Territory served by the CLSC Côte-des-Neiges
NE UCER CH. L
H4P Mont-Royal
H3R
H4P Montréal
AV. DUC H
ARME
RU
H3T
SON
D'INDY
CLSC Côte-des-Neiges 5700, ch. de la Côte-des-Neiges
TAV. VINCEN
INE E-CATHER CÔTE-SAINT
RUE HUTCHI
OUTREMONT
ONT AV. OUTREM
GES TE-DES-NEI
CÔ CH. DE LA
RUE LAVOIE
RNE AV. VAN HO
H3S
CH. DE LA
CÔTE-DES-NEIGES
Outremont Service Office 1271, av. Van Horne
Y AV. DE VIM
ON E JEAN-TAL
H2V
MARY
H3W H3V
RIE
BOUL. DÉCA
CH. QUEEN-
CH. DE LA CÔTE-SAINT-L UC
CH. REMEMBRANCE
A N N U A L A C T I V I T I E S R E P O R T 2002 • 2003 • CLSC Côte-des-Neiges
H3P
2002 • 2003
AINE POLIT
ÉTRO
EM ROUT AUTO
ANNUAL ACTIVITIES REPORT
The territory of the CLSC Côte-des-Neiges covers three boroughs: Côte-des-Neiges/Notre-Dame-de-Grâce Côte-des-Neiges sector (H3S, H3T, H3V and H4P) Snowdon sector (H3W) Town of Mount-Royal (H3R, H3P and H4P) Outremont (H2V)
Cartographie : Dimesion DPR inc.
Ce rapport est aussi disponible en français Graphic design - cover: JAVA Communications Graphic design: Jacques Jobin Translation: Scott Eavenson Printed: Summer 2003 Dépôt légal : Bibliothèque nationale du Québec Centre affilié universitaire Affilié à l’Université McGill
Table of contents A Word from the Chairperson and the Executive Director Our Territory and Population Our Clientele Our Mission, Values, and Objectives Organizational Charts Mental Health Program Child-Family, Youth, Adult Program Child-Family Youth Adults Clinical Care and Services Program Intake Health Line (Info-Santé) Family Medicine Teams Comprehensive Services for Pregnant Women (SIFE) Services for Refugee Claimants Clinique Santé-Accueil refugees and new arrivals; SARIMM: refugee assistance service Birth House (birthing centre) Homecare Program Occupational Health Program Professional Services and Teaching Activities Human Resources Department Financial and Material Resources Department Professional Services Advisors Family Medicine Unit Research and Training Centre Appendices 1. Auditor’s Report and Financial Statement 2. Publications and presentations at colloquia, congresses, conferences, and other work-related gatherings in which CLSC staff participated 3. Code of Ethics and Rules of Professional Conduct 4. Members of the Board of Directors – Members of the Executive Committee of the Council of Physicians, Dentists and Pharmacists – Members of the Executive Committees of the Professional Councils – Members of the Scientific Council – Members of the Teaching Council – Members of the Board of Directors of the Foundation 5. Addresses and a Word about the CLSC Foundation
2 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
3 4 8 11 15 19 22
29
37 41 44 49 53 55 57 58
62 67 70
74 75
A Word from the
Chairperson and the
Executive Director
It was a long time ago that the CLSC Côte-des-Neiges adopted the quality of its services and user satisfaction as fundamental values. This year these values have become official policy with the addition to the organizational plan of a person in charge of the quality issue. With the help of management and all CLSC employees, the quality officer is to implement a continuous quality improvement program. In addition, in the winter of 2004, the CLSC will apply to the Conseil québécois d’agrément for the renewal of its accreditation. Last year is to be remembered as the year that SIPA (comprehensive care for frail elderly persons) came to an end. Following our clientele’s positive evaluation of the SIPA project, the Home-Care Department reviewed its operations, deciding to preserve what had been gained from the project in terms of resource development and new ways of doing things. Moreover, a large par t of the project’s staff joined the regular team. The CLSC also benefited from additional resources for the Child-Family and Youth programs and was thereby able to increase the volume of services delivered to children and families. The neighbourhood-intervention philosophy remains a primary focus for the teams devoted to these programs, and this can be seen in the numerous projects that have been established throughout the year. This last year is also to be remembered as the year that Director General Jacques Lorion retired. He was a man with a vision for the future. With twenty years at the helm of the CLSC, he played a major role in its growth, overseeing a staff that increased from 129 employees in 1983 to nearly 500 in 2003. His concern for excellence, his openness to creativity, and his great sensitivity to the clientele of the CLSC served as encouragement for leading-edge projects such as SIPA, the Diabetes Project, and the Continuum of Palliative Care, which led to new methods of work and efficient partnerships. Jacques Lorion also recognized the impor tance of weaving links with universities. His efforts enabled the CLSC to acquire university status and help to train the professionals of tomorrow. Finally, Jacques Lorion knew how to go about securing the future with strong people who can continue toward his organizational objective of always providing clients with better services. Today our entire organization feels the effects of his legacy as, with heart and soul, it continues on his quest toward excellence.
Claire Dion Chairperson, Board of Directors
Suzanne Walsh Interim Executive Director
3 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Our
Territory and Population
The CLSC Côte-des-Neiges and its local service office cover the areas of Côte-des-Neiges, Snowdon, Outremont, and Ville Mont-Royal. This territory is characterized by its broad cultural diversity and two distinct urban environments. The distinctive marks of one of these (Côte-desNeiges and Snowdon, population: 87,392) are its multiethnicity, modest living conditions, and the predominance of apartment buildings. The other (Outremont and Ville Mont-Royal, population: 43,588) has a higher standard of living and a larger number of people owning single-family homes as well as duplexes and triplexes. The CLSC must be adaptable to the different characteristics that exist throughout its territory.
Age-Group Percentages Remain Stable
population in 1996 and are now 15%. The current
The population living on the territory of the CLSC
region of Montreal is 15.3%. The territory’s 18-64
Côte-des-Neiges has continued to grow since 1991.
age group increased its population from 63% to 64%
From 1996 until 2001, the territory’s total population
between 1996 and 2001. The 0-17 age group still
increased from 126,666 to130,980, but the age-
constitutes 21% of the population, and it is estimated
group breakdown remained stable. For example,
that it could reach 22% in 2005.
overall percentage for this age group throughout the
people aged 65 and over accounted for 16% of the
Population distribution by age 1996
2001
2005
(Census)
(Census)
(Projection)
Total Population
126,666
130,980
136,828
0 – 17 years (%)
21 %
21 %
22 %
18 – 64 years (%)
63 %
64 %
64 %
65 years and over (%)
16 %
15 %
14 %
4 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
1
However, if the Ville Mont-Royal neighbourhood is
rose from 28.5% to 29.8% between 1996 and 2001.
removed from the equation, the percentage rises to
The overall percentage for the Montreal region in-
31.8%, closer to the overall percentage for the region
creased from 31.7% to 33.0 % over the same period.
of Montreal.
Distribution of families with children, by family structure (Data from 2001) Côte-des-Neiges
Snowdon
Outremont
Ville
Region of
Mont-Royal
Montréal
Two-parent
66.4 %
68.5 %
69.6 %
80.6 %
67.0 %
Single-parent
33.6 %
31.5 %
30.4 %
19.4 %
33.0 %
4
CÔTE-DES-NEIGES : A Welcome Place
As of 2001, the main countries of origin of new im-
Many newcomers choose to settle in the Côte-des-
following: the Philippines (13.2%), Sri Lanka (7.8%),
Neiges and Snowdon districts. According to the
the People’s Republic of China (7%), Algeria (6.7%),
1996 census, 18,410 people who had immigrated
and France (6.4%). Moreover, 24% of the neighbour-
over the last five years stated that they were living in
hood’s residents, while at home, speak a language
Côte-des-Neiges, whereas the figure was 16,651 in
other than French or English, as compared to14% for
the 2001 census. The neighbourhood has a long-
the whole of the Montreal region. The primary lan-
standing reputation for multiethnicity, and it continues
guages in the neighbourhood are French (48.5%),
to be enriched by the socioeconomic, linguistic, cul-
English (27.5%), Tamil (3%), Vietnamese (2.1%), and
tural, and religious diversity of its population.
Russian (1.7%).
migrants living in the neighbourhood have been the
Language spoken at home Côte-des-Neiges
Snowdon
2
(Data from 2001)
Outremont
Ville
Region of
Mont-Royal
Montréal
French
47.2 %
21.6 %
79.6 %
55.7 %
64.0 %
English
24.2 %
42.9 %
7.8 %
34.6 %
22.0 %
Other
28.6 %
35.5 %
12.6 %
9.7 %
14.0 %
4
5 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Our territory and population
The number of single-parent families in the territory
Our territory and population
A High Academic Level
for the entire region of Montreal. It should also be
The proximity of the Université de Montréal, the
pointed out that many immigrants were already uni-
École des Hautes Études Commerciales, and the
versity graduates before they arrived in Canada.
École Polytechnique is part of the reason why a large
Similarly, the percentage of neighbourhood residents
proportion of the territory’s population (41.1%) have
20 and over who do not have a secondary-school
university diplomas, in comparison with only 23.1%
certificate is lower than the Montreal average.
Proportion of population 20 and over with a university diploma (Data from 2001) Côte-des-Neiges
38.0 %
Snowdon
30.8 %
Outremont
Ville
54.1 %
Region of
Mont-Royal
Montréal
52.2 %
23.1 %
4
Proportion of population 20 and over without a secondary-school certificate (Data from 2001) Côte-des-Neiges
8.0 %
Snowdon
10.6 %
Outremont
5.4 %
Ville
Region of
Mont-Royal
Montréal
5.2 %
26.5 %
4
Strained-Economic Conditions
15% above the average for the region of Montreal.
The percentage of people in the territory living un-
Snowdon is also higher than the average for the
der the low-income cut-off increased by 7% between
region of Montreal. These factors contribute to the
1990 and 1996. The alarmingly high percentages in
difficult living conditions of neighbourhood residents,
Côte-des-Neiges and Snowdon are approximately
despite their high academic levels.
The unemployment rate in Côte-des-Neiges and
Proportion of people living below the low-income cut-off (Data from 1996) Côte-des-Neiges
48.6 %
6 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Snowdon
49.7 %
Outremont
20.6 %
3
Ville
Region of
Mont-Royal
Montréal
13.3 %
34.8 %
4
Our territory and population
Unemployment rate (Data from 2001) Côte-des-Neiges
13.7 %
1
Snowdon
12.2 %
Outremont
5.4 %
Ville
Region of
Mont-Royal
Montréal
5.0 %
9.2 %
4
The data related to population characteristics are taken from the 2001 census, except for those on the low-income cut-off, for which we had to refer to the 1996 census. The information was compiled and provided by Robert Choinière, of the Direction de la santé publique de Montréal-Centre (Montréal-Centre public health department), who made use of data from Statistics Canada. The data related to the projections for 2005 are taken from the website of the Direction de la santé publique de MontréalCentre: www.santepub-ml.qc.ca/Portrait/Clsc/neiges/ estimation.html.
2
Data concerning the mother tongue were sorted on the basis of whether individuals stated that they had only one mother tongue or more than one. Our analysis was based on the data regarding those who indicated that they had only one mother tongue.
3
The low-income cut-off corresponds to income levels considered as minimums for meeting basic needs in Canada: food, housing, and clothing, plus 20%.
4
The region of Montreal is the territory of the Island of Montreal, i.e., the former Montreal Urban Community.
7 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Our
clientele1
The residents of the territory served by the CLSC
situation. This kind of intervention tends to be ori-
Côte-des-Neiges can benefit from a series of health
ented in the direction of prevention and education.
and social services, no matter how old they are. People living outside the territory may also have
Between April 1, 2002, and March 31, 2003, 28,118
access to certain services provided by the CLSC
different users were provided with CLSC services in
Côte-des-Neiges on the basis of specific regional
the context of individual care; 779 users benefited
mandates that have been conferred upon it.
from family services; and 65, from support for couples. During the same period, the number of those
One of these mandates is carried out under the
who took part in group meetings was 55,790.
Occupational Health Program, which, in addition to the territory of the CLSC Côte-des-Neiges, covers
Many separate interventions were carried out during
those of the LaSalle, Métro, Notre-Dame-de-Grâce/
the provision of the above-mentioned care. Indi-
Montréal-Ouest, René-Cassin, Saint-Henri, Saint-
vidual care accounted for 220,642 interventions.
Louis-du-Parc, and Verdun/Côte-Saint-Paul CLSCs, as
Family and couple suppor t involved, respectively,
well as that of the Clinique Communautaire Pointe
1,840 and 127 interventions. Group interventions
Saint-Charles. Other such mandates correspond to
amounted to 2,975.
the Service d’aide aux réfugiés (SARIMM, refugee assistance service) and to the Clinique Santé-Accueil, which respond to the needs of refugees and newcomers to Canada throughout the entire metropolitan area. The services of the Côte-des-Neiges Birth House (bir thing centre) are also available to women residing in different sectors of Montreal.
Some users benefit from services in the framework of individual intervention aimed at health and welfare objectives. Other users have access to services via group intervention, meaning activities that bring together people who are experiencing a par ticular
8 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Type of Care
Users
Interventions
Individual Care
28,118
220,642
Family Support
771
1,840
Couple Support
65
127
Group Support
55,790
2,975
Public health also accounted for a significant portion
Much like the people living in its territory, the CLSC’s
of interventions: 29%.
clientele is characterized by multiethnicity. Users’ places of bir th are shown in the following illustration
Ser vices under the heading of Frail Elderly Persons
with reference to the different continents and major
accounted for 12%; 10% of the services delivered fell
regions of the world. It can be seen that 50% of the
under the heading of Mental Health; and 6% came
clientele was born outside North America.
under that of Child-Youth-Family. Services provided under Physical Disabilities and Developmental Handicaps constituted, respectively, 3% and 1% of total inter ventions.
This major diversity in the places of origin of our
Users of all ages
clientele is also reflected in their many maternal
A majority (61%) of the CLSC’s users are females.
languages. To provide the best possible service, the
Looking at age categories, we see that the 18-44 age
CLSC calls on interpreters from the Montréal-Cen-
group constitutes 39% of our clientele and that users
tre Regional Board. The languages most frequently
from 1 day to 17 years make up 26% of the total.
requested by the CLSC are Punjabi, Bengali, Tamil,
The 65-and-over age group accounts for 23% of
Spanish, Turkish, Urdu, Russian, Persian, Vietnamese,
users, and the 45-to-64 age group amounts to 12%
Mandarin, and Hindi.
of total users.
Needs of every sort
The following graph shows that, in the 0-to-17 age
Our clientele makes use of CLSC services in re-
group, more males than females receive CLSC ser-
sponse to different problems. Statistics on the use of
vices. The opposite is true for users between the
services are compiled under the heading of Inter ven-
ages of 18 and 44 as well as for those 65 years of
tion Profile. They provide an overall picture of the
age and older. In the 45-64 age group, the gender
different reasons why people make use of CLSC
differential is minimal.
services. This year 39% of users requested CLSC services for problems related to their physical health.
9 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Our clientele
Born under other skies
Our clientele Service requests from various sources
The diversity of the above sources of service re-
The CLSC Côte-des-Neiges delivers services in re-
develop and maintain cooperative relations with
sponse to requests from users, their families, and
partners from all sectors so that it can properly
partner institutions, both private and community-
serve its population.
quests illustrates how important it is for the CLSC to
based. All service requests are forwarded to the CLSC’s centralized reception area, which is responsible for processing and accepting requests.
In 2002-2003, a large number of the requests processed by the reception area (50%) did not originate from a formal referral. In other words, they came primarily from the users themselves or from family members or friends. Another 35% of the requests were the result of formal referrals, in most cases from hospitals.
Requests transmitted by professionals in private practices or by private medical clinics amounted, respectively, to 4% and 3%. Most of these requests were for lab tests needed by the homecare clientele. 1
The service requests from different organizations that work with refugees and immigrants amounted to 4%, whereas another 4% of the requests came from other CLSCs, the police, and the Local Employment Centre.
10 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
All the user data in the present chapter come from the Intégration CLSC (Sic Plus) user information system, except for data concerning the Montréal-Centre Regional Board’s interpreters bank, which was taken from the report presented by the Clinical Care and Services Program, CLSC Côte-des-Neiges, and dated May 31, 2002.
Our mission, values, and objectives
Our mission
help and solidarity; the promotion of people’s inde-
The CLSC Côte-des-Neiges provides front-line
pendence and dignity; and the quality of the relation-
health and social services for the population living in
ship of trust established with our clientele.
its territory in accordance with the mission defined in An Act respecting health services and social services. In addition, the CLSC Côte-des-Neiges has a teaching, training, and research component resulting from its status as a university-affiliated centre attached to McGill University, an affiliation contract with the Université de Montréal, and agreements with other universities and educational institutions at both the secondary and college levels.
These partnerships help to better understand needs, assess interventions, achieve results, and improve both the CLSC’s practices and the services provided to the population.
The CLSC Côte-des-Neiges offers education and training in a wide range of disciplines. It receives interns in social work and nursing, residents in family medicine, and researchers in the framework of its Research and Training Centre.
Our objectives • To improve access to services: this includes not only the hours during which services are provided but also culture, language, location, and physical access to our services. We strive to reach as many people as possible and to deliver ser vices that are well adapted to specific population groups, including the different cultural communities residing in our territory. Our interventions are therefore focussed on neighbourhoods.
Neighbourhood-based intervention is the cornerstone of access to our services. This approach enables us to work more closely with the population and to respond more adequately to needs in physical, mental, and social health, while helping the neighbourhoods to create their own dynamics. It not only preserves the CLSC’s specificity in preventive and
Our values The values that constitute the foundation of our mission and the core of our concerns are a reflection of the Côte-des-Neiges community itself, particularly
promotional roles but also gives members of the community in each of the territory’s five neighbourhoods the oppor tunity to take part in identifying and solving their own problems.
its respect for differences and cultural values; mutual
11 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Our mission, values, our objectives
• To develop the quality of services.
• To be sensitive to the needs of the population and to promote respect
The CLSC Côte-des-Neiges has instituted a con-
for basic rights.
tinuous quality improvement program for all services, which includes continued development of
The CLSC Côte-des-Neiges has two codes of ethics
an intercultural-approach program for our staff and
and sets of rules of professional conduct, one apply-
interns.
ing to all staff members and the other, to members
In addition, efforts are being made to harmonize our action plans with those of organizations devoted to early childhood, young people, refugee claimants, and elderly people. The CLSC ensures that its staff can maintain and develop their knowledge and skills, that the institution will continue to perform well, and that users are satisfied.
of its Board of Directors. In Appendix 3 you will find the Code of Ethics and Rules of Professional Conduct Applicable to the Members of the Board of Directors of the CLSC Côte-des-Neiges. Both of these policies convey the values and beliefs that the CLSC promotes. The CLSC Côte-des-Neiges has two ethics committees, both of which are responsible for ensuring that users’ basic rights are respected. The Clinical
The CLSC Côte-des-Neiges has six professional
Ethics Committee provides advice and assistance for
councils that are responsible for the services pro-
the staff and the institution. Its mandate includes the
vided to our clients: the Conseil des infirmières et
development of guidelines for inter vention in com-
des infirmiers (nurses), the Conseil des médecins
plex or special situations presented by CLSC staff or
(physicians), the Conseil multidisciplinaire
management.
(multidisciplinary), the Conseil des travailleuses sociales et travailleurs sociaux (social workers), the Conseil des sages-femmes (midwives), and the Conseil du personnel auxiliaire et de soutien (auxiliary and support staff). They are mandated to make recommendations and provide advice on the following matters: assessing and improving the quality of professional services, maintaining and promoting professional and technical skills, improving the deliv-
In 1999, the Ministry of State for Health and Social Services and the Ministry of Family and Childhood assigned the Research Ethics Committee the role of ensuring respect for subjects of research, for the quality of research conducted at the CLSC, and for ethical principles stemming from research projects that involve impaired adults and minors. This ministerial designation must be renewed in December 2003.
ery of services to clients, and developing the organization of work from the scientific and technical perspective.
• To make full use of our staff in fulfilling our mission.
Policies on complaint management and service satisfaction assessment enable users to inform
The CLSC’s staff members are our primary resource.
us of their appraisals. Remarks by users allow us to
They make it possible for us to achieve our quality
make needed changes and adjustments. Information
objectives in relation to our clientele and services. It
on the implementation of these policies is provided
is obvious that both our quality and efficiency objec-
in the chapter entitled Professional Services and Teach-
tives are, to a large extent, dependent on the com-
ing Activities.
12 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
The CLSC is updating its mental health programming
our staff members.
by having all its staff provide services - regardless of
The very nature of care and services, as well as their delivery (home visits, community work, presence in schools), requires that our staff be extremely autonomous. Moreover, given the diversity of the problems that we face, the multiethnicity of our population, and the size of our territory, we must constantly develop new ways to intervene and organize our services so as to reach out to those in need as efficiently as possible. We therefore rely enormously on the creativity and knowledge of our staff and expect
their basic training or the program to which they belong - instead of creating a specialized mental health team. This avoids marginalizing the mental health clientele and promotes comprehensiveness and continuity in the provision of services. By integrating mental health services with other services required by the same clientele, the CLSC is showing that it is concerned about having these people integrated into the community, which is what the government’s mental health policy advocates.
them to lead the way for us as we implement innovative means of intervention. We cannot forget to highlight the ethnic and cultural diversity of our staff, an asset that the CLSC can count on when it needs to solve problems and find new ways to intervene.
