In Your Community, We Are Highlighting the Work Being Done in Eastern Charlotte County, Western Charlotte County and Central New Network Is Brunswick

October 2018 | Issue 5

Community Health Needs Assessments in Action COMMUNITY

Eastern Charlotte County

Western Charlotte County

About Eastern About Central About Western 6 Charlotte County 12 New Brunswick 16 Charlotte County Eastern Charlotte County is located in the Central NB is a diverse region Western Charlotte County is southwestern part of the province. It is both geographically and located in the southwestern part a rural area with communities scattered demographically. Salmon fishing of the province. It is a rural area along the Bay of Fundy, including the industry is a major aspect of the with communities scattered along islands of Grand Manan and Deer Island. community’s history and culture, the Bay of Fundy, including as well as a source of employment. Campobello Island. CEO Message Horizon Health In Horizon’s fifth edition of In Your Community, we are highlighting the work being done in Eastern Charlotte County, Western Charlotte County and Central New Network is Brunswick. I’m truly inspired seeing the work that’s being done in these areas, along with the other areas we’ve covered in the previous editions of In Your driven Community. The selfless work New Brunswickers are doing in their by its mission communities is undeniable and it leaves me motivated that we are working together across Horizon and with our partners, to improve health outcomes. Helping People My vision moving forward is for our many sites to come together as One Horizon. In order to do this, we need to focus our attention to every facility across our organization, Be Healthy from clinics to community health centres to hospitals so they all remain first-class Good health lies at the heart of facilities serving the needs of our patients and clients. our daily quality of life. It is what As a health care provider, we are committed to patient and client centered care, across all New Brunswickers want for One Horizon. themselves and those they love. This spring I criss-crossed the province and had the opportunity to meet with many of Helping New Brunswickers be you as part of my third CEO tour. We now have a renewed strategic focus to enhance as healthy as they can be is the our community services and improve access to care for our patients and clients. As one shared purpose that motivates large organization with multiple sites, we will work to better align our networks so they all those who work at Horizon on can all have the same level of success with no weakest link. a daily basis. To achieve the best This tour across Horizon served as reinforcement that hospitals are just one piece of results, Horizon puts patients the health-care puzzle. It’s all the pieces that come together to make health care in New and clients at the centre of the Brunswick work. health delivery system. It’s the work being done in communities to battle food insecurity, to help with senior Each New Brunswick community isolation and primary health care. The work that we focus on in In Your Community is beyond a doubt, an incredibly important piece of the health-care puzzle. served by Horizon is unique. Working with key community The featured stories in the following pages have come together as a result of the partners, clinicians, and other Community Health Needs Assessments that have been completed. These assessments stakeholders, progress has been have identified the gaps preventing citizens from living their healthiest lives, and these made to identify and address stories are showing how communities are filling those gaps, which leads to them helping their specific needs. This is an people be healthy! intentional effort initiated by Yours in health, Horizon to significantly improve community-based primary care, Karen McGrath, President and CEO and support expensive tertiary Horizon Health Network services required by an aging population. 2 A hub and spoke Table of 8 model of care Eastern Charlotte County residents offered care right in Contents their community

The St. George and 10 Area Food Bank Providing programs to enrich lives of those in need in Eastern Charlotte County

October 2018 | Issue 5 Keeping people healthy at home Community Health Needs 14 Assessments in Action COMMUNITY Horizon facilities in Contributor: Creative lead: Western Charlotte County • Shannon MacLeod • Fahad Farooq keep people off highways Resources: Cover credits: • Jean Daigle • Shannon MacLeod to bigger centres • Janet Hogan Printing: • Gabrielle Levesque • Advocate Printing

The following documents were used as resources for this publication: • Central New Brunswick Community Health Needs Assessment Community (October 2015) 18 partnerships encourage • Eastern Charlotte County Community youth to make the right Health Needs Assessment (September 2016) choice • Community Health Needs Assessment: Students in Central NB St. Stephen, St. Andrews and Surrounding Area (October 2014) learn risks involved with tobacco, substance abuse and impaired driving

Comprehensive www.HorizonNB.ca 20 geriatric assessments Addressing and embracing the complexities of seniors health 3 Health care today A well-designed health system With our province’s aging unique needs of the people in each should feature both strong centres of population, southern migration, community. hospital-based care and appropriate and shift from rural to urban The good news is that work is community-based care “close to living, health care as we know it is underway. Horizon Health Network home” for New Brunswick residents. changing. Government and non- (Horizon) is working in partnership It’s a system that would ensure every government organizations and with communities to provide better New Brunswicker has access to the communities alike are looking for preventive, primary, and long-term services they need to be as healthy as ways to deliver care in a way that care to community members, as close they can be. does a better job of meeting the to home as possible. Community Health Needs Assessments Since 2012, Horizon has been address the other 90%. The CHNA Table 1: Determinants of Health working with communities to gain a process provides an opportunity as categorized by the Public Health Agency of Canada better understanding of their health to get everyone around the table care needs using Community Health to look at all areas that are known Needs Assessments (CHNAs). A to impact our health – health 1 Income and Social Status CHNA is a dynamic and ongoing determinants (Table 1). 2 Social Support Networks process that identifies the unique CHNAs help identify priority 3 Education and Literacy strengths and needs of a community. areas in the community that This information provides both Employment and need attention and support the 4 Horizon and the communities with development of action plans to Working Conditions a roadmap to achieving a common address them. This work influences 5 Social Environment goal: to improve the overall health of programming that better serves New Brunswick communities. the population and often supports 6 Physical Environment Have you ever considered how the efforts of primary health care Personal Health Practices 7 housing or access to transportation providers like family physicians, and Coping Skills might affect the health of an nurse practitioners, and pharmacists. Healthy Child 8 individual? You may not know it, Nobody knows a community better Development but measuring community health than the people who live there. This Biology and Genetic 9 goes far beyond studying rates of work to address priority areas is Endowment disease and the availability of health being driven by a local committee 10 Health Services care services. Health services account that is passionate about the well- for only 10% of what influences our being of the community. With 11 Gender health (see pie chart), which is why support from Horizon and other Horizon is working with individuals stakeholders, they are advocating for 12 Culture and agencies at a community level to your health.

