PROGRAM OF ACCESS TO HEALTH AND SOCIAL SERVICES IN THE ENGLISH LANGUAGE FOR THE ENGLISH- SPEAKING POPULATION OF THE MONTÉRÉGIE
Adopted by the Board of Directors January 18, 2007 and revised on March 22, 2007
Author John Britton Agent de planification, programmation et recherche
Secretaries and page layout Marcelle Barbeau Michelle Labbé
Text Correction Hélène Giroux
Conception and creation of Cover Page René Larivière
Publisher Jean-François Lapierre
To obtain a copy of this document
Paper Copy Electronic Copy Secteur Gestion des connaissances – Vente de publications Internet Site of the Agence : Agence de la santé et des services sociaux de la Montérégie www.rrsss16.gouv.qc.ca 1255, rue Beauregard Longueuil (Québec) J4K 2M3 (450) 928-6777, poste 4213 14,00 $ (plus taxes)
Reproduction is authorised for non-commercial purposes upon mentioning the source
Legal Deposit– 1st trimester, 2007 Bibliothèque et Archives nationales du Québec National Library of Canada ISBN 978-2-89342-381-4
In this document, the masculine gender is used only to simplify the text and is in no way discriminatory
Table of Contents
LEXICON OF ABBREVIATIONS ...... 5
INTRODUCTION...... 7
1. PRINCIPLES TO GUIDE THE REVISION ...... 9 1.1 OTHER MEASURES WHICH MAY SUPPORT ACCESSIBILITY ...... 10 2. PROCESS FOR THE REVISION OF THE ACCESS PROGRAM...... 13 2.1 REGIONAL CONSULTATION – APRIL 2006 ...... 13 3. CHARACTERISTICS OF THE REGION ...... 15 3.1 TERRITORY...... 15 3.2 HEALTH AND SOCIAL SERVICES NETWORK...... 15 4. CHARACTERISTICS OF THE MONTÉRÉGIE’S ENGLISH-SPEAKING COMMUNITY.....17 4.1 CHOICE OF AN INDICATOR...... 17 4.2 DATA...... 17 4.3 ANALYSIS OF THE DATE...... 18 4.4 SOCIO-ECONOMIC PORTRAIT ...... 19 5. ORGANISATIONAL AND SOCIAL STRUCTURES IN THE ENGLISH COMMUNITY ...... 21
6. HISTORY OF ENGLISH LANGUAGE SERVICES IN THE MONTÉRÉGIE...... 23
7. OFFER OF SERVICES IN ENGLISH...... 27
8. ACTION PLAN FOR THE MONTÉRÉGIE...... 47
ANNEXE 1 – ACTION PLAN – REVISION OF ACCESS PROGRAM TO HEALTH AND SOCIAL ..... SERVICES IN ENGLISH...... 51
ANNEXE 2 – REGIONAL CONSULTATION ON SERVICES IN THE ENGLISH LANGUAGE IN THE MONTÉRÉGIE...... 53
ANNEXE 3 – STATISTICS – POPULATION IN PRIVATE HOUSEHOLDS...... 55
ANNEXE 4 – ACCESS PROGRAM TO SERVICES IN ENGLISH – 1999 EDITION...... 63
ANNEXE 5 – REGULATION CONCERNING THE RESPONSIBILITIES, THE COMPOSITION AND THE RULES OF THE FUNCTIONING OF THE REGIONAL COMMITTEE ON ACCESSIBILITY TO HEALTH AND SOCIAL SERVICES FOR ENGLISH-SPEAKING PEOPLE...... 67
BIBLIOGRAPHY ...... 73
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Lexicon of abbreviations
LEXICON OF ABBREVIATIONS
BMP Brome-Missisquoi-Perkins C.A. Conseil d’administration (Board of Directors) CAFE Crise-Ado-Famille-Enfance (Family-Youth Crisis Team) CEGEP Collège d’enseignement général et professionnel CETI Centre d’évaluation et de traitement intensif CH Centre hospitalier (Hospital) CHSLD Centre d’hébergement et de soins de longue durée (Nursing Home) CHSSN Community Health and Social Services Network CLSC Centres locaux de services communautaires (Local community service centre) CRDI Centre de réadaptation pour déficience intellectuelle (Rehabilitation Centre for the intellectually handicapped) CRPAT Centre de réadaptation pour les personnes alcooliques et les autres personnes toxicomanes (Rehabilitation Centre for people with Alcohol and other depencies CRSSSM Conseil régional des services de santé et services sociaux de la Montérégie CSSS Centre de santé et de services sociaux (Health and Social Services Centre) CVESPA Châteauguay Valley English-Speaking Persons Association DGACR Direction générale associée à la coordination du réseau DI-TED Déficience intellectuelle - Trouble envahissant du développement (Intellectual Handicapped – Gross Development Difficulties) DSP Direction de santé publique (Public health Department) EES École en santé (Healthy Schools) EIJ Équipe d’intervention jeunesse (Youth Intervention Team) EIO Évaluation - intégration - orientation HOPE Helping Other People Effectively MRC Municipalité régionale de comté MSSS Ministère de la Santé et des Services sociaux (Ministry of Health and Social Services NEGS Naître égaux et grandir en santé (Born equal and growing healthy) OLO Oeuf, lait, orange (Egg, milk,orange) IP Intervention Plan PLOP Première langue officielle parlée (First Official Language Spoken-FOLS) PROS Plan régional d’organisation des services (Regional Plan for the Organization of Services) ISP Individual Services Plan RTS Réception traitement des signalements (Reception and treatment of Reports) RUIS Réseaux universitaires intégrés de santé (Integrated University Health Network) SAD Soutien à domicile (Home Care) SRSO Services de réadaptation du Sud-Ouest SSSS Services de santé et de services sociaux (Health and Social Services)
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INTRODUCTION
In April 2006, the Deputy Minister, Mr. Juan Roberto Iglesias, asked that the health and social services agencies prepare an update of their respective access programs for services to the English-speaking population. Following this request, the Agence de la santé et des services sociaux de la Montérégie prepared a process to realise this mandate in collaboration with all the institutions in the region. This report describes the different elements which affect this revision, the methods used to realise the mandate and present the results of the process which is the new program for access to services in English for the Montérégie.
To assist the agencies and the institutions to revise their access programs, the Ministère de la santé et des services sociaux published in March 2006 an update of its approach called Frame of reference for the implementation of programs of access to health and social services in the English language for the English-speaking population.
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Chapter 1 - Principles to guide the revision
1. PRINCIPLES TO GUIDE THE REVISION
To better situate the process undertaken by the Agence de la santé et des services sociaux de la Montérégie, we present here extracts from certain documents which guided the Agency throughout this process.
« Since the formulation of the last access programs to English language service, new circumstances have impacted differently on accessibility to health and social services. Indeed, the reform of the health and social services system as set out in the Act respecting development agencies, as well as Bill 83, has influenced the revision of the frame of reference. The goal of the reform is to optimize the effects of service on the health of the population, and it is within this new context that the revision is undertaken. » (Frame of Reference, MSSS, p. 12, Legal Context)
« As for Bill 83, its objectives were to bring services closer to the people being served, and to facilitate their mobility throughout the network, The Act, as now amended, provides that regional and local authorities have a responsibility toward the health of individuals in their territory, especially regarding accessibility to services and the efficiency of procedures. The Bill has also clarified the roles and responsibilities of agencies and of local authorities. In this regard, agencies must, among other things, facilitate the development and management of local services networks in their regions, ensure the coordination of services within their regions and with those provided by neighbouring regions, support institutions in the organization of services, and facilitate the conclusion of agreements in order to respond to service needs. The CSSS, for their part, must develop clinical and organizational projects in cooperation with their partners.
Considering that clinical and organizational projects must take into account the particular characteristics of the population concerned, including their linguistic characteristics, as well as the orientations determined by the Ministry and regional guidelines set by the agencies, cooperation among all partners becomes essential in order to respect the new responsibilities which have been entrusted to them. » (Frame of Reference, MSSS, p. 13, Legal Context)
« The responsibility for the revision of access programs to health and social services for English-speaking persons is entrusted to the health and social services agencies. To this end, the agency identifies the regional strategies and guidelines, taking into account the new organizational model for services created by the reform. Two fundamental principles underscore this reform: the population-based responsibility shared among all local network partners and the hierarchical organization of services. » (Frame of Reference, MSSS, p. 14, Organizational Context)
« As regards to access programs to service in the English language, the CSSS's and other institutions within the network cooperate with the agencies and become partners in the development of these programs. Based on an understanding of the population's state of health and well-being, as well as its socio-sanitary needs and its distinctive characteristics, the agency supports the CSSS's to determine the specific needs of the population within its territory. Once the CSSS has an understanding of the profile of its general population and
Agence de la santé et des services sociaux de la Montérégie 9 Program of Access to Health and Social Services in the English Language for the English-speaking Population of the Montérégie of the services offered in English by the local network, the agency and the CSSS together analyse the gaps to be filled and identify the priority clinical targets to be reached which will assist in developing the access programs. Based on the organizational and clinical choices that will have been made, the access programs will aim towards fulfilling the needs that are identified in each milieu.
