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Title: Authentic Partnerships: Working Together To Make A Difference For our Children and Families


1
Authentic Partnerships Working Together To
Make A Difference For our Children and Families
Many the gifts for one community
  • Fay Stupnikoff, Prince Albert Regional
    Intersectoral Committee, Coordinator
  • Dale McFee, Chief of Police, Prince Albert Police
    Service
  • Susan Fowler-Kerry, Pediatric Nursing, College of
    Nursing, University of Saskatchewan
  • George Bolduc, Parkland Ambulance, Emergency
    Medical Services
  • Kristal Hendricks, Special Educator, Wesmor
    Community High School, Saskatchewan Rivers School
    Division
  • Jennfer Orynick Nursing Student, University of
    Saskatchewan
  • Heather Murray-Scriver, Acting Director, Pine
    Grove Correctional Centre for Women
  • Linda Greyeyes, Aboriginal Education Consultant,
    Saskatchewan Rivers School Division
  • Vince Robillard, Director of Urban Services,
    Prince Albert Grand Council
  • Linda Nosbush, Understanding the Early Years
    Community Research Coordinator Early Learning
    Consultant, Saskatchewan Rivers School Division
    Sessional Lecturer, Department of Educational
    Psychology and Special Education, University of
    Saskatchewan

2
The Health and Well-being of our Children Is a
Global Concern As well as a Local Concern
.
3
Understanding the Early Years Study Area
Saskatchewan Rivers School Division No. 119
4
Our Vision
  • We want all children and youth to feel loved, be
    safe, be confident and be well
  • We want our communities to promote the fullest
    health and enjoyment of childhood and youth
  • We want our society to protect all the rights of
    children and youth in a sustainable environment
  • - Canadian Institute of Child Health,
    2000

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  • Working to Establish..
  • A holistic approach to health care
  • Challenging boundaries within the health care
    sector with the primary purpose of improving
    health for all
  • Advocate for multidisciplinary/interdisciplinary
    approaches to health problems
  • Become part of a Community Development Program
  • Encouraged to participate with community
    programs where student nurses would typically not
    be sent
  • Develop a new understanding of primary health
    care and the determinants of health

8
  • Working to Establish Interdisciplinary
    Collaboration
  • When does Inter combine with Disciplinary?
  • It combines not merges
  • It is the great borrowing exercise the
    borrowing of
  • Concepts
  • Ways of framing Issues
  • Tools
  • Criteria
  • Our motto is
  • All for One and One for All
  • (Dumas, The Three Musketeers,
  • DArtagnon)

9
Prince Albert and Area
Regional Intersectoral Committee


  • The Mandate
  • Work collectively to foster and support an
    integrated approach to the planning and delivery
    of programs, policy and projects across sectors
    in response to the needs of children, youth and
    their families
  • Works to establish authentic partnerships by
    enabling relationships between sectors,
    community, and clients in order to meet the
    complex demands of life
  • Develop the capacity to collaboratively meet
    complex challenges that confront our community

10
Prince Albert and Area
Regional Intersectoral Committee


  • The Mandate
  • Grow in our ease to use a combined skill set to
    solve problems, manage resources, and meet the
    demands of an information age
  • Develop comfort in thinking outside the box
  • Grow in our capacity to critically and
    creatively approach our challenges
  • Leave behind old ways of working and dare to
    risk trying new ways of operating, and working
    toward solutions
  • Evolve in our ability to use many lenses to view
    a problem to dare to see as others see
  • Grow in our common unity comm-unity

11
What is Service Integration?
  • Joining of forces, knowledge and means
  • To understand and solve complex issues
  • Whose solutions lie outside the capacity and
    responsibility of a single sector

Federal/Provincial/Territorial Advisory Committee
on Population Health Intersectoral Action Towards
Population Health, 1999
12
Saskatchewans Vision
  • Saskatchewans human services are
  • Innovative,
  • Responsive
  • Effective.
  • They contribute to
  • Self reliance and individual well-being
  • While recognizing the interdependence of all
    Saskatchewan citizens.

