Report to/Rapport
au:
Health, Recreation
and Social Services Committee
Comité de la santé, des loisirs et des services
sociaux
11 September 2003/le 11 septembre 2003
Submitted
by/Soumis par: M. J. Beauregard
Committee Coordinator/coordonnatrice du comité
Contact/Personne-ressource: As above/Sus-mentionée
580-2424, ext/poste 21622 : Monique.Beauregard@ottawa.ca
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Ref N°: ACS2003-CCS-HRS-0017 |
OBJET: PRÉSENTATION
SUR LE CENTRE DE SANTÉ DE L’EST D’OTTAWA
SUBJECT: PRESENTATION
ON THE OTTAWA EAST COMMUNITY
HEALTH CENTRE
REPORT RECOMMENDATION
A coalition of Community Health and Resource Centres from the east of Ottawa has requested that their consultant, Madame Jocelyne Lalonde, make a presentation to Committee on the above-noted project.
A Project Summary is attached for reference.
OTTAWA EAST COMMUNITY HEALTH CENTRE
Project Summary
According
to the 1996 census, 17.1% (123,595 out of a population of over 700,000) of the
Ottawa population (formerly Ottawa-Carleton) list French as their primary
language. Of this number, more than 80,000 live in the following areas of
Ottawa East: Lowertown, Overbrook-Forbes and the former municipalities of
Vanier, Gloucester and Cumberland. Each of these five areas have community
resource centres (CRCs) that provide various services to local residents living
in these areas. Located at the centre of their respective communities, and well
aquatinted with local needs, these five CRCs in Ottawa East have joined forces
to examine the primary healthcare needs of their clients and to determine the
most suitable healthcare delivery model to meet those needs.
The CRCs provide service in both official
languages; in the frame of this project, they have recognised the importance of
providing priority services to Francophones, as this group as a whole often
experiences difficulty in accessing services, and are particularly vulnerable.
With this in mind, the CRCs have developed this community health project
primarily for the Francophone population to respond to this group’s needs. Nevertheless, services provided by the
Ottawa East Community Health Services (Centre
de santé communautaire de l’Est d’Ottawa), will be offered to all
individuals who wish to use this service.
According to the statistics consulted, the
Vanier, Overbrook-Forbes and Lowertown populations have the following
characteristics: a high level of poverty, many new Canadian families (more than
10% of the population), a considerable number of seniors, low-income families
and transients. In Gloucester and Cumberland, the main characteristics are:
low-income families and individuals, a large percentage of young adults (15 and
over) and many transportation problems in getting to the services desired. For
the 5 areas studied, the lack of affordable housing only aggravates the poverty
situation, especially for individuals with low incomes.
Each of the individual studies recognise that
an individual’s socio-economic situation has a direct impact on lifestyle and
on overall health. Indeed, in the Ottawa East region, Francophones have a
poverty rate that is distinctly higher than that for Anglophones with one of
the differences being a higher number of single-parent families. Both the
children and mothers in such situations live in disturbingly poor
circumstances. The Francophone population also shows a high rate of people with
only a primary level of education who are thereby considered to be illiterate.
These various factors have a direct influence on the lifestyle of Francophones
and thus on their standard of health.
The main health needs of Francophones living in
Ottawa East have been identified through the use of target groups. These needs
fall into three categories:
a)
Mental
health seems to be the predominant problem: People do not have access to the
few services that exist. There is an
increasing demand for such services from seniors, young people and women.
b)
Physical
health: The needs in this area are just as great. There are not enough
physicians in Ottawa East. Individuals interviewed report a lack of Francophone
family doctors. These clients say that they often neglect their health and miss
appointments - in a nutshell, they do not receive
the healthcare required to keep healthy.
c)
Community
health: To meet the enormous needs of the clients using Ottawa East community
resource centres, there is need for more than just healthcare. We have to work
on the factors that determine health and improve living conditions through
health promotion and illness prevention.
The needs listed fall under the category of
primary healthcare. However, the shortage of resources (healthcare
organizations and professionals) in this area severely undermines the
availability of an adequate level of such care. For example, the number of
Francophone healthcare professionals in private clinics is insufficient to meet
the demand; also, the physician/population ratio for Francophones in Ottawa
East is lower than that for the general population. For mental health patients,
the situation is even worse. The number of Francophone mental health
organizations and professionals working in so-called “front-line” (primary)
services are few and far between. This situation is very serious, especially
for at-risk clients: seniors, women with young families, particularly
single-parent mothers, and young people. Lastly, there is currently no
Francophone community health organization in Ottawa East.