The access program for services in the English language is distinct from clinical and organizational projects. In this perspective, the program must identify the entirety of the services that are accessible in the English language, even if some of these have not been listed in the clinical and organizational projects of the local networks of health and social services. Nonetheless, the access program is closely linked to the clinical projects since in the course of their gradual implementation, they must integrate the various elements of the access program to English language services with which they are associated. » (Frame of Reference, MSSS, p. 14, Organizational Context)
The process to revise the access program to services in the English language undertaken in the Montérégie also attempted to respect the principles of populational responsibility as described in the document prepared by the Ministry of Health and Social Services entitled Projet clinique: Cadres de référence pour les réseaux locaux de services de santé et des services sociaux. Document principale, octobre 2004. This document points out on page 11 that « the populational responsibility signifies that service providers who offer services to the population of a local territory are invited to collectively share a responsibility to this population by making accessible as complete a range of services as possible and by taking charge of and accompanying people through the health and social services system, while encouraging the unification of efforts to maintain and improve the health and well-being of the population and the communities of which it is composed. »
1.1 Other measures which may support accessibility
The coming into effect of Bill 83, particularly as regards the new responsibilities related to the elaboration of clinical projects which target users of all ages and addresses those who are vulnerable, will allow for progress in accessibility of services destined to the English- speaking population.
The new populational responsibility of the health and social services centres will allow for a consolidation of the commitments made by the institutions in the Montérégie when the decree (1999) on the access plan was adopted. In this context, the adoption of a new decree will permit each CSSS to identify more clearly the offer of services to English- speaking users of their territory as well as the complimentarity and continuity of services agreed to with other institutions and partners.
Other measures may contribute to an improvement in services in English. The articles of the health and social services law which deal with respect for and promotion of user's rights (such as user’s committees, codes of ethics, complaint procedures, etc.) are all means which one can use to receive services in English. The right of users to be informed, to participate in their treatment (I.P. I.S.P. etc.), to receive adequate services from a
10 Agence de la santé et des services sociaux de la Montérégie
Chapter 1 - Principles to guide the revision scientific, human and social point of view, with continuity and in a personalised manner and to have access to one's file, are some other examples.
The participation of the population in the management of services (elections to Boards of Directors of both the institutions and the agency, the Provincial Committee for the provision of English-language services, the regional access committee, user's committees, Forum of the population) all provide other possibilities where the needs of the English community may be taken into account. Finally, the process of planning and co-ordinating services (the elaboration of the clinical projects) provides another opportunity to ensure respect for the right to services in English.
With these principles, the Agence de la santé et des services sociaux de la Montérégie, undertook its own process, with its institutions, to elaborate a new access program to health and social services in the English language for English-speaking people.
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Chapter 2 - Process for the revision of the access program
2. PROCESS FOR THE REVISION OF THE ACCESS PROGRAM
The Ministère de la santé et des services sociaux began the revision of the access programs process by sending the Cadre de référence to the Executive Directors of all institutions in Quebec. At the same time, a letter was sent to all Presidents-executive directors of the agencies asking them to undertake a process to revise their access programs and to deposit it with the Ministry before the end of January, 2007.
The responsibility for the revision of the access program in the Montérégie rests with the Secretary-general and Communications of the Agency. An action plan was drawn up and distributed to all institutions in the Montérégie. You will find a copy of the action plan as Annexe 1. The institutions could count on the support of the agency throughout the process.
The team in the Public Health Department responsible for the state of health of the population prepared statistics for each institution's territory. In addition, the Agency prepared a document which presented a portrait of the region and its health network, particular characteristics of the English community in the Montérégie and a history of the evolution of English language services in the region.
The document sent to the institutions contained the statistical portrait, the 1999 access program and requested that they name a person to be responsible for the Access Program within the institution. We asked that each institution develop an Action Plan up to 2010 which described actions that the institution would undertake to support access to services in English within the institution. These action plans will guide the Agency as it does follow up on the implementation of the access program within the institutions.
The people responsible within the institutions were invited to a meeting with Agency staff in order to clarify their tasks, answer any questions and ensure a common understanding of certain elements in the revision process.
2.1 Regional Consultation – April 2006
The Agency wished to consult representatives of the English community in order to know what their priorities were concerning the revision of the access program. As well, the agency wanted to consult the community about the proposed structure for the regional committee and so a consultation activity was held on April 19, 2006. You will find the agenda of this activity as Annexe 2.
Representatives from throughout the Montérégie were present at this consultation – representatives from the institutions, from English community organisations, English school boards and members of the old regional access committee. In total 54 people attended the consultation – one third from the English community, one third were workers in the network and one third were other partners. The results of the workshops were sent to all those who attended and as well to all the institutions before they began the process to revise their participation in the access program.
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Chapter 3 – Characteristics of the region
3. CHARACTERISTICS OF THE REGION
3.1 Territory
The Montérégie is an area of 10 000 sq. Km. bounded by the Saint Lawrence river to the north, the Outaouais to the west, the American border to the south and the Richelieu Valley to the east. The population of the region was 1 260 185 people in 2001, of which close to 130 000 are English-speaking and 75 000 from diverse ethnic origins. The Montérégie contains 18 % of Quebec’s population and it has a greater population than six of the ten Canadian provinces.
A particular trait of the region is the diversity of its territory. Despite the presence of an urban agglomeration with a dense population (more than 5 000 people per sq. Km. in Lemoyne), 78 % of the territory remains none the less rural with a population density as low as 8.5 people per sq. Km. Many villages are only served by secondary roads and remain distant from the main communication lines. This makes access to basic services very difficult: shopping, health and social services, training and employment.
3.2 Health and Social Services Network
In the Montérégie, the network of health and social services institutions consists of 41 public and private institutions distributed as follows:
11 CSSS 21 private CHSLD (12 private under agreement, 9 private not under agreement) 5 public and 2 private rehabilitation centres 1 Youth institution – Centre jeunesse de la Montérégie 1 University affiliated centre: Charles LeMoyne Hospital affiliated to the Faculty of Medicine of the University of Sherbrooke.
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Chapter 4 – Characteristics of the Montérégie’s English-speaking community
4. CHARACTERISTICS OF THE MONTÉRÉGIE’S ENGLISH- SPEAKING COMMUNITY
4.1 Choice of an Indicator
In order to identify the target population for this revision of the access program to services in English, the Agency decided to use the variable, « First official language spoken » (FOLS). The choice of this variable allows us to identify all the people who possibly may prefer to receive services from the network in English. As well, the health surveillance team of the Public Health Department proposed the use of this variable as the data from Census Canada for the 2001 census was available by different ages, and by municipality which allowed us to provide each institution with a detailed portrait of the population in their territory. You will find as Annexe 3 the portraits which were prepared for each CSSS territory in the region.
4.2 Data
Using the FOLS variable in the 2001 census, the Montérégie has 129 163 English-speaking people (10.2 % of the region’s population) which places our region as the second most important English-speaking population in Quebec after that of Montreal. This represents 15 % of the English-speaking population in the province. Often people are not aware of the importance of the English-speaking population in the Montérégie and will identify either the Outaouais or Estrie regions as those with a more important concentration of English- speaking people after that of Montreal. If we make an approximate analysis of the data, we find that 60 % of the English-speaking population of Quebec is in Montreal-Centre, 15 % in the Montérégie, 6 % in the Outaouais and 3 % in the Estrie and 16 % spread over the remaining regions of Quebec. The fact that close to 15 % of the English-speaking people of Quebec are in the Montérégie gives our region a particular responsibility as regards the organisation of services for this population.
The following table presents the distribution of the target population among the different health and social services centres (CSSS) territories. As well, this table presents the percentage of the regional population which is found in each CSSS territory and the cumulative.
Agence de la santé et des services sociaux de la Montérégie 17 Program of Access to Health and Social Services in the English Language for the English-speaking Population of the Montérégie
TABLE 1 :
Cumulative total of the population in private households whose first official language spoken is English, CSSS and Montérégie, 2001
% of the English- speaking population by CSSS within the Montérégie Proportion English-speaking Pop. Total of English Part by Part Population by CSSS of CSSS pop. in CSSS cumulative CSSS1 CSSS Champlain 38 198 182 195 21.0 % 29.6 % 29.6% Vaudreuil-Soulanges 22 748 101 280 22.5 % 17.6 % 47.2% Jardins-Roussillon 21 750 164 585 13.2 % 16.8 % 64.0% la Pommeraie 11 138 48 080 23.2 % 8.6 % 72.6% Pierre-Boucher 8 603 226 150 3.8 % 6.7 % 79.3% Richelieu-Yamaska 7 375 184 485 4.0 % 5.7 % 85.0% Haut-Saint-Laurent 7 065 21 605 32.7 % 5.5 % 90.5% Haut-Richelieu–Rouville 6 623 149 025 4.4 % 5.1 % 95.6% de la Haute-Yamaska 3 348 80 380 4.2 % 2.6 % 98.2% du Suroît 1 840 53 195 3.5 % 1.4 % 99.6% de Sorel-Tracy 478 49 205 1.0 % 0.4 % 100.0% Montérégie 129 163 1 260 185 10.2 % 100 % Source: Census 2001, Statistics Canada. Compilation : Équipe surveillance de l’état de santé de la population, DSP Montérégie
¹ The English includes all of the “English” and one half of those who indicate “English and French” as their First official language spoken.
4.3 Analysis of the date
We note in the above table that English-speaking people are present in every CSSS territory. As well, in order to fully understand the statistics, it is necessary to simultaneously analyse the number and the relative importance of the population in each CSSS territory. As an example, in the CSSS Haut-Saint-Laurent, 32.7 % of the population is English-speaking, which are 7 065 individuals out of a population of 21 605 residents. In contrast, in the CSSS Pierre-Boucher, the 8 603 English-speaking people represent « only » 3.8 % of the total population in this territory. For these two CSSS, the impact on the offer of services in English is identical but the reasons to justify it are different. In the case of
18 Agence de la santé et des services sociaux de la Montérégie Chapter 4 – Characteristics of the Montérégie’s English-speaking community the CSSS Haut-Saint-Laurent, the relative importance of the English-speaking population is primordial in the consideration of the offer of services in English, while in the case of CSSS Pierre-Boucher, it is the high number of English-speaking people involved which leads to the offer of services in English.