• To form partnerships with community organizations and with institutions that belong to the health and social services network, and to develop intersectorial cooperation. We are developing and maintaining ties and ex-
• To strengthen the multidisciplinary and interdisciplinary approach.
changes with other organizations in our sector and with institutions belonging to the health network so as to ensure the complementarity and continuity of
The CLSC values a brand of humanization based on a common approach for all staff, comprehensive and continued intervention, respect for people’s autonomy, prevention, maintenance and recovery of health, allowing people to remain in their natural environment, and innovation. Our staff develop an approach that takes all of a person’s needs into account. This kind of approach requires that all CLSC professionals work together on a multidisciplinary basis.
services for our users. We are also striving to create and maintain links with other sectors such as education, public security, justice, and the municipality. These kinds of alliances enable us to improve living conditions and to develop healthy and safe environments for our programs and activities. We promote individual and community-based responsibility for problem solving as well as participation on the par t of those organizations and institu-
The CLSC is also developing an interdisciplinary
tions that are best able to intervene. Recognition of
approach intended to fur ther integrate disciplines
and respect for the specific spheres of competence
and programs, thereby creating greater cohesiveness
of all our par tners can only help us to better define
in our interventions. Our neighbourhood-based
how and where the CLSC should take action,
intervention efforts promote this interdisciplinary
thereby allowing us to maximize the results of our
approach, and the CLSC is striving to begin this kind
inter ventions.
of practice with its intervention teams.
13 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Our mission, values, our objectives
petence, creativity, motivation, and autonomy of all
Our mission, values, our objectives
• To optimize the use of resources.
continuity in the inter vention process and interdependence between those who provide advisory
The allocation of resources is determined by the
expertise and those who possess intervention exper-
principle of achieving the greatest possible impact on
tise. This focus is to be found in the 2002-2005 pro-
the health and well-being of the population and is
gramming developed by each department.
based on an order of priority for the problems that exist throughout the territory. The allocation of resources is also based on an indepth knowledge of our population’s socio-demographic characteristics. This knowledge enables us to develop the most adequate strategies for reaching out to our clientele and efficiently solving problems.
• To maintain an organizational structure that reflects the mission and objectives of the institution. The CLSC’s organizational plan formally establishes the internal levels of responsibility for the implementation of all aspects of its mission. The CLSC regularly updates its organizational plan so that its structure will remain attuned to new developments and to the resources and mandates entrusted to it. The organizational structure of the CLSC Côte-desNeiges, as can be seen in the following organizational char ts, provides for the participation of different councils and committees that are accountable to the Board of Directors and that inform and guide the Board in its decision making.
The CLSC’s organizational plan also illustrates the structure developed on the basis of the different services available to the population. This structure reflects the concern for facilitating an exchange of expertise between programs and staff. It ensures
14 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
The organizational structure also reflects the importance of education and research by maintaining a direct link with university environments and by establishing an internal structure that encourages and supports the development of education and research activities.
Organizational Char ts Councils and committees responsible to the Board of Directors Board of Directors Board of Directors' Executive Committee Audit Committee Teaching Council Research and Training Scientific Council Clinical Ethics Committee Research Ethics Committee Council of Physicians, Dentists and Pharmacists Council of Nurses Multidisciplinary Council Council of Social Workers Council of Auxiliary and Support Personnel Council of Midwives
15 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Executive Directorate Board of Directors
Executive Directorate
Reception and Health Line Clinical Care and Services Family Medicine (4 teams)
Professional Advisors: Nursing Social Work Midwifery
Comprehensive Services for Pregnant Woman Financial and Material Resources
Santé-Accueil Clinic Refugee Assistance (SARIMM)
Occupational Health and Safety
Human Resources
Bir th House
Multidisciplinary Team (East Section) Child-Family,Youth, Adult Health Multidisciplinary Team (West Section)
6 Multidisciplinary Teams
Professional Services and Teaching Activities
Homecare (Multiclient) Research and Training Centre
16 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Teaching Activities and Research and Training Activities
Executive Director
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Scientific Council, Research and Training Centre
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Teaching Council
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McGill University
Université de Montréal
McGill University
Université du Québec à Montréal
Université de Montréal Assistant Director for Research
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Université du Québec à Trois-Rivières
Director, Research and Training
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Scientific Director, Research and Training Centre
Université du Québec à Montréal
Director of Professional Services and Teaching Director
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Council of Partners
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Assistant Director for Training
Teaching Committee
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Council of Researchers and Educators Pulication Committee
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Chief of Medical Services and Director of Medical Teaching Unit
Medical Teaching Coordinator
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Assistants, Medical Ser vices
Functional tie Affiliated
17 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
18 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Mental Health Program
Intervention in mental health is a concern for all
Accomplishments
staff. The CLSC is updating its mental health pro-
In order to deliver quality services it is important to
gramming by having all staff members deliver serv-
heighten levels of competence. Throughout the year
ices (regardless of their basic training or the pro-
the CLSC has continued its mental health training
gram to which they belong) instead of creating a
activities. Training sessions on crisis intervention
specialized mental health team. Our intention is to
were held for professionals in all programs. Some
avoid marginalizing the mental health clientele and
professionals also underwent training in suicide emer-
to promote continuity in the provision of our serv-
gency assessment and intervention.
ices. Ser vice agreements with the St. Mary’s Hospital CenMental health issues fall under the responsibility of a
tre, the Jewish General Hospital, the Tracom Crisis
psychologist, who is assisted by CLSC work teams
Centre, Forward House, and Projet Arc community
and is accountable to the Director of the Child-
organizations, as well as with the CLSC Homecare
Family, Youth, Adult Program.
Program, were implemented to help people with severe and persistent disorders to remain in the community.
Operations Intake, orientation, and referral services are provided
The CLSC is taking par t in the MARCO project,
by centralized intake and by all staff members in the
aimed at ensuring continued services for people in
course of their work with people in the community.
emergency suicide situations in the combined territor y of the CLSC Côte-des-Neiges and the St.
Staff members in the different programs, including
Mary’s Hospital Centre. Suicide-Action Montréal and
homecare, include mental health services in other
the emergency and crisis-intervention departments
services specific to their own activities. They meet
of the St. Mary’s Hospital Centre, the Centre
users and their families during home visits, CLSC
Dollard-Cormier, and the Tracom Crisis Centre are
visits, or anywhere that CLSC activities take place or
par tners in this project.
services are provided. These mental health services are delivered as a complement to those offered by
The CLSC facilitates the work of and participates in
community-based organizations and hospital centres
the “Comité clinique pour clients présentant une
that serve our territory.
situation difficile dans la sous-région Centre-Ouest”
19 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Mental Health Program
(Centre-West subregional clinical committee for
In keeping with the multidisciplinary approach, individual
clients living with a difficult situation). The objective
consultation services will be offered by psychologists for
of this committee is to promote a continuum of
staff members. These services are much appreciated
good mental health services for adults (18 and over,
because staff members see that they have a direct effect
including the elderly) with multiple, complex needs
on their clients.
and for whom no satisfactory solutions seem to have been found. It consists of a pilot project supported
A bio-socio-psychological development screening clinic
by the Table de concertation en santé mentale de la
for children aged 2 to 4 was held in the Plamondon
sous-région Centre-Ouest (Centre-West subregional
neighbourhood. The multidisciplinary team for this clinic
mental health consultation committee) and includes
included a nurse, an educator, a dental hygienist, and a
staff and directors from community-based organiza-
psychologist. This same psychologist also acted as a
tions, hospitals, and CLSCs, in addition to a user of
consultant for the neighbourhood-intervention team
the project’s services.
regarding a problem with arcades located near a school.
In the framework of Bill 38,001, An Act respecting the
The CLSC Côte-des-Neiges offers a transcultural semi-
protection of persons whose mental state presents a
nar intended to provide an opportunity for discussion
danger to themselves or others, agreements are being
and sharing ideas on how to work with a multicultural
formally concluded with two other CLSCs (René-
clientele. The CLSC Côte-des-Neiges and the Montreal
Cassin and Notre-Dame-de-Grâce/Montréal-Ouest)
Youth Centres have been presenting this jointly organ-
and with the neighbourhood police stations that
ized seminar since 2001. A dozen staff members from
serve the respective territories of the par ticipating
each institution - all involved in helping relationships -
CLSCs. Fur thermore, collaboration with UPS
take par t in the different sessions of the seminar. Two
(Urgence Psycho-Sociale) Justice is planned to begin
specialists in child psychiatry, one from the Montreal
in December 2003.
Children’s Hospital and the other from the SainteJustine Hospital, act as resource persons for the group.
Moreover, work has begun with the St. Mary’s Hospi-
The sessions are focussed on discussions of clinical cases
tal Centre, the Tracom Crisis Centre, and a repre-
presented by the participants. The objectives of the
sentative of foster families for persons with mental
seminar are (1) to enable staff members to develop
disorders in the Centre-West for the purpose of
their understanding, expertise, and interpersonal skills,
defining comprehensive ser vices for persons with
particularly with regard to situations in which the usual
personality disorders.
means of intervention are not very effective, and (2) this year, to reduce the fragmentation of services and
The CLSC is offering group cognitive behavioural therapy for people with depression and anxiety. The group sessions will be held simultaneously in French and English and will be facilitated by psychologists and social workers. Fur thermore, again this year the
Interventions for users with
CLSC is offering group sessions for the development
mental health problems or whose
of self-esteem in an effort to promote mental health
mental health is threatened
in our territory.
(all programs combined)
20 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
2001
2002
2002
2003
58,604
52,990
replace them.
In 2002-2003, the Research and Training Centre, in coordination with Mental Health, conducted the
Depression Screening Day
following projects:
For the four th consecutive year, the CLSC took part
* Centre de recherche-inter vention, santé mentale,
in a depression screening day in the framework of
culture, transuniversitaires-multidisciplinaires,
Mental Health Week. This activity is linked to a
autochtones, immigrants (centre for research-
Harvard University research project, and participating
intervention, mental health, culture,
organizations were Ami Québec, the Tracom Crisis
transuniversity-multidisciplinary, indigenous, immi-
Centre, Concordia University, the Université du
grants)
Québec à Montréal, college-level institutions, and the
(Principal researcher : Cécile Rousseau)
Centre-West hospitals and CLSCs. This prevention-
* State-Organized Violence Adult Attachment Relation-
oriented activity took place at two locations in the
ship and the Mental Health of Immigrant and Refu-
territory. At the CLSC Côte-des-Neiges, in addition
gee Women
to depression, we screened for disorders related to
(Principal researcher : Marta Valenzuela)
mood, anxiety, and post-traumatic stress.
* Réduire la détresse psychologique et le fardeau des aidants familiaux de personnes âgées vulnérables : étude évaluative d’un programme d’intervention de
2001
2002
2002
2003
distress and the burden on family caregivers who help frail, elderly persons: an evaluative study of a
Number of people who received information / filled out
gestion du stress à domicile (reducing psychological
465
526
home stress-management intervention program) (Principal researchers: Francine Ducharme and
questionnaires
Paule Lebel) Number of people who showed signs of having major disorders
76
67
Such screening makes it possible to identify people who are developing symptoms or are in the early stages of an illness. In addition to becoming aware of the signs of depression, anxiety, post-traumatic stress, and mood disorders, the participants learn that these diseases can be treated, and they are given referrals so that they can receive help. Our objectives also include screening adolescents and young adults and improving access to services for young people between 14 and 25 with anxiety disorders.
21 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Mental Health Program
pants cannot attend, any other staff members may
Research and Training Activities
provide support for staff members. If regular partici-
Child-Family, Youth, Adult Program
The services of different programs combined under the Child-Family, Youth, Adult Program are offered to families, parents, pregnant women, newborns, children, adolescents, and adults with needs related to their physical or mental health, different handicaps, psychosocial problems, or problems linked to their surrounding environment or to community life.
Our intervention teams are under the responsi-
Neighbourhood intervention is based on an
bility of the director and are supported by two
intervention policy that makes it possible to organize
neighbourhood leaders. These teams include nurses,
work in the neighbourhood: a multidisciplinary team,
educators, homecare assistants, consultant child psy-
a specific territory, identified needs, an action plan,
chiatrists, social workers, nutritionists, community
and periodical assessments of progress toward the
organizers, community workers, psychologists, dental
established objectives. Emphasis is placed on the
hygienists, and secretaries.
promotion of health and well-being, and the two primary components of neighbourhood intervention
Operations
are (1) the empowerment of individuals and, eventu-
The characteristics of the CLSC Côte-des-Neiges
ally, of the neighbourhood and (2) intersectorial
territory differ considerably from one neighbour-
work with community-based organizations, schools,
hood to another. This is the reason why interven-
the police, etc. In this context, neighbourhood inter-
tions resulting from the above programs converge
vention is intended to bring people together by go-
within each neighbourhood, the true natural environ-
ing beyond the natural barriers of isolation and mis-
ment of each individual. The territor y can be divided
trust and the lack of communication and social
into five small “natural” neighbourhoods: Outremont/
networks. This approach also promotes mutual aid
Ville Mont-Royal, Mountain Sights, Plamondon, South,
and autonomy on the part of residents and creates
and Centre. These divisions enable the teams to
greater visibility for both the culture and customs of
work more closely with the population and to be
Montrealers.
more familiar with the characteristics, needs, and strengths of both the neighbourhoods and their community-based partners.
22 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
from one neighbourhood to the next. Never theless,
The Mountain Sights Neighbourhood
this year each team has developed a community
Over the course of the year emphasis has been
diagnosis that specifically defines the needs, issues,
placed on (1) consolidating and developing the com-
and resources of its neighbourhood.
munity centre, which, jointly managed by the CLSC
Both the process and the pace of teams are different
Prenatal and postnatal meetings as well as parentchild activities with meetings on specific themes are offered in all neighbourhoods, as are the Projet Répit (respite project) and dental clinics. A team of educators is working in the different neighbourhoods on
and an organization called PROMIS, hosts a weekly average of over 200 people for different activities; and (2) improving living standards in the neighbourhood and housing conditions for the residents of Mountain Sights Street.
group activities that provide a stimulus for children and support for the role of parents. A social worker from the Youth Program is present in each neighbourhood to promote the empowerment of young people. A psychologist from the Clinical Care and Services Program is providing help in dealing with the arcades problem. Finally, work in conjunction with our institutional, private, and community-based partners has increased, thereby enabling us to ensure complementarity and continuity of services.
The Plamondon Neighbourhood In 2002-2003, activities took place in premises that we shared with the Municipal Housing Corporation, which also manages the building. These activities were the following: establishing a profile of the neighbourhood; organizing group prenatal meetings through links with the SIFE project (Services intégrés pour la femme enceinte, comprehensive services for
Partnerships are of fundamental impor tance to us,
pregnant women); organizing neighbourhood clinics
and they have taken the concrete form of alliances
on health and social problems; organizing school
that we promote and plan to make successful via
support in par tnership with schools and community-
individuals, families, friends, the community, and staff
based organizations; promoting educational activities
from other sectors. We have worked with the Youth
for children from one to five years of age; inter vening
Centres, child-care centres, school boards, hospitals,
in physical and mental health.
the police, and others in an effort to improve interconnections and avoid overlapping roles and responsibilities. We have also clarified mandates regarding promotion, prevention, and curative care.
A mother-child activities project is being carried out in par tnership with the Grandir Ensemble project (supported by Invest in Kids) and the Côte-desNeiges Sports Centre. Grandir Ensemble is a men-
Finally, we would like to promote an intersectorial
tal-health intervention project for young families and
approach, given the many aspects of the problems
toddlers. In addition, a multidisciplinary clinic for
faced by our population. We are already working in
screening bio-socio-psychological development in
cooperation with our institutional, private, and com-
children up to five years of age has begun to oper-
munity-based partners to ensure complementarity
ate.
and continuity of services, and we would like to formalize and improve these relationships.
23 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Child-Family, Youth, Adult Program
Accomplishments in our Neighbourhoods
Child-Family, Youth, Adult Program
The South Neighbourhood
from one sector to another is a factor that makes it
Activities for young families are offered at the Côte-
difficult for staff members to maintain a regular ex-
des-Neiges Sports Centre, where a team of nurses, a
change of information, given that there are not many
social worker, and an educator provided parents with
things in common throughout the neighbourhood.
information and support through group prenatal care, conducted postnatal educational activities, and encouraged the development of physical activities at the Spor ts Centre. The number of people taking part in activities increased this year.
Before it sets up appropriate activities, the team wants to identify the neighbourhood’s primary needs. Adults often have very basic needs such as food, housing, and employment. In many cases, it is difficult to become integrated, and isolation is perpetuated due to the inability to speak the language of the
Outremont and Ville Mont-Royal
majority, the lack of access to a network (especially in
The team organized parenting skills development
family networks in their countries of origin), and
sessions (Parents efficaces, efficient parents), which
problems in making contacts. The neighbourhood
were a great success. The team also surveyed the
environment is in a precarious state: it lacks green
clientele in an attempt to better direct the develop-
spaces; housing units are in need of repair ; and the
ment of its activities and the promotion of mental
population is very diverse. There is a generalized lack
health. Other activities were also carried out, includ-
of nearby recreational facilities or stimulation for
ing a canvassing effort for the purpose of improving
children and their parents. In 2003, emphasis will be
our understanding of different aspects of our sector
placed on implementing and conducting the appro-
and postnatal meetings intended to help mothers
priate activities.
overcome isolation and to promote optimal child development.
the case of newcomers, who have left behind their
In addition to activities that constitute the underpinnings of the neighbourhood-intervention philosophy, the population is provided with services in
The Centre Neighbourhood
the context of the Child-Family, Youth, Adult Pro-
This year the approximately 15 staff members work-
gram. These services are delivered in continuity
ing in the neighbourhood decided to conduct an
and in the framework of the preventive, family ap-
exhaustive study. The team saw that the disparity
proach.
Accomplishments of the Child-Family Program Prenatal group meetings help to prepare future
parents. Our collaboration with certain organiza-
parents for the birth of their child. This year we
tions and our partnership with the Côte-des-Neiges,
addressed midwifery services and delivery at the
Notre-Dame-de-Grâce, and St-Laurent local employ-
Birth House (birthing centre). The Naître en santé
ment centres enable us to identify pregnant women
(being born healthy) approach (including EMO: eggs,
and thereby proceed with early intervention.
milk, oranges) continues to be used for screening underweight babies and family problems. This ap-
Screening for postpartum depression and situations
proach continues to make it possible to open doors,
entailing risk or vulnerability have been the objectives
create trust, and prepare intervention plans with
of our postnatal meetings. In addition to provid-
24 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Family support remains constant. Two homecare
mote parental mutual aid and parent-infant relation-
assistants help families when the mother, father, or
ships as well as initial networking among parents. We
both parents need a rest and help at home. Social
would like to increase the number of times that we
workers offer help and support for problems related
visit the parents of a first-born child. Furthermore,
to conjugal violence, immigration, isolation, and men-
educators have made home visits for the purpose of
tal health. They also cooperate with the DPJ (youth
providing both support for parents and educational
protection depar tment) to address problems of
follow-up for children with difficulties.
abuse and negligence.
Individual counselling on nutrition is the main
There is an increasing demand on the financial aid
activity in the area of nutrition for pregnant or
program for the respite needed by families in which
breastfeeding women and for children up to five
there is a mental handicap, and we are attempting to
years of age (up to 12 years of age, beginning in
reduce the number of people on the waiting list. We
September 2003). Two dietitians/nutritionists offer
are also developing a parental support group in col-
individual appointments, and each covers a specific
laboration with the Miriam Centre, which provides
territory. Occasional group information-and-discus-
services for people with mental handicaps.
sion meetings provide an opportunity to answer food-related questions asked by future parents and by parents of young children. The following are the problems and subjects most frequently addressed in both individual and group meetings: lack of appetite; picky eating habits; slow growth and eating problems; anemia; prevention and/or treatment in the area of nutrition; food allergies; prevention and additional information following a diagnosis; introducing solid foods; breastfeeding; weaning and dietary supplements; child obesity.
An educator provides support services for the childcare centres in our territory via specific super vision activities for educators. An increase in the number of childcare slots available for neighbourhood children is, again this year, an objective that remains to be achieved. A community organizer suppor ts the development of childcare centres in several ways, including her par ticipation at the coordinating meetings of the childcare network. The educators at Place Sésame, a CLSC early childhood stimulation centre, continued their stimulation activities with children
In addition to immunization, screening, and monitor-
between the ages of 18 months and 5 years. This
ing of children’s growth, the Children’s Clinic em-
centre allows for networking among the parents of
phasizes the importance of screening children for
children who use the centre.
delays in development.
Accomplishments of the Youth Program On the basis of needs and health problems seen at
In the framework of the family medicine clinic, doc-
schools and in the community, the team de-
tors and nurses are providing full-time curative and
voted its efforts to health prevention and promotion
preventive care for young people. Dental hygien-
activities (sexuality, smoking, drug abuse) with young
ists are implementing the preventive dental services
people between the ages of 4 and 20. The team
public program throughout the territory’s public
organized group meetings, group classroom activities,
elementar y schools. A community organizer
and workshops together with partners in the com-
worked closely this year with the Table Jeunesse
munity.
