Community-Level Strategies for Recruiting and Retaining Health Care Providers to Rural and Remote Areas

Attracting healthcare providers to rural BC communities can occasionally be a challenging process. There is no one “tried and true” surefire solution to recruiting rural primary care providers.

Below are some provincial resources available to rural communities to assist in the search for healthcare professionals. 

Also included are documented success stories of rural BC communities who utilized innovative approaches to attract rural physicians to their communities.

https://med-fom-crhr.sites.olt.ubc.ca/files/2019/09/Rural-Evidence-Review-Community-Level-Recruitment-and-Retention-Scoping-Review-FINAL-reduced-file-size.pdf

https://rccbc.ca/rural-communities/recruitment-and-retention-strategies/

The Time Has Come for a National Pharmacare Plan

Nobody should be forced to choose between paying for groceries and paying for the medication they need.

Send a message to your Member of Parliament. Ask them to support establishing a universal national prescription medication system to provide coverage for everyone in Canada—regardless of their income, age, or where they work or live.

It only will take a few seconds out of your busy day.

You can also find out: 1. how many Canadians support a National Pharmacare plan and 2. why pharmacare makes economic sense, and other answers to your question.

OK, the answer to the first question is: 91% of Canadians 

http://www.aplanforeveryone.ca/mp?utm_campaign=unopened_february_test_b_2&utm_medium=email&utm_source=canadianlabour

Individuals

Johanna Trimble – Sunshine Coast.
Johanna brings a wealth of experience to our organization as a Lecturer for the Care of the Elderly (Dept. of Family Practice, UBC) and through her work on Medication Safety for Elders.  
https://www.deprescribingnetwork.ca/our-champions/ 

RESEARCH ARTICLES

https://www.ubyssey.ca/science/rural-health-review/
UBC Rural Evidence Review aims to identify highest-priority health needs in rural BC communities

Many residents in rural communities have to travel to other communities for general and specialized care, but this process has its own challenges, such as how to ensure reliable transportation. Alex Vanderput

As BC continues to face gaps within its rural healthcare system, UBC researchers are working to amplify rural communities’ perspectives in high-level planning processes.

Since starting a year ago, the group of researchers working on the Rural Evidence Review (RER) project has been surveying rural residents from across the province on their experiences and priorities accessing healthcare. Newspapers from communities ranging from Revelstoke to Fort Nelson have been calling for participation from their local residents.

For RER Co-Director Dr. Jude Kornelsen, it’s this grassroots approach that differentiates the project from the numerous studies that have already been done about rural healthcare.

According to Kornelsen, previous systemic reviews have seen large influence from health authorities while the team now wants to engage mainly with on-the-ground stakeholders. She added that most studies she has seen also tend to come from an urban focus, losing some nuances about rural populations — which include numerous Indigenous communities — along the way.
“Rural is not just small urban,” said Kornelsen.
As the co-director of the UBC department of family practice’s Centre for Rural Health Research, she has researched rural healthcare needs extensively.
“And you can’t really group them together. ‘If you’ve seen one rural community, you’ve seen one rural community’ is something that we often say,” she added.

Edward Staples — a lead of the BC Rural Health Network (BCRHN), which provides support for RER’s research — agreed with Kornelsen. In fact, he said this is represented in BCHRN’s structure itself, which brings together 16 autonomous organizations working in 14 different communities. (NOTE: at this time – September 19, 2019 the BCRHN has grown to represent 30 communities/organizations.)


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APRIL 2020

Society for Protection and Care of Seniors TRAIL

The Society for Protection and Care of Seniors (SPCS) is a non-profit, volunteer based Seniors’ health care advocacy group located in Greater Trail. We advocate and pursue options for adequate, accessible and the safe continuing care of seniors’ resources within our communities. We communicate, disseminate information and educate to accomplish these goals.

In 2004, many seniors had difficulty accessing appropriate health care. There was a need for an advocacy group to bring awareness to IHA. The Trail Health Watch was formed to speak out for seniors with health issues.