If we continue the analysis, we note that:
• English-speaking people are found throughout the region. Of the 180 municipalities in the Montérégie only 11 have no English-speaking people; • Also, we note that the English-speaking community is quite concentrated; 60 % of this population is found in just 11 municipalities; • In addition, 90 % of the English-speaking population is found in 50 of the 180 municipalities in the Montérégie, which represents only 28 % of the municipalities.
4.4 Socio-economic portrait
For many years, little data was available regarding the socio-economic profile of the Montérégie’s English-speaking population. In August 2006, an economist for the Labour Market Information sector in the Longueuil office of Services Canada prepared a socio- economic profile of the English-speaking population in the Montérégie. You will find below an extract from the conclusions contained in his report:
• Between 1996 and 2001, the English population diminished by 4.7 % in the Montérégie, compared with a growth of 1.4 % in the general population.
• Living in a strongly French environment, a large majority (62 %) of the English speaking population of the Montérégie is bilingual.
• Anglophones who are members of a visible minority represent 13.3 % of the population , slightly less than for the Province of Quebec as a whole (15.9 %), but much higher than Francophones in the Montérégie (2.1 %).
• The aging of the Montérégie’s Anglophone population is more pronounced than that of the francophone population, and the situation is amplified by the small proportion of the English population under 30 years of age which represents the future of the English population.
• The rate of participation of Anglophone adults in educational activities is slightly lower than for Francophones, but they have a higher level of education than the Francophone population.
• As regards labour market participation and unemployment, the situation is much less favourable for Anglophones than for Francophones. The dominant professional groups among Anglophones are business, finance, and administration and sales and services. Management is relatively more important in the professional structure of Anglophones as compared to Francophones. Three industrial sectors provide work
Agence de la santé et des services sociaux de la Montérégie 19 Program of Access to Health and Social Services in the English Language for the English-speaking Population of the Montérégie
to more than 37 % of Anglophones; they are manufacturing, retail commerce and transport and warehousing.
• The proportion of Anglophones who are employed is much lower than for Francophones (57.9 % vs. 64.1 %).
• The proportion of adults without revenue in the Montérégie is greater among Anglophones. The presence of revenue below $10,000 is also more frequent among them. However, the portion of Anglophones who gain more than $60,000 per year is much greater than for francophone adults.
• The average revenue for Anglophones in the Montérégie varies greatly from one MRC to another.
Below, one will find data on each MRC territory where the majority of the English- speaking population is found:
• MRC Champlain: large decrease in the English population between 1996 and 2001; large proportion of people whose mother tongue is neither French nor English who have adopted English as their working language; large percentage of Anglophones have university degrees.
• MRC Vaudreuil-Soulanges : increase in the English population in the period 1996-2001; the English population is younger than in other MRCs; very well educated; very high labour market participation and low unemployment; high average income.
• MRC Roussillon : decrease in the English population between 1996 and 2001; the English population is relatively young; it is situated pretty much in the middle as regards most characteristics of the English population.
• MRC Le Haut-Saint-Laurent : important decrease in its English population in the period 1996-2001; it has few immigrants in its English population and has few visible minorities; the English population is less educated compared to Anglophones in the Montérégie; low average income.
• MRC Brome-Missisquoi important decrease in the Anglophone population in the period 1996-2001; it formed by a relatively low proportion of immigrants and has few visible minorities; the English population is less educated than Anglophones in the Montérégie; labour market activity is particularly low and their incomes are among the lowest.
20 Agence de la santé et des services sociaux de la Montérégie Chapter 5 – Organisational and social structures in the English community
5. ORGANISATIONAL AND SOCIAL STRUCTURES IN THE ENGLISH COMMUNITY
In order to better understand the Anglophone community it is important to be aware of what it has developed as organisational and social structures to support itself.
The community is served by four school boards at the primary and secondary levels as well as one English CEGEP for postsecondary studies. During the last few years, the school boards have been faced with the challenge of reorganising their school network as enrolment has fallen. In addition, schools in the English community serve as the place for all sorts of exchanges on a variety of issues that face the community- a type of community centre.
As regards support services, the English community often has developed its own network of services organised around their churches. It is note worthy that many times these structures are informal. An example of this is « Meals on Wheels » and other food distribution programs. Project HOPE (Helping Other People Effectively) on the territory of the CSSS Champlain, offers a multitude of services to the most vulnerable in the community and has been in existence since 1986. Yet, the organisation is not incorporated, functions entirely with volunteers, serves both the English and French communities and receives no public financing. In 2005-2006 this organisation offered services to close to 300 people.
As well, while these services are not directly related to health and social services, the English community has developed a multitude of social and cultural activities and various support groups meet on a regular basis across the region (Moms and Tots, 50 Plus, Golden Age Clubs, theatre groups, etc.).
In a study of community and volunteer groups in the Montérégie published by the Agency in 2005, Portrait des organismes communautaires et bénévoles oeuvrant dans le domaine de la santé et des services sociaux en Montérégie, 32 % of the 390 organisations which took part in the study indicated that they served English-speaking clients. This means that the English community makes use of resources in their communities as does the francophone community.
For many years, the English-speaking community has created associations which while they do not offer health and social services, do take on the mandate to promote the interests of the English-speaking community. The Agency maintains a special relationship with these organisations. Normally these types of organisations, which exist throughout Quebec, are defined by territories which correspond to administrative territories (regions). In the Montérégie, we have two such organisations – Townshippers’ Association (Haute-Yamaska and La Pommeraie) and the Châteauguay Valley English-speaking People’s Association, CVESPA, (the western part of the Montérégie). Presently the population in the central part of the Montérégie is not represented by such an organisation since the closing of the Alliance Quebec - South Shore chapter. There is a new organisation, South Shore Community Partners, which encourages exchanges amongst various sectors of the English- speaking community in the central part of the Montérégie (Champlain and Pierre-Boucher).
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Over the past four years, the community has developed community economic development corporations (CEDEC), in collaboration with Services Canada, to assist the community to reinforce its capacities and increase the community’s participation in the labour market. As well, these organisations help members to create small enterprises and other projects in response to the community’s needs.
The English-speaking community is benefiting from the emergence of a new organisation, the Community Health and Social Services Network (CHSSN), which sponsors several projects financed by Health Canada as part of its program to support Quebec’s initiatives to improve access to health and social services for English-speaking people. This organisation has published studies about the situation of the English- speaking community in Quebec and has developed a funding program for projects to improve front line services, an initiative to offer language training to health care workers and funding to create networking projects in certain communities One such project functions in the territories of the CSSS La Pommeraie and Haute-Yamaska in collaboration with the Townshippers’ Association.
Over the years, the English-speaking community has maintained good relations with the representatives of the health and social services institutions in the Montérégie. Certain institutions have formed liaison committees with this population and many count members of the community on their Boards of Directors, User’s Committees, etc. In general, the institutions in the Montérégie have demonstrated openness to integrating the preoccupations of the English-speaking into the various planning and liaison activities they have established.
There are two First nation communities in the Montérégie – one is Akwesasne and the other is Kahnawake. Between them these communities have between 15 and 20 000 residents. First line health services and many social services are offered to the residents inside their communities. However, when members of these communities use services outside their communities, they can make use of the Access Program to health and social services in English, as the vast majority of this population is English-speaking. Special attention will be made to publicise the program within these two communities.
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Chapter 6 – History of English language services in the Montérégie
6. HISTORY OF ENGLISH LANGUAGE SERVICES IN THE MONTÉRÉGIE
In this section and in order to better understand the current situation, we present a brief history of the evolution of the provision of English-language services in the Montérégie.
• The first Access Program was adopted by the Board of Directors of the Conseil regional de la santé et des services sociaux (CRSSSM) in 1989. This access program was realised in collaboration with institutions in the region and with the knowledge which existed at the time. Given that neither the Ministry, the regional bodies, nor the institutions had any experience in the elaboration of such an access program, this first program was neither exhaustive nor complete.
• In 1994, the Ministry of Health and Social Services created a frame of reference to guide the process for the revision of the access programs for services to English- speaking people. This framework had as an objective to encourage a common understanding of the orientations, objectives and content of the access programs and to ensure coherence in the work carried out by the Ministry, the regional boards and the institutions. The access program which resulted from this process was more complete, included more institutions and allowed for the identification of more services as being accessible in English in the region. Several institutions confirmed that the clarifications and definitions provided in the frame of reference had the effect of making their participation in the program easier. The program was initially adopted by the Board of Directors of the Régie régionale in November 1995. After certain requests for precisions requested by the Ministry, the program was the object of a decree in June 1999. You will find in Annexe 4 a table which presents this access program by CSSS and we propose that this program serve as a base for the new program.
Since the adoption of the first access program, there have been developments in the organisation of services for the English-speaking community. In this section we identify certain of these developments and their impact on the provision of services in English.
• Following a major reorganisation of the offer of outpatient services by the Montreal Children’s Hospital, the Agency granted a budget to Charles Lemoyne Hospital in order to develop an outpatient pedopsychiatry service. The partners, particularly Riverside School Board, have expressed their satisfaction with the service.
• As well, following the adoption of the regional service organization plan (PROS) on dependencies in 1995, Foster Pavilion was given the mandate to develop outpatient services in collaboration with the CLSCs in the region. These services continue to this day and are greatly appreciated by the community and the other partners who work with this same clientele.