25 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Child-Family, Youth, Adult Program
ing opportunities for exchange, these meetings pro-
Child-Family, Youth, Adult Program
(youth committee) to structure recreational activi-
Neiges and Multi Jeunesse au service; Table Jeunesse
ties and job access for adolescents.
Côte-des-Neiges; Programme de prévention de la toxicomanie; Loisirs sportifs Côte-des-Neiges; Com-
Community action is underway with the following
mission consultative sur la famille d’Outremont; and
partners: Carrefour Jeunesse Emploi Côte-des-
Table de concer tation Jeunesse Outremont.
Accomplishments of the Adult Program Social services have provided help and support
Community organizers are involved in the following
for adults with relationship problems (family, couple),
activities and organizations: French courses; the con-
personal problems (mental health, psychiatry, malad-
sultation committee on immigrant reception and
justment, mental handicaps, isolation, stress), crisis
adaptation in Côte-des-Neiges; the Conseil
situations, and situational difficulties.
Communautaire de Côte-des-Neiges/Snowdon; the
We have developed an intervention program so that we can fight family violence more efficiently. We provide screening and follow-up services for women who are victims of conjugal violence. Aggressive spouses receive referrals. Agreements for collaboration with institutions, the police, and communitybased organizations are always updated. A CLSC social worker is a member of the RESOVI consortium (a Université de Montréal scientific centre on family violence). We are planning to complete a reference framework
Multi-Caf community cafeteria (provides warm lunches for schools); and the Corporation de développement économique communautaire de Côte-des-Neiges/Notre-Dame-de-Grâce (CDEC CDN-NDG, community economic development corporation). At the tenth anniversary of the CDEC CDN-NDG, the National Assembly awarded our community organizer with a medal for his continuing involvement in the CDEC from the time of its foundation and for his outstanding contribution as the Chairperson of its Board of Directors over the last eight years.
on intervention in conjugal/family violence and to provide training for the neighbourhood teams.
The following table draws a summary profile of the activities conducted within the Child-Family, Youth, Adult Program. It is not, however, an exhaustive list of all activities carried out by staff members.
Nursing Activities
2001-2002
2002-2003
87
98
Prenatal and postnatal home visits
3,108
3,709
Follow-up and immunization interventions (children’s clinic)
3,936
4,162
329
442
7,182
10,097
Prenatal and postnatal group meetings
School group meetings Number of participants in meetings
26 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
2001-2002
2002-2003
9,371
9,489
892
1,014
4,986
3,874
90
114
Number of participants in meetings
1,330
1,616
Nutrition Related Activities
2001-2002
2002-2003
Home visits
152
69
Group meetings
27
13
Number of participants in meetings
306
127
2001-2002
2002-2003
401
450
2001-2002
2002-2003
1,239
943
Visits to childcare centres
116
63
Group meetings
384
476
Individual interventions at Place Sésame
154
65
Group meetings at Place Sésame
369
203
Dental Hygiene Activities
2001-2002
2002-2003
3,457
4,751
130
76
2,291
1,532
2001-2002
2002-2003
404
763
8,011
13,795
2001-2002
2002-2003
Number of people benefiting from family support
189
197
Number of people on waiting list for family support
41
48
Individual interventions (elsewhere than at schools) Home visits Individual interventions at schools School group meetings
Homecare Activities Individual interventions in suppor t of young families
Education Activities Home visits
Individual interventions Group interventions Number of participants in meetings
Community Action Activities Group meetings Participants in meetings
Family Support Activities
Child-Family, Youth, Adult Program
Social Work Activities
27 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Child-Family, Youth, Adult Program
Teaching Activities In 2002-2003, the Child-Family, Youth, Adult intervention teams received 30 interns. Intervention internships
Observation internships
9 interns in social work
3 interns in nursing
6 interns in nursing
2 interns in psychology
3 interns in psychoeducation
1 intern in childbirth assistance (doula)
2 interns in dental hygiene
1 intern in dental hygiene
1 intern in couple/family therapy
1 intern in medicine Clinical-research internship 1 intern in social work
Research and Training Activities In 2002-2003, the Research and Training Centre, in coordination with the Child-Family, Youth, Adult Program, conducted the following projects: Les compétences socio-éducatives attendues des intervenant(e)s de première ligne auprès des jeunes enfants et de leur famille en milieu socio-économiquement faible (socioeducational skills expected of front-line staff working with young children and their families in socioeconomically disadvantaged environments) (Principal researcher: Bernard Terrisse) Situations de vie et de pauvreté des jeunes en milieu pluriethnique : adéquation des ressources publiques et communautaires (life and pover ty situations of young people in multiethnic environments: adequation of public and community resources) (Principal researcher: Catherine Montgomery) Les pratiques traditionnelles des femmes immigrantes au Canada (traditional practices of immigrant women in Canada) (Principal researcher: Bilkis Vissandjée) Empowerment et femmes immigrantes : diffusion des connaissances (empowerment and women immigrants: disseminating knowledge) (Principal researcher: Ginette Berteau ) Vérification d’un modèle prédictif de la santé des hommes âgées aidants naturels: suivi longitudinal sur les facteurs spécifiques «caregiving» (verifying a prediction model for the health of elderly male natural caregivers: longitudinal follow-up on factors specific to caregiving) (Principal researcher: Francine Ducharme) Les réponses sociales à la violence envers les femmes (social responses to violence against women) (Principal researchers: Mylène Jaccoud and Maryse Rinfret-Raynor) Les trajectoires des membres de la communauté sri lankaise à Montréal comme facteur explicatif de l’intégration sociale (backgrounds of members of the Sri Lankan community in Montreal as an explanatory factor for social integration) (Principal researcher: Annick Lenoir) Travail des femmes et construction sociale du risque pour la reproduction (women’s work and the social construction of risk for reproduction) (Principal researcher: Romaine Malenfant)
28 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Clinical Care and Services Program
The Clinical Care and Services Program includes intake (telephone and outpatient), the Info-Santé health line, the family medicine teams (medical, nursing, and social services), psychology, nutrition, the Clinique Santé-Accueil (for refugees and new arrivals), SARIMM (refugee assistance service), and the Birth House (birthing centre). The Program is also responsible for the authentication of health insurance cards.
The Director of Clinical Care and Services is sup-
8 CLSCs in the subregion. The average length of a
ported by three program coordinators, each of
call is 8 minutes, and 80% of calls are answered, in
whom is responsible for one of the following teams:
comparison with 75% last year.
the Support and Psychology Team; the Nursing, Social-Work, and Nutrition Team; and the SARIMM
Furthermore, during the CLSC’s business hours, the
team. The Director of Clinical Care and Services
social workers at intake provide a similar information
works closely with the head of the Family Medicine
service with regard to social and mental health prob-
Unit and the Director of Midwife Services.
lems.
Operations Telephone and/or outpatient intake is provided by nurses and social workers who respond to requests for services of a social, psychological, community, or health-related nature. Most service requests come from the clients themselves, their family members, and hospitals.
The CLSC’s Info-Santé service is provided by nurses who respond to the immediate health needs of the population between 8 a.m. and 8 p.m., from Monday to Friday. Outside these hours, the service is provided by a central switchboard that serves
The CLSC also provides a service for the authentication of health insurance cards to anyone residing in the territory served by the CLSC Côte-des-Neiges. This service is available from Monday to Friday, between 12 noon and closing time. The same as last year, there is a weekly average of 300 requests for this service.
By emphasizing continuous follow-up by appointment, our family medicine teams deliver care and services to clients of all ages. The CLSC has four family medicine teams, one of which provides services at the Outremont Ser vice Office. These services are provided with or without an appointment on
29 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Clinical Care and Services Program
Mondays, Wednesdays, and Thursdays, from 8 a.m.
Furthermore, the nurses and the nutritionist led
until 8 p.m., and Tuesdays and Fridays, from 8:30 a.m.
monthly educational workshops on health problems
until 4:30 p.m. One of our objectives is to improve
such as diabetes, cholesterol, and breast cancer, alter-
access by increasing the number of evening and
nating from month to month between French and
weekend hours.
English. As a result of these workshops, we want to develop prevention programs for cer tain health is-
In addition to participating in the services delivered
sues, although we will have to give consideration to
by the family medicine units, nurses attend to the
the availability of resources.
continuity of hospital and postoperative services for those clients who can travel to the CLSC. A
The social services and psychological counselling
homecare team continues care and services, if
team helped again with the depression screening day.
needed, during evening hours and weekends.
One of the team’s objectives is to fur ther develop interdisciplinary work while maintaining a balance
Staff members belonging to the social services
between social and psychological services, on the
and psychological counselling team provided
one hand, and other services, on the other hand.
help and support for people with relationship prob-
Another objective is to work with the family medi-
lems (family, spouse), personal problems (mental
cine teams and the neighbourhood-intervention
health, psychiatry, maladjustment, mental handicaps,
sectors.
isolation, stress), crisis situations, and situational difficulties.
Again this year, psychologists, along with social workers, developed group therapy interventions for cli-
Accomplishments The CLSC physicians are applying to the Ministry for accreditation as a family medical group (GMF in French). They have received the support of the board of directors in this process. The primar y objective of GMFs is to improve access to medical services for those clients who are registered with a CLSC family doctor. The CLSC has signed a service agreement with the Herzl Family Medicine Unit at the Jewish General Hospital in the framework of their GMF accreditation application.
In the framework of the CLSC’s promotion and prevention activities, nurses organized an influenza and pneumococcus vaccination clinic for people 65 and older and those considered at risk. This year, just as in the rest of Quebec, we saw a decrease in the clientele receiving this service. At the CLSC Côte-des-Neiges, the decrease was 10%.
30 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
ents with problems specifically related to anxiety and/or depression so as to explore these problems in an atmosphere of mutual help and personal growth.
One of the team’s psychologists helped to supervise family medicine residents, and another is involved in a neighbourhood intervention team. Furthermore, another psychologist is collaborating with the nutritionist on the development of a weight loss program.
The CLSC continued with its comprehensive services for pregnant women (Services intégrés pour la femme enceinte, SIFE), providing continuous interdisciplinary care throughout pregnancies and during the postnatal period. The network of services for pregnant women comprises all perinatality staff members (both medical and alternative fields, including the Birth House) and encourages collaboration with community-based partners. This project has
The CLSC Côte-des-Neiges is also becoming “baby
CLSC’s Child-Family Team within a framework of
friendly” in the framework of a provincial activity that
complementarity and continuity.
encourages breastfeeding by no longer providing a systematic supply of infant formula to new mothers.
The SIFE team is made up of midwives and of the members of a family medicine team from the Clinical Care and Services Program. A gynecologist from the Jewish General Hospital acts an a consultant.
Services for Refugee Claimants The regional mandates of the CLSC Côte-des-Neiges make it responsible for delivering health (Santé-Accueil Clinic) and social (SARIMM) services to refugee claimants.
Operations
ers, and people with unstable status in the region of
The CLSC Côte-des-Neiges Santé-Accueil Clinic
Montreal and, if necessary, for those outside the
provides health services for refugee claimants who
region.
have trouble obtaining access to regular health care services. Doctors and nurses provide care for differ-
SARIMM also provides services for specific clienteles
ent health problems, including those related to these
by way of contracts between the CLSC and different
clients’ migratory travel. They also carry out screen-
bodies, i.e., the Immigration and Refugee Board, the
ing for infectious diseases.
ministère des Relations avec les citoyens et de l’Immigration (ministr y of relations with citizens and
One of our objectives is to improve the understand-
of immigration), and the International Social Service.
ing that different network institutions and intersectorial partners have with regard to the serv-
Staff members act as designated representatives for
ices provided by the Santé-Accueil Clinic and
unaccompanied minors and impaired persons
SARIMM. This also means establishing ties and/or
at Immigration and Refugee Board (IRB) hearings.
agreements with the Montreal CLSCs in an attempt to improve the delivery of ser vices to asylum seek-
SARIMM’s intake service is now staffed by five
ers.
CLSC social workers who receive, assess, and direct all requests for information or consultation between
The Service d’aide aux réfugiés et aux immi-
9 a.m. and 5 p.m.; and by two Downtown YMCA
grants de Montréal métropolitain (SARIMM,
workers who receive clients referred to them for
refugee assistance service) provides social services
temporary shelter.
for refugee claimants, recognized refugees, newcom-
31 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Clinical Care and Services Program
made it possible to develop closer ties with the
Clinical Care and Services Program
SARIMM also provides long-term psychosocial care
Radio, visual media, and print media have all highlighted
for specific clienteles, such as high-risk families, unac-
SARIMM’s work with unaccompanied minors. This has
companied minors (mental health), women who are
made SARIMM’s services better known, thereby ena-
victims of conjugal violence, people who have been
bling the organization to recruit mutual suppor t families
subjected to organized violence (rape, torture), and
and to enrich our housing bank with new families (in-
people who are suicidal, in a state of shock, or suffer-
cluding Quebeckers) interested in hosting young people.
ing from depression.
At the same time, a committee is discussing housing needs and the kinds of shelter available for unaccompa-
This year the primary reasons for intervention were
nied minors.
the following: various social problems (45%); socioeconomic problems (25%); social adaptation (23%);
We are also establishing additional partnership agree-
family life (3%); information of a social nature (1%);
ments with community resources in Montreal and with
problems related to victimization (1%); and behav-
youth centres throughout the province.
ioural problems (1%). Several groups have been active in 2002-2003. A mutual support group named Ar tisanat sans frontières
Accomplishments
(artisans without borders) allows women ar tisans to
Staff members at the Santé-Accueil Clinic devel-
overcome isolation by networking. In collaboration with
oped a project for systematic medical check-ups in
the Santé-Accueil Clinic, SARIMM is taking part in a
order to provide more intensive screening for refu-
mutual-support group for Sikh men by providing infor-
gees exposed to precarious socio-sanitary conditions.
mation on social adaptation in Quebec. Activities are
Moreover, a doctor and a social worker held a group
also being offered for two groups of unaccompanied
intervention session with men from the Sikh commu-
minors from the Pakistani and South African communi-
nity to provide health information, help with their
ties. Under the title of “My New Life in Quebec,” these
integration, and overcome their isolation.
activities consist of field trips and group discussions held in French so that the young people can learn the lan-
Over the course of the year, 18 information sessions
guage. Such activities enable them to overcome isola-
on different health topics (including infectious dis-
tion, while helping to inform and reassure them. In
eases) were held for refugees at the YMCA, and one
addition, a social worker facilitated information sessions
session was held for YMCA employees.
at the YMCA on the process of claiming refugee status.
In accordance with a mandate from the Ministry,
This year the CLSC published a document entitled Pra-
SARIMM is responsible for unaccompanied minors
tique sociale interculturelle au SARIMM (intercultural
until they obtain permanent residence or legally
social practices at SARIMM), which deals with models
become adults. The CLSC has therefore signed an
for social intervention with the refugee clientele and
agreement with the Centres Jeunesse de Montréal
new arrivals, specifically describing the social practices
(CJM, Montreal youth centres) that defines the roles
used by SARIMM. This document is the product of a
and responsibilities of each party in cases of place-
consultation process with all of SARIMM’s staff mem-
ments or transfers of young people to the CJM until
bers. It is a valuable tool for all those working in this
they obtain permanent residence.
sector. Fur thermore, SARIMM is highly appreciated as a research site.
32 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
The Maison de naissance Côte-des-Neiges offers midwife services to women and couples who want to experience pregnancy and childbirth in a safe and private environment.
Operations
Accomplishments
First proposed in the framework of a pilot project,
Clients adapt very well to the presence of the stu-
these services are now offered on a permanent basis
dents who are doing their undergraduate studies in
as a result of the National Assembly’s adoption of
midwifery at the Université du Québec à Trois-
legislation on midwifery in 1999. The main objectives
Rivières. This is the first year that we have received
of the Birth House are to offer the regional popula-
midwifery interns. We have seen that a relationship of
tion the prenatal and postnatal services of midwives
trust develops between the interns and the clients.
as well natural childbirth in the cases of women
The university curriculum therefore seems to provide
who are in good health and whose pregnancy has
a good insight into the reality of the profession of
progressed normally. These services are covered
midwifery. The Council of Midwives ensures the
with the health insurance card and have been inte-
safety and quality of the care and services that we
grated into the CLSC’s perinatal program.
provide.
After presenting the Ministry with a report file that
The Bir th House team also supports other CLSC
demonstrated the enormous demand for our serv-
Côte-des-Neiges programs, including SIFE (Compre-
ices and the length of the ever-growing waiting list
hensive Services for Pregnant Women), whose meet-
for them, we were able to increase the number of
ings with CLSC psysicians are attended by the team in
midwife positions from 6.7 to 8.7. We now have
an effort to increase access and collaboration among
over three times more requests (977) than available
professionals. The Birth House team also takes part in
places (277 follow-ups completed).
prenatal courses with CLSC nurses. The team con-
The percentage of the clientele from the CLSC’s territory is approximately 13%. Clients from outside the territory break down as follows: Plateau MontRoyal (27%), Rosemont (23%), East Island (11%),
tributes to these courses by addressing means of managing pain, by demystifying labour and delivery, and by making women aware of the presence of midwives within the CLSC.
Notre-Dame-de-Grâce (4%), Verdun-LaSalle (4%),
The new legislation provides for midwives’ access to
Centre-Ville (3%), Ahuntsic (3%), West Island (3%),
hospitals. Thinking, discussions, and dialogue on future
Saint-Laurent (1%); and previous clients from the
agreements are moving ahead. For the time being, we
Rive-Sud (5%) and Rive-Nord (3%).
can continue to count on our partners within the
User satisfaction remains high, and returning clients account for almost 50% of the current clientele. The continuity of care, provided by a two-midwife team per client, is a key factor in the quality of services. Prenatal courses are very much appreciated and have met with a high level of par ticipation (90%). A postnatal meeting for the evaluation of services helps when it comes to making adjustments for future care.
practice of midwifery. Our contacts with the Jewish General Hospital and the Montreal Children’s Hospital enable us to maintain the quality of our services and to ensure that mothers and their newborns will receive the best of care at all times. Fur thermore, the Ordre des sages-femmes (order of midwives) and the Quebec Professions Board are currently developing regulations concerning home birthing.
33 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Clinical Care and Services Program
The Maison de naissance (Birth House)
Clinical Care and Services Program
The Birth House users group remains active and
babies. An autonomous group has grown out of
continues to hold its Thursday-afternoon meetings.
these meetings; it deals with vaccination and meets
The issues addressed and the presence of invited
on the morning of the last Friday of ever y month.
staff members attract many young parents with their
The following table draws a summary profile of the activities conducted within the Clinical Care and Services Program. It is not, however, an exhaustive list of all activities carried out by staff members.