13
  • Prince Albert Police Service
  • Systemic Causes of Issues Police Encounters
  • Addictions, Drugs, Substance Abuse
  • 1713 intoxicated persons picked up by the Police
    Service in Prince Albert in 2003
  • Family History/Intergenerational Dysfunction
  • Violence, Abuse, Neglect, Addictions,
    Criminogenic Behaviour


14
Many talents and many skills are required to
ensure the safety and protection of a community.
15
Prince Albert Police Service Solutions/Responses
  • Target Program
  • Structure for Success
  • Victim Services
  • Ridealongs for Integrated Nursing Practicum
  • Balanced Score Card
  • Benefit of Participation in Integrated Nursing
    Program Working Together to Form Relationships
    so We Can Serve Our Clients More Effectively

16
There is only one female correctional centre in
the Province of Saskatchewan.
  • Our Client Profile
  • Low Education (below eighth grade level)
  • Low Employment
  • Mothers without Resources
  • Personal
  • Community
  • Basic Know-how to Access the Resources that Exist

17
  • Issues
  • Addictions
  • Employment
  • Peer Pressures
  • Solutions/Responses
  • Provide Support Systems
  • Appreciation/Understanding of Needs of Women in
    conflict with the law
  • Core Acute Care Placement in The Integrated
    Nursing Program Our Contribution

18
Role Of School
SchoolPLUS
  • Educating the Whole Person
  • Supporting the Family
  • Planning for Student Success (responsive
    planning)
  • Support Service Delivery
  • To serve as a centre at the community level for
    the delivery of social, health, recreation,
    justice and other services for children and their
    families

19
There is a pattern that connects us all
  • Gives us a deep sense of connectedness to
  • Mother Earth
  • Each other
  • Our families and children
  • The work that we do together
  • How we form community
  • How we live and work together

The Metaphor The earth is the skin and the
roots, like the blood vessels in our bodies,
connect us, sustain us and give us life.
20
What Authentic Partnerships Mean to Us
  • Knowing that youre not solely responsible for
    children in the community
  • There is a community response to keeping
    children safe
  • Others are involved in improving the lives of
    children and families
  • Listening as you work with others
  • Gives insight
  • Enables you to consider other options to
    increase the quality of life for children and
    families

21
  • Develop knowledge of how childhood experiences
    shape learning, health and well-being
  • Track how well children are doing and
  • Build the communitys capacity to improve child
    development through policy, program and resource
    development.
  • Knowledge Exchange and Pay It Forward
  • The development of an Integrated Human Services
    Practicum will build strong bonds between the
    Human Services and will enable better response
    systems to childrens and familys complex needs.

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24
The Virtuous Circle
Prosperous Society
Social Stability
Innovation and Competitive Workforce
Resources to Fund Programs that Foster Healthy
Child Development
Healthy Children and Adolescents
Healthy Child Development
Doherty Offord
25
1200 Of our children Will begin their lives In
Prince Albert and area This year Who will they
be?
26
Urbanization is Happening
Out of the 1200 Children Born
  • 780 will live in urban areas
  • 420 will live in rural areas

27
Culture
Out of the 1200 Children Born
  • Aboriginal - 442
  • First Nations - 293
  • Métis 149
  • Other 758
  • Immigrants Refugees
  • All Other Cultures

In 2002 36.8 of our population is AboriginalBy
2010 50 of our population will be Aboriginal
28
Teen Pregnancy
Out of the 1200 Children Born
  • 209 of you will be born to mothers who are
    between 10 and 19 years of age
  • Saskatchewan has the 3rd highest teen pregnancy
    rate in Canada
  • Prince Albert has a 46.6 higherteen pregnancy
    rate than the provincial average

29
Infant Mortality
Out of the 1200 Children Born
  • 14 of you will die before the age of 1
  • This is almost double the Canadian rate
  • This is thirty percent higher than the
    Saskatchewan rate
  • Canadian figures suggest
  • Injuries 43
  • Congenital Anomalies 30
  • Sudden Infant Death Syndrome 11
  • Other 9

30
Birth Weight Prince Albert Regional Health
Authority 9, 2001
  • Total Deliveries 1153
  • Low Birth Weight 32 - 3(less than 2500 Grams
    5.5 pounds)
  • Average Birth Weight 851 - 74(between 2501 and
    3999 grams over 5.5 pounds and under 8.8
    pounds)
  • High Birth Weight 270 - 23