In February 2006, a tragedy now known as “The Albo case” occurred. The Albo family’s parents were both Trail hospital patients, when suddenly, contrary to the family’s wishes, the parents were separated. Their mother was transferred to a long-term care facility in Grand Forks where two days later, she passed away. Their father passed away just 10 days later. 

SPCS changed its name to The Society for the Protection and Care of Seniors. As a result of all the work SPCS has done over the past years, there has been considerable impact on how and what decisions are made by IHA. In 2010, a ten year span ‘Lost Services Report’ was created to identify detrimental changes to services – many are still concerns 15 years later! This Report can be viewed on our website: www.spcstrail.weebly.com. SPCS continues to advocate for improvements to service and to express concern regarding cuts to health care. An important role is to help citizens give voice to their valid concerns.

We are proud to be a part of Connected Communities – a West Kootenay group that meets regularly to discuss shared issues and advocate for change. Twice a year Connected Communities representatives meet with Kootenay Boundary IH Administration to discuss concerns and offer recommendations for dealing with identified concerns. This provides an avenue of transparency with IH. As a member of BCHC and COSCO, we also have a voice in provincial issues.

Members of SPCS find it rewarding to be actively involved in improving and enhancing positive changes to our health care system. SPCS advocates for the implementation of both the Ombudsperson’s and BC Senior’s Advocate’s recommendations. We continue to be a force for change locally, regionally and provincially.

We are driven by the mandate first voiced by Jim Albo: to keep meeting, attend vigils and give time, energy and expertise to SPCS “until there are changes for the better”. 

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MARCH 2020

About Adult Abuse, Neglect, and Self-Neglect

Adult abuse is any action causing harm to someone over the legal age of 18. Abuse may be financial, physical, sexual, or psychological. Other forms of abuse can include over or undermedication, censoring mail, violation of civil and human rights, denial of access to visitors, or invasion or denial of privacy.

Elder abuse commonly refers to adult abuse where the target is a senior or older adult. An abuser is someone who is likely known to the abused older person, like a friend, family member, or caregiver. 

Neglect is when lack of care, assistance, or attention leads to physical, mental or emotional harm, or loss of financial assets. Self-neglect is the failure to care for one’s self that causes serious physical or mental harm, or damage to or loss of assets.

BC does not have a law saying you must report abuse, however, Part 3 of the Adult Guardianship Act says if you do make a report to a Designated Agency, the claim must be addressed and in the least intrusive way. 

Community connection and awareness are keys to identifying and preventing all manners of abuse and neglect. 

The BC Association of Community Response Networks (BC CRN)

The BC CRN is a provincial, non-profit organization whose mandate is to partner with communities and local service providers to raise awareness of and educate the BC public on how to spot the signs of adult abuse, neglect, and self-neglect, and what they can do to correctly address it.

Community response networks (CRNs) are groups of concerned community members who come together to coordinate community responses to adult abuse, neglect, and self-neglect.

In 1993, CRNs were piloted in five communities – Duncan, Penticton, Castlegar, Abbotsford, and Vernon. Thanks to the efforts of the Regional Mentors, CRN coordinators, community partners, and countless number of volunteers, as of 2019, 80 CRNs serve 232 communities in the smallest of rural villages to the largest of urban centres province wide. This number also includes borderless CRNs who serve and support the Chinese, Francophone, Aboriginal, and LGBTQ2S+ communities.

How Community Response Networks Educate Communities

Local CRNs hold a variety of public engagement and awareness activities and programs while BC CRN provides resources and support in the form of resources and programs.

Some examples of the provincial offerings include the It’s Not Right! and Gatekeeper programs that help communities learn the signs of abuse, neglect, and self-neglect (BC CRN is the authorized provider of both programs.), and near monthly provincial learning events on various topics. All events are free of charge and everyone is welcome. View a sampling of local CRN events and projects.

How You Can Get Involved

If you’re interested in getting involved in the activities of the CRN in your community, please contact your local CRN Coordinator.

If no CRN exists in your community and you want to set one up, please contact the Regional Mentor for your area.

To stay updated on the latest, join BC CRN’s Facebook or Twitter, subscribe to the free
E-Connector newsletter by emailing info@bccrns.ca, or visit www.bccrns.ca.  