• In the area of adult mental health services, the mental health PROS pointed out an important lack of services for the adult Anglophone population. As a result, specific budgets were granted to several organisations across the region to address this
Agence de la santé et des services sociaux de la Montérégie 23 Program of Access to Health and Social Services in the English Language for the English-speaking Population of the Montérégie
weakness. The following organisations received grants: Ami-Quebec (family support); Espoir and Maison Goeland (community support); Service Centregens (self-help group).
• Recently, the pre-hospital services sector of the Agency updated a guide used by ambulance technicians in the administration of certain medications. The questionnaire and the possible responses related to each protocol were translated in order to facilitate the interaction between the ambulance technicians and the English-speaking clientele.
• In 2001, the Agency presented a plan for the reorganisation of pedopsychiatry services in the Montérégie, Grandir en santé mentale en Montérégie. The base of this plan is to develop front line services in the CLSC units throughout the region. The plan specified that five CLSC in which we find the majority of the English- speaking population were to have the mandate to serve English-speaking youth in their territory and in neighbouring territories.
In addition to the above mentioned specific actions regarding the evolution of services in English, we wish to underscore certain activities which have been very helpful in supporting the efforts of our institutions in their offering of services to the English- speaking community – namely, translation of documents and language training.
• In 2005-2006, McGill University received a mandate to organize a training and human resource development project in collaboration with the Community Health and Social Services network (CHSSN). The team responsible for training in the network in the Agency’s human resource planning and development department organized this training with all the institutions. In the first year, 250 individuals followed the English second language training in several locations throughout the region. For the second year of this project (2006-2007) there are 410 participants registered for this training.
Champlain College was selected to offer these courses. With more than 25 years of experience in providing this type of training, the College indicated to us that they had never encountered a group of learners who were as enthusiastic and dedicated as the groups made up of the workers from the various institutions in the Montérégie. In order to assist the participants to maintain there new skills, volunteers from the English community were recruited to meet with small groups of participants to for an « English conversation club ». This program which is financed by Health Canada will last three years. We believe that this initiative will have a major impact on the capacity of the institutions to be able to respond to their English-speaking clientele.
• For several years, the Agency has accepted to translate, at its expense, certain documents for the institutions in the region. As an indication, since 2002-2003, more than 100 documents such as flyers describing services, post-operation protocols, procedures regarding complaints and other documents judged to be useful to clients, have been translated. As well, in 2000-2001, certain institutions took advantage of a program sponsored by the English-speaking Catholic Council in
24 Agence de la santé et des services sociaux de la Montérégie
Chapter 6 – History of English language services in the Montérégie
order to translate documents. Lastly, the Agency has undertaken the translation of several documents in the prevention programs of the Public Health sector.
• A regional committee for access to health and social services in English for English- speaking people has been in place in the Montérégie since 1987. Due to the reorganisation in the network, the Agency was obliged to revise the regulation concerning its regional committee for access programs to services in English. This regulation was adopted by the Board of Directors of the Agency on June 14 2006. The call for candidates and the consultation process allowed for the members of the committee to be confirmed in October, 2006. You will find attached as Annexe 5 a copy of the regulation. A strength of the new regulation is that it ensures a good representation of the English community from across the region.
Agence de la santé et des services sociaux de la Montérégie 25
Chapter 7 – Offer of services in English
7. OFFER OF SERVICES IN ENGLISH
Each institution was asked to reflect on their capacity to offer services in English while respecting the frame of reference of the Ministry of Health and Social Services.
The results of this exercise are very encouraging both with regards to the number of institutions involved as well as the diversity of services offered by the institutions of the Montérégie to its English-speaking population. Four institutions have been added who did not participate in the 1999 access program.
The process used by the institutions to arrive at their offer of services differed from one institution to another. The Agency was impressed by the rigor and the amount of reflection demonstrated by the institutions throughout this revision process. The quality of the work done internally to arrive at their offer of services and the detailed reports sent to the Agency were all remarkable.
Each institution who has accepted to participate in the program must develop an action plan for the 2007-2010 period which will support the offer of services in English. These action plans will be followed by the Agency as part of its monitoring function during this same period.
In the following pages you will find the services to be included in the access program to services in English in the Montérégie. As no model for the nomenclature of services offered by the institutions has been offered, we note that the lists of services vary from one institution to another, some are very detailed and others are more summarised.
As required by the Ministry's Frame of Reference, the offer of services presented here is confirmed by a resolution of the Board of Directors of the institution concerned.
Agence de la santé et des services sociaux de la Montérégie 27 Program of Access to Health and Social Services in the English Language for the English-speaking Population of the Montérégie
CSSS CHAMPLAIN
Principal municipalities served : Brossard, Saint-Lambert, Saint-Hubert
Total Population : 182 195
Number of English-speaking People : 38 198
Percentage of the population - Anglophone : 21 %
SERVICES INCLUED IN THE ACCESS PROGRAM :
Basic CLSC Health and Social Services, Home care and in schools Reception-evaluation-orientation Info-Santé CLSC Child-family Services Youth Services Home Care Blood Test Centre Stop Smoking Centre Asthma Education Centre Travel Health Clinic CAFE Reception Residential Care Psychosocial Services Day Hospital Intensive Functional Rehabilitation Day Centre
28 Agence de la santé et des services sociaux de la Montérégie
Chapter 7 – Offer of services in English
CSSS DE LA HAUTE-YAMASKA
Principal municipalities served : Granby, Waterloo
Total Population : 80 380
Number of English-speaking people : 3 348
Percentage of the population - Anglophone : 4.2 %
SERVICES INCLUED IN THE ACCESS PROGRAM :
Basic Services First Line Mental health Team Mental Health- 2nd line Children-Youth People with loss of autonomy – Homecare Residential Services
Agence de la santé et des services sociaux de la Montérégie 29 Program of Access to Health and Social Services in the English Language for the English-speaking Population of the Montérégie
CSSS DU HAUT-SAINT-LAURENT
Principal municipalities served : Huntingdon, Ormstown
Total Population : 21 605
Number of English-speaking people : 7 065
Percentage of the population - Anglophone : 32.7 %
SERVICES INCLUED IN THE ACCESS PROGRAM :
Designated institution All services
NOTE : This institution is recognized by the Charte de la langue française (article 29.1) and designated by decree of the Ministry of Health and Social Services t offer services in English to English-speaking people.
30 Agence de la santé et des services sociaux de la Montérégie
Chapter 7 – Offer of services in English
CSSS HAUT-RICHELIEU–ROUVILLE
Principal municipalities served : Saint-Jean-sur-Richelieu, Chambly, Noyan, Lacolle
Total Population : 149 025
Number of English-speaking people : 6 623
Percentage of the population - Anglophone : 4.4 %
SERVICES INCLUDED IN THE ACCESS PROGRAM :
Psycho-social services (Follow up) Info-santé CLSC (regional) Intensive Functional Rehabilitation Day Centre
Agence de la santé et des services sociaux de la Montérégie 31 Program of Access to Health and Social Services in the English Language for the English-speaking Population of the Montérégie
CSSS LA POMMERAIE
Principal municipalities served : Cowansville, Lac Brome, Sutton, Bedford
Total Population : 48 080
Number of English-speaking people : 11 138
Percentage of the population - Anglophone : 23.2 %
SERVICES INCLUDED IN ACCESS PROGRAM :
Reception and Appointment Centres Info-Santé Communication Services Inpatient Care Units - BMP Out patient Services at BMP Blood Test Centres Diagnostic Services (Medical Imagery, respiratory physiology and others) Rehabilitation Services Pre and Post Natal CLSC Services CLSC Services to 0-5 years of age (Children and parents) Reception - Health Reception - Psychosocial Psychosocial Services (0-100 years of age - individuals, families and care givers) 1st and 2nd Line Mental Health Services CAFE Program Chronic Illnesses and Systematic Follow up School Health and Social Services CLSC Youth Services for 5-17 years of age GMF Services Basic Health and Social Services Youth Clinic Geriatric Services for 65 years and older Residential Services – Bedford – Sutton - BMP - Cowansville Day Centre – Bedford – Cowansville – Sutton – Lac Brome Requests for Residential Care Specialized Geriatric and Psycho-geriatric Team Psychosocial Services for Adults Homecare Services and Care DI-TED Nursing Clinic Walk-in Medical Clinics Vaccination
32 Agence de la santé et des services sociaux de la Montérégie
Chapter 7 – Offer of services in English
CSSS JARDINS-ROUSSILLON
Principal municipalities served : Châteauguay, Candiac, La Prairie, Hemmingford
Total Population : 164 585
Number of English-speaking People : 21 750
Percentage of the population - Anglophone : 13.2 %
SERVICES INCLUDED IN THE ACCESS PROGRAM :
Multiclienteles Services • Prevention and Health Promotion Reception - Evaluation – Orientation 1st line Medical, Nursing and Psychosocial Services Info-Santé Blood Test Clinic Short Term Physical Health and Specialized Services • Prevention and Promotion Pre-admission Operating Room, Day Centre, Sterilization Emergency Intensive Care Surgical Units Outpatient Surgery Endoscopy Respiratory Therapy Rehabilitation Services Nutrition Clinic Home Care Psychosocial Services Intensive Functional Rehabilitation Family Children Youth Prevention and Promotion Mother, Child and School Health Services Youth Clinics CAFÉ Special Programs for vulnerable clients School Social Services Nutrition Clinic Dental Health Birthing Centre Family Planning