Intake Activities
2001-2002
2002-2003
Service requests
4,708
4,987
Nursing care
3,923
4,110
Social work
785
877
Information requests
23,618
24,709
Nursing care (Info-Santé)
22,160
23,776
Social work
1,458
933
2001-2002
2002-2003
Medical appointments
13,208
16,129
Côte-des-Neiges
10,788
12,625
Outremont
2,420
3,504
11,353
12,076
Côte-des-Neiges
8,337
8,988
Outremont
3,016
3,088
Medical and nursing care walk-in visits
12,600
10,121
Côte-des-Neiges
10,228
8,161
Outremont
2,372
1,960
120
168
Users of the Santé-Accueil Clinic
2,105
2,410
Influenza and/or pneumococcus vaccinations
2,457
2,255
Social work interventions
1,697
1,434
Psychology interventions
512
604
2001-2002
2002-2003
Service requests
3,129
3,121
Users
2,892
3,078
350
320
6,409
6,000
Total:
Total:
Clinical Activities Total:
Total:
Total:
Nursing care appointments
Women receiving care through the SIFE project
SARIMM Activities
Unaccompanied minors Users at the YMCA
34 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
2001-2002
2002-2003
Women requesting care
686
977
Women registered
285
294
Care completed
244
274
Childbirths at Birth House
164
189
Clinical Care and Services Program
Birth House Activities
Teaching Activities In 2002-2003, the Clinical Care and Services teams received 40 interns. Intervention internships
Observation internships
16 interns in medicine
3 interns in nursing
9 interns in midwife training 7 interns in social work 2 interns in pediatric medicine 1 intern in nursing 1 intern in psychology 1 intern in health administration
Research and Training Activities In 2002-2003, the Research and Training Centre, in coordination with the Clinical Care and Services Program, conducted the following projects: La construction et l’explicitation des savoirs d’action dans des équipes d’intervention sociale (construction and explicitation of action knowledge in social intervention teams) (Principal researcher: Guylaine Racine) Les auxiliaires familiaux en CLSC: ethnicité, formation et insertion institutionnelle; enquête questionnaire. (CLSC homecare assistants: ethnicity, training, and institutional insertion; survey questionnaire) (Principal researcher: Deirdre Meintel) Système de services intégrés pour patients diabétiques de type 2 du territoire de Côte-des-Neiges: évaluation des effets (integrated service system for type-2 diabetic patients in the Côte-desNeiges territory: effect assessment) (Principal researcher: André-Pierre Contandriopoulos) L’interprétariat dans l’intervention médicale et psychosociale de première ligne (interpreting in front-line medical and psychosocial intervention) (Primary researcher: Louise Tremblay) Impact d’un système de communication standardisé entre les départements d’urgence et le réseau de soins primaires: l’effet sur la continuité ainsi que la qualité des soins de santé (impact of a standardized communication system between emergency departments and the primary care network: effect on health care continuity and quality) (Principal researchers: Marc Affilalo, Jean François Boivin, and Eddy Lang)
35 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Clinical Care and Services Program
Éthique et ethnicité : la question de l’autonomie en santé publique (ethics and ethnicity: the issue of autonomy in public health) (Principal researcher: Hubert Doucet) Points de vue de gestionnaires sur l’insertion, la réalisation et le maintien d’un programme d’intervention de groupe auprès d’enfants exposés à la violence conjugale (managers’ viewpoints on the inser tion, implementation, and maintenance of an intervention program for children exposed to conjugal violence) (Principal researcher: Maryse Rinfret-Raynor) Processus migratoire et présentation du tableau de l’autisme chez des enfants de familles de migration récente (migratory process and autism profile in children belonging to recently migrated families) (Principal researchers: Vania Jimenez, Jacques Rhéaume, and Jean-François Saucier) Étude multisite du processus décisionnel de la commission de l’immigration et du statut de réfugié (multi-site study of the Immigration and Refugee Board decision-making process) (Principal researcher: Vissandjé Bilkis) Needs of Refugee Mothers After Pregnancy- Early Response Service. (Principal researcher: Anita Gagnon) Pregnancy and Child Bearing in Refugees : Transitionnal Health - A Feasibility Study (Principal researcher: Anita Gagnon) State-Organized Violence Adult Attachment Relationship and the Mental Health of Immigrant and Refugee Women (Principal researcher: Marta Valenzuela) Analyse de l’implantation : système de services intégrés pour des femmes enceintes (SIFE) (implementation analysis: system of compressive services for pregnant women) (Principal researcher: Vania Jimenez) Allaitement maternel et marrainage en milieu multiethnique: transfert des connaissances (breastfeeding and mentoring in a multiethnic environment: transfer of knowledge) (Principal researcher: Carmen Loiselle)
36 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Homecare Program
More than 175 staff members provide homecare
Operations
services for some 7,000 people so that they can
Each multidisciplinary team is assigned to one of the
stay at home while remaining independent and
six neighbourhoods into which the large CLSC Côte-
supporting their families. We want to respect the
des-Neiges territory has been divided. The fact that
will of people to live in their own homes with a
each staff member continues to work with the same
decent quality of life for as long as possible. Our
clientele and in collaboration with the same neigh-
Homecare Team is therefore responsible for ensur-
bourhood organizations and agencies promotes the
ing that its clients receive the care and services
quality and continuity of our interventions. This prin-
that they require in an appropriate setting. These
ciple constitutes one of the cornerstones of neigh-
clients include the frail elderly, the handicapped,
bourhood inter vention. This division of work also
people with mental disabilities or mental health
reduces travelling time between home visits.
problems, convalescents, people with chronic illnesses, and those who wish to die at home.
This principle is also included in the mandate under which CLSCs ser ve as an entry point into the health
Our multidisciplinary teams are made up of nurses,
system. As a single window for access to long-term
social workers, occupational therapists, physiothera-
services, CLSCs provide for continuity among the
pists, dietitians, homecare and social assistants, doc-
different services for the elderly. To properly fulfill
tors, a community worker, and a community organ-
this mandate, the Homecare Program continues to
izer. These teams work under the supervision of six
improve its contact mechanisms with the main re-
program coordinators, a management advisor, and
sources in the territory so that all those in need will
the homecare director, and they receive additional
receive the care and services that they require, in-
backing from the administrative support staff.
cluding those that follow hospitalization, a change of residence, or any other change in personal living conditions. The past year has been particularly rich in this respect. (See the “Accomplishments” section.)
To better meet the needs of our clientele, we have extended homecare visiting hours to seven days a week, including holidays, from 7 a.m. to 11 p.m. If needed, nurses may visit the same client as many as
37 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Homecare Program
four times a day. A team can also be quickly made available to assess a situation when a beneficiary is referred for emergency care. Most requests come from hospitals, from users, or from the user’s family or friends.
The Info-Santé regional switchboard provides for telephone service and urgent intervention when the CLSC is closed. Moreover, a team of doctors and nurses is always on duty for those clients who have expressed that they wish to die at home and for those with complex health problems.
The quality of life of elderly persons is also main-
Accomplishments
tained through volunteers and community-based
Many changes have occurred in the last year within
resources that accompany the elderly, make friendly
the Homecare management team, creating a need
visits, cook meals, help with household chores, and
for cohesiveness. A new director was appointed, an
offer suppor t to people and families in difficult situa-
advisory position was added, and two new program
tions. These resources include SARPAD Côte-des-
coordinators were appointed. This team’s priority
Neiges, the Côte-des-Neiges Volunteer Centre,
has been the development of a common philosophy
Multi-Écoute, the Réseau d’entraide bénévole
that makes it possible to take full advantage of every-
d’Outremont, Meals on Wheels, Project Genesis, the
one’s strengths and talents via mutual suppor t. The
Cummings Centre, and several other community-
synergy produced by this philosophy has had a con-
based groups that work with the Homecare Team.
crete effect on the regular homecare activities and has led to the implementation of measures aimed at
Over the last five years, the Homecare Program has
improving the quality of services:
accumulated a unique brand of expertise as a result of its par ticipation in two large research projects on
Information and consultation meetings with staff
palliative care (Vers un continuum de
for the purpose of disseminating a plan for the
services en soins palliatifs, moving toward a continuum
reorganization of work and the programming of
of services in palliative care) and gerontology
the year’s activities.
(SIPA : Soins intégrés aux personnes âgées en perte
Implementation of a rotating schedule for the
d’autonomie, comprehensive care for frail elderly
program’s nurses so as to cover weekends and
persons). At the end of the SIPA project, the
holidays as well as to provide continuity of care;
Homecare Program was able to keep a large number
because regular nurses are doing this work, we do
of the staff members who had worked on the
not have to resor t to the services of private
project and was therefore able to integrate their
agencies.
invaluable experience in terms of know-how and the
Creation of regular positions for homecare and
development of resources.
social assistants and a reduction in the use of agency services, which allows for greater stability and improved quality in homecare services.
38 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
with curative interventions. We are therefore work-
eral Hospital and the CLSC René-Cassin regard-
ing toward both long-term and short-term objec-
ing single-window operations.
tives.
Development, in collaboration with our main partners, of a subregional home support services
We also want to improve the quality of life for our
harmonization plan.
staff by reviewing job descriptions, making changes in the way that waiting lists are managed, and providing
Objectives
for a realistic replacement budget so that our staff
One of the program’s objectives for the coming
will not be overworked. We rely on oppor tunities
years is to develop group interventions aimed at
for resourcing, task and practice diversity, and flexibil-
preserving the autonomy of clients younger than
ity in the organization of work.
those that we currently serve. We want to encourage people to engage in habits that are healthy from
We would also like to improve the continuity and
several points of view - physical, psychological, social,
quality of ser vices. Fur thermore, if the budget allows
community - and to do so before problems begin to
for it, we want to improve the frequency of our serv-
appear. Of course, activities in the areas of preven-
ices so as to meet the real needs of our clientele.
tion and promotion must be planned in conjunction
This would include providing more homecare assist-
with our institutional and community-based partners.
ance.
We plan to practise these activities while continuing
Prevention and Promotion Activities Annual Activities
2001-2002
2002-2003
Number of participants in community activities
6,217
9,433
Number of vaccinations (influenza and pneumococcus) outside the CLSC
1,731
2,040
2001-2002
2002-2003
Visits by nurses*
36,003
34,481
Visits by doctors
517
567
Visits by homecare and social assistants
85,830
86,236
Visits by social workers
3,735
3,566
Visits by occupational therapists
1,997
1,716
Visits by physiotherapists
1,585
1,970
Visits by dietitians
750
501
Total interventions
149,546
147,111
6,446
6,122
Homecare and Services Activities Homecare Activities
Number of users met by staff members (all together)
* Following the adoption of the SIPA methodology, we were par ticularly careful about the quality of our exchanges with our institutional and community-based partners because we wanted to improve on our continuity of care. This partially explains why the number of visits by nurses decreased: more time was devoted to case management and the coordination of our services. The difference from one year to the next is equivalent to a decrease of one visit per nurse per week.
39 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Homecare Program
Formal agreement reached with the Jewish Gen-
Homecare Program
Teaching Activities In 2002-2003, The Homecare Team received 32 interns. Intervention internships
Observation internships
3 interns in homecare assistance
12 interns in physiotherapy
2 interns in nursing
5 interns in medicine
2 interns in social work
4 interns in nursing
1 intern in occupational therapy
1 intern in nutrition 1 intern in homecare assistance
Research internship 1 intern in industrial engineering
40 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Occupational Health Program
The Occupational Health Program delivers services and proposes activities for companies and their workers. In addition to the Côte-des-Neiges territory, the Occupational Health Team covers those of the LaSalle, Métro, Notre-Dame-de-Grâce/Montréal-Ouest, René-Cassin, Saint-Henri, Saint-Louis-du-Parc, and Verdun/Côte-Saint-Paul CLSCs, as well as that of the Clinique Communautaire Pointe Saint-Charles.
workplaces targeted for health programs and multi-
Risk-Free Maternity Program
ple interventions in the framework of An Act respect-
All companies, except those under federal jurisdiction,
ing occupational health and safety. To implement
are subject to the regulations governing the preventive-
these programs the team relies on the expertise of
leave program, Pour une maternité sans danger (risk-
doctors, nurses, occupational hygiene specialists and
free maternity). Any pregnant woman who believes
technicians, as well as the administrative support staff
that her work is harmful to her own health or to that
that works under the responsibility of a coordinator.
of her unborn child may request that her employer
This large pool includes 11,957 workers in 190
assign her to a different job. Each year the OccupaEmployers and workers are given information ses-
tional Health Team processes approximately 1,900 such
sions on the contaminants that are present in the
requests for preventive leave.
company, their effects on health, and individual means of protection. These sessions also include an assessment of the risks to which workers are exposed when they carry out their jobs. A total of 208 establishments were contacted in 2002 for program development, updating, and implementation.
Requests for Investigation from the Commission de la santé et de la sécurité au travail (CSST, Quebec Commission of Occupational Health and Safety) At the request of the CSST, the Occupational Health Team conducted 65 workplace investigations. In 22 of these investigations, environmental assessments were required so that complete data could be presented for the evaluation of applications for compensation related to occupational illnesses.
41 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Occupational Health Program
The Occupational Health Program's Promotional Activities
Priorities for 2003
By taking par t in public shows organized by the hotel
board), the five regional CSST departments for the
and restaurant industries and health-and-safety
Island of Montreal, and the CLSC Côte-des-Neiges.
shows at the Palais des Congrès, we have been able
Consultation mechanisms have been established for
to meet with workers outside their working environ-
the purpose of implementing provincial and regional
ments and to address issues such as first aid and
priorities. The bodies to be involved in these mecha-
ergonomics.
nisms are the Table de concertation régionale (re-
The planning of priorities was the result of close cooperation between the Régie régionale (regional
gional coordinating committee) - which includes the Furthermore, our participation in the provincial
representatives of the five regional CSST depart-
“Forklift Committee” enabled us to work with our
ments - the Direction de la santé publique (public
occupational health par tners to define guidelines for
health department) de Montréal-Centre, and the
2003-2005.
program coordinators for the five CLSCs with occupational health mandates in the region of Montreal.
A seminar on noise source reduction, directed by Phat Nguyen, an engineer who has specialized in this
The CLSC Côte-des-Neiges Occupational Health
field, brought together representatives from nine
Team has been working for the last few years to
companies at the CLSC Côte-des-Neiges. The par-
realistically present planning activities on which it will
ticipants’ evaluation of this activity was very positive.
be able to follow through. In 2002 we invested con-
Moreover, a pilot project aimed at proposing activi-
siderable efforts in improving our targeting of higher-
ties to reduce workplace noise has begun in two
risk workplaces, where we plan to intervene in 2003.
companies in the CLSC’s territory. Provincial intervention priorities are to provide folThe Team has begun to develop workplace-specific
low-up on the following programs in targeted
health programs to meet the needs of the con-
workplaces: electrostatic powdering, musculoskeletal
cerned parties (employers, workers, CLSC) while, at
conditions, isocyanates, and beryllium. These pro-
the same time, abiding by the spirit of An Act respect-
grams have arisen from the primary objective of An
ing Occupational Health and Safety. This process pro-
Act respecting occupational health and safety, namely,
vides for the intervention of occupational health staff,
the at-source elimination of risks.
in collaboration with the workplace, in cases of risks that are clearly recognized by all concerned, for the purpose of achieving concrete results within a given period of time.
42 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
1
Activities
Workplaces
Targeted workers
Initial workplace assessment
48
781
Development and updating of specific health programs
13
1415
Monitoring of workplace environments and sampling of risks
58
1422
Health surveillance
67
1175
Information
123
1827
First aid
21
808
1
Occupational Health Program
Planning Activities 2003
Contrary to the other CLSC programs, Occupational Health uses the calendar year (January 1-December 31) as its financial year.
Teaching Activities In 2002-2003, The Occupational Health Team received four interns. Intervention internships 2 interns in secretarial studies
Observation internship 1 intern in nursing
1 intern in occupational health
43 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Professional Services and Teaching Activities
The Professional Services Department is responsible for the implementation of teaching programs, continuous quality improvement and client satisfaction, and the Clinical and Research Ethics Program, as well as for the Medical Records Department, management of the user information system, the documentation centre, and the CLSC’s website.
Teaching Program
The Teaching Program also helps to improve the
For several years the Teaching Program has been
quality of the work environment, making the CLSC a
contributing to the training of new CLSC
stimulating place where university people work side
professionals in health and social services. Its contri-
by side with clinical staff. The satisfaction derived
bution has grown in terms of the number of
from supervision is something that our staff
internships and of the diversity of supervised discipli-
members emphasize. This environment attracts
nes. The Program has led to the evolution of
highly trained, competent professionals who are
professional practices because it has stimulated
committed to delivering services to the community
thinking about knowledge, skills, and attitudes,
and information to their peers.
thereby improving the quality of intervention. Our teaching role is constantly updated, as we In 1997 the CLSC acquired the status of a university-
welcome residents in family medicine, medical
affiliated centre (affiliated to McGill University), and
students, and interns and students from many disci-
this status was maintained in 2001. It also has an
plines. Last year the CLSC received a total of 151
affiliation agreement with the Université de Montréal
interns from all three university levels and from the
and has signed agreements with other universities
secondary and collegiate levels. We also hosted
and with different teaching institutions at the
foreign delegations from Great Britain, French
secondary and collegiate levels.
Guiana, Denmark, Chile, France, Haiti, Palestine, and Uruguay.
44 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Professional Services and Teaching Activities
Disciplinea of Interns
Numbers for 2002-2003
Family medicine
64
Nursing
20
Social work
19
Physiotherapy
12
Midwifery
9
Administration
8
Homecare assistance
4
Dental hygiene
3
Psychology
3
Psychoeducation
1
Nutrition
1
Childbirth assistance (doulas)
1
Couple/family therapy
1
Occupational therapy
1
Occupational health
1
Industrial engineering (research)
1
Continuous Quality Improvement and Client Satisfaction Program
In accordance with An Act respecting health services
The quality of services and client satisfaction are values
With the adoption of amendments to the act in
adopted by the CLSC, recognized in its organizational
2002, this function is now incumbent upon the
plan, and suppor ted by an organizational structure. The
CLSC’s local service quality commissioner (patient
organizational structure accords an important role to
representative), who is responsible for ensuring that
the professional councils with regard to the quality of
users’ rights are respected and that their complaints
professional services and has implemented a quality
are promptly handled. The local commissioner may
improvement program involving management and all
also present recommendations to the institution’s
the staff members in accordance with their roles and
authorities regarding measures aimed at improving
responsibilities.
the quality of services and user satisfaction. This year
and social services, the CLSC Côte-des-Neiges receives and examines the complaints filed by users.
28 complaints were handled; this compares with 44 The program is aimed at carrying out the objectives
for the previous year. This decrease is the result of
identified in the institutional improvement plan, which is
the changes made in the complaint-handling system,
composed primarily of the elements brought up during
which now provides for compiling expressions of
the CLSC’s evaluation process, that of the Conseil qué-
dissatisfaction in a different category from that of
bécois d’agrément (Quebec accreditation council). This
complaints. This year 7 expressions of dissatisfaction
year’s work includes the development of tools that will
were recorded. The complaints concerned the
enable us to better adapt our services to the needs of
following:
users and to conduct regular surveys on their level of satisfaction.
45 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Professional Services and Teaching Activities
Reasons for Complaints
2001-2002
2002-2003
Access or continuity
20
10
Delivery of care or services
10
5
Interpersonal relations
16
8
Surroundings and material resources
2
3
Financial resources
2
2
Individual rights
3
1
Many accounts of satisfaction with care and services
Risk management is another concern for the CLSC
are also handled by the local commissioner. Most of
as well as an obligation to which it adheres.
these come from users or their families. This year 54
Therefore, the CLSC processes incident/accident
messages of satisfaction were conveyed, in
reports to ensure that service delivery meets the
comparison with 42 for last year. The most
safety requirements that users have a right to expect.
frequently emphasized reasons for this satisfaction
The reports contain information on events occurring
were competence and quality in the provision of
while a service is being provided or that have had or
services (22%); listening and support (14.8%); the
might have consequences on a user’s health or well-
devotion and availability of staff (14.4%); and
being. Report analysis is intended to identify risks
efficiency and excellent coordination in the delivery
and, if need be, implement corrective measures. The
of services (13%).
reports processed this year concern the following:
Aspect of Service Delivery
Number of reports
Confidentiality
0
Continuity
6
Occupational safety
18
Physical security
2
Computer security
0
Total
26
Over the course of 2003-2004 the CLSC will formalize its risk-management process and will set up a risk and quality management committee that will provide for user participation.
46 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
In 2002-2003, 11,973 new records were opened in
Respect for ethical principles and user rights during
performance of their duties, requested a daily ave-
intervention and in research is an institutional
rage of 1,200 records. Medical records librarians
concern that has been updated and supported by
analyzed 753 requests for access to information
clinical ethics and research ethics committees. Mana-
contained in records. Users were at the origin of
gement and staff may consult a bioethics specialist to
129 of these requests. Disclosure of information is
support their interventions and decision-making in
dependent on the user’s consent, except in cases
complex situations involving issues of ethical
provided for by law.
the different programs, and staff members, in the
principles or user rights.
Medical Records Department
User Information System: Indicators and Performance Measurement
As provided for in An Act respecting health services
The user information system called “Intégration
and social services, the CLSC prepares and keeps
CLSC” is a computer system that has been designed
medical records for all users who receive services.
and developed for all CLSCs. By using the system’s
Records are essential tools for multidisciplinary inter-
data on age, gender, problems, interventions, etc., we
vention. They make it possible for professionals to
can better understand the characteristics of our
communicate, to promote the continuity of services,
clientele as well as the volume of our activities.
to assess the quality of services and care, and to
Analysis of this data also provides us with valuable
meet specific research- and teaching-related needs.
information on what directions should be taken for
They also provide users with access to the personal
the organization and delivery of services. We can
information to which they are entitled and enable
thereby adapt and optimize our interventions with
them to take legal action.
users.
We currently have 133,217 records. They are the
This system also enables us to produce reports that
responsibility of the Medical Records Department,
support our university mission. Such reports include
whose mandate is to ensure that they are accessible
profiles of clienteles that our interns are servicing or
and well kept. The Department is also responsible
provide impor tant research data. The system also
for protecting the records and the confidentiality of
gives us the data required by government authorities
the information contained in them. Moreover, the
for the purpose of objectively monitoring the
Department ensures that established guidelines for
evolution of service delivery. Names are absent
the writing and preservation of records are
from all repor ts so that confidentiality will be
respected. To do so, it conducts specific analyses
protected. The fact that confidentiality is a priority
based on standards recognized by the professional
for the institution led to the adoption during the
corporations.
course of the year of a policy on computer security aimed at protecting data confidentiality, integrity, and availability.
47 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Professional Services and Teaching Activities
Clinical and Research Ethics Program
Professional Services and Teaching Activities
information systems enable us to develop indicators
Our Objectives and Directions for 2003-2004
for the purpose of monitoring our organizational
The 2003-2004 year will be devoted, in par ticular, to
performance levels. This year, in collaboration with
a second renewal of our accreditation and to the
the Université de Montréal, the CLSC began to work
development of our organizational performance
on a performance assessment model. The model
assessment model, both of which are part of the
that we are designing will measure all aspects of the
present context arising from agreements to be
CLSC’s performance because we believe that they
signed with the Regional Board. The introduction
are all important and complementary. We have a
and implementation of the complaint management
particular interest in assessing the impacts of our
system are also objectives that will contribute to
interventions on the health and well-being of our
optimized processing and transmission of informa-
clientele; the work atmosphere; user satisfaction;
tion.
The use and crossover of the data contained in our
optimal resource management; and the quality of our services.