What influences our health? 40% Health What is primary Behaviours health care? 40% Social & Economic Factors Primary health care refers to an approach to health and a spectrum of services beyond the traditional health care 10% Physical system. It includes all services that play a part in health, Environment such as income, housing, education, and environment. Primary care refers to health promotion, illness and 10% Health injury prevention, and the diagnosis and treatment of Services 4 illness and injury. (Health Canada) 17 Community Common Themes Emerging Health Needs REGIONAL PRIORITY Assessments Awareness of completed Food Insecurity Services & System Navigation

Social Supports to Transportation Help Individuals Move Out of Poverty Mental Resiliency and Coping Skills Housing Among Children & Youth Collaboration Addictions & with First Nations Mental Health Services Supporting the Alcohol and New Family Reality The province is divided into Drug Use/Abuse 33 unique communities to ensure a better Expansion of Senior Isolation and perspective of regional Sexual Health Lack of Community/ and local differences. Services & Sexual Social Supports for Abuse Treatment/ Seniors Community Health Needs Prevention Assessments have been Senior Home Care completed wherever Access to Primary and Outreach Horizon is located. Health Care Services Services • Oromocto and Area • Fredericton and Surrounding A Shift to More Area Comprehensive, Recreation • St. Stephen, St. Andrews and Team-Based Primary Health Care Surrounding Area Enhanced • Petitcodiac, Salisbury and More Focus on Collaboration, Surrounding Area Chronic Disease Communication & • Saint John Prevention Connectedness • Moncton and Surrounding Area Healthy Eating Continual • Grand Lake Area & Physical Activity Community • Neguac Area Engagement • Miramichi Area • Tantramar Area In your community • Central New Brunswick Knowing what is happening in your community is important. In the previous four issues of In Your Community, Horizon worked with the Fredericton and Oromocto; • Albert County Area Petitcodiac, Salisbury, Elgin and Havelock; Saint John and Grand Lake; Miramichi • Carleton County Area and Neguac Areas; and Albert County and Carleton County. This fifth issue • Tobique and Perth-Andover Area is profiling what is happening in Eastern Charlotte County, Western Charlotte • Eastern Charlotte County Area County and Central New Brunswick. In the pages that follow, you will get a better understanding of what these areas are doing to build healthier communities and will • Nackawic, Harvey, McAdam, showcase specific priorities, challenges, and successes. Canterbury Area Watch for our next issue, which will feature news from other Horizon communities. • Sussex and Surrounding Area 5 About Eastern

Charlotte County Key Stakeholders (Advisory Committee)