Agence de la santé et des services sociaux de la Montérégie 33 Program of Access to Health and Social Services in the English Language for the English-speaking Population of the Montérégie
Rehabilitation Paediatrics Psychosocial Services Home Care Development Clinic Community Intervention Mental health and Dependencies Prevention and Promotion Outpatient Psychiatry Services Intensive Community Follow up Inpatient Psychiatric Services Pedopsychiatry Day Centre Non-institutional Resources Psychosocial Services Home Care Rehabilitation Basic Mental Health Team Services Community Intervention
Physical Health and Chronic Illnesses Prevention and Promotion Outpatient Medical Services Day Medicine Inpatient Medical Units Respiratory Therapy Rehabilitation Nutrition Clinic Oncology Palliative Care Psychosocial Services Home Care Community Intervention Loss of Autonomy due to Aging or Physical Deficiency Prevention and Promotion Outpatient Services Non-institutional Resources Residential Services Active Geriatrics Respiratory Therapy Rehabilitation Nutrition Clinic End of Life Care Psychosocial Services Home Care Day Centre Community Intervention
34 Agence de la santé et des services sociaux de la Montérégie
Chapter 7 – Offer of services in English
Public Health
Public Health services are divided into three categories: • Promotion\Prevention\Protection (such group activities as: Quitting smoking clinic, Healthy after 50, Breast cancer screening, prevention of falls, etc.) • Health in the Workplace • Social and Community Development Services
Agence de la santé et des services sociaux de la Montérégie 35 Program of Access to Health and Social Services in the English Language for the English-speaking Population of the Montérégie
CSSS PIERRE-BOUCHER
Principal municipalities served : Longueuil, Boucherville
Total Population : 226 150
Number of English-speaking People : 8 603
Percentage of the population – Anglophone : 3.8 %
SERVICES INCLUED IN ACCESS PROGRAM :
Pierre Boucher Hospital • Reception • Emergency Room • Specialized Outpatient Clinics • Assistance Program for Victims of Sexual Assault • Physiotherapy Services Chevalier-De-Levis Residential Centre • Palliative Care Program CLSC Longueuil-Ouest • Clinic Reception • Home Care Program CLSC Simonne-Monet-Chartrand • Health Reception • Blood Tests • Home Care Program • Basic Health Services CLSC des Seigneuries • Clinic Reception • General Psychosocial Services
36 Agence de la santé et des services sociaux de la Montérégie
Chapter 7 – Offer of services in English
CSSS RICHELIEU-YAMASKA
Principal municipalities served : Saint-Bruno-de-Montarville, Saint-Hyacinthe, Beloeil
Total Population : 184 485
Number of English-speaking People : 7 375
Percentage of the population - Anglophone : 4 %
SERVICES INCLUED IN THE ACCESS PROGRAM :
CLSC des Patriotes • School Health and Social Services • Home Care Services • Basic Health and Social Services
Agence de la santé et des services sociaux de la Montérégie 37 Program of Access to Health and Social Services in the English Language for the English-speaking Population of the Montérégie
CSSS VAUDREUIL-SOULANGES
Principal municipalities served : Vaudreuil-Dorion, Pincourt, Île Perrot, Hudson, Saint-Lazare
Total Population : 101 280
Number of English-speaking People : 22 748
Percentage of the population - Anglophone : 22.5 %
SERVICES INCLUDED IN THE ACCESS PROGRAM :
CLSC of Vaudreuil-Soulanges (La Presqu’Île) • Specific and General Health and Social Services • Services due to Loss of Autonomy : health, social and rehabilitation • Reception • Reception-Evaluation-Orientation • Info-santé (until Dec. 30, 2006) Residential Centres : Laurent-Bergevin, de Couteau-du-Lac, de Rigaud, de Vaudreuil • Residential Care Units and Day Centres
38 Agence de la santé et des services sociaux de la Montérégie
Chapter 7 – Offer of services in English
CSSS DU SUROÎT
Principal municipalities served : Salaberry-de-Valleyfield, Beauharnois
Total Population : 53 195
Number of English-speaking People : 1 840
Percentage of the population - Anglophone : 3.5 %
SERVICES INCLUDED IN THE ACCESS PROGRAM :
Department for Services to People with a Loss of Autonomy Department of Mental Health Services Department of Family, General Services and Public Health Department of Physical Health and Medical Affairs • Medical and Surgery Programs • Diagnostic and Therapeutic Services
Agence de la santé et des services sociaux de la Montérégie 39 Program of Access to Health and Social Services in the English Language for the English-speaking Population of the Montérégie
HÔPITAL CHARLES LEMOYNE
SERVICES INCLUDED IN ACCESS PROGRAM :
Reception Pastoral Care Emergency Room Outpatient Clinics Laboratories Intensive Care Perinatality - 1er Nord - paediatrics – gynaecology 2e Sud - traumatology 3e Sud - surgery 3e Nord – neurological sciences and orthopedics 4e Nord - geriatry, family medicine , palliative care Oncology 5e Sud - cardiology, gastroenterology 5e Nord - medicine Out patient Services Rehabilitation Services Social Services Pedopsychiatry inpatient (1 bed in adopsychiatry) and outpatient services 0-17 years Medical Imagery Respiratory Therapy Dialysis Operating Room
NOTE : L’Hôpital Charles LeMoyne is an affiliated university centre with a regional mandate to offer certain specialized and ultra-specialized services.
40 Agence de la santé et des services sociaux de la Montérégie
Chapter 7 – Offer of services in English
CENTRE JEUNESSE DE LA MONTÉRÉGIE
SERVICES INCLUED IN THE ACCESS PROGRAM :
Youth Protection Services Reception and treating of reports Evaluation - orientation Revision Psychosocial Services Children Adolescents Residential Services Foster Homes Supervised Apartments Rehabilitation Services External Intermediate Resources Institutional Resources Specific Services Adoption Reunification Services Expertise to the Superior Court Research and Evaluation Complaint Service
NOTE : This institution has a formal agreement with Batshaw Youth and Families Centre (Montreal-Centre) concerning residential rehabilitation services.
Agence de la santé et des services sociaux de la Montérégie 41 Program of Access to Health and Social Services in the English Language for the English-speaking Population of the Montérégie
LES SERVICES DE RÉADAPTATION DU SUD-OUEST ET DU RENFORT (SRSOR)
SERVICES INCLUDED IN THE ACCESS PROGRAM :
Access, Evaluation and Orientation Services Adaptation and Rehabilitation Services for individuals At home In the workplace In the community Specialized Educational Assistance Services to Families and Relatives Residential Services
42 Agence de la santé et des services sociaux de la Montérégie
Chapter 7 – Offer of services in English
CRDI MONTÉRÉGIE-EST
SERVICES INCLUDED IN THE ACCESS PROGRAM :
Access, Evaluation and Orientation Services Adaptation and Rehabilitation Services for individuals At home At work In the community Specialized Educational Assistance Services to Families and Relatives Residential Services
Agence de la santé et des services sociaux de la Montérégie 43 Program of Access to Health and Social Services in the English Language for the English-speaking Population of the Montérégie
PAVILLON FOSTER
SERVICES INCLUDED IN THE ACCESS PROGRAM :
Designated Institution All services
NOTE : This institution is recognized by the Chartre de la langue française and is designated by decree of the Ministry of Health and Social Services to offer services in English to English-speaking people.
CENTRE D’HÉBERGEMENT C.P.L. ARGYLE INC. (RÉSIDENCE DU PARC)
(This institution is a private nursing home for seniors)
SERVICES INCLUDED IN THE ACCESS PROGRAM :
Designated Institution All services
NOTE : This institution is recognized by the Chartre de la langue française and is designated by decree of the Ministry of Health and Social Services to offer services in English to English-speaking people.
44 Agence de la santé et des services sociaux de la Montérégie
Chapter 7 – Offer of services in English
CENTRE MONTÉRÉGIEN DE RÉADAPTATION
SERVICES INCLUDED IN THE ACCESS PROGRAM :
Programs for Children and Youth : motor deficiency language deficiency hearing deficiency (oralist method) traumatology residential resources specialized clinics : o dysphasia o evaluation of complex development difficulties: children aged 0-7 years; medical evaluations (regional) Programs for adult clients : motor deficiency hearing deficiency (oralist method) traumatology personalised care of sprains and muscular injuries Programmes 0-100 years : technical aides mobility and positioning hearing assistance aides access to technology and communication
Agence de la santé et des services sociaux de la Montérégie 45 Program of Access to Health and Social Services in the English Language for the English-speaking Population of the Montérégie
INSTITUT NAZARETH ET LOUIS-BRAILLE
SERVICES INCLUDED IN THE ACCESS PROGRAM :
Programs : • Professional Support • Early Childhood Development and Integration into School • Socio-professional Integration and Autonomy • Community Integration and Home Care • Deaf-Blindness
Services : • Technical Aides Service • Sales Counter • Toy Library • Documentation Centre • Adaptation of information into substitute media
NOTE : This institution has a formal agreement with the Montreal Association for the Blind concerning services for the English-speaking population.
46 Agence de la santé et des services sociaux de la Montérégie
Chapter 8 – Action Plan for the Montérégie
8. ACTION PLAN FOR THE MONTÉRÉGIE
Throughout the process of revising the Access program, the Agency, the institutions and our partners representing the English-speaking community identified certain gaps in the health and social services offered to English-speaking people in the Montérégie.
The principal gaps are the following : • the availability and continuity of services offered to adults who have mental health problems; • lack of certain specialized services for youth in difficulty and their families; • the lack of response to documented needs by school boards concerning day treatment services for certain students for whom these same school boards are obliged to offer educational services; • the challenges in offering residential services within long term care centres, particularly when the English-speaking population represents a small minority within the institution; • the absence of studies to verify the real access by English-speaking people to home care services in the region; • lack of studies regarding the satisfaction of English-speaking people with the services offered in the region.
Below, one finds the principal actions suggested to improve access to services in English for English-speaking people in the Montérégie.
