Introduction to Community Care

Erie St. Clair Community Care Access Centre

Introduction to Community Care

Outstanding care- every person, every day.

Table of ContentsWelcome ...................................................................................3

How can the Erie St. Clair CCAC help me? ......................................3

Connecting you to community services ..........................................4

How does my Care Coordinator partner with me? ............................5

What is a care plan? ...................................................................5

Your care journey .......................................................................6

CCAC Nursing Clinics ...................................................................6

When living at home is no longer possible ......................................6

Do I pay for Erie St. Clair CCAC services? ......................................7

What is MY role?.........................................................................7

How can my family and friends help? ............................................9

Patient and Family Advisors .........................................................9

Telemedicine ..............................................................................9

T.R.U.S.T. - Partnering for your care ............................................ 10

Patient Bill of Rights .................................................................. 11

Your Privacy ............................................................................. 12

Feedback, Complaints and Appeals ............................................. 14

Accessibility ............................................................................. 15

PATIENT SERVICES GUIDE | 3

Welcome

How can the Erie St. Clair CCAC help me?

The Erie St. Clair Community Care Access Centre (CCAC) is your guide for accessing home and community care. This booklet is designed to provide you and your family with information about the services available to you both in your community and through the Erie St. Clair CCAC. It also tells you about your role as the most important person on your care team.

If you have any questions or need further information, please speak with your Erie St. Clair CCAC Care Coordinator.

Cette brochure est disponible en français. Pour demander une copie, ou de demander des services en français, s’il

vous plaît contactez-nous au 1-888-447-4468.

The Erie St. Clair CCAC helps you access the care you need to reach your health goals. Not only does the Erie St. Clair CCAC provide a wide range of health care services to eligible patients, but we also know your community well and can help you connect to valuable supports and resources.

The Erie St. Clair CCAC helps patients to:• Connect with health information and community services;• Find a family doctor;• Attend school;• Get home from hospital;• Stay independently at home for as long as possible;• Find the right place to live if home is no longer an option;• Die at home if that is their wish;• And more.

In 2013/14, the Erie St. Clair CCAC served over

37,900 patients


We are fortunate in the Erie St. Clair region to have access to many community supports and services. Your Care Coordinator is knowledgeable in these services and can help you to access those supports that benefit your wellbeing. We work closely with agencies that provide:• Adult day programs (supervised programming in a group setting for dependant adults);• Meal delivery and community dining;• Home help and homemaking;• Seniors’ centres;• Exercise programs;• Respite care;• Transportation services;• Housing services;• Friendly visiting;• And much more!

You do not need to be an Erie St. Clair CCAC patient to access information about community health and social services. This information is available to everyone and can be accessed in one of two ways:

2. Call us at 1-888-447-4468Anyone can call the Erie St. Clair CCAC for information on health and social services in their community. Simply call 1-888-447-4468 between 8:00 a.m. and 8:00 p.m. to connect with us!

12

3

Go to www.eriestclairhealthline.ca.

Connect with the service of your choice!

Choose your region, enter your postal code or search by common health service categories.

Thousands of patients receive assistance through our information

and referral services

Connecting you to community services

1. Visit the Erie St. Clair Healthline


How does my Care Coordinator partner with me?

What is a care plan?

Your Erie St. Clair CCAC Care Coordinator is a compassionate, regulated health professional who may have a background in nursing, social work, occupational therapy, physiotherapy or speech therapy. As your health guide, he or she works with you and your family to:• Assess your needs;• Develop a shared understanding of your challenges and goals;• Answer your questions;• Determine what services you require;• Develop a care plan to meet your needs;• Connect you to community health and social services;• And improve your independence.

Your Care Coordinator will take the time to get to know you and understand your situation. Together, you will decide what help you need and make arrangements to access that help. Your Care Coordinator will help you to navigate the health system, check back with you regularly to see how things are going as you work towards your goals and adjust your care plan as necessary.