In keeping with the teaching dimension of our university mission, we will make efforts to host more interns. As members of a teaching institution, we
Documentation Centre and Website
would like to take part in the collective effort to
The documentation centre’s mission is to offer
increasing the number of interns, particularly in
access to recent, high-quality, specialized information
nursing. In cooperation with the Human Resources
that can be of support for the care and services
Department, we would also like to support our staff
provided to clients and for research and teaching
in their teaching roles by providing them with rele-
activities. The documentation centre’s objectives are
vant training so that they can both maintain and
to acquire recent documents, develop ties with
improve their skills and expertise.
counter the system’s deficit of health professionals by
partners, and disseminate information in support of our staff, whose roles include teaching and on-theground research.
The website presents the CLSC’s programs and activities. This is the second consecutive year that visitors (516) and visits (7,569) to the site have doubled. Fur thermore, 531 messages were received by e-mail. These messages addressed subjects such as information requests regarding CLSC activities and services, job applications, and health system service offers.
48 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Teaching Activities The Professional Services Team received one intern in secretarial studies.
Human Resources Department
When we think about achieving the mission of the CLSC, we realize that our staff is our primary source of wealth. The Human Resources Department must therefore demonstrate leadership with regard to the quality of life in the workplace, activation of our staff, and the development of human resources.
The combination of a scarcity of human resources,
In the current context of scarce human resources, it
the aging of our staff, and the increased demand for
is a constant challenge to recruit and retain staff.
services requires that the Human Resources
Over the last 12 months, 54 new employees joined
Department use a proactive management approach.
the institution, while 66, including 5 retirees, left. In
Such an approach includes constantly renewed
an effort to reduce job insecurity and thereby
recruitment and selection activities, an appropriate
promote the retention of staff, we created 42
entry-and-integration program for new employees,
tenured positions, including 31 full-time positions.
and a safe, healthy, and stimulating workplace
Regular non-management positions thereby
atmosphere, as well as thoughtful and courteous
increased from 55% to 65% of our work force in
service at all levels of human resource management.
2002-2003.
Work Force by Employment Status
2001-2002
2002-2003
Management staff
27
23
Regular full-time staff
238
272
Regular part-time staff
31
34
Casual staff
95
85
Temporary full-time staff
95
55
486
469
TOTAL
49 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Human Resources Department
The institution’s Health and Safety Committee,
The CLSC Côte-des-Neiges is counting on staff to
whose tasks include the reduction of occupational
help with providing a new direction for programs
hazards, continued its work on a regular basis. Nine
adapted to the changing needs of our clients. An
events were recorded over the course of the year,
updating of skills on the part of the health care and
the majority of which included falls outdoors when
management staff will therefore be essential. This
beneficiaries were being transferred. The Work
year, in partnership with the Université de Montréal,
Attendance Management Plan was submitted and
we developed a managerial development program
implemented. Another important issue is absence
for our institution. Coaching, performance
covered by wage-loss insurance, which is still slightly
assessment, and suppor t for employees with
above 5%.
emotional difficulties were at the centre of this program.
With a view to soundly managing labour relations, we held regular meetings throughout the year with
Over the course of the last year the CLSC allocated
the representatives of the different certified unions.
1.7 % of its total payroll to train its staff. Some of
A total of 27 grievances were submitted, in
the training sessions were prepared and directed by
comparison with 29 last year. Of those 27, 20 were
CLSC employees who have developed exper tise in
settled by way of the Labour Relations Committee,
specific fields or by our Research and Training Centre.
and the other 2 went to arbitration. Two projects
The review of the Human Resources Development
related to the introduction of a 32-hour/4-day
Program has begun and will continue in the coming
schedule were agreed upon: one with the nurses in
year.
the Clinical Care and Services Program and the other with the social workers in the Child-Family, Youth, Adult Program.
Work Force by Union Certification FIIQ
Syndicat des infirmières et infirmiers du CLSC Côte-des-Neiges (nurses union)
107
CSN
Syndicat des travailleurs du CLSC Côte-des-Neiges (workers union)
206
SIPSQ-CPS
Syndicat des intervenants professionnels de la santé du Québec (professional health workers, as of February 27, 2002)
86
CUPE
Canadian Union of Public Employees
10
SEQ-CPS
Syndicat des ergothérapeutes du Québec (occupational therapists)
9
SPDNQ
Syndicat professionnel des diététistes et nutritionnistes du Québec (dietitians and nutritionists)
SPTRPQ-CPS
7
Syndicat des physiothérapeutes et thérapeutes en réadaptation physique du Québec (physiotherapists and exercise therapists)
50 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
3
Human Resources Depar tment
Table of Hirings and Departures by Occupation
April 1, 2002 – March 31, 2003 Occupation
Hired
Departed
Administrative Director
0
1
Administrative Technician
1
0
Admissions Clerk
2
4
Childbirth Assistant
4
3
Clerk
1
2
Dental Hygienist
1
0
Dietitian
1
1
Director General
0
1
Documentation Technician
1
1
Educator
1
1
Intermediate Clerk
6
3
Intern (trainee)
1
0
Management Officer
1
1
Medical Records Librarian
1
1
Midwife
2
1
Nurse
14
17
Occupational Health Technician
1
3
Physiotherapist
0
2
Program Coordinator
0
1
Research Officer
5
6
Secretary
0
1
Senior Clerk
1
1
Social Homecare Assistant
0
6
Social Worker
10
8
Stockroom Attendant
0
1
54
66
Total
51 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Human Resources Department
Work Force by Job Category Category
Number
Health-sector staff (others)
61
Homecare and social assistance staff
83
Management staff
26
Midwives
9
Nursing staff
109
Office and administrative staff
107
Psychosocial staff
72
Scholarship researchers
2
Teaching Activities In 2002-2003, The Human Resources Team received two interns. Intervention internship 1 intern in health administration
52 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Observation internship 1 intern in secretarial studies
Financial and Material Resources Department
The main responsibility of the Financial and Material Resources Department is to ensure that the funds entrusted to the CLSC are managed efficiently. The Department also provides technical support for care and services. Our team is assigned to tasks involving the processing of accounting data, payables and receivables, the production of reports, and data analysis.
The Material and Informational Resource Manage-
Finally, $118,584 was allocated to strengthening
ment Team is involved in issues related to
front-line services for children, young people in
procurement, property management, technical sup-
difficulty, and their families. These funds specifically
port for staff, telecommunications, lending and
targeted psychosocial counselling, suppor t for the
perfoming maintenance on equipment, and managing
development of parenting skills, inter vention services
the CLSC’s different computer networks.
in cases of crisis or distress, intensive follow-up services for families in difficulty, and respite care.
Financial Resources This year the CLSC Côte-des-Neiges was again granted supplements to its core budget. The extra sums were allocated to programs as follows:
• Child-Family,Youth, Adult Program An extra $238,000 was allocated for the development of the Youth Program. This money has been earmarked for families at risk and clients aged 0 to 11 as well as their families. Human Resources benefited from the additional sums in the form of new staff members: a community organizer, a nurse, an educator, a social worker, and an administrative technician.
• Clinical Care and Services Program An additional $256,975 was allocated in the course of the year to respond to the growing demand for the ser vices provided by SARIMM (refugee and immigrant assistance). Of that total, $189,884 is added recurrently to our core budget. The remaining $67,091 is allocated only for the 2002-2003 year.
We also received an additional $125,795 for the development of our Midwifery Program. This enabled us to add two midwives to the program, which means that more women will be able to give bir th at the Birth House.
Another $66,403 was allocated to the Young Parents Support Program to target mothers under 20 years of age with problems that could compromise the development of their children.
53 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Financial and Material Resources Depar tment
The ending of the SIPA project (comprehensive care
Physical and Informational Resources
for frail elderly persons) had a considerable impact
In the last year the CLSC acquired movable proper ty
on the management of the Homecare Program’s
valued at $205,006. The amount of $99,537 was
financial resources. Because of the nature of the
spent on upgrading the telephone system; $30,015
project, the services provided by SIPA increased
was invested in updating and replacing computer
significantly. The reinsertion of patients into the
equipment; $56,236 was allocated to the purchase of
regular Homecare Program at the end of the project
equipment for Homecare clients; $11,037, to the
and a lack of funds for this purpose entailed exten-
purchase of office furniture and equipment; and
sive additional expenditures and required great ef-
$8,217, to the purchase of medical equipment.
• Homecare Program
forts in terms of reducing the intensity of services, primarily in the area of homecare assistance.
The ending of the SIPA project enabled us to recover
Therefore, so as to preserve what had been gained
the space that had been rented temporarily for the
from this leading-edge project, we provided $70,000
project, thereby increasing our rentable floor area by
in additional funding for the services of a manage-
398.54 square metres.
ment consultant. This year’s priorities in the area of informational A sum of $38,407 was also added to the Homecare
resources were access to our networks and data
budget to provide resources for another group of at-
security. Therefore, together with the Professional
risk users: those suffering from chronic obstructive
Services Department, we developed our Policy on
pulmonary disease.
Computer Security for Informational Assets. The CLSC owns and provides technical support for a
• Mental Health Program
computer population of 224 work stations, which are
An additional amount of $81,995 was allocated to
connected to 6 servers.
the budget of the Mental Health Program. Given that a comprehensive approach is part of all our programs, this sum was distributed equally among
Teaching Activities
the three departments that deliver ser vices to users.
The Finance team received one intern in accounting.
• Refugee Claimant Assistance Fund The total expenditures of the Refugee Claimant Assistance Fund exceeded $8.5 million. This was the highest amount of expenditures since the SARIMM program was transferred to the CLSC Côte-des-Neiges in 1997. The increase was caused by a rise in the number of refugee claimants and by longer waiting periods in different government agencies responsible for processing claimants’ applications.
54 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Professional Services Advisors
The framework of multidisciplinary work and the development of professional practices make clinical advice essential. This advice comes from the directors of nursing, social work, and midwifery, who provide support for the Executive Directorate Team.
Nursing Advisor
including the Immunization Committee, the Infection-
In accordance with An Act respecting health services
Prevention Committee, and the Interinstitutional
and social services, the primary mandate of the
Committee. Her participation in these committees is
Nursing Advisor is to monitor, evaluate, and promote
par t of her responsibility to ensure the quality of
the quality of nursing acts performed in the CLSC
nursing care. By joining different committees outside
and to provide advice to the Director General
the CLSC as well, she highlights the profession of
regarding the quality of the professional practices of
nursing and contributes to its advance.
the CLSC nurses.
The Nursing Advisor is supported in her work by
Social Work Advisor
two clinical specialists who supervise recently hired
The mandate of the Social Work Advisor is to
nurses and ensure that all nurses receive clinical
provide advice to the Executive Directorate for the
training.
purpose of furthering the professional development and the quality of social work at the CLSC in colla-
In coordination with the Teaching Coordinator and
boration with the Ordre professionnel des tra-
the Director of the Professional Services
vailleurs sociaux (professional corporation of social
Department, the Nursing Advisor develops a close
workers). She also works on the development of
working relationship with different universities and
tools designed to facilitate the practice of social work
takes an active par t in the development of content
at the CLSC.
for intern training and student evaluations. The Nursing Advisor also studies strategies for recruiting
The complexity of this work and the recent arrival of
and retaining nurses.
social workers who are just beginning their careers in the profession have led to a need for clinical super vi-
The Nursing Advisor is an ex-officio member of the
sion. Recognized and experienced social workers
Council of Nurses (Conseil des Infirmières et Infir-
provide such supervision to all new social workers.
miers, CII). She also sits on various committees,
This supervision ensures the quality of our services
55 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Professional Ser vices Advisors
and helps to acculturate the new CLSC workers The
Midwife Services Advisor
Social Work Advisor is responsible for the quality of
The Midwife Services Advisor is responsible for the
the supervision.
clinical management and implementation of the services provided by the Birth House. She monitors
Given that the CLSC’s Research and Training Centre
and oversees the acts performed by the midwives
offers an excellent setting for social and
and provides for the development of rules for
multidisciplinary research, our social workers are
midwife care. She also assumes responsibility for all
called upon to take par t in activities involving
tasks arising from compliance with An Act respecting
research and the transfer of knowledge. The Social
the practice of midwifery. Responsibility for
Work Advisor provides her perspective on different
professional qualifications is assumed by the Council
issues related to the role and intervention of CLSC
of Midwifes (Conseil des sages-femmes).
social workers.
56 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Family Medicine Unit
Since July 1, 1992, the CLSC’s family medicine clinic has been recognized as an independent family medicine training unit. The CLSC pursues its teaching and research mission via its affiliation with McGill University and its collaboration with the Jewish General Hospital and the St. Mary’s Hospital Centre.
The Collège des médecins (Quebec college of
Moreover, in the framework of the McGill University
physicians) has authorized the CLSC Côte-des-Nei-
Faculty of Medicine training program, CLSC
ges to serve as a training centre for a maximum of
physicians have trained 28 students in third-year
18 family medicine residents from McGill University.
medicine.
An agreement with the Jewish General Hospital’s Herzl Family Medicine Clinic enables many students
In addition to facilitating the implementation of the
to perfect their medical training through that institu-
principles of the College of Family Physicians of
tion. Twelve have been trained so far at Côte-des-
Canada, the CLSC’s teaching unit has led to some
Neiges, while eight more were trained at the
noteworthy innovations in the practice and teaching
Outremont Service Office.
of family medicine.
The Outremont Service Office plays an important role in training residents from the St. Mary’s Hospital
Teaching Activities
Centre. The objective of the training program, which
The Family Medicine Unit received 40 interns in
lasts from one to three months, is to better
medicine.
understand the concept of family medicine as a community-based experience.
57 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Research and Training Centre
The Research and Training Centre is mandated to
The team’s main partner is the CLSC Côte-des-
develop research and training activities that meet
Neiges. In addition, the team has three categories of
university standards and satisfy needs for interven-
partners:
tion in health and social services, particularly in multiethnic environments.
1) University Partners • Centre d’études ethniques des universités
The Research and Training Centre is headed jointly by the Scientific Director and the Director of
montréalaises (CEETUM) • Centre de recherche interuniversitaire de
Research and Training Activities. This kind of lea-
Montréal sur l’immigration, l’intégration et la
dership reflects the collaborative nature of the
dynamique urbaine, Université de Montréal
partnership between the CLSC and the universities.
(Immigration and Metropolis)
The Research and Training Centre is home to a research team funded by the Fonds québécois de la recherche sur la société et la culture (FQRSC, Quebec fund for research on society and culture), formerly the Conseil québécois de la recherche sociale (CQRS, Quebec council for social research). The 24-member team is composed of 10 staff
• Centre de recherche sur les services communautaires, Université Laval • Équipe de psychiatrie transculturelle, Hôpital de Montréal pour enfants, Université McGill • Équipe FQRSC (CQRS) - Centre de recherche de l’Hôpital Douglas (ERASME) • Groupe de recherche sur l’ethnicité et l’adap-
researchers in several CLSC disciplines and programs
tation au pluralisme en éducation, Université
as well as 14 university researchers in different disci-
de Montréal (GREAPE)
plines from the following 4 universities: McGill, Laval, Université de Montréal, and Université du Québec à Montréal.
• Groupe de recherche ethnicité et société, Université de Montréal (GRES) • Groupe de recherche interdisciplinaire en santé, Chaire CHSRF/CIHR, Université de Montréal (GRIS ) • Programme de recherche sur le racisme et la discrimination, Université de Montréal (PRRD)
58 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
The Research and Training Centre is also helping to
• CLSC de Hull
upgrade the CLSC’s human resources by developing
• CLSC de Sherbrooke
training activities based on in-house dissemination of
• CLSC Villeray
research results. The very nature of this practice
• CHSLD - CLSC Nord-de-l’Île
requires interdisciplinar y cooperation on the part of
• CHSLD - CLSC St-Laurent
researchers and staff. The concept of interdisciplinarity has been shaped around a gradually
3) Community-Based Par tners • Association latino-américaine multiethnique de
evolving model that we now call “knowledge sharing.”
Côte-des-Neiges (ALAC) • Carrefour jeunesse emploi Côte-des-Neiges
The knowledge obtained through research and trai-
• Centre Jeunesse Arabe
ning is also shared with people who work outside
• Promotion, Intégration, Société Nouvelle
the CLSC and have an interest in multiethnic
(PROMIS ) • Solidarité des femmes africaines (SFA)
environments. Their interests in health and social services and in the multiethnic make-up of populations lead these researchers to go beyond the
The general theme of the team is “Health and Social
boundaries of the CLSC Côte-des-Neiges territory
Services in a Multiethnic Environment: the Dynamics
and to develop forms of intersectorial collaboration.
of Health Professionals at Work.” The research program was renewed for the 2001-2004 period and was given an “A” rating by the CQRS evaluating committee for its high-level performance.
The objective of our research and training programming is to better understand the dynamics of the players (individuals and institutions) and the social issues so that we can be efficient at adapting our action to reality. This means having a better understanding of the players’ profiles, backgrounds, knowledge, and practices. It also means analyzing how these life stories can be joined with structural and contextual factors that include issues such as citizenship and community.
59 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Research and Training Centre
2) CLSC-CHSLD Par tners
Research and Training Centre
Research Activities 2002-2003
I -
THE FQRSC (CQRS) TEAM’S PROGRAMMING)
The Research and Training Centre currently has 3 research-infrastructure grants, including those of the FQRSC (CQRS) team.1 The breakdown for the projects directly included in the team’s 20022003 programming is the following: 7 have been completed; 20 are in progress; 8 were submitted in 2003; and 3 involve dissemination and the transfer of knowledge. Lists of program-specific research projects are included in the corresponding chapters of the CLSC’s annual report.
Projects in Progress via Grants for Research Infrastructure Services de santé et services sociaux en milieu pluriethnique: la dynamique des acteurs dans l’intervention (Bayreuther-Cognet-Côté-Dongier-Huneault-Jaccoud-Jimenez-Leduc-Loiselle-McAll-Meintel-MurphyMontgomery-Racine-Renaud-Rhéaume-Rosenberg-Roy-Saillant-Saucier-Sterlin-Vissandjée-Xenocostas). FQRSC (CQRS), 2001-2004. Formation et ethnicité dans les pratiques professionnelles des intervenants en services de première ligne et soins ambulatoires (Cognet-Meintel-Renaud-Rhéaume). FQRSC (CQRS), 2000-2004. Situations de vie et de pauvreté des jeunes en milieu pluriethnique: adéquation des ressources publiques et communautaires (Montgomery). FQRSC (CQRS), 2003-2005.
Completed Projects Genre et enjeux de sécurité humaine (Bélisles-Boyd-D’Amico-Mulay-Vissandjée). CRSH, 2000-2003. La construction et l’explicitation des savoirs d’action dans des équipes d’intervention sociale (Racine). CRSH, 20002003. Les auxiliaires familiaux en CLSC: ethnicité, formation et insertion institutionnelle; enquête questionnaire (CognetMeintel-Renaud). FQRSC (CQRS) / Immigration et Métropoles, 1999-2003. Les pratiques traditionnelles des femmes immigrantes au Canada (Aitachimi-Kantiebo-Levine-Ndejuru-RenaudVissandjée). PNRDS / Greenshields, 1996-2002. Les sens et les finalités des pratiques d’intégration sociale dans quatre maisons d’hébergement pour femmes sans abri et en difficulté: projet pilote (Racine). FQRSC (CQRS), 1999-2003. Trajectoires de vie et pauvreté en milieu multiethnique: l’impact de différentes stratégies d’intervention développées par le secteur communautaire (McAll-Montgomery). FQRSC (CQRS), 1999-2002. Women’s Health Status Report: A Multidimensional Look at the Health of Canadian Women (DesmeulesVissandjée). Santé Canada, 2001-2002.
Projects in Progress Accès à l’indemnisation des travailleurs immigrants (Boucheron-Gravel-Patrie-Vissandjée). FQRSC (CQRS), 2002-... Action communautaire, empowerment et construction identitaire: ethnicité et pauvreté (Côté-Julien-Rhéaume). FQRSC (CQRS), 2001-...
The names of researchers responsible for a research project and/or program appear in bold.