Sharon Johnson, CPA, CGA
Director of Administrative Services
BC Association of Community Response Networks (BC CRN)
sharon.johnson@bccrns.ca
604-290-5110
www.bccrns.ca

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FEBRUARY 2020
Support Our Health Care Society (SOHC)
Princeton

Support Our Health Care (SOHC) was formed in April, 2012 in response to the gradual deterioration of health care services in Princeton. The tipping point was reached when Interior Health announced nighttime closure of our Emergency Room at Princeton General Hospital beginning May 1st. We originally called ourselves Save Our Hospital Coalition but changed our name to Support Our Health Care to better reflect a collaborative and cooperative approach to improving Princeton’s health care model. 

Through a connection with Dr. Barbara Pesut at UBC Okanagan, SOHC organized a Health Care Community Consultation held on January 29, 2013. Dr. Pesut facilitated this research-based consultation with assistance from her research assistants. The Rural Health Services Research Network of BC also provided support and assistance. Over 40 stakeholders from Princeton and Area attended the Consultation, where they were asked to identify both positive and negative aspects of the community’s health care model. From the information gathered, Dr. Pesut prepared the Princeton Health Care Community Consultation Summary which was released to the public in early February, 2013.

In response to the Consultation Summary, Interior Health and community leaders formed the Princeton Health Care Steering Committee. The committee included representation from local governments, Princeton healthcare practitioners, Princeton General Hospital administration, BC Ambulance Services, South Okanagan Similkameen Division of Family Practice, SOHC, and Interior Health. Beginning in February 2013, the committee met once a month for six months and developed the Princeton Health Care Action Framework, outlining a strategy for the implementation of an improved and sustainable model of health care for our community.

Over the past several years, SOHC has worked collaboratively with its local healthcare providers, Interior Health, and local government to stabilize and improve our healthcare model. Our community now has five Family Physicians, two half time Nurse Practitioners, a full complement of Registered Nurses, Licensed Practical Nurses, and a team of allied health professionals providing a full range of services. Other improvements include the installation of a tele-health station at the hospital, increased access to specialist services at PGH, and beautifying Cascade Clinic through the donation of artwork by local artists.

Over the past year, SOHC has been focusing on succession planning to guarantee the stability and viability of our healthcare advocacy efforts. We have also shifted our efforts into developing community wellness programs that address the social determinants of health. 

SOHC is a founding member of the BC Rural Health Network and actively supports the programs and initiatives of this organization.

For more information, visit SOHC’s website at www.sohc.ca or visit our member page here at
https://bcrhn.ca/princeton/

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JANUARY 2020
Health and Wellness Coalition
Ashcroft

This community group was founded in 2014/2015, when we had only one physician, and the Emergency room was closed more than it was open. Our health site supports a catchment area of 7,500.

At that time the group was assisted by Dr. Barbara Pesut and the Princeton SOHC (Support Our Health Care Society) who organized a Community Consultation. From this a plan of action was developed. (https:// bcrhn.files.wordpress.com/2019/05/ashcroftcommunity-consultation -summary_final-3.pdf)

Interior Health located physicians through the Practice Readiness Assessment program. However, these physicians did not stay once they met their contractual obligation. Over the past years there have been as many as two physicians at any given time, with a rare occasion of three for a month or two. For this reason, our emergency services deteriorated to opening hours starting on Friday at 1800 until Monday at 0800. Medical Clinic hours were short and inconsistent, and patients were unable to get in for urgent care needs.

In 2018 a revitalized meeting format was put in place, with guest speakers from various programs and services within the community.

Municipal representation was sought and the six First Nations Communities were invited tothe table. Membership grew to 50.

On April 15th 2019, in collaboration with United Way and Interior Health, we hosted a very successful Navigating Healthcare Fair within our community. At the time of the fair we created a survey with the help of Dr. Barb Buckley, Thompson Rivers University Assistant Professor.
Through this gathered information we found out how people were managing with inadequate emergency services and insufficient doctors. It also told us that they wanted emergency services extended to meet community needs.