• Extra Mural Program • Primary Health Care Program • Village of Blacks Harbour Eastern Charlotte County is located emphysema or Chronic Obstructive • Town of St. George in the southwestern part of the Pulmonary Disease (COPD), when • Social Development, Wellness province. It is a rural area with compared to the provincial averages. Branch • Vibrant Communities communities scattered along the Quantitative data review and Charlotte County Bay of Fundy, including the islands qualitative data collection, review • Horizon’s Fundy Health of Grand Manan and Deer Island. and analysis were used by Horizon’s The main employment industries in Centre, Management Community Health Assessment • St. George and Area Food the community are in the sectors of (CHA) team. Data compilations Bank fishing, aquaculture, manufacturing produced by the New Brunswick • Action Ministries of Grand and tourism. Health Council (NBHC) such as Manan The population of the Eastern My Community at a Glance and • Association for Community Charlotte County Area is 11,289 The Primary Health Care Survey Living (NBACL) and has seen a decrease of one per were used to review currently • RCMP cent from 2006 to 2011. The median available quantitative data. • Habitat for Humanity, Saint household income in the community John Region Based on limitations of the • Public Health is $51,741 and 18 per cent of the quantitative data review, a • Canadian Mental Health population is living in low-income qualitative data collection plan Association households. Residents of the was established by the CHA team • Fundy High School area expressed that the income is in partnership with the Eastern • Pharmacist somewhat skewed because of the Charlotte County Area Community • Primary Health Care, Grand inclusion of certain communities, Advisory Committee (CAC). As Manan such as those on Grand Manan, part of this plan, key informant • Primary Health Care, Deer where the fishing industry is interviews were held with Island prominent and therefore the median stakeholders in the area of primary • Department of Transportation household income would be lower health care and key stakeholder and Infrastructure in other communities in this area. groups were consulted through the Data indicates that the Eastern focus group interview method. Charlotte County Area has increasing rates of high blood pressure, arthritis, depression, cancer, heart disease and 6 What was learned How are we doing? Where do we go through the from here? Community Health Since the completion of the CHNA Needs Assessment? for Eastern Charlotte County, Eastern Charlotte County is refocusing the approach to health vibrating with a positive shift. Priority Areas: care has taken great strides. The Through collaboration among 1. The need for improved Fundy Health Centre serves as the service groups, citizens are getting supports in the community for hub and Horizon’s Deer Island better access to programs. families who are struggling and Health Centre and St. George We are looking forward to learning experiencing difficulties. Medical Clinic are its spokes. Clinics more about what will happen in 2. Transportation issues in the and education programs help foster the area to help fulfill the needs community that impact health. new behaviours as well as take an identified in the CHNA. upstream approach to health care. 3. An insufficient amount of In the following pages you will affordable housing options, At the St. George and Area Food learn about a few of the wonderful including transitional/ Bank, they are not only supplying things that are going on in Eastern emergency type housing, in the food in the traditional food bank Charlotte County that are helping community. sense, they’re running programs people be healthy! 4. The need for more after- to help families. If there is a need, hours access to primary health Sarah Norman will do what she can care, including mental health to fulfill that need. services, in the community. The initiatives in Eastern Charlotte 5. The need for more affordable County are addressing food recreational activities for insecurity, access to primary health children and youth in the care and improving support for community. families that are struggling. 6. The need for increased access to mental health services in order to address the growing rate of mental health issues in the community. 7. Food insecurity in the community. 8. A decrease in mental resiliency and coping skills among children and youth in the community.

7 Horizon Health Network conducted a Community Fundy Health Centre and Health Needs Assessment in 2016. The following article highlights the key Deer Island Health Centre recommendations adopt a hub and spoke model of care Horizon’s Fundy Health Centre acts “We also have nurses and other as a hub for health care providers providers who have training and Access to Primary at Horizon’s Deer Island Health have specialized skills to provide Health Care Services Centre and the St. George Medical expert care in areas such as Chronic Centre. Obstructive Pulmonary Disease The need for more after-hours (COPD), wound care, foot care, and access to primary health care, more” “Personally, I have referrals weekly including mental health services, Services include X-ray, for women’s health, teen and sexual in the community was a need laboratory (specimens collected), health, reproductive management identified by the Community Electrocardiography (ECG) and and this is so unique that women Health Needs Assessment, and the holter monitoring services. do not have to leave the local areas Fundy Health Centre, located in There are clinics for asthma and for such care,” said Kate. “We have Blacks Harbour, provides primary allergy, hypertension, diabetic shorter wait times, easier parking, health care services seven days per education, Beltone hearing, and a friendly atmosphere. It is week. respiratory issues, and smoking important to the people in our area For Kate Burkholder, a nurse cessation. The centre has specialists that they know they can get care in practitioner at the Fundy Health who travel to the health centre their community.” Centre, it is important people to facilitate access for Eastern The Fundy Health Centre also living in rural communities have Charlotte County residents, has a walk-in service, covered by a equitable, timely and appropriate including a respirologist, urologist, physician or registered nurse seven health care, just like urban centres. cardiologist, rheumatologist, days per week. “Our patients are fortunate that gynecologist and an obstetrician. Susan MacKillop, manager of the we have a variety of clinics where Therapeutic services include Fundy Health Centre, said in June specialist physicians come at least physiotherapy, nutrition counselling 2017, 2,441 patients visited the once a month,” Kate said. and 24-hour blood pressure health centre. monitoring.