60 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Analyse des impacts du partenariat sur les pratiques de chercheurs en recherche sociale (Racine). FCAR, 2001-... Analyse transdisciplinaire et multisite du processus décisionnel de la Commission de l’immigration et du statut de réfugié au Canada (Crépeau-Foxen-Montgomery-Rousseau). VRQ / CRSH / FCAR, 2002-... Biographie d’un parcours: l’analyse des trajectoires en emploi de jeunes immigrants récemment arrivés au Québec (Isseri-McAll-Montgomery). FQRSC, 2003-... Doctor-patient communication in primary care in the presence of an interpreter : the process and the differences between professional and lay interpreters (Dongier-Dupuy-Godin-Lussier-Rhéaume-Rosenberg). IRSC, 2002-... Ethnicity and Migration as Determinants of Health: A Critical Review of Literature (Abdool-Kazanjian-Vissandjée). IRSC, 2003-... Exploration des pratiques d’organismes communautaires visant à contrer l’exclusion (Racine). CRF, 2002-... Immigration, maternité et acculturation: le rôle des institutions publiques québécoises (Cognet-Jimenez-JutrasRosenberg-Saucier-Weinfeld). CRSH, 2001-... Infirmières et travailleurs sociaux: entre les modèles culturels et les modèles professionnels (Cognet-CouturierMeintel- Rhéaume-Renaud). IRSC, 2002-... L’interprétariat et les soins infirmiers interculturels (Hemlin-Robinette-Vissandjée). RRSSS, 2003-... L’interprétariat dans l’intervention médicale et psychosociale de première ligne (Brouillet-McAll-Rhéaume-TremblayXenocostas). IRSC, 2001-... L’inter vention sociale en contexte pluriethnique: les figures de l’autre (Cognet-Couturier-Roy-Rhéaume-VatzLaaroussi). FQRSC, 2003-... L’autre chez soi. Lien social, identités et significations des pratiques humanitaires auprès des réfugiés au Québec (Cognet-Roy-Saillant). FQRSC (CQRS), 2002-... Needs of Refugee Mothers After Pregnancy - Early Response Services (Dongier-Dougherty-Gagnon-JanssenJimenez-Jones-Klein-Oxman-Martinez-Saucier-Stewart-Wahoush). IRSC, 2002-... Patterns of Health Services Utilization of Immigrants: Secondary Analysis of Large Data Sets - Phase I (DesmeulesVissandjée). Santé Canada, 2001-... Patterns of Health Services Utilization of Immigrants: Secondary Analysis of Large Data Sets - Phase II (DesmeulesKazanjian-Manual-Yang-Vissandjée). Santé Canada, 2001-... Pregnancy and Child Bearing in Refugees: Transitional Health - A Feasibility Study (Bibeau-Gagnon-JimenezJohnston-Oxman-Martinez-Platt-Saucier). IRSC / Immigration et Métropoles, 2002-... Sociologie implicite des populations immigrantes en matière de ser vices sociaux et de santé (Hivon-MeintelRhéaume). CRSH, 2001-...
Projects Submitted in 2003 A Trans-cultural Representation of Prostate Cancer Originated from Men’s Health - Life Experiences (CognetTalbot-Upshur-Xenocostas-Zanchetta). Congressionally Directed Medical Research Programs, USA. Attentes et solutions des aidants familiaux et des intervenants: pour une offre de ser vices culturellement cohérents (Carpentier-Ducharme-Paquet-Vissandjée). CRSH / FQRSC. Écoles et santé mentale: une articulation à repenser dans une société en transformation (Guzder-Lashley-MeashamMontgomery-Petrakos-Rousseau). FRSQ. Groupe pour l’élaboration interculturelle d’une nouvelle médecine (GEINM) (Bibeau-Jimenez-Saucier et al.). International Collaborative Women’s Health Assessment: A multidimensional approach using health sur veillance data (Desmeules-Kazanjian-MacLean-Stewart-Vissandjée). IRSC / Santé Canada. The names of researchers responsible for a research project and/or program appear in bold.
61 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Research and Training Centre
Adéquation des services sociaux et de santé de première ligne aux besoins des populations immigrantes (BattagliniLafrenière-Le Gall-Poirier-Toussignant-Xenocostas). IRSC, 2002-...
Research and Training Centre
Racisme et discrimination dans les pratiques soignantes: programme de recherche (Cognet). FRSQ. Trajectoires et déterminants de l’utilisation des services sociaux et de santé: perspective des hommes récemment immigrés (Belleau-Le Gall-Meintel-Montgomery). Racisme et discrimination dans les pratiques soignantes: maladies infectieuses, maladies chroniques (Cognet).
Projects Involving the Transfer and Exchange of Knowledge Allaitement maternel et marrainage en milieu multiethnique (Côté-Loiselle). FQRSC (CQRS), 2001-2003. Empowerment et femmes immigrantes: diffusion des connaissances (Berteau-Côté-Durand-Rhéaume). FQRSC (CQRS), 2001-... Formation interculturelle 1 “Les mots pour dire et pour faire” et Formation interculturelle 2 “Les statuts et trajectoires migratoires” (Hohl-Kanouté-Le Gall-Xenocostas). FQRSC (CQRS), 2002-...
II -
PROGRAMMING OF THE UNIVERSITY-AFFILIATED CENTRE (UAC)
The team’s research programming in cooperation with the UAC deals with the area of “front-line health and social services in a multiethnic context” and comes under the supervision of the Research and Training Centre. It includes current and future research involving 4 complementary themes, each one of which is under the responsibility of at least one university researcher as well as practitionerresearchers in this field. Theme I :
Evaluative Research on CLSC Programs and Practices
Theme II :
Social Determinants in Health and Health-Care Practices
Theme III :
Intersectorial Intervention and Community-Based Action
Theme IV :
Promoting Practices of Inclusive Citizenship The four th theme is primarily the responsibility of the FQRSC (CQRS) team.
The projects under the heading of UAC programming include 3 completed research projects, 34 projects in progress, and 14 that were submitted in the year 2003.
Theme I: Evaluative Research on CLSC Programs and Practices Projects in Progress Étude de fidélité test-retest de l’évaluation à domicile de l’interaction personne-environnement (ÉDIPE) (Rousseau). FCAR, 2002-... Étude préliminaire du projet Répit (Bayreuther-Dufour-Lindsay-Sassine-Vissandjée-Vitez-Whebi-Xenocostas). 2001-... Évaluation d’un programme d’éducation visant à diminuer la douleur et augmenter le sentiment de contrôle chez les arthritiques confinés à la maison (Laforest). 2000-... Évaluation du processus d’implantation d’un programme transversal de santé mentale en émergence dans un CLSC: une approche communautaire de concertation et d’intervention (Bayreuther-Corin-Descoteaux-Rodriguez-SévignyZuniga). FQRSC (CQRS), 1999-... From school to work: Learning through guided participation in socially situated practices (Paré). CRSH, 2000-... The names of researchers responsible for a research project and/or program appear in bold.
62 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
L’impact d’un système de communication standardisé entre les départements d’urgence et le réseau de soins primaires: l’effet sur la continuité ainsi que la qualité des soins de santé (Afilalo, Boivin, Lang). FCRSS/ MSSS/ RRSSS/ FRSQ, 2003-... Putting Evidence into Practice: An Observational Study of Knowledge Translation in Postgraduate Medical Trainees (Grad). IRSC, 2003-... Réduire la détresse psychologique et le fardeau des aidants familiaux de personnes âgées vulnérables: étude évaluative d’un programme d’intervention de gestion du stress à domicile (Ducharme, Lebel). IRSC, 2003-... Vérification d’un modèle prédictif de la santé des hommes âgés aidants naturels: suivi longitudinal sur les facteurs spécifiques « caregiving » (Ducharme-Lachance-Lévesque-Vézina-Zarit). IRSC, 2002-...
Projects Submitted in 2003 Évaluation « randomisée » d’un traitement alternatif de la fibromyalgie: une étude comparative (Arsenault-ColletGaron-Lecours-Saucier). Fondation Chagnon, 2003-... Use of Emotional Appeals in Computer-Based Interactive Communications (Dubé-Knauper-Mukherjee). CRSH, 2003-...
Completed Project Évaluation de l’exigence physique à monter les rampes d’accès en fauteuil roulant manuel chez les adultes et les personnes âgées (Aissaoui-Bourbonnais-Rousseau). SCHL, 2001-2002.
Theme II: Social Determinants in Health and Health-Care Practices Projects in Progress Formation/information multimédia personnalisées en réseau par personne diabétique de type 2 (Jimenez-MarchandNasmith). Partenaires privés, 1999-... Impact des otites sur les habilités de perception du langage dans la petite enfance (Rvachew). 2002-... La dépression chez les personnes âgées : détection et prise en charge (Cole-Dendukuri-McCusker-OxmanMartinez-Poulin de Courval-Rowe-Yaffe). FRSQ, 2002-... La qualité des soins et services dans un système intégré de services: l’application de protocoles de démence et de nutrition (Béland-Bergman-Kergoat-Lebel-Shatenstein). Santé Canada, 2003-... Les pratiques d’intervention des travailleurs sociaux auprès des femmes âgées victimes de violence conjugale (Hockenstein-Israël-Montminy-Racine-Straka). CRSH, 2003-... Les réponses sociales à la violence envers les femmes (Beaulieu-Cousineau-Damant-Guérard-Hébert-JaccoudRinfret-Raynor). CRSH, 2000-... L’influence des modes d’organisation des services de première ligne sur l’accès des groupes défavorisés aux services et son impact sur la santé (Toussignant). IRSC, 2003-... L’inter vention par quartier au CLSC Côte-des-Neiges: systématisation de l’expérience accumulée et perspectives d’avenir (Racine-Zuniga). CRF, 2003-..... Naissance d’une perception et perception d’une naissance: les femmes et leur rapport aux discours en périnatalité (Bereza-Jimenez-Klein-Lippman). CRSH, 2000-... State-Organized Violence Adult Attachment Relationship and the Mental Health of Immigrant and Refugee Women (Bouchard-Dongier-Valenzuela). FRSQ, 2000-... Susceptibility to Vaccine Preventable Diseases in Newly Arrived Immigrants and Refugees in Montreal, Canada (Boivin-Dongier-Greenaway-Miller-Schwartzman). FRSQ, 2002-... The names of researchers responsible for a research project and/or program appear in bold.
63 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Research and Training Centre
Grandir ensemble (Bayreuther-Descoteaux-Gauthier-Robaey). Hincks Foundation, 1996-...
Research and Training Centre
Système de services intégrés pour patients diabétiques de type 2 du territoire de Côte-des-Neiges: évaluation des effets (Contandriopoulos-Côté-Jimenez-Larouche-Marchand-Nasmith-Pineault-Rodriguez). CRSS, 2001-... Travailleuses et mères d’enfants ayant le THADA (trouble d’hyperactivité avec déficit de l’attention) (Home-Hlinovshy). CRSH, 2002-... Un essai clinique sur l’efficacité d’un programme de prévention de la carie dentaire chez les jeunes enfants (Allison-Platt-Shapiro-Véronneau). IRSC, 2003-... Cultural Constructions and Assessment of Depression in the Elderly from Diverse Ethnic-Racial Backgrounds (Oxman-Martinez-Poulin de Courval). FRSQ, 2003-...
Projects Submitted in 2003 Depression in Patients with Dementia (Cole-Dendukuri-Laplante-Poulin de Courval). FRSQ, 2003-... Écoles et santé mentale: une articulation à repenser dans une société en transformation (Guzder-Lashley-MeashamMontgomery-Petrakos-Rousseau). FRSQ, 2003-... Étude des facteurs de risque et de la prévalence de la chlamydiose et de la gonococcie parmi des personnes consultant dans des milieux cliniques à Montréal (Allard-Haley-Lambert-Roy-Vincelette). 2003-... Individual and Interpersonal Effects of Humor Appeals in Presenting Web-Information (Bartlett-Esquilant-DubéJimenez-Mukherjee). CRSH, 2003-... La reconnaissance et la prise en compte de la différence culturelle du point de vue des usagers participant à une démarche ergothérapique de maintien à domicile (Thibault). 2003-... Procédés d’intervention sur les habiletés numériques initiales (HNI) destinés aux enfants qui présentent des incapacités intellectuelles (Dionne-Langevin-Lavoie-Rocque). ADOQ / FQRSC / CNRIS, 2003-... Symptom explanations of patients and their physician: shared or distinct understanding? - Explications de symptômes par les patients et leur médecin: compréhension partagée ou distincte? (Bélanger-Dominicié-Dao-DworkindGroleau-Kirmayer-Rosenberg-Young). Hôpital juif, 2003-... Responses of Childbearing Newcomers to Referrals for Care (Gagnon-Merry). IRSC, 2003-...
Completed Project Le développement social: le point de vue des acteurs (Bruno-Laperrière-Lévesque-White). FQRSC / CSBE, 20002002.
Theme III: Intersectorial Intervention and Community-Based Action Projects in Progress Continuité des soins en première ligne au Québec: barrières et facteurs (Beaulieu-Brunel-Gauthier-GouletHaggerty-Pineault-Rodrigue). FCRSS, 2001-... Éthique et ethnicité: la question de l’autonomie en santé publique (Battaglini-Descoteaux-Doucet-Gravel-Laudy). CRSH, 2001-... Exploration des pratiques d’organismes communautaires visant à contrer l’exclusion (Racine). CRF, 2002-... Feeding Assistance Program for the Elderly in the Community (Saba). Santé Canada, 2000-... Les pratiques de réinsertion sociale dans des maisons d’hébergement pour femmes sans abri (Racine). FQRSC (CQRS), 1999-... Points de vue de gestionnaires sur l’insertion, la réalisation et le maintien d’un programme d’intervention de groupe auprès d’enfants exposés à la violence conjugale (Campeau-Ber tot-Rinfret-Raynor). CRIVIFF, 2002-...
The names of researchers responsible for a research project and/or program appear in bold.
64 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Un quartier sans préjugé (McAll-Véronneau). Patrimoine Canada, 2003-... Un système de services intégrés pour personnes âgées en perte d’autonomie (SIPA), projet de démonstration (Béland-Bergman-Contandriopoulos-Denis-Ducharme-Lebel-Monette-Tousignant). FCRSS / FRSQ / MSSS / RRSSS, 1998-...
Projects Submitted in 2003 Development of migration and reproductive health studies (Gagnon-Merrez). IRSC, 2003-... Évaluation de l’action communautaire à Côte-des-Neiges: déterminants stratégiques de l’impact social (DumaisVaillancour t-Tremblay-Rhéaume). CRSH, 2003-... Intégration des ser vices et transformation du système de soins (Contandriopoulos-Denis). FCRSS, 2003-... Un bilan de l’action communautaire dans le quartier Côte-des-Neiges (1975-2003): vers un type de pratique porteur d’avenir? (Dumais-Rhéaume-Vaillancour t). FQRSC, 2003-...
Completed Project Les compétences socio-éducatives attendues des intervenant(e)s de première ligne auprès des jeunes enfants et de leur famille en milieu socio-économiquement faible (Larose-Lefebvre-Terrisse). CRSH, 2000-2003.
Dissemination and Training Activities 2002-2003
In this area of programming, and with a view to exchanging knowledge, the Research and Training Centre and its research team organized a number of impor tant activities related to the dissemination and transfer of knowledge and based primarily on partnership. Dissemination and training activities include colloquia, information meetings, publications, noon lectures, training seminars, team theory seminars, and the supervision of interns and students.
tion with different CLSC programs. The objectives of these meetings are to present our UAC research and training program and to consolidate service, teaching, and research links. In 2002-2003 we organized meetings with 3 teams: Home Care (September 26), Birth House (November 27), and Clinical Care and Ser vices (December 19). Additional consultation meetings will be held in early 2004.
III. PUBLICATIONS I. COLLOQUIUM Rappor ts de culture et rappor ts de pouvoir: l’intervention interculturelle dans le système de santé et services sociaux. Forum held in the framework of the 70th Convention of ACFAS, Science et Savoir, Pour qui? Pourquoi?; Université Laval, Quebec City; organized by the CLSC Côte-des-Neiges Research and Training Centre; May 14, 2002.
Beginning in June 1999, the Série de publications du Centre de recherche et de formation has included research repor ts, notes from colloquia, and other documents related to publications by researchers and staff members. The number of publications to date is 10, the last of which was a research paper on unaccompanied minors: Young refugees seeking asylum: the case of separated youth in Quebec, Catherine Montgomery, number 10, 2002 (available at the Research and Training Centre).
II. INFORMATION MEETINGS These tours were a series of information and consultation meetings on our mission as a universityaffiliated centre (UAC) and were held in collabora-
References to some of the research team’s publications (reports, ar ticles, colloquium proceedings) are included in Appendix 2 of the CLSC’s annual report.
65 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Research and Training Centre
Psychose et culture: le rôle d’espaces de négociation (patients - familles - intervenants) dans le rapport aux services (Corin-Lesage-Marotte-Rousseau). FRSQ, 2002-...
Research and Training Centre
IV. Noon Lectures
V. TRAINING SEMINARS
Noon lectures allow for the presentation and dissemination of the findings from the team’s projects and from research in par tnership or collaboration with the CLSC and its staff or with interns in master’s or doctoral programs. In 2003, 8 such lectures were presented at the CLSC.
The Research and Training Centre has developed a training and dissemination program focussed on health and social services in a multiethnic context. This program is based on partnership and knowledge exchange, which means that researchers and staff members work in close collaboration. Four kinds of training are provided: (1) training seminars resulting from FQRSC (CQRS) grants for “the transfer and dissemination of knowledge”; (2) basic training for CLSC staff in the area of intercultural intervention; (3) specialized training on a specific theme; (4) continuing training in all programs. Four training seminars (covering two of the kinds of training mentioned above) were held:
Recherche exploratoire sur les pratiques d’intervention auprès des femmes âgées vivant de la violence conjugale, Guylaine Racine et Lyse Montminy, Université de Montréal, École de service social, 4 avril 2002. Établir des ponts: les mauvais traitements envers les personnes âgées provenant des communautés ethnoculturelles et le rôle des divers intervenants, Maxime Lithwick, CLSC René-Cassin, 2 mai 2002. L’interpellation de l’ethnicité dans les différents groupes professionnels en santé: les médecins et les auxiliaires familiaux, Marguerite Cognet et Spyridoula Xenocostas, CLSC Côte-des-Neiges, Centre de recherche et de formation, 26 septembre 2002. L’ethnicité et ses impacts dans la rencontre clientsintervenants: les points de vue de médecins et d’auxiliaires familiaux, Marguerite Cognet, Ellen Rosenberg et Spyridoula Xenocostas, CLSC Côtedes-Neiges, Centre de recherche et de formation, 3 octobre 2002. Le présent à la lumière de l’histoire, Rachad Antonius, Université de Montréal, Centre d’études ethniques; Yakov Rabkin, Université de Montréal, Département d’histoire, 19 septembre 2002. Entre nuages et réalités. Les défis de la réunification après de longues séparations, Jocelyne Bertot, CLSC Côte-des-Neiges, Centre de recherche et de formation, 31 octobre 2002. La construction de stratégies d’information. Un exemple de leur utilisation: les hommes âgés ayant le cancer de la prostate, Margaret Zanchetta, Université Queen’s, Département des sciences infirmières, 28 novembre 2002. Profils et trajectoires de mineurs non accompagnés, Catherine Montgomery, CLSC Côte-des-Neiges, Centre de recherche et de formation, 23 janvier 2003.
66 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Seminars resulting from FQRSC (CQRS) grants for “the transfer and dissemination of knowledge”: Allaitement et marrainage en milieu pluriethnique (C. Loiselle, B. Côté); Empowerment et femmes immigrantes (G. Berteau, J. Rhéaume, B. Côté); Formation interculturelle I « Les mots pour dire et pour faire » Formation interculturelle II « Les statuts et trajectoires migratoires » (F. Kanouté, J. Hohl, S. Xenocostas, J. Le Gall, M. H. Pham, A. Lynch, G. Roy, M. Shermake, M. L. Roc). Specialized training on a specific theme: La culture de l’intervenant(e): ressource ou obstacle?, J. Hohl, Université de Montréal; D. Laroche, Hôpital Fleury, CLSC Côte-des-Neiges, 20 et 26 septembre 2002.
VI. TEAM THEORY SEMINARS The FQRSC (CQRS) team organizes seminars for its members on a regular basis. The main objectives of these seminars are the following: (1) to have a better knowledge of the work carried out by members of the team; (2) to promote an exchange of knowledge between those involved in applying practices and those working in research; (3) to create a space for theoretical and/or methodological debates; (4) to link research and programming; (5) to create support for thinking that can lead to an advance and an evolution in programming during the quarterly period. The team held four seminars on the following dates: September 12, 2002; November 14, 2002; February 13, 2003; and April 10, 2003.
Research and Training Centre
VII. SUPERVISION OF INTERNS AND STUDENTS Within the framework of training and research, the team regularly receives interns and students from B.A., master’s, doctoral, and postdoctoral programs, enabling them to take an active par t in the team’s research and dissemination projects. These interns and students come from several universities, including Université de Montréal, McGill University, Université Laval, Université du Québec à Montréal, Concordia University, and Université de Sherbrooke. They represent different university departments: anthropology, social work, social service, sociology, nursing, geography, linguistics, transcultural psychiatry, psychology, public health, educational sciences, human sciences, political science, and statistics. Furthermore, the supervision of research and training involves research professionals from diverse disciplines such as anthropology, communications, demography, social work, psychology, political science, nursing, social service, and sociology.