Communication and Information Activities – Firstly, the Agency proposes to produce a brochure on the Access Program for distribution throughout the Montérégie. The institutions might also organize information sessions with members of the English-speaking community in their territory; these meetings will serve to explain the local Access Program and also hear from the community members about their preoccupations regarding services in English. Finally, the institutions and the representatives of the English-speaking community may identify other measures to ensure a good understanding of the Access Program.
Language Training – Given the positive impact of the language training program for health care workers who offer services in English, the Agency is committed to participating in all discussions which may contribute to the continuation of the existing language training programs.
Clinical Projects – As part of the development of the clinical plans for each services continuum, the Agency will ensure that the preoccupation of accessibility in English will be present in the development of these projects by those institutions who serve the English community. Throughout these processes, the Agency will make reference to the Ministerial document « Pour élaborer des projets cliniques en tenant compte des besoins et des particularités des personnes d’expression anglaise et du cadre legislatif en place » in order to guide the activities undertaken in this regard. As well, the Agency will inform the Regional Committee about the development of the clinical projects in the region.
Agence de la santé et des services sociaux de la Montérégie 47 Program of Access to Health and Social Services in the English Language for the English-speaking Population of the Montérégie
Translation of Documentation – Despite the high level of bilingualism of the Montérégie’s English-speaking community, their level of proficiency in reading French is not very high and as a result the institutions must inventory those documents which it judges must be translated into English. The Agency will collaborate with the institutions in developing this inventory and work with the institutions to find the most efficient way to make these documents available in English. Finally, the Agency will also collaborate with other Agencies and the Ministry in an ongoing process to ensure that the largest amount of documentation will be available in English.
Follow-up and Evaluation of the Access Program – « The Ministry, acting in cooperation with the agencies and the Provincial Committee for the dispensing of health and social services in the English language, ensures the follow-up and evaluation of access programs. To this end, follow-up and evaluation parameters will be determined by the Ministry, which will define, among other things, the type of follow-up and evaluation to be retained (e.g. follow-up of the of the implementation of access programs, evaluation of results derived from their realisation) priority goals, and methods. Performance indicators will be developed on the basis of available measurement tools and other work undertaken on the subject (for instance, the Aide-mémoire of the Secrétariat à l’accès aux services en langue anglaise et aux communautés culturelles). Eventually, certain select indicators retained to evaluate access programs could be included in management agreements. » (Frame of reference for the implementation of programs of access to health and social services in the English language for the English-speaking population, p. 22)
Implication of the Regional Committee – The Agency will ensure that the Regional Committee participates fully in different aspects related to the provision of services in English in the region and that it will be consulted at different times during the process. This could be concerning the development of clinical projects, the evaluation of the Access Program for services in English as well as other aspects which may have an impact on the provision of services in the English language.
48 Agence de la santé et des services sociaux de la Montérégie
ANNEXES
Agence de la santé et des services sociaux de la Montérégie 49
Annexe 1
Annexe 1 – Action Plan – Revision of access program to health and social services in English
ACTION PLAN (Revised)
Activity Responsability Deadline
Launch of the operation with Agency / Institutions May 31, 2006 Directors and identification people responsible for the issue in the institutions
Internal consultation with the Agency June 22, 2006 professionals of the DGACR and the DSP
First materials sent to people Agency June 9, 2006 responsible (statistics, orientations, etc.)
Elaboration of services offered for Institutions October 27, 2006 each institution
Presentation of program to Agency November7, 2006 Regional Committee and Work Plan
Validation of the results for the Agency November 10, 2006 regional program
Identification of modifications Agency / Institutions November 24, 2006 required and negotiation with the institutions
Circulation of the final version of Agency December 1, 2006 program to the institutions
Adoption of Board resolutions by Institutions January 15, 2007 the institutions
Agence de la santé et des services sociaux de la Montérégie 51 Program of Access to Health and Social Services in the English Language for the English-speaking Population of the Montérégie
Meeting of Regional Committee to Agency January 16, 2007 finalize their opinion
If necessary, final modifications to Agency January 17, 2007 program for presentation to Agency’s Board of Directors
Adoption by Agency’s Board of Agency January 18, 2007 Directors
Submission of Program to MSSS Agency Before January 30, 2007 (with resolutions)
September 6, 2006
52 Agence de la santé et des services sociaux de la Montérégie
Annexe 2
Annexe 2 – Regional Consultation on Services in the English language in the Montérégie
April 19, 2006
AGENDA
Animator : John Britton, Agence de la santé et des services sociaux de la Montérégie
16 h Welcome
Luc Boileau, président-directeur général de l’Agence de la santé et des services sociaux de la Montérégie
16 h 10 Organization of English-language services in the Montérégie
1. Orientations of the Québec Ministry of Health and Social Services (MSSS) Julie Desjardins, directrice du Secrétariat des services en langue anglaise 2. Provincial Committee of MSSS Ron McNeil, Secretary of the Provincial Committee on the Dispensing of health and Social Services in the English Language 3. Regional Committee for services in English of the Montérégie Lorraine Torpy, President of the Committee 4. Federal Projects to support accessibility James Carter, Community Health and Social Services Network 5. Networking Activities – The Success of the Townshippers Georges Courville, Co-ordinator 6. The McGill University Language Training Program Lise Blondeau, Agence de la santé et des services sociaux de la Montérégie, Training in the Network
17 h 10 Question Period 17 h 30 Supper 18 h 30 Introduction to workshops 18 h 40 Discussion in small groups Theme 1 : Services in English – successes and needs Theme 2 : Regional Committee – renewal and composition 19 h 30 Plenary Session Sharing of comments and opinions from workshops 19 h 50 Closing Remarks Lorraine Torpy, President of Regional Committee for Services in English 20 h End of Meeting
Agence de la santé et des services sociaux de la Montérégie 53
Annexe 3
Annexe 3 – Statistics – Population in Private Households
Population in private households whose First Official language is English, CSSS, municipalities et CRDI of the Montérégie, 2001
Équipe Surveillance de l’état de santé Direction de santé publique de la Montérégie
By Dominique Agossou with the collaboration of J. Britton and E. Savoie
June 2006
NOTE : The numbers in the tables are rounded off; the totals for the English-speaking population may vary slightly from the totals for the population by CSSS territory.
Agence de la santé et des services sociaux de la Montérégie 55
Annexe 3
Cumulative total of the population in private households whose first official language spoken is English, CSSS and Montérégie 2001
% of the English-speaking population by CSSS within the Montérégie Proportion of English-speaking Population total English- Part Part CSSS Population by CSSS speaking pop. by CSSS cumulative by CSSS1 in CSSS Champlain 38 198 182 195 21,0% 29,6% 29,6% Vaudreuil-Soulanges 22 748 101 280 22,5% 17,6% 47,2% Jardins-Roussillon 21 750 164 585 13,2% 16,8% 64,0% la Pommeraie 11 138 48 080 23,2% 8,6% 72,6% Pierre-Boucher 8 603 226 150 3,8% 6,7% 79,3% Richelieu-Yamaska 7 375 184 485 4,0% 5,7% 85,0% du Haut-Saint-Laurent 7 065 21 605 32,7% 5,5% 90,5% Haut-Richelieu–Rouville 6 623 149 025 4,4% 5,1% 95,6% de la Haute-Yamaska 3 348 80 380 4,2% 2,6% 98,2% du Suroît 1 840 53 195 3,5% 1,4% 99,6% de Sorel-Tracy 478 49 205 1,0% 0,4% 100,0% Montérégie 129 163 1 260 185 10,2% 100,0% Source : Census 2001, Statistics Canada
¹ The English includes all of the ' English' and one half of those who indicate 'English and French' as their first official language spoken.
Note : English-speaking people are present in all CSSS territories.
Prior to taking decisions based of the statistics presented in these tables, it is important to analyse simultaneously the number and the relative importance of the population in each CSSS territory.As an example, in the CSSS Haut-Saint-Laurent, 32.7% of the population is English-speaking, which are 7,065 individuals out of a population of 21,605 residents. In contrast, in the CSSS Pierre-Boucher, the 8,603 English-speaking people represent 'only' 3.8% of the total population in this territory. For these two CSSS, the impact on the offer of services in English is identical but the reasons to justify it are different. In the case of the CSSS Haut-Saint-Laurent, the relative importance of the English-speaking population is primordial in the consideration of the offer of services in English, while in the case of CSSS Pierre-Boucher, it is the high number of English-speaking people involved which leads to the offer of services in English.
The implication of Article 2 of the Law respecting Health and Social Services is that all CSSS have a responsibility as regards the English-speaking population even if their number is small. In this way, even though there are only 478, people in the territory of CSSS Sorel-Tracy, one must ensure that services are available in English by service agreements.
Agence de la santé et des services sociaux de la Montérégie 57 Program of Access to Health and Social Services in the English Language for the English-speaking Population of the Montérégie
Population in private households whose first official language spoken is English, CSSS and Montérégie 2001
0-4 5-17 18-29 30-64 65-74 75 yrs Total Total % CSSS years years years years years and + English1 Population English Champlain 1 548 6 396 6 294 19 253 2 833 1 875 38 198 182 195 21,0% de la Haute-Yamaska 108 538 415 1 795 230 263 3 348 80 380 4,2% de Sorel-Tracy 40 45 40 273 55 25 478 49 205 1,0% du Haut-Saint-Laurent 378 1 399 806 3 173 685 625 7 065 21 605 32,7% du Suroît 58 210 180 975 273 145 1 840 53 195 3,5% Haut-Richelieu–Rouville 218 1 051 1 085 3 220 625 425 6 623 149 025 4,4% Richelieu-Yamaska 263 1 169 952 3 680 815 498 7 375 184 485 4,0% la Pommeraie 515 1 979 1 334 5 160 1 093 1 058 11 138 48 080 23,2% Jardins-Roussillon 1 175 4 203 2 618 10 960 1 745 1 050 21 750 164 585 13,2% Pierre-Boucher 355 1 215 1 293 4 645 563 533 8 603 226 150 3,8% Vaudreuil-Soulanges 1 585 5 011 2 362 11 680 1 260 850 22 748 101 280 22,5% Montérégie 6 240 23 214 17 376 64 813 10 175 7 345 129 163 1 260 185 10,2% Source: Census 2001, Statistics Canada
¹ The 'English' includes all of the 'English' and one half of those who indicate 'English and French' as their first official language spoken.