31
  • Barriers to Access
  • Transportation Child Care
  • Comfort Cost
  • Literacy Levels
  • Cultural Acceptability

Resource Distribution
32
Socio-Economic Status
Out of the 1200 Children Born
  • 780 of you will be low to very low SES
  • 280 of you will be vulnerable
  • 276 of you will be middle SES
  • 74 of you will be vulnerable
  • 144 of you will be high to very high SES
  • 30 of you will be vulnerable

384 of you will be vulnerable
33
Mobility
Out of the 1200 Children Born
  • 975 of you will live in neighbourhoods where
  • 10 60 of you or your neighbours have moved at
    least once in the past year.
  • 225 of you will live in
  • neighbourhoods where
  • less than 1 in 10 will
  • move at least once in
  • the past year.

34
Mobility
35
Poverty in Saskatchewan
  • 20 of the provinces children in 1989
  • 17.9 in 1999
  • 45,300 children
  • Although the rate is lower, the actual number of
    children living in poverty is higher (Social
    Policy Research Unit, University of Regina, 2001)
  • 18.1 in 2000 (Canada Council on Social
    Development, 2002)

36
Youth CrimeAges 12 - 17Canadian Centre for
Justice Statistic, 2001 Gullickson, SK Justice,
2002
Out of the 1200 Children Born
  • 132 criminal code offence charges will be laid
    (SK) Canadian statistics suggest the type of
    crimes committed
  • 17 for Violent Crimes (physical assault, sexual
    assault, homicide)
  • 58 for Property Crimes (shoplifting, theft,
    break and enter)
  • 43 for Other Criminal Code Offenses (disturbing
    the peace, mischief, vandalism, weapons,
    administration of justice)
  • 105 will offend only once in any given year
    (1999-2000)
  • 27 will be repeat offenders in any given year
    (1999-2000)
  • Figures exclude traffic violations

Saskatchewan has the 2nd highest rate of
participation in Alternative Measures in Canada
(1998-1999).
37
Education Levels
Out of the 1200 Children Born
  • 185 of you will have less than a Grade 9
    education
  • 126 of you will have less than a Grade 12
    education
  • 367 of you will have a Grade 12 Diploma
  • 311 of you will have post-secondary training
  • 121 will have some university
  • education
  • 90 will hold a university degree

University Degree
Less than Grade 9
Some University
Less than Grade 12
Non-University
Training
Grade 12 Diploma
38
Watch over us. Wrap us up against the cold and
the rain, and give us shade from the hot sun.
Make sure we have enough to eat and drink and if
we are sick, nurse and comfort us.

- Castle, C. Lynch, P. J. For Every
Child
39
For Every Child Whoever we are, Wherever we
live, These are the rights Of every Child Under
the sun And the moon And the stars These are the
rights of the child.
- Castle, C. Kitamura, S. For Every
Child
40
Our Children Our Future
  • These children are our nieces, nephews,
    neighborhood children, the care takers of
    tomorrow our very own
  • The next step is up to us . . . . .
  • How will we help our young build their future?

41
Socioeconomic Gradients
problematic
desired
Literacy Level
The pattern wherein risk increases in a stepwise
fashion as one descends the socioeconomic ladder
is known as a gradient.
Parents Level of Education
42
Socioeconomic Gradients
  • The pattern wherein risk increases in a stepwise
    fashion as one descends the socioeconomic ladder
    is known as a gradient and once established it
    tracks across the life course (Hertzman, 2002)
  • Steep gradients give important clues as to
    whether a society is supporting or undermining
    the development of its populationsteep gradients
    are associated with overall poor outcomes in
    comparisons among countries or regions (Keating
    Hertzman, 1999)

43
Socioeconomic Gradients
  • Indicate causal relationships
  • Are influenced at various levels of social
    aggregation
  • Are evident for all major diseases and
    competencies that affect health and well-being
  • Even when major diseases change, the gradient
    replicates itself
  • Point to fundamental biological processes
    connecting Socioeconomic Progress to human
    resilience and vulnerability, to disease, and
    strongly suggest a role for early childhood
    development
  • Are expressed over the entire life course but
    they appear early in life
  • - Hertzman 2000