67 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Appendix 1
Auditor's Report and Financial Statements
Chartered accountants General Partnership Member of the network Grant Thornton International 600 de La Gauchetière West Suite 1900 Montreal (Quebec) H3B 4L8
Telephone: Fax:
(514) 878-2691 (514) 878-2127
To the members of the Board of Directors of the Côte-des-Neiges Local Community Service Centre We have audited the financial statements, suppor t information, data, and appendixes listed in the table of contents of the annual financial report for the year ending on March 31, 2003. The report has been presented in the form prescribed by the ministère de la Santé et des Services sociaux in compliance with the Act respecting health ser vices and social services. The annual financial repor t is the responsibility of the institution’s Board of Directors. Our responsibility consists of expressing an opinion, based on our audit, about the annual financial report and the other items described in Appendix 1 of the regulation concerning the financial management of the institutions and regional boards. Our audit has been carried out in accordance with generally recognized auditing standards. These standards require that the audit be designed and performed so as to provide reasonable assurance that the annual financial repor t and the other items described in Appendix 1 of the regulation on the financial management of institutions and regional boards are free of important inaccuracies, omissions and deficiencies. The audit procedure includes an examination, on a test basis, of evidence supporting the sums and other disclosures in the annual financial repor t. It also involves an evaluation of the accounting principles followed and of important estimates made by management, as well as an assessment of the overall presentation of the annual financial report. In our opinion, • the institution has complied with the provisions of the above-mentioned Act and with the associated regulations concerning any matter affecting its revenues, expenditures and volume of services or of activities; • the institution has complied with the instructions and definitions regarding the preparation of the annual financial report; • the institution’s accounting practices are in compliance with the standards and definitions contained in the Manuel de gestion financière published by the ministère de la Santé et des Services sociaux; • the units of measurement employed by the institution are in compliance with the definitions set forth in the Manuel de gestion financière published by the ministère de la Santé et des Services sociaux; • the quantitative data submitted by the institution are based on valid auditing and recording procedures; • the internal control procedures employed by the institution with regard to the financial data are valid; • the institution has complied with all administrative directives issued by the ministère de la Santé et des Services sociaux and by the Montréal-Centre Regional Board except Remark 1 mentioned in the appendix of the auditors’ report; • the annual financial report is an accurate reflection, in all important respects, of the institution’s financial situation on March 31, 2003, its revenues and expenses, the developments in its financial situation, and its financial and quantitative data on its centres of activity for the year concluding on that date in accordance with the standards and practices recognized in the institutions under the ministère de la Santé et des Services sociaux. Chartered Accountants Montréal June 4, 2003
68 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Operating Fund
Year ending March 31, 2003
FINANCIAL STATEMENT Current Year 1
Previous Year 2
01 02 03 04 05 06
23 440 425 7 000 133 270 0 196 766 133 313
24 471 985 0 109 767 0 190 700 67 338
07
23 910 774
24 839 790
08 09 10 11 12 13 14
13 797 171 3 766 065 1 811 543 0 190 706 0 4 517 812
14 199 140 3 666 846 1 795 757 0 211 839 0 4 705 399
15
24 083 297
24 578 981
SURPLUS (DEFICIT), PRINCIPAL ACTIVITIES (L.07 – L.15)
16
(172 523)
260 809
ACCESSORY ACTIVITIES REVENUES Public and Parapublic Financing Commercial Revenues Other revenues
17 18 19
2 269 805 0 320 256
2 257 434 0 169 914
20
2 590 061
2 427 348
21 22 23 24
1 340 312 345 994 223 785 679 970
1 202 036 350 812 198 205 676 295
25
2 590 061
2 427 348
SURPLUS (DEFICIT), ACCESSORY ACTIVITIES (L.20 – L.25)
26
0
0
SURPLUS (DEFICIT), OPERATING FUND (L.16 + L.26)
27
(172 523)
260 809
PRINCIPAL ACTIVITIES REVENUES Regional Health or ministère de la Santé et des Services sociaux Other Establishments Users Sales of Services Collections Other Sources
TOTAL (L.01 to L.06) EXPENSES Salaries Benefits Social Expenses Medications Medical and Surgical Supplies Foodstuffs Other
TOTAL (L.08 to L.14)
TOTAL (L.17 to L.19) EXPENSES Salaries Benefits Social Expenses Other
TOTAL (L.21 to L.24)
69 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Operating Fund - Principal Activities
Year ending March 31, 2003
GROSS EXPENSES PER ACTIVITIES SECTOR - CLSC Field of activities
Current Year 1
Previous Year 2
Variation c.1 - c. 2 3
374 703 2 541 510
347 366 2 736 695
27 337 (195 185)
3 179 567
3 879 137
(699 570)
60 811 1 132 999 1 101 588
77 285 1 327 501 1 079 077
(16 474) (194 502) 22 511
720 819
699 205
21 614
MULTI-USER SERVICES Multi-User Program* 5980 Family medicine group nursing care 6000 Administration of nursing care 6090 CLSC Health Line 6173 In-Home nursing care (Unallocated) 6390 Pastoral Care Services 6441 Foster families for children - allowances (note 1) 6442 Residences for adults and the elderly - allowances (note 1) 6530 Homecare 6566 Psychosocial services – MAD other than PAPA 6568 Psychosocial services (Outside CLSC's territory) 6598 In-School services (Outside CLSC's territory) 6861 Audiology 6862 Speech therapy 6863 Audiology and speech therapy (Unallocated) 6864 In-Home Audiology and speech therapy 6870 Physiotherapy 6880 Ergotherapy 7121 Community intervention – Homecare 7151 Management & support – Homecare 7152 Management & support – other programs 7154 Management & support – Health Line 7155 Management & support – Refugee Services 7158 Management & support (Outside CLSC's territory) 7160 Ergotherapy and physiotherapy – Homecare 7999 Special activities
07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25
TOTAL
26
9 111 997
10 146 266
SOCIAL ADAPTATION Child-Family, Youth Program 6592 School social services 7170 Social and family education services
27 28
424 104 752 357
358 501 756 716
65 603 (4 359)
TOTAL
29
1 176 461
1 115 217
61 244
1 096 527
1 156 249
(59 722)
1 096 527
1 156 249
(L.01 to L.25)
(L.27 + L.28)
01 02 03 04 05 06
Alcoholism and Drug Abuse Program 6680 Rehabilitation – drug addicted persons (registered users)
30
TOTAL
31
(L.31 = L.30)
Frail Elderly Persons Program 5514 Intermediary Resources for frail elderly persons 6380 Walking services, psychogeriatry 6563 Psychosocial services for frail elderly persons 6968 Day Clinic for frail elderly persons (Outside CLSC's territory) 6969 Day Clinic for frail elderly persons (Unallocated) 7156 Management & support, in psychogeriatry or the day clinic 7402 Transportation, users 65 and over
32 33 34 35 36 37 38
TOTAL
39
(L.32 to L.38)
* Distribution supported by CLSC Note 1 : Line 6440 applies to the CLSC mission only for the James Bay Cree Council
70 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Operating Fund - Principal Activities
Year ending March 31, 2003
GROSS EXPENSES PER ACTIVITIES SECTOR - CLSC Field of activities
Current Year 1
Previous Year 2
Variation c.1 - c. 2 3
451 229
351 017
100 212
451 229
351 017
100 212
1 218 981 763 591
1 052 758 757 683
166 223 5 908
17
1 982 572
1 810 441
172 131
PHYSICAL HEALTH Physical Health Program 5990 Midwife services 6240 Emergency 6307 Routine health Services 6308 Routine health Services (Outside CLSC's territory) 6322 Sterilization and Distribution Centre (other) 6351 In-Home Inhalation therapy 6352 Inhalation therapy - other 6462 Health services, refugee status claimants 6558 Curative dental services (Outside CLSC's territory) 6559 Curative dental services (Unallocated) 6606 Sampling Centre 6607 Laboratories 6710 Electrophysiology 6831 Radiology 6839 Medical imaging support 7401 Inter-establishment transport, beneficiaries 7403 Transportation of beneficiaries – air evacuation 7404 Transportation, elective cases
18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35
702 173
657 939
44 234
937 513
842 084
95 429
183 952
174 585
9 367
TOTAL
36
1 823 638
1 674 608
SOCIAL ADAPTATION (continued) Physical Deficiency Program 7081 Support for families of persons with physical deficiencies 01 7391 Transportation, persons with physical deficiencies 02
TOTAL
(L.01 + L.02)
03
Intellectual Deficiency Program 7082 Support for families of persons with intellectual deficiencies - allowances 04 7101 Users with intellectual deficiencies in natural environment 05 7392 Transportation, persons with intellectual deficiencies 06
TOTAL
(L.04 to L.06)
MENTAL HEALTH Mental Health Program 5513 Intermediary resources - mental health 6461 Social service, refugee status claimants 6562 Psychosocial services – other than PAPA and MAD 6564 Psychology 6565 Social services 6806 Pharmaceutical care 6938 Mental health - Social Integration and reintegration (Outside CLSC's territory) 6939 Mental health - Social Integration and reintegration (Unallocated) 6972 Day centre (mental health)
TOTAL
(L.08 to L.16)
(L.18 to L.35)
07
08 09 10 11 12 13 14 15 16
71 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Operating Fund - Principal Activities
Year ending March 31, 2003
GROSS EXPENSES PER ACTIVITIES SECTOR - CLSC Current
Previous
Variation
Year
Year
c.1 - c. 2
1
2
3
998 312
977 287
21 025
PUBLIC HEALTH Public Health Program 6513 Parent and infant health - CLSC 6518 Parent and infant health (Outside CLSC's territory) 6540 Preventive dental care 6587 Mass and emergency vaccination 6588 Public health, prevention and protection (Outside CLSC's territory) 6589 Public health, prevention and protection (Unallocated) 6591 School health 7110 Nutrition 7122 Community intervention – other
01 02 03 04 05 06 07 08 09
148 345
114 073
34 272
41 196 424 310 179 078 303 641
257 688 324 687 237 779 319 392
(216 492) 99 623 (58 701) (15 751)
TOTAL
10
2 094 882
2 230 906
xxxx
75 987
75 274
713
12
75 987
75 274
713
SUPPORT SERVICES 7202 Coordination and support 7301 Executive directorate 7302 Financial administration 7303 Human resources administration 7304 Professional and hospital services administration 7306 Financial and human resources administration (Unallocated) 7320 Technical services administration 7340 Data processing 7531 Reception – telecommunications 7532 Medical records 7533 Reception - medical records - telecommunications (Unallocated) 7643 Housekeeping - other 7648 Housekeeping (Outside CLSC's territory) 7650 Medical waste management 7703 Operation of facilities - other 7708 Operation of facilities (Outside CLSC's territory) 7710 Security 7801 Facilities maintenance (general) 7802 Facilities maintenance and repair (Medical equipment) 7808 Facilities maintenance and repair (Outside CLSC's territory) 7809 Facilities maintenance and repair (Unallocated)
13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33
189 476
172 528
16 948
2 538 788
2 170 958
357 830
133 773 703 379 566 026
219 383 683 266 624 034
(85 610) 20 113 (58 008)
52 343
50 199
2 144
1 955 984
1 903 679
52 305
150 375
140 452
9 923
TOTAL
(L.13 to L.33)
34
6 290 144
5 964 499
325 645
Transferts of general expenditures
35
50 479
24 515
25 964
TOTAL
36
6 239 665
5 939 984
299 681
(P.62, L.26 + L.29 + L.31 + L.39) + (P.63, L.03 + L.07 + L.17 + L.36) + (P.64, L.10 + L.12 + L.36) 37
24 052 958
24 499 962
xxxx
(L.01 to L.09)
Personnel benefiting from employment security or stability measures 7900 Personnel benefiting from employment security or stability measures 11
TOTAL
(L.12 = L.11)
(L.34 – L.35)
TOTAL GROSS EXPENSES, ACTIVITY CENTERS
72 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Appendix 2 Publications and presentations at colloquia, congresses, conferences and other work-related gatherings in which CLSC staff participated Bertot, Jocelyne, présentation: Entre nuages et réalité : les défis de la réunification familiale après de longues séparations, conférencemidi, CLSC Côte-des-Neiges, Montréal, octobre 2002. Bouvier, Lorraine, Beauregard, Luce, Dubois, Danielle, présentation: Un partenariat et des pratiques de gestion renouvelés, colloque L’expérience SIPA, Hôtel Delta, Montréal, septembre 2002. Bouvier, L., publication : L’empowerment, vous connaissez?, P’tit Journal du Centre des aînés de Côte-des-Neiges, Montréal, novembre 2002. Bouvier, L., Paul, Sonia, présentation: Une approche gérontogériatrique systématique et rigoureuse, colloque L’expérience SIPA, Hôtel Delta, Montréal, septembre 2002. Bouvier, L., présentation: Le guichet unique, la gestion de cas et le travail en partenariat, Hôpital général juif, Montréal, novembre 2002. Bouvier, L., publication: La gestion de cas dans le cadre du projet SIPA , bulletin Bien Vieillir, Institut de gérontologie sociale du Québec, Montréal, mai 2002. Cognet, Marguerite, présentation: Des enjeux de l’immigration au prix de la construction de la vulnérabilité , Congrès ACFAS, Université Laval, Québec, mai 2002. Cognet, M., publication: Les enjeux de territoires et d’identités dans le travail des auxiliaires familiaux et sociaux des centres locaux de services communautaires du Québec , Sciences sociales et santé, Vol. 20, no 3, pp. 37-64, Paris, septembre 2002. Cognet, M., présentation: L’accès à l’emploi dans les services de santé, colloque CEETUM, Montréal, février 2003. Cognet, M., présentation: Les auxiliaires familiaux dans les programmes de maintien à domicile de Montréal: le poids du genre et des origines ethniques, conférence-midi de l’Institut de recherche féministe (IREF), Université du Québec à Montréal, décembre 2002. Cognet, M., présentation: Les effets de la transformation du système de santé canadien sur les emplois de soins et de services chez les femmes immigrantes , colloque international « La transformation des systèmes de santé et de services sociaux et le mouvement pour la santé des femmes: enjeux contemporains, résistances et pratiques novatrices », Québec, avril 2002. Cognet, M., présentation: Racisme et discrimination, les politiques des établissements publics de santé , Semaine internationale d’action contre le racisme, Montréal, 14-23 mars 2003. Cognet, M., publication: Des métiers, des femmes et des immigrantes/ Professions, Women and Immigrant Women , Actes du colloque « Santé des femmes et diversité/Women’s Health and diversity », CESAF, Montréal, 2002. Cognet, M., publication: La santé des immigrés à l’aube des modèles politiques d’intégration des étrangers, Bastidiana, no 39-40, Rennes, pp. 97-130, juillet-décembre 2002. Cognet, M., publication: Les femmes, les services et le don, Cahiers de recherche sociologique, Femmes et engagement, no 37, pp. 51-77, 2002. Cognet, M., Raigneau, Laurent, publication: Le genre et l’ethnicité : les critères voilés de la délégation des actes en santé, Cahiers du GRES, Centre d’études ethniques des universités montréalaises, 3, 1, pp. 25-38, 2002. Cognet, M., Raigneau, L., présentation: Les origines ethniques des auxiliaires familiaux et sociaux dans l’accès aux emplois des soins et services , congrès de l’ACFAS, Université Laval, Québec, mai 2002. Cognet, M., Xenocostas, Spyridoula, Rosenberg, Ellen, présentation: Les identités professionnelles, de genre et ethniques dans la rencontre clinique : une comparaison entre les médecins et les auxiliaires familiaux , conférence-midi, CLSC Côte-des-Neiges, Montréal, octobre 2002. Cyr, Hélène, présentation : Programme d’entretien préventif des chariots élévateurs, Santé publique de Québec et CSST, Québec, avril 2002. Gagnon, A.J., Dougherty, G., Jimenez, V., Leduc, N., publication: Randomized Trial of Postpartum Care Following Hospital Discharge, Pediatrics, June 2002, 109 (6), pp. 1074-1080. Hénault, Hélène, entrevue pour le cours: Alimentation et vieillissement, Formation à distance, Université de Montréal, juillet 2002. Hénault, H., Demers, Lucie, Bussières, Josée, Tremblay-Krochenski, Annie, Lafortune, Patricia, Molina, Evelyne, animation: Manger sainement... C’est simple et savoureux , CLSC Côte-des-Neiges, Montréal, mars 2003. Inkell, Diane, présentation: Infirmiers en CLSC Info-Santé et infirmières praticiennes dans le cadre d’un GMF , Université de Montréal, département des Sciences infirmières, février 2003. Jimenez, Vania, publication: Préface Guide de santé de votre enfant , Édition Hurtubise, 2002. Jimenez, V., Rubenstein, Heather, Benigeri, M., publication: Évaluation de l’outil « Le diabète et nous » (pour personnes diabétiques de type 2), Final report, décembre 2002.
73 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Jimenez V. et al. : publication: La gaffe, La Presse, 8 décembre 2002. Jimenez V. et al. : publication: Le poids des mots , La Presse, 30 juin 2002. Jimenez, V., publication: Le CLSC : un lieu privilégié de prise en charge et de suivi des patients , Le Collège, printemps-été 2002, XLII (1), pp. 9-10. Jimenez, V., présentation: L’estime de soi et la communication clinicien-patient en contexte interculturel, septième colloque annuel de l’Association des intervenants(es) pour le développement de l’estime de soi, Montréal, 11 octobre 2002. Jimenez, V., présentation: Chemin parcouru et vision d’avenir, Colloque de l’équipe de première ligne organisé par la Faculté de médecine de l’Université de Montréal, Montréal, 19 septembre 2002. Jimenez, V., présentation: Le CLSC : un lieu privilégié de prise en charge et de suivi des patients, Colloque du Collège des médecins du Québec, Montréal, 3 mai 2002. Jones, Hélène, Roy, Ghislaine, présentation: SARIMM: An introduction to the Who? What? When? Where? And Why?, Hôpital général juif, Montréal, mars 2003. Lefebvre, Manon, Asconiga, Monica, Arcos, Gabriela, présentation: Bilan-Intervention de groupe auprès des enfants exposés à la violence conjugale / Intervention auprès des mères, CLSC Côte-des-Neiges, Montréal, août 2002. Legoff, Frédérique, McAll, Christopher, Montgomery, Catherine, rapport: La transformation du communautaire : expériences d’intervention auprès de jeunes sans emploi, Centre de recherche et de formation, CLSC Côte-des-Neiges, 2003. Montgomery, Catherine, cours: Health and Medicine in Modern Society: Social inequalities and Health, Université McGill, département de sociologie, Montréal, automne 2002. Montgomery, C., Mailloux, Annie, présentation: Developing tools for the future. Young immigrants and community-based strategies in the struggle against poverty, Fifth International Conference of the Organization for the Protection of Children’s Rights, Montréal, mai 2002. Montgomery, C., Mailloux, A., Fournier, Georges, publication: The Politics of inclusion in a context of poverty , Canadian Review of Social Policy, no. 49-50, pp. 25-41, 2002. Montgomery, C., présentation: At the margins of the nation: right and lesser right in the life situations of young refugees, Learned Society, Toronto, mai 2002. Montgomery, C., présentation: Au-delà du stigma: définir la pauvreté des jeunes immigrants autrement, colloque: Rapports de culture et rapports de pouvoir, ACFAS, Québec, mai 2002. Montgomery, C., présentation: Être en marge de la nation: droit et moindre droit dans le vécu de jeunes réfugiés non accompagnés, Colloque sur la nation : entre l’ancrage territorial et symbolique, ACFAS, Québec, mai 2002. Montgomery, C., présentation: Jeunes réfugiés en exil. Mineurs non accompagnés au Québec, CLSC Côte-des-Neiges, Montréal, mars 2003. Montgomery, C., publication: The « Brown paper Syndrome ». Unaccompanied Minors and Questions of Protection, Refuge, vol. 20, no. 2, pp. 56-67, 2002. Montgomery, C., publication: Young refugees asylum: The case of separated youth in Quebec, Centre de recherche et de formation, CLSC Côte-des-Neiges, 2002. Pham, My Huong, présentation: Séminaire en violence conjugale/familiale en milieu multiethnique, CLSC Côte-des-Neiges, Montréal, octobre et novembre 2002. Proulx, Myriam, Bouvier, L., présentation: Gestion de cas projet SIPA , Montréal, septembre 2002. Provençal, Carole, présentation : Programme maternité sans danger, Santé publique de Montréal-Centre, Montréal, décembre 2002. Rapoport, Richard, formation: Vieillissement et comportements sexuels en institution : interventions interdisciplinaires et considérations éthiques, CHSLD Le Trifluvien, Trois-Rivières, février 2003. Roberge, Mireille, Nolet, Suzette, Dupont, Michèle, publication : Prudence avec le sang - pochette d’information Sida et hépatite, Régie régionale de Montréal-Centre, Montréal, février 2003. Roy, Ghislaine, publication: Pratique sociale interculturelle au SARIMM, CLSC Côte-des-Neiges, Montréal, mars 2003. Roy, G., Vatz-Laaroussi, M., présentation: Fragments de pratique interculturelle et richesses de la banalité apparente , colloque ACFAS, Québec, mai 2002. Roy, G., Montgomery, C., publication: Practice with Immigrants in Quebec , Oxford University Press, 2003. Stathopoulos, Elizabeth, Legendre, Françoise, animation d’atelier : Discipline, École St-Pascal Baylon, Montréal, janvier 2003. Stathopoulos, E., Legendre, F., animation d’atelier : Relation parents-enfant, École St-Pascal Baylon, Montréal, février 2003. Stathopoulos, E., Auguste, Gaëlle, animation d’atelier : Discipline, École Petite Lavoie, Montréal, février 2003. Sterlin, Carlo, animation du colloque: Bilan des alternatives dans les services de santé et les services sociaux, Institut interculturel de Montréal, Montréal, mars 2002.