Based on your assessment, the Erie St. Clair CCAC may provide you with the following services:

Your Erie St. Clair CCAC Care Coordinator will meet with you to perform a comprehensive health assessment to determine your needs. Based on this regulated assessment, your Care Coordinator will work with you to develop a care plan. Your care plan describes your health care goals and which services, supplies and equipment you need to meet those goals. Your care plan may also include services from community supports or partners that may benefit you as you work towards your health goals.

Your Care Coordinator will check in with you regularly. He or she will regularly reassess your situation and your care plan will be adjusted as needed. If your health care needs change in between visits, please call your Care Coordinator. He or she will work with you to plan for the next phase of your care.

• Nursing;• Physiotherapy;• Occupational therapy;• Nutritional counselling;

• Speech therapy;• Social work;• Personal support;• And/or medical supplies and equipment.


Your care journey

CCAC Nursing ClinicsNot everyone needs to receive their care at home. Your Erie St. Clair CCAC Care Coordinator may connect you with a CCAC nursing clinic to receive IV therapy, wound care and/or other treatments. Erie St. Clair CCAC nursing clinics are staffed with professional nurses who partner to provide you with the care you need.

When living at home is no longer possibleWhen living safely at home is no longer possible, your Care Coordinator will work with you to explore your options. This may mean moving to a retirement home or long-term care home (LTCH).

Making the decision to move to a retirement home or a long-term care home is a life-changing step for you and your family. It is important that you have all of the information you need to choose the home that is right for you. Not only is your Care Coordinator a great resource in making this decision, the Erie St. Clair CCAC also produces a number of tools to provide information about both retirement homes and long-term care homes. This includes information booklets, wait times reports for long-term care and virtual tours of long-term care homes.

More information on these resources can be accessed on our website at www.healthcareathome.ca/eriestclair or by speaking to your Care Coordinator.

Contact us for information on health and social services in

the community

A care coordinator will assess your health care needs

We will connect you to the care you need,

at home and in the community


Do I pay for Erie St. Clair CCAC services?

What is MY role?

The services we provide to eligible patients are free of charge to those with a valid Ontario Health Card. The Ministry of Health and Long-Term Care provides the funding for these services.

However, there may be other costs associated with your care, such as:• Equipment: You may need to pay for a walker or other mobility aid.• Community programs: Your care plan may include a referral to a program in your

community that charges a fee, such as a meal delivery program.

There are supports available in our community for those with financial needs. Please discuss any financial concerns you may have with your Care Coordinator.

You are the most important person in your care team! It is important to recognize your role.

Partnering to achieve your health goals

YOUYour Family and Friends

Erie St. Clair CCAC

Community SupportServices

Hospital, Physician

and Other Health Professionals

YOU identify what is important to you and work towards achieving your health goals.

Family and friends assist where they are able (i.e. meal preparation, transportation, helping to care for you, etc.).

Hospitals, physicians and other health professionals work with you and the Erie St. Clair CCAC to help you receive the right care in the right place at the right time.

The Erie St. Clair CCAC partners with you, your family and friends, your other health care professionals and community supports to connect you with the best care possible.

Community Support Services work with you and the Erie St. Clair CCAC to ensure you are supported at home and in the community.


The best thing you can do is to be an active partner in your care. While your Erie St. Clair CCAC Care Coordinator is here to offer you help, support and guidance along the way, you are ultimately in charge of your care. Here are just a few of the ways that you can partner with us for your care:

• Set goals and work with us to move toward them;• Follow your care plan and take medications as directed;• Tell us if your needs or situation changes;• Be honest and open with your Erie St. Clair CCAC Care Coordinator and all health

professionals;• Tell us if a treatment hurts or makes you feel uncomfortable;• Tell us if you have any suggestions or concerns about your care;• Be ready for your appointment(s);• And let your service provider know at least 24 hours in advance if you have to reschedule

an appointment.

Talking to your health care professionalIt is important to understand what your doctor, nurse, therapist, pharmacist and/or other health care professional is explaining to your during visits. Here are some tips for communicating clearly:

• Before a visit, make a list of your concerns and questions;• Be sure you have answers to the following three questions:

• What is my health problem?• What do I need to do?• Why do I need to do this?