44
Socioeconomic Gradients
  • Early Childhood Development initiates gradients
    in health, well-being, and competence throughout
    the life course according to three processes
  • Latent Effects
  • Pathway Effects
  • Cumulative Effects
  • Social Exclusion has many forms and sometimes it
    can occur when there are no distinguishing
    features features evident one of the most subtle
    forms emerges early in life when the child is in
    the process of becoming and it shapes
    childrens readiness to learn at school
  • If our physical and social environments, and the
    institutions that govern them, systematically
    limit the chances of some groups of children to
    develop as fully as others, then this too is a
    form of social exclusion (Hertzman 2002).

45
Early Development Instrument Percentage of
Children Who Lack Readiness to LearnIn the
Prince Albert Area
These neighbourhoods have many children who lack
readiness to learn at school.
9 schools have more than 30 of children who lack
readiness to learn
These neighbourhoods have most children ready to
learn
46
Examining Readiness to Learn ScoresAcross the
Distribution Our goal is to have all children
ready to learn when they enter school but alas
that is not so..
Children who will readily adapt to school the
transition will be negotiated with little or no
support.
Children who will have problems adapting to
school.
Children who are at-risk for adapting to school.
Children who are above average in their ability
to adapt to school there will be a transition
but they will make it easily.
Children who are below average in their ability
to adapt to school but with support will be able
to do so.
47
The New PovertyHaberman, Harvard, 1993
  • Todays poverty is unlike that of the past.
    Children experiencing the new poverty face the
    following
  • Growing up without adults they can trust
  • Living in communities where violence abuse of
    human beings is high
  • Experiencing feelings of despair and lack of
    hope
  • Witnessing their familys inhuman treatment from
    the bureaucracies that were established to help
    them
  • Resigning themselves to a state of
    powerlessness, being at the whim of some other
    authority outside their families.

48
The Attachment System
  • Motivates children to
  • Seek proximity to parents
  • Establish communication with them
  • Attachment
  • Improves chances of survival
  • Helps the infants immature brain to organize its
    own processes by using the mature functions of
    the parents brain
  • Serves to increase the childs positive emotional
    states and modulate the negative states by giving
    them a haven of safety
  • Through repeated experiences sets up expectations
    or mental models about the world

49
ABCs of AttachmentSiegel 2003
  • Attunement aligning your own internal state
    with those of your children. Often accomplished
    by the contingent sharing of nonverbal signals.
  • Balance Children attain balance of their body,
    emotions, and states of mind through attunement
    with you
  • Coherence The sense of integration that is
    acquired by your child through your relationship
    with them in which they are able to feel
    internally integrated and interpersonally
    connected to others.

50
Timing of Attachment
  • Attachment to a primary caregiver is critical
  • The first seven months are especially important
  • Relationships with parents change over time as do
    childrens attachments
  • It is never to too late
  • Nurturing relationships with someone other than
    the parent with whom the child feels understood
    and safe provide an important source of
    resilience
  • However, they do not replace a secure attachment
    with a primary caregiver but they are a source of
    strength for the childs developing mind.

51
Types of Attachment
  • Secure
  • Insecure - Avoidant
  • Insecure - Anxious/Ambivalent
  • Insecure - Disorganized

52
Prince Albert Parkland Health Region
  • Maternal Child
  • Obstetrics
  • Pediatrics
  • Mental Health, Addictions Community Development
  • Community and Mental Health
  • Addiction Services
  • PACADA
  • Primary and Community Care
  • Sexually Transmitted Disease Centre
  • Public Health
  • Critical Care
  • Emergency

53
  • Working with vulnerable families to provide
  • Universal Screening at Birth
  • Indepth Assessment for those in Targeted Areas
  • Home Visiting
  • Early Learning and Care
  • Addictions and Mental Health Support

54
Emergency Medical Services
  • Point of need to Medical Centre
  • The process
  • The support medical and psycho-social
  • The collaboration with other emergency services
  • The continuum of care
  • Responding to patient needs
  • Resources for other family members especially
    children
  • Prevention Services

55
Emergency Medical Services
  • On the front line
  • At the scene providing initial emergency care
  • Dealing with the family
  • Responding to the needs of the patient