HAWC created an electronic petition, and booths were set up in each of the four communities. 2,000 plus signatures were obtained and the petition was forwarded to the Minister of Health, CEO and President of Interior Health, and our local MLA. We asked for recruitment and retention to become a priority for all disciplines required to keep our emergency department open.
Sheila Corneille, President Ashcroft Healthcare and Wellness Coalition a38400

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DECEMBER 2019
Salt Spring Community Health Society

As a result of a chronic shortage of family physicians on Salt Spring Island (approximately 1/3 of the population was without a primary health care provider) a group of 11 concerned citizens formed a steering group in the fall of 2017 with the idea of one day opening an inter-disciplinary community health centre.

We researched existing primary and community health centres on other Gulf Islands, in rural and remote communities along the coast and elsewhere across Canada to better understand how they operate. We studied Island Health’s Local Health Area Profile for the Gulf Islands. We developed Terms of Reference so people understood what we were about and what we were trying to accomplish. We became a BC Society in January 2018 and began recruiting members and supporters, holding information meetings and town halls. Knowing we would need to begin fundraising at some point, we set about becoming a registered charity – which we achieved in December 2018. 

In the fall of 2018, the local chapter of the Division of Rural and Remote Family Physicians announced they had recruited three new doctors to the island. It had happened before, but we were hopeful it would work out this time. But what about us? Would people think the new doctors would address all the residents’ health needs?

Before we decided whether or not we should fold our tent, we thought it was important to find out from individuals in the know what they thought. We interviewed some 30 connected community leaders and people with expertise in health care, community health, and community services. 

Building on that knowledge – the final and most important step – was to hear from the residents themselves. We hired a consultant to help us create a comprehensive community health needs assessment focusing on the Social Determinants of Health, access to health services and community health needs. Once the final report was written, we developed a marketing and communications strategy that ensured the report was heavily promoted and would get into as many hands as possible because the report contained important information for many service providers and community groups.

As a result, numerous individuals and organizations are using the report for planning purposes, we’ve been approached by several individuals with significant health and mental health care experience wishing to become advisors to the board and/or board members, and we’ve learned the information gathered through our needs assessment will be key to developing a proposal to the Ministry of Health to fund a community health centre. 

And finally, the report has opened doors to what we anticipate will be meaningful conversations with our local physicians, and other health care and mental health service providers about how we might begin to fill gaps in much-needed services, remove barriers to accessing those services, and ensure all Salt Spring residents receive the right kind of care when they need it.
Martha Taylor,
Board Member, Salt Spring Community Health Society

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OCTOBER/NOVEMBER 2019
Community First Health Co-op
NELSON

We mortals know that Wellness is a Mind, Body, and Soul journey. Through the shared values of co-operation, connectedness, compassion, education, inclusion, and kindness, community is engaged in serving wellness with Community First Health Co-op. 

Community First Health Co-op is a not for profit co-op, incorporated in 2003 with a volunteer community board, now with membership of over 1500 community members across the full spectrum of the community.  Creating community responses through the lens of the World Health Organization’ Social Determinants For Good Health has provided unlimited possibilities and adventures to create more opportunities for wellness for all in our community.  Social connection to others and community is a key determinant for good health.
The Co-op’s, Nelson and Area Wellness and Education Centre (Health Centre) has tracked over 70,000 (a conservative count), annual visits.

Programs provide outreach programs and services, educational sessions including multidisciplinary self-management chronic pain programs, drug awareness, addictions treatment and support, counselling, street outreach, multi-sector health promotion, home visits and or telehealth for those that are unable to come to the centre in communities across the Central Kootenay and Kootenay Boundary Regional Districts.

Accessibility, prevention and health promotion activity, client and family-centeredness and chronic disease management contribute to
community enthusiasm and satisfaction.

Research has shown that Community Health Centres reduce hospital emergency room visits as compared to other models. The Nelson and Area Wellness and Education Centre, exceeds expectations in reducing emergency room visits.

Over 50 practitioners, several volunteer boards of partners and 17 volunteer community organizations work together to respond to emerging community wellness issues through support, education and services at the Wellness Centre and across Central Kootenay and Kootenay Boundary Regional Districts without additional financial burden on the participants. 