58 Agence de la santé et des services sociaux de la Montérégie
Annexe 3
Population in private households whose first official language spoken is English,Territory of CRDI Montérégie-est, CSSS and Montérégie, 2001
0-4 5-17 18-29 30-64 65-74 75 yrs Total Total CSSS % English years years years years years and + English1 Population Champlain 1 548 6 396 6 294 19 253 2 833 1 875 38 198 182 195 21,0% de la Haute-Yamaska 108 538 415 1 795 230 263 3 348 80 380 4,2% Richelieu-Yamaska 263 1 169 952 3 680 815 498 7 375 184 485 4,0% de Sorel-Tracy 40 45 40 273 55 25 478 49 205 1,0% la Pommeraie 515 1 979 1 334 5 160 1 093 1 058 11 138 48 080 23,2% Pierre-Boucher 355 1 215 1 293 4 645 563 533 8 603 226 150 3,8% TOTAL CRDI Montérégie-Est 2 828 11 341 10 327 34 805 5 588 4 250 69 138 770 495 9,0% Montérégie 6 240 23 214 17 376 64 813 10 175 7 345 129 163 1 260 185 10,2% Source: Census 2001, Statistics Canada
Population in private households whose first official language spoken is English,Territory of CRDI SRSO and Le Renfort, CSSS and Montérégie, 2001
0-4 5-17 18-29 30-64 65-74 75 yrs Total Total CSSS % English years years years years years and + English1 Population Jardins-Roussillon 1 175 4 203 2 618 10 960 1 745 1 050 21 750 164 585 13,2% Vaudreuil-Soulanges 1 585 5 011 2 362 11 680 1 260 850 22 748 101 280 22,5% du Suroît 58 210 180 975 273 145 1 840 53 195 3,5% Haut-Richelieu–Rouville 218 1 051 1 085 3 220 625 425 6 623 149 025 4,4% Haut-Saint-Laurent 378 1 399 806 3 173 685 625 7 065 21 605 32,7% TOTAL SRSOR 3 413 11 873 7 050 30 008 4 588 3 095 60 025 489 690 12,3% Montérégie 6 240 23 214 17 376 64 813 10 175 7 345 129 163 1 260 185 10,2% Source: Census 2001, Statistics Canada
¹ The English includes all of the 'English' and one half of those who indicate 'English and French' as their first official language spoken.
Agence de la santé et des services sociaux de la Montérégie 59
Annexe 3
Population in private households whose first official language spoken is English Service Territories of mental health institutions, Montérégie, 2001
The statistics are presented according to the mental health territories. These territories are determined by agreements between the Psychiatry Departments of the institutions. The territories have not been altered since the creation of the CSSS.
Équipe Surveillance de l’état de santé Direction de santé publique de la Montérégie
By Dominique Agossou with the collaboration of J. Britton and E. Savoie
June 2006
Agence de la santé et des services sociaux de la Montérégie 61 Program of Access to Health and Social Services in the English Language for the English-speaking Population of the Montérégie
Population in private households whosefirst official langauge spoken is English, mental health territoires, Montérégie 2001
75 yrs + Total Total Territoires 0-4 yrs 5-17 yrs 18-29 yrs 30-64 yrs 65-74 yrs % English over English Population
CH Charles LeMoyne 1 984 8 103 7 721 24 193 3 560 2 333 47 893 304 190 15,7% CH du Suroît 2 105 6 868 3 420 16 563 2 343 1 735 33 033 180 050 18,3% CH Anna Laberge 865 3 170 2 098 8 113 1 435 840 16 520 110 645 14,9% CH de Granby 493 2 010 1 420 5 850 1 070 1 038 11 880 119 490 9,9% CH Haut-Richelieu 398 1 659 1 477 4 670 953 713 9 868 177 350 5,6% CH Pierre-Boucher 239 743 738 3 015 353 330 5 418 157 630 3,4% CH Honoré-Mercier 118 606 464 2 128 408 333 4 055 153 610 2,6% CH Hôtel-Dieu de Sorel 40 55 40 283 55 25 498 57 220 0,9%
Total Montérégie 6 240 23 214 17 376 64 813 10 175 7 345 129 163 1 260 185 10,2% Source: Census 2001, Statistics Canada
¹ The English includes all of the 'English' and one half of those who indicate 'English and French' as their first official language spoken.
62 Agence de la santé et des services sociaux de la Montérégie
Annexe 4
Annexe 4 – Access Program to services in English – 1999 edition
NAME OF CSSS INSTALLATIONS SERVICES
CSSS Champlain 5811, boul. Taschereau, bureau 100 CLSC Saint-Hubert Home Care Services Brossard (Québec) J4Z 1A5 Social Services at home 450-445-4452 School Haelth and Social Services
CLSC Samuel-de-Champlain Basic Health and Social Services Reception Info-santé CLSC Evaluation-orientation Child and Family Services Youth Services Home Care
CHSLD de la MRC de Champlain Reception Care Units Psychosocial Services Day Hospital Intensive Functional Rehabilitation Day Centre
CSSS de la Haute-Yamaska CLSC-CHSLD de la Haute-Yamaska Early Childhood Services 205, boulevard Leclerc Ouest Children - Youth Services Granby (Québec) J2G 1T7 Basic Psyhchosocial Services 450-375-8000 Home Care Centre de Waterloo All Direct Services to Clients CH de Granby Psychiatric Services Day Centre - 1 day/week CSSS du Haut-Saint-Laurent CLSC Huntingdon Basic health and Social Services 28, rue Gale Reception Ormstown (Québec) J0S 1K0 Info-santé CLSC 450-264-6108 Evaluation-orientation Child and Family Services Youth Services Home Care CHSLD de Huntingdon All Direct Services to Clients Hôpital Barrie-Memorial All Direct Services to Clients CSSS Haut-Richelieu-Rouville CLSC du Richelieu Psychosocial Services (Follow up) 978, boulevard du Séminaire Nord Info-santé CLSC (regional) Saint-Jean-sur-Richelieu (Québec) Centre Rouville Intensive Functional Rehabilitation J3A 1E5 Day Centre 450-358-2578
CSSS La Pommeraie CLSC-CHSLD de la Pommeraie Basic Health and Social Services 950, rue Principale Reception Cowansville (Québec) J2K 1K3 Info-santé CLSC 450-263-6606 Evaluation-orientation Child and Family Services Youth Services Home Care Care Units Day Centre Hôpital Brome-Missisquoi-Perkins All Direct Services to Clients
Agence de la santé et des services sociaux de la Montérégie 63 Program of Access to Health and Social Services in the English Language for the English-speaking Population of the Montérégie
NAME OF CSSS INSTALLATIONS SERVICES
CSSS Jardins-Roussillon CLSC Kateri School Social Services 200, boulevard Brisebois Basic Health and Social Services Châteauguay (Québec) J6K 4W8 Home Care 450-659-7661 Youth Services CLSC Châteauguay Basic Health and Social Services Reception Info-santé CLSC Evaluation-orientation Child and Family Services Youth Services Home Care CLSC Jardin du Québec Home Care Psychosocial Services Early Childhood Services School Health and Social Services CHSLD Trèfle d'Or Reception CA Laprairie Day Centre CA Pierre-Rémi Narbonne Foyer de Châteauguay CH Anna-Laberge All Direct Services to Clients CSSS Pierre-Boucher CLSC Longueuil-Ouest Services in Schools 1303, boulevard Jacques-Cartier Est Family Support Services Longueuil (Québec) J4M 2Y8 Basic Health and Social Services 450-463-2850
CSSS Richelieu-Yamaska CLSC-CHSLD des Patriotes Services in Schools 2750, boul. Laframboise Family Support Services Saint-Hyacinthe (Québec) J2S 4Y8 Basic health and Social Services 450-771-3333
CSSS de Vaudreuil-Soulanges CLSC la Presqu'île Basic health and Social Services 412, boulevard Harwood Reception Vaudreuil-Dorion (Québec) J7V 7H4 Info-santé CLSC 450-455-6171 Evaluation-orientation Child and Family Services Youth Services Home Care CHSLD des Trois-Rives Care Units Foyer de Rigaud Day Centre CA Le Vaisseur d'Or CA Vaudreuil CA Laurent-Bergevin
64 Agence de la santé et des services sociaux de la Montérégie
Annexe 4
Regional University-affiliated Hospital SERVICES
Hôpital Charles LeMoyne Reception 3120, boul. Taschereau Emergency Room Services Greenfield Park J4V 2H1 Outpatient Medical Services 450-466-5000 Intensive Care Services Traumatology Unit Cardiology Unit Physiotherapy Services Occupational Therapy Services Social Services Pedopsychiatrie (Outpatient Services)
Youth Services Center SERVICES
Centre Jeunesse de la Montérégie Youth Protection 25, boul. Lafayette Adoption and Reunification Services Longueuil J4K 5C8 Parental Contributions 450-928-5125 Social Emergencies Young Offenders Foster Homes Non-institutional Resources Complaint Procedures Psyhchosocial Expertise to the Superior Court
Rehabilitation Centers SERVICES
Intellectual handicap
Les Services de réadaptation du Sud-Ouest et du Renfort Educational Assistance (0-17 ans) 273, rue Saint-Jean-Baptiste Educational Assistance (18 ans et plus) Châteauguay J6K 3C4 Professional Social Services 450-692-1010 Family-type Residential Resources (RTF)
CRDI Montérégie-Est 1255, rue Beauregard Longueuil J4K 2M3 450-679-6511
Dependence Pavillon Foster All Direct Services to Clients 6, rue Foucreault Saint-Philippe J0L 2K0 450-659-8911
Private organisations SERVICES
Centre gériatrique Courville inc. Care Units 5305, avenue Courville C.P. 580 Day Centre Waterloo J0E 2N0 450-539-1821
Résidence du Parc All Direct Services to Clients
Agence de la santé et des services sociaux de la Montérégie 65
Annexe 5
Annexe 5 – Regulation concerning the responsibilities, the composition and the rules of the functioning of the Regional Committee on accessibility to health and social services for English-speaking people.