56
Emergency Medical Services
  • Working as a Team
  • With agencies such as Mobile Crisis and Prince
    Albert City Police
  • Transporting the children if needed to the
    hospital
  • Waiting for family or crisis workers to attend
  • With emergency room nurses to continue care

57
Emergency Medical Services
  • On the front line
  • Deals only with the urgent and present situation
  • Does make a difference through the smile and eyes
    of the children

58
Prince Albert Grand Council Urban Services
Linking On and Off Reserve Services Supports
  • Support of First Nations Peoples as they make
    their transition to Urban Life
  • Urban Sport Culture and Recreation Program
  • FASD moving from diagnosis to treatment
  • Housing Transition Housing
  • Working with other sectors, agencies,
    community-based organizations to ensure ease of
    transition to urban life
  • Post-secondary support, training and employment
  • Youth Justice Project
  • Job Skills Coach (Carlton, St. Marys, Wesmor)

59
Prince Albert Grand Council Urban Services
Exploring Collaborative Partnerships
  • Support of First Nations Peoples as they make
    their transition to Urban Life
  • Indian Child Family Services
  • Urban Family Violence Program
  • Urban Referral and Parenting Program (CAPC)
  • ECD and Youth Initiatives
  • Explore more and better ways to support our
    parents and young children
  • Working with other sectors and other departments
    within PAGC

60
Our Goals
  • Breaking down Barriers
  • Understanding Client Needs and Socio-demographic
    Trends
  • Ages 1 34 have 5,000 more people than the 35
    70 year old age group
  • Use a Balanced Approach a Proactive Role in
    balance with a Reactive Response System
  • Enhance Information Flow between and among
    sectors
  • Realign resources and services
  • Realize that we need to do things differently if
    we want different results
  • Provide Leadership and Vision An alternative
    way of being
  • Integrated Nursing Program
  • The Dirty Dozen

61
Breaking the Cycle A Balanced Approach
  • Identify the root causes
  • Problem solve common issues
  • Move toward early identification
  • Intervention
  • Acute Services
  • Collaborate to create joint solutions
  • Communication Strategy
  • Engaging the stakeholders
  • Engaging the whole community

Increasingly more expensive but easier to measure
62
Evidence-based Decision-making
  • Conceptualizing the data needed to make the case
    for supports and services along the continuum of
    care from prevention to acute care intervention
  • Ease of data collection
  • Availability of data
  • Representativeness of data
  • Softer measures
  • Integrated data sets
  • Joint data sets to build a more comprehensive
    picture of the community

63
Our ModelStrong Children grow up in Strong
Families, Strong Neighbourhoods, Strong Peer
Groups, and Strong Nations
Vision Leadership Structural Change
  • Four Worlds of Childhood(SchoolPLUS)
  • Family
  • Peer Group
  • School
  • Neighbourhood and Community

Acute Care
Education and Awareness
64
Realizing our Vision
  • Coming together in collaborative ways
  • Joint problem-solving
  • Common Vision
  • Common Goals
  • Different Competencies, Skills, Strategies
  • Common Indicators of Success
  • Shared Resources
  • Joint Responsibility
  • Different lenses for viewing the world
  • Respect, trust, capacity to listen and to
    challenge respectfully
  • Learning to live and grow in the shelter of each
    other

65
Integrated Nursing Practicum Students Comment
about Their Experiences
  • Allowed me to move from thinking outside the box
    to practicing outside the box
  • Getting to see many aspects of the community and
    how they all work together
  • The community affects a persons health and
    their health affects the community

66
Social Justice and the Social Determinants of
Health, Well-being and Competence
67
  • Wholeness. All things are interrelated.
    Everything in the universe is part of a single
    whole. Everything is connected in some way to
    everything elseit is therefore possible to
    understand something only if we can understand
    how it is connected to everything else.

Bopp, J., Bopp, M., Brown, L. Lane, P. (1989).
The sacred tree Reflections on Native
American spirituality (3rd ed.). Twin Lakes, WI
Lotus Light.
68
Conceptualizing the Common Humanity in Human
Services
A Tapestry of Support - Realize Our Collective
Promise
69
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