8 “Every day we get people coming in for a dressing change, blood pressure or things like that,” Colleen said. “The whole idea is to keep people from leaving the island; it’s a big deal to have to leave, especially for health care.” Sharon Pendleton, an admin at the health centre, said on average they see between 200 and 300 patients per month. “Considering the population of the island is about 800, we do very well supporting the health needs of our community,” Sharon said. The St. George Medical Centre, a “We offer prostate cancer clinics spoke of the Fundy Health Centre, because we have high instances of The St. George Medical Centre is resulted from the municipality of prostate cancer here on the island,” located at 127 Brunswick St. in St. George developing a primary said Colleen. St. George and can be reached by calling care space to recruit family medicine Diabetic education clinics and 506-755-9020. physicians who were interested in pulmonary function clinics are working as part of a collaborative Horizon’s Fundy Health Centre offered on an as-needed basis, and is located at 34 Hospital St., team. a few times per year, Colleen goes in Blacks Harbour and can The medical centre hosts sleep to Deer Island Community School be reached by calling apnea clinics, Beltone hearing clinics to teach handwashing techniques 506-456-4200. and Believe Specialty Shop, which and winter safety. A daily walk-in Horizon’s Deer Island caters specifically to cancer patients. service is also available. Health Centre is located at Dr. Meena Natarajan has her 999 Route 772 in Fairhaven and can be reached by calling practice there. 506-747-4150. Across a ferry, Horizon’s Deer Island Health Centre – another spoke in this model – is where a team provides care to the approximate 850 island residents five days per week. During the week, a nurse practitioner is on site three days, blood labs take place during two days, and a physician is there one day. There are two admins and two registered nurses who work out of the centre. Colleen Green, a registered nurse at health centre, said staff from Public Health come monthly for well-baby clinics and immunizations, and a urologist comes three times per year. 9 Horizon Health Network conducted a Community Health Needs Assessment St. George and Area Food in 2016. The following article highlights the key Bank fills food insecurity recommendations gap and more The St. George and Area Food change something,” Sarah said. Bank provides not only traditional “When people can come in to chat, Social Supports food bank service, but more than a and we can empower them, then to Help Individuals Out dozen programs to help the citizens that’s exciting.” of Poverty of Charlotte County. The core program continues to be The food bank was established food distribution three days per several decades ago by a local week. But with the food bank’s church to provide for families recent growth, it has expanded and individuals living in poverty into offering other programs Continual Food Community Insecurity without the proper resources to and services that support the Engagement sustain their daily needs. It is community, like: clothing, school a non-profit registered charity supplies, furniture and household operating under the authority of items, income tax preparation, the Eastern Charlotte Association Christmas hampers, transportation that void for eight weeks during the for Community Living. assistance, healthy cooking classes, summer,” she said. For the past 10 years, Sarah a community garden and more! The Rescue Box program, a Norman has been its executive The After the Bell program is partnership with Extra Mural director and she is continually offered in conjunction with Food Program nurses, came about by trying to find ways to help people Banks of Canada. chance. One afternoon, a nurse help themselves. “During the school year, kids take came to see Sarah, saying she had “A lot of the time, people have zero advantage of breakfast programs, just come from a patient’s house and confidence. They have the abilities, and After the Bell provides four or left feeling very concerned. but they’ve never been told they five bags of healthy snacks to fill can do something, or they’ve never been told they have the power to

10 “There was absolutely nothing at Sarah loves that the food bank home,” she said. has become more of a hub, a true Sarah packed up a few things for resource centre for clients. the nurse, who brought them to the “I love when people drop in and patient. they’re not necessarily here for food “We were just really lucky that she – they stop by to chat,” she said. “It’s had time to do that, that she had the really neat to create friendships with compassion to follow through on people.” that,” said Sarah. “To ensure that Sarah said in her 10 years, she has doesn’t happen again, we came up seen and heard some amazing with the Rescue Box program.” things. Extra Mural nurses have a box in the “[A client] told me ‘We have never trunk of their cars filled with pre- enjoyed needing the food bank, packaged dry foods. but anytime we went, we were Crystal Cook, mayor of St. George, welcomed, we were comforted and said they are so lucky to have Sarah empowered. It was because of you at the food bank because she’s so guys that we felt we could continue dedicated to what she does. on, even when things were really bad’.” “She has a mission in her mind like you wouldn’t believe. “Sarah is a sweetheart. She has a heart of gold. The service she does for the For more information, community is incredible,”said Call: 506-755-2603 Email: [email protected] Mayor Cook. or find them on “While she’s located in St. George, Facebook at she thinks about all of Eastern facebook.com/StGeorgeFoodBank Charlotte County.” On average, there are 100 families who use the food bank per month with five or six using its food services more than once.

11 About Western Charlotte County

Western Charlotte County is located The aboriginal population is very the provincial averages. in the southwestern part of the small at 2.7 per cent. There is a Data indicates that in Western province. It is a rural area with significant immigrant population, Charlotte County, from 2008 to communities scattered along the Bay 1,450 people, living within the 2012, prevalence of these conditions of Fundy, including the Campobello community. This may be explained, has remained essentially stable, Island. The main employment in part, by the proximity to the similar to the rest of Canada. industries in the community are in Canada-USA border as well as the the sectors of fishing, aquaculture, active recruiting approaches of local The Community Health Needs manufacturing and tourism. businesses to fill gaps in the labour Assessment (CHNA) for Western force. Charlotte County commenced in Approximately half of Western spring of 2013, with the assembly of County residents (11,300 people) In St. Stephen, St. Andrews and our CHNA Community Advisory live in the towns of St. Andrews and surrounding area, 60.7 per cent Committee (CAC). Comprised St. Stephen. Hence, a substantial reported one or more chronic health of enthusiastic and energetic rural population exists which need conditions. community residents representing to travel significant distances to Typically, of persons who have one numerous localities, interests and acquire goods, services and activities chronic disease, 30 per cent will have activities throughout our area, this which are available in the larger two or more. The chronic illnesses CAC has committed to providing centres. that are most prevalent are high long term leadership and guidance Almost all the St. Stephen, St. blood pressure, arthritis, depression, for the project and its outcomes. Andrews and surrounding area cancer, heart disease and emphysema population speak English as their or Chronic Obstructive Pulmonary primary language (99.2 per cent). Disease (COPD), when compared to