74 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Sterlin, C., conférence: La présentation interculturelle, Colloque « Les sciences humaines mènent le monde », Collège Ahuntsic, Montréal, mars 2002. Sterlin, C., cours: La profession médicale: connaissance, pouvoir et autonomie , Département d’administration de la santé, Faculté de médecine, Université de Montréal, Montréal, octobre 2002. Sterlin, C., entrevue: La présentation interculturelle dans les services de santé et les services sociaux , Télé-Université UQAM, Montréal, mars 2002. Sterlin, C., animation d’atelier: La filosofia intercultural de Raimon Panikkar, Symposium international, Barcelone, février 2002. Thériault, Laurier, animation: La réduction du bruit en milieu de travail, kiosque au Salon Santé Sécurité au travail, Montréal, octobre 2002. Veillette, Nathalie, formation: Évaluation à l’urgence hospitalière; comment déterminer l’orientation la plus appropriée , Institut de formation continue du Québec, Montréal, novembre 2002. Veillette, N., formation: L’impact fonctionnel des troubles cognitifs chez une clientèle âgée , Institut de formation continue du Québec, Montréal, mars 2003. Veillette, N., présentation: L’utilisation d’Internet comme outil de recherche en réadaptation, CLSC Côte-des-Neiges, Montréal, juin 2002. Veillette, N., présentation: Résumé du colloque de psychogériatrie 2002 du Centre de consultation et de formation en psychogériatrie , CLSC Côte-des-Neiges, Montréal, janvier 2003. Veillette, N., formation: Le dépistage des troubles cognitifs à l’aide du Mini-Mental , version Montréal, Soutien à domicile, CLSC BordeauxCartierville, Montréal, avril 2002. Xenocostas, Spyridoula, Cognet, M., présentation: The impact of gender and ethnic identities on the clinical encounter within a pluriethnic setting/Impact des identités professionnelles, de genre et ethniques dans la rencontre clinique, Congrès Annuel de la SCSA 2002, University of Toronto, mai 2002.
75 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
Appendix 3 By virtue of article 52 of the Code of Ethics and Rules of Professional Conduct applicable to members of the Board of Directors of the CLSC Côte-des-Neiges, “the establishment must make the present code accessible to the public and publish it in its annual report.” In the last year no one has filed a complaint, nor has anyone reported a breach under the present Code of Ethics and Rules of Professional Conduct.
CODE OF ETHICS AND RULES OF PROFESSIONAL CONDUCT APPLICABLE TO THE MEMBERS OF THE BOARD OF DIRECTORS1 OF THE CLSC CÔTE-DES-NEIGES PREAMBLE The administration of a public establishment has characteristics and obeys imperatives that distinguish it from a private administration. This type of social contract necessitates a relationship of special trust between the establishment and the public. Consequently, it is the establishment’s constant concern to maintain conduct that is congruent with ethics and the rules of professional conduct in order to preserve, strengthen or restore the relationship of trust with the population and ensure the latter integrity in the management of public funds. In respecting core values, it is essential to include in the present Code of Ethics and Rules of Professional Conduct the principal guidelines to which the administrators of this establishment adhere.
GENERAL OBJECTIVE AND FIELD OF APPLICATION 1. The present Code is not intended to replace the laws and regulations already in force or to establish an exhaustive list of standards of conduct expected of an administrator. Above all, it is offered as a reference tool with an additional regulatory function. Among other things, it deals with: .–
– – – –
the administrator’s duties and obligations in the exercise of his or her functions and after the completion of his or her mandate; the identification of situations involving conflicts of interest; practices related to the remuneration of the administrator; methods of applying the present Code; distribution of the present Code.
2. Every administrator in the establishment must abide by the ethical principles and rules of conduct stipulated by the law and the present Code. The administrator has the same obligations when, at the request of the establishment, he or she serves as an administrator in another agency or enterprise, or is a member of another agency or enterprise. In case of divergence, the strictest principles and rules must be applied. The administrator must, in case of doubt, act in keeping with the spirit of these principles and rules.
DEFINITIONS 3. In the present Code, unless the context suggests a different meaning: a) administrator means a member of the board, whether he or she is elected or appointed; b) conflict of interest means in particular, without limiting the legal scope of this expression, any situation in which
76 Annual Activities Report 2002-2003 CLSC Côte-des-Neiges
the direct or indirect interest of the administrator is such that there is a risk of compromising the impartial execution of his or her task because his or her judgment may be influenced and his or her independence affected by the existence of this interest; c) enterprise means any form that an organization that produces goods and services may assume or any other business of a commercial, industrial or financial nature and any group aiming to promote certain values, interests or opinions or exer t an influence on the authorities of the establishment d) direct interest means the interest as the result of which the administrator himself or herself reaps the benefits resulting from a decision taken or to be taken by the board; e) indirect interest means the interest as the result of which someone close to the administrator receives the benefits resulting from a decision taken or to be taken by the board; f) someone close means the administrator’s legal or common law spouse, child, father, mother, brother, and sister. This notion also includes the legal or common law spouse and the child of the persons previously mentioned as well as the administrator’s associate.
THE ADMINISTRATOR’S DUTIES AND OBLIGATIONS THE ADMINISTRATOR IN THE EXERCISE OF HIS OR HER FUNCTIONS: *
Acts within the limits of his or her powers
To this end, the administrator: 4. Must abide by the law, the article of incorporation of the establishment and the regulations. * Acts in the interest of the establishment and of the population it serves To this end, the administrator: 5. Is attuned to the needs of the population and promotes the respect for the fundamental rights of the individual. He or she emphasizes, among other things, the autonomy of individuals and their dignity. 6. Is aware of the importance of the social fabric that links the person to the world in which he or she lives. 7. Fosters the empowerment of the people and the communities. 8. Takes an approach that is holistic, multidisciplinar y, intersectoral, community-based, and preventive.
9. Ensures the relevance, quality and effectiveness of the care and services dispensed. Care and services must be personalized and adapted to each person’s needs and unique life situation. They must also be marked by professionalism and humanism, that is, empathy, openness, a willingness to listen, warmth, a respect for differences, and tolerance. 10. Ensures that the human, material and financial resources are used economically and efficiently. They must also be used with rigour, flexibility and creativity. Thus, the capacity for invention and initiative, a critical spirit and the capacity to learn of the staff members, the principle of seeking the biggest impact on the population’s health and wellbeing, the development, updating and upgrading of staff members’ skills, skill sharing among staff members from various disciplines and among programs will be encouraged. 11. Ensures the participation, motivation, self-actualization, skill maintenance and development of human resources.Thus, he or she promotes the advancement of knowledge and its dissemination, the development of attitudes compatible with the respect for differences and competencies, collaboration between persons, work teams and professions, the flexibility and inventiveness of people in defining for themselves the rules of the game. *
Acts with care, prudence, diligence and competency
To this end, the administrator: Availability and active participation 12. Makes himself or herself available to carry out his or her functions and takes an active role in the board’s decisions. Care and competency 13. Makes sure to comprehend and follow the evolution of the institution; he or she makes sure he or she is informed before making a decision and avoids making rash decisions. 14. Dissociates himself or herself from any illegal or fraudulent act. Supervision and control 15. Selects carefully his or her officers and directors and, only in the case of suspicion, supervises them and exercises control. 16. Receives a copy of all minutes and sees to it that they are corrected, if necessary. Neutrality 17. States his or her position on motions by exercising his or her right to vote as objectively as possible. To this end, he or she must not make any commitment to a third party or give any assurance whatsoever concerning the vote or any decision. Discretion 18. Is discreet about knowledge he or she has acquired in the exercise of his or her functions. He or she must also be prudent and discreet regarding confidential information the
communication or use of which could be inimical to the interests of the establishment, constitute an invasion of privacy or give an unwarranted advantage to a physical or moral person. 19. Preserves the confidentiality of facts or information that he or she possesses and the confidentiality of which must be respected according to the law or a board decision. Public relations 20. Obser ves the rules of politeness and courtesy and avoids any form of discrimination or harassment prohibited by the law. 21. Strives to give citizens, at all times and as soon as possible, the information that they request and that they are entitled to obtain; if he or she cannot do it himself or herself, he or she must direct the citizen to the appropriate service in the establishment. 22. Adopts a discreet and prudent attitude in expressing his or her views in public. *
Acts with honesty and loyalty
To this end, the administrator: 23. Acts in good faith and in the best interests of the establishment and the population it serves without consideration for the interests of any other person, group or entity. 24. Opposes any form of abuse of power such as conflicts of interest, rules violations, inefficient management, waste, disclosure of confidential information, granting of favours, covering up his or her errors or deceiving the public. The administrator other than the Director General: conflicts of interest 25. The administrator other than the Director General, on pain of forfeiture of his or her office, must make written disclosure of his or her direct or indirect interest in an enterprise which creates a conflict between his or her personal interest and that of the board or of one of the establishments that he or she administers. Fur thermore, the administrator must refrain from sitting in on or taking par t in any deliberation or decision when an issue concerning the enterprise in which he or she has an interest is being debated. However, the fact that the administrator is a minority shareholder in an enterprise whose shares are traded on a recognized stock market and of which he or she does not constitute an insider in the sense of article 89 of the Loi sur les valeurs mobilières (L.R.Q., chapter V-1.1) (Securities Act, R.S.Q., c. V-1.1.), does not constitute a conflict of interest. Assets of the establishment 26. Uses the assets, resources or services of the establishment according to the recognized utilization modalities applicable to ever yone. The administrator must not mistake the assets of the establishment for his own. Unwarranted advantages or benefits 27. Behaves in such a way as not to obtain unwarranted advantages, for him or her or for others, from his or her function as an administrator.
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28. Must not accept or seek any advantage or benefit, directly or indirectly, from an individual or enterprise that has a business relationship with the establishment or acts on behalf of or for the benefit of such a person or enterprise, if that advantage or benefit is intended to or liable to influence him or her in the exercise of his or her functions or encourage expectations in that sense. In par ticular, any gift, sum of money, preferential rate loan, debt remission, job offer, special favour or anything else with an appreciable monetary value that may compromise the administrator’s ability to make just and impartial decisions is considered a prohibited advantage. 29. Must not receive any salary or other pecuniary advantage with the exception of reimbursement for expenses incurred in the exercise of his or her function according to the conditions and to the extent determined by the government. Transparency 30. Discloses any information or fact to other members of the board when he or she is aware that communicating this information or fact may have a significant influence on the decision to be taken. Unwarranted intrusions 31. Refrains, unless he or she is the Director General or a senior officer, from making an unwarranted intrusion in the staff hiring process. 32. Refrains, unless he or she is the Director General or a senior officer, from inter vening in an unwarranted manner in the internal functioning of the establishment.
Must, as Director General, within thirty (30) days following the conclusion of any contract for professional services, submit to the board a written declaration indicating the existence of such a contract concluded with an establishment by an enterprise in which he has pecuniary interests. Exclusive functions of the Director General 37. Must, as Director General, on pain of forfeiture of his or her office or suspension without pay and subject to exceptions provided for in the law, apply himself or herself exclusively to the work of the establishment and to the duties of his or her function. However, when he or she takes on another position, responsibility or function, he or she must produce within sixty (60) days following his or her designation to this end and, ever y year, within sixty (60) days of the anniversary of his or her appointment, a written declaration indicating the existence of this fact. The Director General: unwarranted advantages or benefits 38. Must refrain, as Director General, on pain of forfeiture of his or her office, from accepting a sum of money or a direct or indirect advantage from a foundation or a moral person who requests sums of money or donations from the public in the health and social services sector.
THE ADMINISTRATOR UPON COMPLETION OF HIS OR HER MANDATE *
Acts with prudence, discretion, honesty and loyalty
To this end, the administrator: 33. Refrains from manoeuvring to gain favours for friends or someone close. 34. Refrains from acting as an intermediar y, even on a voluntary basis, between a profit making or nonprofit organization and the establishment. The Director General: conflicts of interest 35. Must not, as Director General, on pain of forfeiture of his or her office, have a direct or indirect interest in an enterprise, thus creating a conflict of interest between his or her personal interest and that of the establishment. However, forfeiture will not result if such an interest falls to him or her through succession or donation, provided that he or she renounces it or, after informing the board, he or she disposes of it within the delay set by the board. 36. Must, as Director General, within sixty (60) days after his or her appointment, submit to the board a written declaration indicating the existence of pecuniary interests that he or she possesses in enterprises liable to conclude contracts with any establishment.This declaration must be updated within sixty (60) days of the acquisition of such interests by the Director General and, every year, within sixty (60) days of the anniversary of the appointment. Failure to complete the declaration deprives the Director General of the right to sit on the board as long as he or she has not remedied his or her oversight.
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39. Acts in such a manner as not to gain an unwarranted advantage, for him or her or for another, from his or her previous functions as an administrator. 40. Refrains, in the year following the conclusion of his or her term of office, from acting, in his or her own name or on behalf of another, in a proceeding, negotiation or other process in which the establishment is involved and concerning which he or she possesses information unavailable to the public. 41. Refrains, in the year following the conclusion of his or her term of office, if he or she is not already in the employ of the establishment, from seeking a job in the establishment. 42. Must not use confidential information that he or she has obtained during the course of his or her mandate as administrator. 43. Avoids tarnishing the reputation of the establishment and of any individuals who work there.
MECHANISMS FOR APPLYING THE CODE Submitting a request for an investigation 44. Any allegation of a breach of the law or of the present Code brought against an administrator must be transmitted to the chairperson of the Committee on Ethics and Rules of Professional Conduct or, if the allegation concerns the chairperson, to any other member of the Committee. The person
to whom this accusation is transmitted shall inform the Committee which must meet, at the latest, within the following thirty (30) days. The Committee can also examine, on its own initiative, any situation involving a breach of the rules of ethics and of professional conduct prescribed by the law or by the present Code, committed by an administrator. A brief investigation 45. When an allegation is transmitted to him or her by virtue of the preceding ar ticle, the Committee chairperson, or another member of the Committee if the allegation concerns the chairperson, may reject, after brief examination, any allegation that he or she deems frivolous, persecutory or in bad faith. He or she must, however, inform the other members of the Committee about the allegation during the next meeting. The Committee can then decide to investigate this allegation nevertheless. Conducting an investigation 46. The Committee shall decide on the means necessary for conducting any investigation that comes under its authority. The investigation must, however, be conducted in a confidential manner and must protect, as much as possible, the anonymity of the person who brought forward the allegation.
DISTRIBUTION Accessibility to the present Code 52. The establishment must make the present Code accessible to the public and publish it in its annual report. Obligatory content in the annual repor t 53. The annual repor t must, among other things, note the number of cases considered by the Committee, their followup, breaches noted during the year by the Committee, decisions by the Committee, sanctions imposed by the competent authority as well as the names of individuals removed from office or suspended during the year.
AGREEMENT 54. Within sixty (60) days of the adoption of the present Code by the board, ever y administrator must sign and submit the agreement contained in Appendix I of the present Code. Every new administrator must do the same within sixty (60) days following the beginning of his or her mandate. Fur thermore, ever y person responsible for applying the present Code must sign and submit, within sixty (60) days after assuming the responsibility, the agreement contained in Appendix II of the present Code.
Notification to the administrator concerned 47. When the Committee deems the moment opportune, it must inform in writing the administrator of the breaches which he or she is alleged to have committed, indicating to him or her the relevant provisions of the law or the present Code. At his or her request and within a reasonable delay, the administrator has the right to be heard, be accompanied by his or her representative, have any individual testify and introduce any document he or she considers pertinent. Submission of the report to the board 48. When the Committee reaches the conclusion that the administrator has violated the law or the present Code, it must submit to the board a report containing a summary of the investigation and a recommendation for sanction. The report is confidential. Decision 49. The board shall meet, in camera, to decide on the sanction to be imposed on the administrator. The latter cannot participate in the deliberations or in the decision but can, if he or she so requests, be heard before the decision is taken. Sanctions 50. According to the nature and gravity of the breach, the sanctions that can be applied are a call to order, reprimand, suspension or forfeiture of office, which shall be instituted before the courts.The administrator shall be informed in writing of the sanction that is to be taken against him or her. Repayment of benefit received 51. The administrator who has gained a financial advantage because of a breach of the law or of the present Code is accountable to the State to the value of the financial advantage received.
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Appendix 4 MEMBERS OF THE BOARD OF DIRECTORS Bédard, Josée Belliveau, Francine Colin, Christine Cruickshank, John Dehertog, Marleen Dion, Claire - prés. Gravel, Louisette Jimenez, Vania Laurencelle, Francine Lefebvre, Charles-A. Moatti, Myriam Ortiz, Martha Pavilanis, Alan Trottier, Barbara Vandal, Valérie Vaughn, Kathryn Walsh, Suzanne
Council of nurses Population Régie régionale Appointed Member Council of midwives Foundation Population Département régional de médecine générale Council of Social Workers Population Population Appointed Member Teaching Population Régie régionale Régie régionale Interim Executive Director
Executive Committee Members Belliveau, Francine Dion, Claire Lefebvre, Charles-A. Walsh, Suzanne
Vice-President President Treasurer Secretary
Members of the Audit Committee Belliveau, Francine Dion, Claire Lefebvre, Charles-A.
Vice-President President Treasurer
MEMBERS OF THE EXECUTIVE COMMITTEE OF THE COUNCIL OF PHYSICIANS, DENTISTS AND PHARMACISTS Dongier, Pierre Dowdall, Mary Nguyen, Kim-Anh Rousseau, Hélène Walsh, Suzanne Mahood, Robert
President Ex-Officio Member Treasurer
Council of Nurses
Rumscheidt, Margaret Walsh, Suzanne
Consultant Nursing Advisor Consultant Vice-president President Executive Director Representative Consultant Ex-Officio Member
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(The Council has not met since April 2002) Comerford, Sheila Legault, Nathalie McDonald, Françoise Sylvain, Sylvie
Council of Auxiliary and Support Personnel (The Council has not met since September 2000) Chevalier, Sylvie Gomes, Daniel Lupien, Monique Picard, Johanne Talib, Amina - représentante de la d.g.
Council of Social Workers Chammas, Grace D’Andrea, John Fahmy, Mona Roc, Marie-Lyne Roussel, Francine Shermarke, Marian Vitez, Kristine Walsh, Suzanne
Vice-President Consultant President Secretar y Social Work Advisor Ex-Officio Member
Council of midwives Brabant, Isabelle Dehertog, Marleen Drévès, Élisabeth Hamelin, Lucie Leduc, Micheline Piltan-Goubayon, Anne Shaiek, Mejda Walsh, Suzanne
Secretar y
Vice-President President Ex-Officio Member
MEMBERS OF THE SCIENTIFIC COUNCIL Basmadgian, Nathalie Beausoleil, André Descoteaux, Suzanne Infante-Rivard, Claire Renaud, Jean Richer, Jean-Pierre Xenocostas, Spyridoula
Bayreuther, Jacqueline Dandurand, Francine Dion, Claire Jimenez, Vania Rhéaume, Jacques Walsh, Suzanne
Vice-President
MEMBERS OF THE EXECUTIVE COMMITTEES OF THE PROFESSIONAL COUNCILS Boisvert, Nancy Bourgon, Aline Boutaleb, Abiba Lam Lee Ngoc Murphy, Cathy Proulx, Marie-Thérèse
Multidisciplinary Council
MEMBERS OF THE TEACHING COUNCIL Aalamian, Armand Bourgon, Aline Hohl, Janine Jimenez, Vania Proulx, Marie-Thérèse Vitez, Kristine Xenocostas, Spyridoula
Bayreuther, Jacqueline Couillard, Jacques Huneault, Nicole Lapointe, Monique Racine, Guylaine Walsh, Suzanne
MEMBERS OF RESEARCH ETHICS COMMITTEE Bereza, Eugene - President Khalil, Halima Lapointe, Monique Leduc, Nicole Lévesque, Ginette Moss, Ellen Rosenberg, Ellen
MEMBERS OF THE FOUNDATION Dion, Claire Garneau, Madeleine Lorion, Jacques Mongeau, Christine Ranti, Irène Trottier, Barbara
President Secretar y Vice-President Treasurer
Appendix 5 Addresses CLSC Côte-des-Neiges - Headquarters 5700, chemin de la Côte-des-Neiges Montréal, H3T 2A8 Telephone: (514) 731-8531 Fax: (514) 731-0563 (Medical records) (514) 731-9600 (Administration) (514) 731-3532 (Homecare) (514) 731-2552 (SARIMM) Web site: www.clsccote-des-neiges.qc.ca E-mail:
[email protected] Occupational Health Program Telephone: (514) 739-2044 Fax: (514) 739-8132 Outremont Service Office 1271, avenue Van Horne Outremont, H2V 1K5 Telephone: (514) 270-1536 Fax: (514) 270-8731 Research and Training Centre Telephone: (514) 731-8531 Fax: (514) 731-4143 Web site: www.clsccote-des-neiges.qc.ca E-mail:
[email protected] Birth House 6560, chemin de la Côte-des-Neiges Montréal, H3S 2A7 Telephone: (514) 736-2323 Fax: (514) 736-0705 Mountain Sights Community Hall 7802, avenue Mountain Sights Montréal, H4P 2B2 Telephone: (514) 737-4644 Fax: (514) 737-4142
CLSC CÔTE-DES-NEIGES FOUNDATION The purpose of the Foundation, from the time of its inception, has been to alleviate pover ty, isolation, and distress. Its main activities include support for families and nutritional assistance for pregnant women. The Foundation's revenues come from different activities such as the pictures taken for the health insurance card and a yearly fundraiser with CLSC employees. The Foundation also receives donations from users and their relatives. For further information on the CLSC Côte-des-Neiges Foundation, please call (514) 731-1386, extension 2331.
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