• If you don’t understand something, ask for clarification, and keep asking until you feel comfortable;

• Bring a family member or a friend to the appointment;• Bring all your medications and ask about side effects and interactions;• And take notes.


TelemedicineSupported by the Ontario Telemedicine Network (OTN), the Erie St. Clair CCAC’s telemedicine program utilizes video-conferencing technology to connect you to health practitioners across the province without the cost of travel. This technology provides for a convenient, private and confidential means to delivering health care. Ask your Care Coordinator for more information!

How can my family and friends help?

Patient and Family Advisors

Your family, friends, neighbors and community volunteers all play a role in your care. Here are some tips for making the best use of their help and support:

• Involve your family in discussions with your Care Coordinator and other health professionals, discussing how they can best help in your care;

• If friends offer to help, ask them to do specific tasks that are useful to you, such as taking the dog for a walk or picking up groceries;

• Don’t hesitate to say how you want things done;• And remember to express your appreciation.

The Erie St. Clair CCAC partners with our patients and their families to improve the quality of community care. Patient and Family Advisors (PFAs) provide a voice that represents all patients and families who receive care from our organization.

A PFA is a volunteer who has either received care or is a family member of someone who has received care from the Erie St. Clair CCAC within the past five years. PFAs volunteer approximately one to four hours a week by giving advice to the Erie St. Clair CCAC based upon their experience with the organization. They help to improve the patient experience by working with staff and providers on either short or long-term projects.

If you are interested in applying as a PFA, please speak with your Care Coordinator or visit www.healthcareathome.ca/eriestclair for more information.


T.R.U.S.T. - Partnering for your careTalk (communicate)

Respect

Understanding

Safety

Teamwork

T.R.U.S.T. is a philosophy followed by the Erie St. Clair CCAC, our service providers and our patients. This philosophy centres on the Erie St. Clair CCAC and our health care partners working together with you - the patient - as an active partner in your care.

Together, we will collaborate and communicate to provide you with the best quality, patient-centred care, ensuring that everyone’s role in your care is clear. In addition, we will work together to set your care goals and ensure there is a concrete understanding of your care plan, including the services being provided.

T.R.U.S.T. also guarantees the appropriate education is provided for the safety of you, as the patient, as well as those who provide your care. Together, we promote respect and cultural sensitivity for all members of the care team from patients to Care Coordinators to care providers.

As a partner, you: As a partner, CCAC and our health care partners:

• Need to know that violence will not be tolerated;

• And must not smoke tobacco or any other substance while we are in your home.

• Will respect you and our colleagues;• And understand that quality care delivery

includes cultural sensitivity.

• Will work with the CCAC to establish health goals and a care plan to meet your care needs.

• Will work with you and your family to establish goals and a care plan to help you meet your needs;

• And will work together to understand the care plan, ensuring your expectations are realized.

• Are encouraged to be an active partner in your care, including discussing your progress and suggesting changes to your care plan with your CCAC Care Coordinator or other health care professional(s).

• Will monitor your progress, revise your care plan and adjust your services accordingly;

• And will listen to you as an active partner in your care.


Patient Bill of RightsThis document summarizes provisions contained in the Home Care and Community Services Act, 1994, S.O. 1994, Chapter 26. Every person receiving service from the Community Care Access Centre has the right to:

• Courtesy and respect;• Dignity and privacy;• Freedom from mental, physical and financial abuse;• Individual autonomy;• Sensitive response to individual needs

and preferences (ethnic, spiritual, linguistic, familial and cultural factors);

• Information about the services being provided and by whom;

• Participation in the assessment of needs, the development of a service plan and the re-assessment, evaluation and revision of a service plan as indicated;

• Give or refuse consent for the provision of any community service;

• Raise concerns about or recommend changes to services provided without fear of interference, coercion, discrimination or reprisal;

• Be informed of laws, rules and policies affecting the operation of Community Care Access Centres;

• Be informed in writing of the procedures for initiating complaints about the Community Care Access Centre and/or the Service Providers;

• And confidentiality of personal and health information in accordance with the law.