12 What was learned How are we doing? Where do we through the Since the completion of the CHNA go from here? Community Health for Western Charlotte County, the Having quality and safe health care Needs Assessment? Charlotte County Collaborative readily available in your backyard is Priority Areas: Wellness Centre has been developed so important. to create an interdisciplinary team- 1. Develop a collaborative Without having to travel for based approach to primary health model of care to deliver medical appointments, educational care for Western Charlotte County comprehensive, integrated sessions or clinics, patients are more residents. primary health services for the at ease. A five-minute drive rather community. Much like the staff at the wellness than an hour-long drive is always a centre in St. Stephen want to keep better option. 2. Address the lack of affordable people off the highway to Saint transportation. While there are still steps to John, staff at the Campobello be taken to tackle all of the 3. Address the longstanding and Health Centre want to keep people recommendations out of the emerging need for mental off the highway to St. Stephen. CHNA, having ready access to health and addictions services. Keeping people healthy in their primary care is one huge step 4. Simplify the Long Term Care home communities is so important forward. Assessment and placement and that’s exactly what’s being done In the following pages you will process. in Western Charlotte County. learn more about Western Charlotte 5. Support the development of safe County and the strides they’ve made and affordable housing. with access to primary care. 6. Enhance services offered by the Charlotte County Hospital. 7. Improve navigation for information sharing and knowledge of service access.

13 Horizon Health Network conducted a Community Health Needs Assessment for the Bringing care to patients and Western Charlotte County Area in October 2014. The following article highlights key outcomes of keeping them off highways to that assessment. bigger centres

The idea of ‘build it and they will come’ might have worked in the , but it’s not the case in health care. Field of Dreams Access to A Shift to a more Primary comprehensive, Yvonne Bartlett, nurse practitioner at the Charlotte County Health Care team-based Collaborative Wellness Centre Services primary health care Located on the third floor of the a licensed practical nurse and two Charlotte County Hospital, the fee-for-service physicians who make Charlotte County Collaborative up the team that acts as the hub Wellness Centre is a one-stop for primary health care services in working in collaboration with the shop for an upstream approach to Western Charlotte County. health team to support the health and wellness of the community served. healthcare. “The staff is housed at the centre, The space has been provided by but they provide outreach services If, for example, one of the doctors or the hospital to implement a health to St. Stephen, Saint Andrews, and the nurse practitioner are on vacation, and wellness centre in St. Stephen, Campobello Island,” said Dan. patients can make an appointment which acts as a hub, while the “Saint Andrews is really exciting, with another primary care provider at Campobello Island Health Centre because the need was identified the wellness centre, so the continuum and Saint Andrews are its spokes, there and we’re going to be of care is maintained. which was a recommendation by providing some outreach services to the Community Health Needs support resident access to primary Assessment (CHNA). health care and other health services. Dan Doherty, director of Primary Health Care for the Saint John Its location provides a unique Area, said when the CHNA collaboration between the wellness was completed, one of the centre and the hospital. priorities identified was creating “We offer upstream respiratory an interdisciplinary team-based health screening and COPD approach to primary health care education at the health centres as for Western Charlotte County respiratory health issues has been residents. identified as a major concern for the This is exactly what was communities in Western Charlotte Yvonne Bartlett, nurse practitioner at accomplished through the creation County; there are many people the Charlotte County Collaborative of this collaborative centre. living with undiagnosed COPD,” Wellness Centre, said the whole idea said Dan. “In the last two years there has been is to keep people off the highway to a tremendous amount of progress There is a space at the wellness Saint John. and development at the wellness centre where a dietitian comes in Yvonne said in order to do that, they centre,” said Dan. “We started with to offer consultations and diabetes started offering clinics to suit the one nurse practitioner and one education. clients’ needs. Through her work in administrative support.” Dr. Athir Ghanim and Dr. Felix the schools Yvonne saw the need for Today, there is an administrative Udoh are physicians who have a concussion clinic. They are linking support, two nurse practitioners, recently set up practice out of the into the geriatric clinic and offer work wellness centre; both are with dementia patients, and she offers a well-women’s clinic.

14 “Anything related to the wellness p.m., as well as evenings and Maryanne said video conferencing is of a woman will be handled during weekends for health education used to accommodate their patients. this clinic, I don’t need a referral initiatives. They have a nurse “We want to keep people off the because I don’t want anyone practitioner three days per week, highway to St. Stephen, so if we can standing in the way of a woman’s a doctor two days per week, two save them a trip to the emergency health,” Yvonne said. administrative support and two room, we’re going to do that,” With the determinants of health, registered nurses who provide care Maryanne said. resources need to be deployed out for the roughly 1,000 people on Meghan Paul, registered nurse at into the community or into the Campobello Island. the Campobello Health Centre, said schools. Primary care providers Blood work is done at the health she chose community health care are out in the community, which is centre and it’s sent to St. Stephen for because of the familiarity of the where they need to be, rather than analysis – but patients don’t leave clients. having them sitting in an office the island for it, which is the goal. waiting for patients to come to “You make a bond with people, They offer diabetic education, them. you’re with them along their diabetic risk assessment, upstream journey,” said Meghan. “The idea of ‘build it and they will respiratory health screening clinics, come’ might have worked in the a methadone clinic, smoking Field of Dreams, but it’s not the cessation program, mental health Horizon’s Campobello Health case in health care,” Yvonne said. services, Public Health on site for “We’re facing people with a lack Centre is located at 640 Route immunizations, and they go into the 774 in Welshpool, and of transportation or the lack of school to provide flu-shot clinic and can be reached by calling knowledge of the system. Instead, provide sexual health services. 506-752-4100 the provider is out there, with the Maryanne Maillet, nurse Horizon’s Charlotte County clients building that trust.” Collaborative Wellness Centre, practitioner at the Campobello Based on identified community located on the third floor of Health Centre, provides primary the Charlotte County Hospital, needs, they offer clinics and care and runs a general family 4 Garden St. in St. Stephen, education at the wellness centre. practice. can be reached by calling 506-465-4416 “We need to keep people off that “It’s a variety. It’s pre-natal care, to road to Saint John, we need to do babies, to children to adults.” more here,” Yvonne said. “We are bringing the services here; it makes Stephanie Simms, registered nurse more sense to move a clinician than at the Campobello Health Centre to move the clients.” said something that’s unique to health care on the island is the use of Much like the staff at the wellness video conferencing. centre want to keep people off the highway to Saint John, staff at the “A lot of our chemo patients will Campobello Health Centre want to consult with a specialist over keep people off the highway to St. video conference,” Stephanie Stephen to receive quality and safe said. “We really try to do what services right on the island. we can before we send people off The health centre is open Monday the island.” to Friday from 8:30 a.m. to 4:30