In the context of this wide range of needs,
five priority population groups have been identified in terms of strategies for
improving access to primary healthcare: Francophone children and adolescents,
Francophone families, Francophone women, Francophone seniors, and transients. Since these target groups require primary
healthcare but the resources available are insufficient to meet the demand, the
CRCs have chosen the Community Health Centre (CHC) model as being the most
suitable for responding to the needs identified. This model includes such
features as a philosophy and set of basic principles that encourages
decompartmentalization and an integrated approach to service delivery to
ensure: an overall approach to accessible healthcare delivery; solid investment
in health promotion and illness prevention; the support needed to empower
individuals and the community in general; and community participation in
governance.
The primary operating principles of the Ottawa East CHC have thus been
determined on the basis of these major objectives. Its mission and mandate are
described as follows: The Ottawa East Community Health Centre seeks to improve
the living conditions of Francophones in Ottawa East by programs and activities
that will enable them to take charge of their own health. This mandate involves
providing a full range of primary healthcare services (mental, physical and
community) mainly to Francophones living in Ottawa East through an overall
approach that emphasizes health promotion and illness prevention.
The CRCs have also developed an overall healthcare
program based on the needs of pre-identified priority groups. Programs and
services have been established for the following categories: Pre- and
post-birth; children aged 0 to 6, 6 to 12, and their parents; young people (12
to 19); adults and general services; seniors; and community support and
development. These programs and services will be provided by the following
healthcare professionals: 2.5 physicians, 5 nurse practitioners, 5 registered
nurses, 3 nutritionist-dieticians, 2 health promoters, 1 psychologist, 1
psychometrist, 5 mental health practitioners and 2 community workers. The
estimated cost of these professionals is $1.5M, based on the salary scales of
the Ontario Ministry of Health and Long-Term Care. Thus, the total estimated
operating cost of both professional and managerial staff for the Ottawa East
CHC comes to $4M per year.
It is necessary to set up a Francophone CHC in
the Ottawa region so as to improve access to French-language primary healthcare
for all Francophones living in Ottawa East. These programs, services and
activities will round out and complement the work performed by organizations
such as the Anglophone CHCs already existing in the region, institutions such
as Montfort Hospital, Catholic Family Services, and the community resource
centres.
UN CENTRE DE
SANTÉ COMMUNAUTAIRE
DANS L’EST D’OTTAWA
Depuis plus
de 3 ans, cinq Centres de ressources communautaires (CRC) se sont regroupés
pour former un comité de santé. Les CRS
sont: Basse-ville, Overbrook-Forbes,
Vanier, Gloucester et Cumberland. Ce
comité a examiné les besoins en soins
de santé primaires de leurs clientèles et
a déterminer le modèle de prestation de services de santé le plus apte à
y répondre.
L’étude des
besoins en soins de santé primaires, effectuée en 2001, a révélé les principaux besoins suivants:
n
La
santé mentale semble être le problème le plus important: Les gens n’ont pas accès aux services et ces
derniers sont peu nombreux. Les besoins
sont grandissants chez les aînés, les jeunes et les femmes.
n
La
santé physique: Les besoins dans cette
catégorie sont tous aussi importants.
Il n’y a pas suffisamment de médecins dans la région de l’Est d’Ottawa. Les gens rencontrés disent manquer de
médecins de familles de langue française.
n
La
santé communautaire: Pour faire face
aux énormes besoins des clientèles des Centres de ressources de l’Est d’Ottawa,
il faut plus que des soins de santé. Il
faut agir sur les déterminants de la santé et améliorer les conditions de vie
par le biais d’activités de promotion de la santé et de prévention des
maladies.
Il en
résulte que le modèle d’un Centre de santé communautaire a été retenu pour
répondre aux besoins identifiés en santé.
Le Centre
de santé communautaire sera autonome et la prestation des services de santé sera
faite à partir d’infrastructures existantes dans les cinq CRC. Il couvrira tous les territoires des cinq
CRC couvrant l’Est d’Ottawa.
Les
services seront offerts dans les deux langues officielles mais on reconnaît
l’importance d’offrir prioritairement des services aux francophones vivant dans
l’Est d’Ottawa puisque ceux-ci sont confrontés à d’importants problèmes d’accès
aux soins de santé en français.
Une gamme
complète de services de santé physique, santé mentale, et santé communautaire
seront offerts par les professionnels de la santé suivants: médecins, infirmières praticiennes,
infirmières licenciées, diététistes-nutritionnistes, promoteurs de la santé,
psychologue, psychométricien, intervenants en santé mentale et travailleurs
communautaires.