence-based fashion.” quality care for Islanders. • A first set of priority needs identified.

4 CHSSN EXCHANGE CONFERENCE 2017 | CHSSN.ORG 5 OF 847 INTER-REGIONAL TAKING SOME OF THE PAIN OUT OF TRANSFER PATIENTS INTERREGIONAL HEALTH CARE 75% THE INTERREGIONAL CHALLENGE WEB BASED SOLUTIONS AND WERE NOT PROFICIENT ENOUGH INNOVATIVE Many patients have to travel for specialized A HUMAN TOUCH AS WELL IN FRENCH TO UNDERSTAND hospital services, especially in areas east and The community-based organizations with MEDICAL TERMS “ENGLISH-SPEAKING northeast of Quebec City. Traveling, often great CHSSN and CISSS support launched several distance to unfamiliar cities and institutions innovative products including the Traveling AGENT” IN ABITIBI can be a very stressful experience for for Health Toolkits, the Travel4Health.ca patients and their families, stress that’s often website, and the Health and Harmony staff will assist users in accessing specialized “Provision of Services by English-Speaking Agent” is a joint compounded by language challenges. recognition program as well as the Cancer health and social services in Quebec City. project of the Rouyn-Noranda English-speaking community English-speaking community groups Gaspésie website, cancergaspesie.com. The response to the demonstrated need group Neighbours and the CISSS de l’Abitibi-Témiscamingue. from the Gaspé and Magdalen Islands came “We’ve been fortunate to have sustained is impressive, but the partners see the need

It’s one of several innovative regional approaches that were Annie Vienney together in 2015 to do a survey of 847 inter- support for the project,” noted Cathy Brown, for sustained attention. discussed at the conference. regional transfer patients. They found that: Executive Director of CASA. “In the work that has been done so far Annie Vienney, Répondante langue anglaise for the • 75% were not proficient enough in French In addition, because so many transfers and the work that remains to be done, we CISSS, Sharleen Sullivan, Executive Director, Neighbours and to understand medical terms; are to Quebec City, CHSSN developed opted for the long-term,” said Jean-François Claudiane Dufour, the English Health Services Agent with EVIDENCE-BASED • 40% speak only English. a project to implement a new Health Cassivi, Senior Advisor with the DRHCAJ, Neighbours, presented the project. Navigator, an on-the-ground person who CISSS de la Gaspésie. RESPONSES TO PUBLIC THE EVIDENCE OF STRESS IS CLEAR The polling determined that language barriers WHAT’S THE SITUATION IN ABITIBI-TÉMISCAMINGUE? HEALTH CHALLENGES do exist between patients and health care staff. • A high proportion of anglophones from Abitibi region “The survey underlines that we have are unilingual; daptation projects are built on a firm evidence base of research to always take into consideration that the • Few CISSS personnel are able to express themselves on determinants of health in English-speaking communities population of Gaspésie-Îles-de-la-Madeleine in English; across Quebec. This research effort has been done in close is extremely vulnerable,” said Jessica Synnott, • English-speaking clients, especially older ones, have collaboration with the MSSS, various universities, and the Executive Director, Vision, to conference trouble expressing themselves in French; AInstitut national de santé publique du Québec (INSPQ). delegates. • English-speaking clients hesitate and wait before trying Some of the latest 2016 census-based analysis was shared at the Leaders of the Gaspésie-Îles-de-la-Mad- to access services. conference by Joanne Pocock and Bill Floch from JPocock Research eleine English community associations CASA, Consulting, and Mai Tu Thanh from the INSPQ. Their presentations are Vision, and CAMI along with representatives available on the CHSSN website at chssn.org. of the CHSSN and the CISSS de la Gaspésie WHAT’S THE SOLUTION? showcased their solutions to the problems A community-CISSS partnership has put in place a “Health POWERFUL NEW DATA MODELS TO UNDERSTAND NEEDS faced by English-speaking patients facing an Services Agent.” The agent helps users navigate the Floch also presented a new graphical model that consolidates a number interregional health care transfer. healthcare system, accompanies English-speaking persons of public-health-determining factors that has been used to develop to their appointments at the hospital or other healthcare profiles of English-speaking communities across Quebec. establishments, facilitates communication between English- Called “Composite Indicators of Community Vitality,” these graphs speaking clientele and healthcare professionals, and informs integrate a variety of geo-spatial, demographic, and socio-economic English-speaking users about their rights and the benefits data to provide a visual overview of regional communities in comparison of asking for services in English. to the majority community in the same area. It created a lot of interest among participants. OTHER WORKSHOPS OFFERED ENGLISH LANGUAGE SERVICES: THE MONTREAL EXPERIENCE WHAT ARE THE RESULTS? HOW IT HELPS DECISION-MAKERS AT BUILDING TOGETHER 2017 Florente Démosthène, Conseillère-cadre au partenariat et diversité, • The English Health Service Agent has made it possible “This way of presenting data can tell a story very quickly,” Floch said. Direction adjointe / Bureau du président-directeur général adjoint — to reach English-speaking users who were reluctant “It blends more than 150 data points and gives you a very powerful HELPING STANSTEAD AREA YOUTH SINCE 2012 Partenariat et soutien à l’offre de service, to access services; understanding of the situation in communities.” Katie Lowry, Executive Director, Phelps Aide/Phelps Helps CIUSS du Centre-Sud-de-l’Île-de-Montréal • Earlier intervention or care; For community and health and social services system decision- Jayme Marrotte, Project Co-ordinator, Phelps Aide/Phelps Helps • Healthcare professionals say they’re happy to receive makers, these Composite Indicator graphs can help identify rapidly CLINICAL PLACEMENTS TO FACILITATE WORKING WITHIN the Agent’s support; what is most important to a community and what efforts or investments IMPROVING THE SPECTRUM OF SERVICES OFFERED OFFICIAL LANGUAGE MINORITY COMMUNITIES (OLMC) • Undeniable benefits for English-speaking clients. should be prioritized. TO ENGLISH-SPEAKING SENIORS Jacinthe Savard, Assistant Professor and Director, Occupational Brigitte Paquette, adjointe au PDGA, CIUSSS de la Capitale-Nationale Therapy Program, University of Ottawa