15 About Central New Brunswick Key Stakeholders (Advisory Committee) The Central New Brunswick area is rates of chronic diseases such as • Management, Horizon’s Central a diverse region both geographically arthritis, asthma, diabetes, and Miramichi Community Health and demographically. With emphysema/Chronic Obstructive Centre the exception of the growing Pulmonary Disorder (COPD). • Social Worker, Horizon’s Central Miramichi Community community of Douglas, the region A qualitative data collection plan is primarily comprised of rural Health Centre was established by the Community • Registered Nurse, Horizon’s villages. The population of the Health Assessment (CHA) team Boiestown Health Centre Central NB Area is 15,803 (2011). in partnership with the Central • Registered Nurse, Horizon’s Although the population has seen an NB Area Community Advisory Stanley Health Centre increase of three per cent between Committee (CAC). As part of this • Nurse Practitioner, Horizon’s 2006 and 2011, this increase is due plan, key informant interviews were Central Miramichi Community Health Centre mainly to the development of the conducted and focus groups, made • Mayor of Doaktown Douglas area. up of community members, were • Teacher, Central NB Academy Similarly, although data indicates held. • Upper Miramichi Rural Council Central NB has a younger The qualitative component • Boiestown Nursing Home population, this is skewed by the of CHNAs conducted by • Stanley Village Council inclusion of the Douglas area where Horizon’s CHA Team is guided • Stanley Food Bank many younger families reside. by the Interpretive Description • Clerk, Horizon’s Stanley Health Historically, the rural areas of methodology, using a ‘key issues’ Centre Central NB relied predominantly on analytical framework approach. A • RCMP Community Program the forestry industry which has seen summarized list of key issues was Officer a decline in recent decades. then presented to the Central NB • Wellness Consultant, Social Development Given that large parts of the area Area CAC for feedback, and CAC • Upper Nashwaak Community follows the Miramichi River, the members were asked to participate Outreach Inc. salmon fishing industry is a major in a prioritization exercise of the key • Dietitian, Stanley, Boiestown, aspect of the community’s history issues based on their own experience Doaktown and culture, as well as a source of in the community. • Anglican Parish of Stanley employment. In the more rural parts The priorities that emerged • Live Well Bien Vivre Health Coach of the community, the population is from the exercise are used to mainly made up of seniors. finalize the list of priorities and Median household income in the recommendations for the Central community is $56,579 (2011) and 17 NB Area. per cent of people in the Central NB area live in low income. Data shows that the community has elevated 16 What was learned How are we doing? Where do we through the go from here? Community Health Since the completion of the CHNA Needs Assessment? for Central NB, there have been Central NB is addressing two great strides made in addressing the important populations, our youth Priority Areas: gaps identified by the assessment. and seniors. Taking action to help 1. Transportation in the By conducting Comprehensive our seniors assess every aspect of community that impacts health. Geriatric Assessment Clinics, their lives helps create a healthy, 2. The need for more mental seniors are able to identify what thriving population. Teaching health services in the needs to change in their lives to have healthy habits to youth is creating a community and an improved a better quality of life. By having healthier generation. The future of process for referral to mental Central NB looks bright. health and addictions. base-line data, lives are changing – for the better! The programs 3. The need for more access to Central NB still has a ways to go and services offered out of the Extra Mural Program services in tackling all seven of the priority in the community. Doaktown Library are undoubtedly areas identified by the CHNA, supporting seniors so they’re able to 4. The need for more affordable but it’s clear the right people are seniors housing in the live their best life. Socialization and in place, doing the right work in community. less isolation are good for everyone’s helping people be healthy. mental wellbeing. 5. Alcohol use in the community. In the following pages you will 6. Limited recreational The work being done out of the learn more about Central NB and programming/activities for Central New Brunswick Academy the work being done. youth in the community. is a direct result of what was identi- 7. Increased use of amphetamines fied in the CHNA. Youth have among youth and young adults access to a program that teaches the in the community. dangers of smoking, alcohol use, and drug use. The school is more than just a school; it’s a community centre that is fostering a healthier generation.