E r i e S t . C l a i r C C A C

Declaration of Values

Th

e V

oic

e o

f O

ur

Pa

tie

nt

Th

e V

oi c

e o

f Ou

r C

CA

C

Dignity

Compassion

Communication

Accountability

Efficiency

Supporting my dignity is

showing me that you care.

I will feel your

compassion when

you listen to my story.

I feel better when I receive

clear communication about my care.

Accountability for

the trust I have placed in

you is important to me.

When the care I receive is

efficient, I can be more

independent.

We will demonstrate

respect for your dignity

and you will know that we

care.

Understanding your hopes

and desires will be central

to the care we provide.

By communicating

effectively, the care we

provide will have better

outcomes for you.

Having your trust is a

privilege; we will work

with you to responsibly

meet your expectations.

By being efficient we

will facilitate your

independence.


Your PrivacyWhat is Personal Health Information?Personal Health Information includes information about your health status, health history, health card number, eligibility for health-care services and care needs that includes identifying information about you, such as your name.

Protecting Your Personal Health InformationOntario’s health privacy law requires anyone providing health services to protect a patient’s personal health information. This means that the Erie St. Clair CCAC is obligated to tell you what we do with your information and, in certain situations, ask your permission before we get it, use it or give it out.

A health care organization such as the Erie St. Clair CCAC is only allowed to collect personal information that is necessary to provide care. We are also required to ensure that any personal health information is kept private and secure.

Implied ConsentWhen you receive health care from the Erie St. Clair CCAC, we assume that we have your permission to collect, use and share your personal health information among your health care providers. These health care providers have the same legal obligations to keep your personal health information private and secure.

In order to provide you with health care services, we share your personal health information with:

• Our contracted service providers (such as nurses, personal support workers, etc.);• Other external health care providers that assist in providing your care (such as hospitals,

physicians, long-term care homes, etc.);• And authorized CCAC staff.

The Erie St. Clair CCAC may make your information available to other health care providers through various communication channels such as by telephone, fax or secure electronic sharing systems.

Express ConsentThe Erie St. Clair CCAC cannot always assume that we have your permission to share your personal health information. For example, except where the law allows otherwise, we must ask for permission to give your personal health information to:

• People who do not provide you with health care, like a family member who does not havethe legal authority to act for you, a friend or an insurance company;

• Or health care professionals or providers who are not involved in your care.


When Your Consent is Not RequiredWe use and share your personal health information without consent for the following reasons:

• To process payments through government programs like the Ontario Health InsurancePlan (OHIP);

• To plan, administer and manage our internal operations;• For quality improvement activities;• For risk management purposes;• To comply with legal and regulatory requirements;• For research purposes (as long as strict privacy requirements are met);• For education and training purposes;• And to fulfill other purposes permitted or required by law.

Some laws permit the Erie St. Clair CCAC to disclose certain information without your permission. For instance, we may share your information in an emergency situation.

Your Rights and ChoicesYou, or someone who can make decisions about your personal care, have the right to:

• Receive a copy of your personal health information;• Ask us to make corrections to your record if there is inaccurate or incomplete

information;• Ask us not to give out your personal health information to other health care providers

(unless required or permitted by law);• Request that you are not contacted to participate in a satisfaction survey to help us

improve patient care;

• And be notified if your personal health information is stolen, lost or improperly accessed.

There are certain limited exceptions to these rights, so please contact us if you have any questions.

How to Restrict or Withdraw Your ConsentAs an Erie St. Clair CCAC patient, you have the right to restrict or withdraw your consent at any time. You should let us know if you do not wish for us to use or share your personal health information with certain health care providers. However, please note that this may make it difficult for us to provide you with the health care that you require. When we share your information with other health care providers, we are required to tell them when we think the information is inaccurate or incomplete, including when we think the missing information could affect the care you receive.


Privacy and Your AssessmentAs with other personal health information, you have the right to:• Tell us if you do not want us to share your assessment with other health service providers;• Request to see your own assessment at any time;• And/or ask for corrections or updates to your assessment record.

To learn how your assessment information is being used and shared, please contact our Privacy Officer at 1-888-447-4468 ext. 5333. If you wish to withdraw or change your consent to the sharing of your assessments in Ontario’s Integrated Assessment Record system, please contact the IAR Support Centre at 1-855-585-5279.