REGULATION
Regulation concerning the responsibilities, the composition Page: 1 of 5 and the rules for the functioning of the Regional Committee on accessibility to health and social services for English- speaking people Reference : Article 510 of the Act respecting health services Effective on : June15 2006 and social services(L.R.Q., c. S-4.2) Resolutions : RCA 87-209-99, 91-141-72, 91-339-164 et 93-12-213-152 Replaces : Regulation to create the Regional Committee for Number: R 2006-03 access programs to health and social services in the English language R 1993-08
Section I – General Dispositions
1. Definitions
In the current regulation, unless the context indicates another sense, we understand by : « Agency or the Agency » : Health and social services agency in the sense of the Act respecting health services and social services(L.R.Q., c. S-4.2) « Committee » : Regional Committee on accessibility to health and social services for English-speaking people « CSSS » : Health and social services centre « Law » : An Act respecting health services and social services (L.R.Q., c. S-4.2) « Representativity » : Refers to, different parts of the Montérégie territory and to different sectors of activity, programs or service continuums in the domain of health and social services
Agence de la santé et des services sociaux de la Montérégie 67 Program of Access to Health and Social Services in the English Language for the English-speaking Population of the Montérégie
2. Constitution
A regional access committee is hereby constituted under the name of « Regional Committee on accessibility to health and social services for English-speaking people of the Montérégie ».
3. Responsibilities of the committee
The committee serves in an advisory role to the Agency’s President- Executive Director.
The committee must : a) present opinions to the President-Executive Director on Access Programs elaborated by the Agency; b) evaluate the access program and, if need be, present opinions to the President-Executive Director regarding modifications; c) present opinions to the President-Executive Director about the implantation and the evolution of services in the English language;
d) encourage and support the participation of the English-speaking community in the management of the network; e) present opinions to all commissions or committees regarding all questions concerning the English-speaking community; f) carry out all other mandates which may be given to it by the President-Executive Director.
4. Composition and nomination modalities
The committee is composed of 14 members who are representative of English-speaking people and the institutions of the Montérégie, named by the President-Executive-Director.
The composition of the committee is as follows : a) five managers named by institutions which serve the English-speaking population, namely : one person named by Hôpital Charles LeMoyne, two people named by the CSSS which serve the English-speaking population (Champlain, Haut-Saint-Laurent, Vaudreuil-Soulanges, La Pommeraie, Pierre-Boucher, Jardins-Roussillon, Richelieu- Yamaska, Haut-Richelieu–Rouville), one person named by the Centre jeunesse de la Montérégie, and one person named by the rehabilitation centres;
68 Agence de la santé et des services sociaux de la Montérégie
Annexe 5 b) two people named by the associations or groups which represent the English-speaking community of the Montérégie. The Townshippers’ Association and the Chateauguay Valley English-speaking Peoples’ Association are part of this category; c) four people from the English-speaking community. The Board of Directors or the Executive Directors of the following CSSS each name one of these people : - Champlain (one person); - Vaudreuil-Soulanges (one person); - Jardins-Roussillon (one person); - La Pommeraie (one person); d) one person named by the English school boards of the Montérégie; e) two co-opted members named by the members of the committee who are part of the above named categories and who are chosen so as to ensure a good representation of different sectors of activity and the different parts of the Montérégie.
5. Length of a member’s mandate
The length of the mandate of each member is four years and is renewable. However, in order to ensure continuity for the committee, the length of the mandate of one half of the members chosen at random is fixed at two years.
6. Vacancies
A member ceases to be a part of the committee if they lose the quality to sit on the committee or if they miss three meetings without valid reason.
7. Replacement of a member
To fill a vacant position, the President-Executive Director proceeds with the nomination of a member based on a recommendation of the committee. This recommendation must take into account the categories and the representativity outlined in Article 4. The length of the mandate of the new member is equal to the non-expired period of the member being replaced. The mandate of this new member is renewable.
8. Regular meeting of the Committee
The committee will meet in ordinary sessions at least two times a year.
The committee’s meetings are called by written notice indicating the day, time and place of the meeting. This notice must be accompanied by an agenda and other pertinent documents. This convocation must be sent to the members at least seven days before the date of the meeting.
Agence de la santé et des services sociaux de la Montérégie 69 Program of Access to Health and Social Services in the English Language for the English-speaking Population of the Montérégie
9. Quorum
The whole number greater than 50% of the voting members constitutes the quorum.
10. Right to vote
Each member has a vote. The committee makes decisions by resolution adopted by the majority of the members present. The members must vote and cannot abstain except in the case where the Agency’s ethical Rules apply. In case of a tie vote, the president casts a deciding vote.
11. President and Vice-president of the Committee
Each year the members will chose from among themselves a President and a Vice-president. Their mandates are renewable.
All meetings of the Committee are presided over by the President and in his\her absence or inability to carry out this function by the Vice-president. In the case of the absence or incapacity of the Vice-president, the members shall name from among themselves someone to preside over the meeting.
12. Professional and Technical Support for the Committee
The Secretary General is responsible to provide the committee with the professional and technical supports needed, such as, calling of meetings, preparation of the agenda, editing of minutes, keeping archives and contacting and co-ordinating resource people in the realisation of the committee’s mandates.
13. Special Meeting of the Committee
The President, three members of the Committee or the President-Executive Director of the Agency may call a special meeting of the Committee. This meeting must be called, by a notice sent by the professional responsible at least two days in advance.
At a special meeting, one can only discuss subjects specified in the convocation notice of such a meeting, except if all the committee members and they agree to take under consideration a subject not specified in the notice of meeting.
14. Powers of the Committee
The Committee may : a) create study committees and determine the composition, mandate and duration of such committees;
70 Agence de la santé et des services sociaux de la Montérégie
Annexe 5 b) proceed with consultations, solicit opinions, receive and hear requests and suggestions from people, organisations, associations or institutions in order to prepare its opinion and to make recommendations in conformity with Article 510 of the Law; c) establish its internal rules of functioning, such rules must receive the approval of the President-Executive Director.
If costs are associated with certain activities, the committee must obtain the approval of the President-Executive Director.
15. Studies, recommendations and opinions of the Committee
Studies, recommendations and opinions of the Committee are submitted to the President- Executive Director in a written form. Minutes of a meeting of the Committee shall serve as a written report.
16. Remuneration of a member of the Committee
Members of the Committee receive no remuneration as such.
Section II – Effective Date
17. This regulation replaces the Regulation to create the Regional Committee for access programs to health and social services in the English language – Regulation R-1993-08.
18. This regulation comes into effect when it is adopted by the Board of Directors.
Agence de la santé et des services sociaux de la Montérégie 71
BIBLIOGRAPHY
RESSOURCES HUMAINES ET DÉVELOPPEMENT DES COMPÉTENCES CANADA, Profil socio- économique de la communauté anglophone Montérégie, août 2006 (non publié), 42 p.
MINISTÈRE DE LA SANTÉ ET DES SERVICES SOCIAUX. Projet clinique, Cadre de référence pour les réseaux locaux de services de santé et de services sociaux, document principal, Québec, octobre 2004, 81 p.
MINISTÈRE DE LA SANTÉ ET DES SERVICES SOCIAUX. Pour élaborer des projets cliniques en tenant compte des besoins et des particularités des personnes d’expression anglaise et du cadre législatif en place, L’aide-mémoire, Montréal, Secrétariat à l’accès aux services en langue anglaise, mars 2005, 15 p.
MINISTÈRE DE LA SANTÉ ET DES SERVICES SOCIAUX, Cadre de référence pour l’élaboration des programmes d’accès aux services de santé et de services sociaux en langue anglaise pour les personnes d’expression anglaise, Québec, Secrétariat à l’accès aux services en langue anglaise, mars 2006, 37 p.
COMMUNITY HEALTH AND SOCIAL SERVICES NETWORK (CHSSN), Health Determinants of English-speaking Québec, Baseline Data Report, 2004-2005, Québec, 59 p.
RÉSEAU COMMUNAUTAIRE DE SANTÉ ET DE SERVICES SOCIAUX, Caractéristiques démographiques et sociales de la population anglophone de la région sociosanitaire de la Montérégie (RSS-16), septembre, 2002, Québec, 136 p.
AGENCE DE LA SANTÉ ET DES SERVICES SOCIAUX DE L’ESTRIE, Programme régional d’accessibilité des services en langue anglaise, Estrie, 2007-2010, document en consultation, décembre, 2006, 46 p.
Agence de la santé et des services sociaux de la Montérégie 73