17 Horizon Health Network conducted a Community Health Needs Assessment in 2015. The following article highlights the key recommendations of that Youth programs foster assessment. healthy living for life

Alcohol and Enhanced Students are learning the dangers said the mock crash really impacts drug use collaboration, of alcohol, drug and tobacco use, the students and it sticks with them. Communication thanks to a partnership between the And for her, the reality really sets in. and Connectedness Central New Brunswick Academy “The students said they had a really (CNBA) and Horizon’s Central hard time with it, but that it was Miramichi Community Health really, really well done,” Barbara Centre. said. “I don’t do well with that stuff, The Community Health Needs fake or real, but it’s just the thought to every single grade. Assessment, which was completed of something like that happening “Every single class from Grade 6 in October 2015, identified an to my students, I have a hard time to 12, so every kid has heard the increased use of amphetamines with that.” stories and some have heard it again among youth and young adults in The morning is spent at the mock- and again,” she said. “And we’ll the community; and alcohol use in crash scene, while in the afternoon, continue that this year. Just continue the community. students rotate through different to bring that message home.” Lynsey Wilson, social worker sessions. They visit with health-care Lynsey said she talks about the other and community developer for the professionals and first responders drugs and their dangers, but they Doaktown and Upper Miramichi to see all the different variables focus on amphetamine use. areas, said Preventing Alcohol and that can result from driving while “Our biggest concern, especially Risk-related Trauma in Youth impaired. as it was identified in the needs (PARTY) is a partnership between In the past, with PARTY, only assessment is this amphetamine use the health centre, the RCMP, the alcohol was discussed, but because that has seemed to pop up out of fire department, Ambulance NB, amphetamine use was identified by nowhere,” she said. “We want to CNBA, as well as other community the CHNA, they’ve expanded the catch the young people before they partners. This community-wide conversation. even have a chance to try it.” initiative focuses on Grade 9 students from CNBA and Stanley Shelly Donahue, Community Lynsey said Teens Taking Action High School is an exceptional Program Officer with the RCMP, Against Tobacco Use (TATU) is collaboration for the area. said they try to reinforce the dangers primarily a middle school program, of drug use. that was established in the spring There is a mock crash scene and of 2017, following the Community students get to talk to professionals “The key aspect of PARTY is Health Needs Assessment. from the different agencies about to empower youth to make an what’s involved in a situation like informed decision,” Shelly said. “One of the primary things we do is that. “These kids have skills, talents and go to different markets and events abilities that are uniquely theirs. throughout the community with “It’s focused on impaired driving, Making the choice to use drugs our education tools and talk to the but we also focus in on any other could take their dreams away.” community about the dangers of types of risky behaviours,” said tobacco use,” she said. “And we Lynsey. “It’s very intense.” Lynsey started presenting on amphetamine and other drugs, but also provide information on how to Barbara Long, principal at the primarily focused on amphetamines quit.” Central New Brunswick Academy,

18 In the 2018-2019 school year, students will learn to facilitate small group discussions and how to give presentations. “This will be a way to empower them. They’re doing a great job as is, but this would take the next step and give them a skill they can use forever,” she said. “The hope is they will become what we’ll call TATU ambassadors.” Lynsey said the ambassadors will attend presentations as a support to the middle school students and begin implementing the program into the elementary school.

If you or someone you know is struggling with substance abuse issues, call Horizon’s Central Miramichi Community Health Centre for more information: (506) 365-6100

19 Horizon Health Network Community aging conducted a Community Health Needs Assessment in 2015. The following article highlights the clinics ensure seniors key recommendations of that assessment. are living well