In 2018 Community First Health Co-op received $110,000 – available over three years- in transitional funding from the current Provincial government as part of their first step to invest in Community Health Centres.

Community First Health Co-op Health promotion is ongoing.  With the consensus of community experiences, volunteers and practitioners increasing support for mental wellbeing and physical activity are underway.  This year over 1.5 million minutes of activity in were collected by Community First Health Co-op, with over 500 events and activities and 1000 free pedometers enthusiastically taken by residents excited to join The Every Step Counts movement and conversation growing in our community while promoting community connections and inclusion.

You can learn more about our communities’ quest for wellness at http://healthco-op.ca or Community First Health Co-op or just email us at cfhcoop@shaw.ca if you would like more information.

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SEPTEMBER 2019


Support Our Northern Seniors
FORT ST. JOHN

SONS is a group of dedicated people wanting to make a difference in our community.
During the 1990’s we had local Health Councils, which gave us an opportunity to provide local input and to provide the Council with an awareness of the needs in the health community. SONS President Jean Leahy was on the first Peace Liard Community Health Council, which pushed hard for the creation of long-term beds, leading to the construction of Heritage Manor I and Heritage Manor II retirement housing in Fort St. John.

It was a painful time for a number of our families as there was a shortage of long-term beds in the North Peace and many loved ones had to be placed in Dawson Creek or Pouce Coupe. It tore couples apart causing a lot of grief. If the spouse left at home could not drive, it made the 50 mile drive seem like 500.

The drive for more beds picked up steam. A plan was put together for the North Peace Care Project. More beds were to be built and additions were to be made to the North Peace Care Facility.  

Nothing happened. There was no money for facilities. Statistics proved that we would continue needing more beds in our area, and so the fight began. 
The group of concerned citizens that would eventually become SONS applied for Society status and held information sessions. It made the community sit up and take notice. 
SONS members attended every meeting and public event that they could to spread the word—Trade Fairs, Select Standing Committees and Peace River Regional District among others.
SONS continues to advocate for infrastructure to help seniors living in Northern BC to age-in-place.

The purposes of Save Our Northern Seniors Society are:

  • To build a facility which will ensure the safety, respect and dignity of our seniors;
  • To provide current and reliable information for the number of facilities and beds available in our area;
  • To pursue all avenues of support for our community – rural and urban – such as Supportive Living, Assisted Living, Intermediate Care, Extended Care, Special Unit, Psycho-Geriatric Care, Adult Daycare, Home Care, and Emergency Care.

SONS is well known for advocating on behalf of Seniors. 
Our goals are:

  • To pursue all avenues of health support for our community no matter what the ages;
  • To have Seniors live in their community with support to keep them safe, independent, healthy, and happy;
  • To have a third house at Peace Villa which would accommodate a minimum of 60 residents, including a Daycare, to support recruitment and retention of NH Employees.

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JULY 2019

Eagle Valley Community Support Society (EVCSS)
SICAMOUS

A Profile, History, Roles and Partnerships
Our Mission Statement: To improve through education, the social, and emotional well-being of all members of the community, and to provide a place where services to support families and individuals are centralized and easily accessible.
Our Vision: To provide inclusive services and supports that enhance the social well-being of residents of Sicamous and its surrounding rural areas, regardless of age, gender, race, religious affiliation, or sexual orientation. To seek out, advocate for and apply for support services needed and to act as a partnering agency to enable others to successfully provide support services and programs of EVCSS and those of others whose services benefit the community.

Eagle Valley Community Support Society (EVCSS)was incorporated as a BC Society in 1992, and became a registered Canadian Charity in 1994. Its first program was resource and referral services and help with photocopying, faxing, form filling and applications. In 1995 the society expanded into children’s programs, in 1996 added a food bank and also began working with CRA to deliver the Volunteer Income Tax Program for low income households. During this phase EVCSS served as an umbrella organization for a local group of100 youth who fundraised to build a skateboard park, applying for grants and managing the funds that within 4 years built the Sicamous Skate Park, designed by and construction supervised by two local youth and a lead adult contracting on the project. So began their significant partnership role in the community and area….a role destined to grow.

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