6 CHSSN EXCHANGE CONFERENCE 2017 7 QUEBEC’S LES COMMUNAUTÉS ENGLISH-SPEAKING D’EXPRESSION ANGLAISE COMMUNITIES DU QUÉBEC

Nunavik 8 770 (66,8 %)

THE CHSSN LE RÉSEAU NPI* NETWORK NPI* DU CHSSN Terres-Cries- de-la-Baie-James 1 Rouyn-Noranda 12 Métis–sur-Mer 14 180 Neighbours Regional Association Heritage Lower Saint Lawrence (82,9 %) 17 of Rouyn-Noranda 13 Baie-Comeau 2 Gatineau North Shore Community Connexions Resource Centre Association (NSCA) Côte-Nord 3 Deux-Montagnes 14 New Carlisle 5 180 4 Korners Family Resource Center Committee for Anglophone (5,7 %) Social Action (CASA) Nord-du-Québec 4 Châteauguay Montérégie West Community 15 Gaspé 445 Network (MWCN) Vision Gaspé-Percé Now (VGPN) (3,1 %) 5 Rawdon 16 Grosse-Île 13 English Community Organization Council for Anglophone Saguenay – Lac-Saint-Jean of Lanaudière (ECOL) Magdalen Islanders (CAMI) 1 970 6 Brossard (0,7 %) 15 Les Îles Assistance and Referral Centre 17 St. Paul’s River Health & Social Services (ARC) Coasters Association (LNSCH) Abitibi-Témiscamingue 650 Gaspésie 12 (5,3 %) 7 Lac-Brome 18 Verdun 5 265 Bas- Townshippers’ Association Collective Community Services (3,6 %) Saint-Laurent 14 8 175 16 (10,6 %) (CCS) 1 8 Drummondville Mauricie et Capitale-Nationale 1 225 Centre-du-Québec (0,6 %) Centre for Access to Services 19 Laval in English (CASE) AGAPE – The Youth & Parents 14 830 AGAPE Association Inc. 6 065 (2,1 %) Outaouais des Laurentides (1,2 %) 9 Sherbrooke Townshippers’ Association 20 70 880 37 985 10 Chaudière- Côte-des-Neiges (18,7 %) (6,5 %) Lanaudière Appalaches African Canadian Development 3 985 19 Est-de- 10 Quebec City & Prevention Network (ACDPN) 2 13 990 l’Île-de-Montréal Jeffery Hale Community Partners (2,9 %) (1,0 %) Laval 11 75 135 21 Saint-Léonard 90 980 21 (14,9 %) 11 Thetford Mines East Island Network for English- 3 5 8 (21,8 %) Megantic English-speaking language Services (REISA) Community Development Corp. 6 Nord-de- Estrie (MCDC) 37 700 Ouest-de- l’Île-de-Montréal 4 9 (8,1 %) l’Île-de-Montréal POPULATION 7 195 780 20 88 805 (55,6 %) (21,1 %) 18 1 103 475 13,7 % Networking and Partnership Initiative Montérégie-Ouest Montérégie-Centre Montérégie-Est Centre-Ouest-de- Centre-Sud-de- 2016 Census of Canada of Quebec 82 850 53 800 19 550 l’Île-de-Montréal l’Île-de-Montréal Recensement du Canada, 2016 du Québec (19,2 %) (13,6 %) (3,8 %) 186 870 78 410 INFORMATION: CHSSN.ORG (54,8 %) (26,6 %)

8 CHSSN EXCHANGE CONFERENCE 2017 | CHSSN.ORG CHSSN EXCHANGE CONFERENCE 2017 | CHSSN.ORG 9