Through comprehensive geriatric different levels of seniors housing assessments, health care providers options, as some seniors are quite independent and just need a more in Central New Brunswick are Housing Senior Isolation collecting baseline data and manageable home, while other and Lack of ensuring seniors are living well. seniors may require more assistance Community/Social with day-to-day tasks. Supports for The Community Health Needs Seniors Assessment identified a need for For the assessment, the patient more affordable seniors housing and comes in with a caregiver. Sarah transportation that impact health in completes a physical assessment and the Central NB Area. interviews the patient. Lynsey meets with the caregiver to do a collateral Sarah Carson-Pond, registered Seniors Health geriatrician, comes interview. nurse at Horizon’s Central to the area every other month. Miramichi Health Centre in “Basically, we get a really good idea, “These assessments are important, Doaktown said, because they do a from the caregiver’s perspective, of because as Dr. Feltmate put it: they comprehensive geriatric assessment, the wellness and functioning of this work. they are touching many of the items person in their home,” Lynsey said. in the CHNA. “Although we may not be tackling specifically affordable seniors housing, certainly we are discussing housing and options for seniors,” Sarah said, referring to the specific need for affordable housing. Through the assessments, they learn how functional a person’s home is, if and what changes to the structure are needed to help seniors stay in their home, what they can do to help, and what kind of support they need to stay in their home. The assessments are done by Sarah and her colleague Lynsey Wilson, social worker and community developer for the Doaktown and Upper Miramichi areas. “The traditional model of providing “One of the interesting things that “We have a direct referral process medical care, focussed on one issue we’ve discovered, is people come in place with Dr. Pat Feltmate, so if at a time, doesn’t work well for frail to find out they’re functioning we believe this person needs to see seniors. They are too complex,” Dr. really well. That’s a huge boost of a geriatrician, we request that their Feltmate said. “Geriatric medicine confidence,” Lynsey said. “If in a primary health care provider send a is based on properly assessing and year from now things are going a consult letter.” embracing this complexity, and the little differently, we’ll reassess.” Dr. Feltmate, medical director evidence shows that this is more The CHNA identified a need for for Horizon’s Collaborative Care effective.” 20 These assessments are best targeted “We discovered that the majority of at complex seniors, who typically the population was older adults and have a long list of medical, there was hardly any programming pharmacological, psychological and for them,” said Belva. social issues. Belva said community programs are “These problems all interact with important developing a community one another, so the full picture spirit and helping eliminate isolation provided by a Comprehensive among seniors, and that’s why the Geriatric Assessment is needed library has been transformed into a in order to make an effective care hub of activities. plan,” Dr. Feltmate said. Everything from book clubs, a Having Dr. Feltmate come to the caregiver support group, puzzles, area improves access. Patients don’t crocheting, knitting, quilting, card have to drive or find transportation parties, computer access, and in the to Fredericton, or sit on a waitlist winter they offer indoor-walking at for six months to see a geriatrician, the adjacent school gym. everything is provided in their own “We always say we’re the noisiest community. library in the world,” Belva said Because many seniors don’t drive, with a laugh. “People tell me going to Fredericton or Miramichi they are improving physically, for services is not an option. This emotionally, and they’re happier transportation issue was also because they’re not stuck in identified by the CHNA. their houses. People are forming “The more we can offer right friendships, they’re bonding.” here in the community, the safer The housing recommendation and healthier our seniors will be,” is about more than just building Lynsey said. “Outmigration is a housing, it’s about providing huge issue with seniors, they often supports in their current homes want to move to cities to be closer as well, so that their homes are to services and then they lose the manageable, and determining what connection with their community, supports are needed for seniors with their friends and family, so the and connecting them to the larger whole idea is to keep people healthy system so they’re not as isolated. and in our community.” Horizon’s Central Miramichi Community Health Centre Belva Brown, librarian at the can be reached at Doaktown Community School 506-365-6100 Library, looked at what the The Doaktown community needs, who the clientele Community School Library were and how well they were can be reached at serving them. 506-365-2018

21 Community Health Needs April 2018 | Issue 4 Assessments in Action COMMUNITY ALBERT COUNTY Message from CARLETON COUNTY

Jean Daigle About Albert County

6 The Albert County Area is a rural About Carleton County area in the Southeastern part of the 14 County Carleton County is an area in the western province on the Chignecto Bay in the part of New Brunswick bordering Maine and is Bay of Fundy. often described as part of the Upper River Valley area as it is situated along the upper part of the Saint John River.

Community Health Needs June 2016 | Issue 1 Assessments in Action COMMUNITY

This is now our fifth edition of In Your Community, which shines a spotlight on communities across Horizon to highlight the important work being done. And that’s something Horizon cannot do alone. Each area we have visited is unique, but the

common themes have presented themselves across Leading the way Under one roof 2 Horizon Health 8 Creating opportunity Cooking can and innovation be ‘Cool’ Lending a hand Network is helping 13 all 22 communities where we have completed communities be in downtown The Oromocto 17 Helping you healthy Fredericton area is gaining a get around in fresh perspective on Petitcodiac, healthy eating Salisbury, Elgin Community Health Needs Assessments. and Havelock

October 2016 | Issue 2 Community Health Needs Seeing the work that’s being done in these remote and harder to reach Assessments in Action COMMUNITY areas, such as Campobello Island or Deer Island, is inspiring. Our staff and community members are doing what they can to keep people off the highways to bigger centres, or off the boat back to the mainland. The hub and spoke approach to health care is crucial to Horizon’s mission of Helping People Be Healthy. Staff have taken an upstream approach to health care – and that’s what the hub and spoke model is all about. They’re out in the community providing workshops, education, women’s wellness clinics, and sexual health clinics for youth in schools. In addition to Horizon staff, I want to thank our community partners who are doing their part in helping people be healthy. I am so impressed by the selfless work people are doing in Central New Brunswick, Eastern It’s about community 2 ‘I Got This’ Horizon Health Network 8 New school program Making connections Charlotte County and Western Charlotte County, in addition to each area is helping people empowers youth in 14 NEW-C has new support be healthy Grand Lake area for Saint John’s North End

we’ve highlighted in In Your Community. In Your Community Oct 2016.indd 1 Community Health Needs October 2017 | Issue 3 Assessments in Action

COMMUNITY2016-10-03 3:02 PM It never ceases to amaze me when I see the lengths people will go to make a better life for someone else. Bravo!

Jean Daigle,VP Community Horizon Health Network NEGUAC MIRAMICHI

22 About Miramichi Area 6 The Miramichi area covers a large geographic area in the northern half of About Neguac Area

New Brunswick and represents a culturally 14 The Neguac area covers a small diverse community. geographic area in the north east part of New Brunswick.

In Your Community Oct 2017.indd 1

2017-10-11 2:44 PM