Contacting Us About PrivacyIf you have any questions about how we handle your personal health information, please contact your Care Coordinator by calling 1-888-447-4468. You may also raise any questions or concerns about privacy rights with our Privacy Officer at 1-888-447-4468 ext. 5333.

If you have a specific complaint and our Privacy Officer cannot resolve your concerns, you may wish to contact the Ontario Information and Privacy Commission by phone at 416-326-3333 (1-800-387-0073) or via their website at http://www.ipc.on.ca.

FeedbackThe Erie St. Clair CCAC’s vision is outstanding care – every person, every day. While working to provide the best possible care, we also want to provide the best possible service. We want to know how we are doing and welcome feedback of all kinds — compliments, concerns, complaints and all other inquiries.

Our programs and services are accessible to everyone in the Erie St. Clair community. Compliments, suggestions and complaints from our patients and their families are important to help us continually improve our programs and services.

To provide any type of feedback, please contact your Care Coordinator directly.

Complaints and AppealsIf you have a specific complaint about your care and the service we are providing please contact; 1. Your Care Coordinator directly or;

2. The Patient Relations Specialist at the Erie St. Clair CCAC at 1-888-447-4468 ext. 5378.

You can ask for an Internal Review if you are not satisfied with the CCAC’s decision about your eligibility for services and the exclusion, reduction or termination of a service. The decision will be reviewed by another staff person and you will receive written notice of the outcome.

Feedback, Complaints and Appeals


Following the CCAC formal review process, if you remain unsatisfied with the decision, you have the right to appeal that decision to the Health Services Appeal and Review Board (HSARB), if:• You are not eligible for services;• There is a reduction in the amount of service you are receiving;• There is an exclusion of a service from your plan of care;• And/or there is termination of a service.

Health Services Appeal and Review Board Contact: 1-416-327-8512

Accessibility for AllThe Erie St. Clair Community Care Access Centre is committed to providing accessible information and communication to all patients, employees, partners and the public. As such, we recognize that persons with disabilities may require information in accessible formats.

All documents required by the Customer Service Standar d and the Integrated Accessibility Standard Regulations (IASR) are available upon request, subject to the Freedom of Information and Protection of Privacy Act (FIPPA).

If you require any of our information in an alternate format, please contact us and tell us what you require. When submitting your request, please include the following information:• Your first and last name;• Email address;• Mailing address (optional);• Telephone number;• Fax number (optional);• Name of required document (s);• Format requested (including but not limited to: large print, hard copy, email, digital, Braille

translation. For digital or video requests, please indicate closed captioning or descriptivevideo);

• And date information is required. (Note: For closed captioning and/or descriptive video, werequire a minimum of two weeks’ notification per request.)

Accessibility Questions and ConcernsWe are committed to addressing the needs of those with disabilities. If you have any questions, comments or concerns about the accessibility of our facilities or if your specific needs were not met, we would like to hear from you. You may present your questions to the Erie St. Clair Community Care Access Centre in person or by mail, email or telephone.

Accessibility

Connect with us!

Web ResourcesErie St. Clair CCACwww.healthcareathome.ca/eriestclair• Information about the Erie St. Clair CCACErie St. Clair Healthlinewww.eriestclairhealthline.ca• Find health and social services in your areaCaregiver Exchangewww.caregiverexchange.ca• Information and inspiration for those caring

for a loved one

Erie St. Clair Local Health Integration Network (LHIN)www.eriestclairlhin.on.ca• The Erie St. Clair LHIN plans, coordinates,

integrates and funds health care services at the local level

Ministry of Health and Long-Term Carewww.health.gov.on.ca• About the Ministry and other health-related

resources, including how to find a family physician (Health Care Connect)

Mail: 712 Richmond St. P.O. Box 306, Chatham, ON N7M 5K4

Phone: 1-888-447-4468

TTY: 519-258-8092

Email: [email protected]

Web: www.healthcareathome.ca/eriestclair www.eriestclairhealthline.ca

Documents

Introduction to Community Care