Contents

1 Introduction2 Summary of Core health Services4 Core health Service categories and Inventory of Existing Services1. health Promotion/Education62. health Protection73. Prevention & Community 11 health Services4. Treatment, Emergency and 19 Diagnostic Services5. Developmental and 23 Rehabilitation Support Services6. Home-Based Care Services257. Long-Term Care268. Mental health Services279. Substance Abuse/Addictions3110. Palliative Care33 Implementing the Core health Services34 Contents2 IntroductionIn May 1992, Quality health for Manitobans The Action Planwas launched. Thishealth-policy document called for a renewal of the health -care system inManitoba and outlined the following goals:Over 13,000 Manitobans, including consumers, service providers, stakeholdersand members of the public, participated in discussing the plan and develop-ing implementation strategies.

2 The key message throughout the consultationprocess was that Manitobans wanted a greater say in how their health servicesare an effort to respond to this request, Manitoba health is in the process ofdecentralizing decision-making for health to regional governance authoritiesknown as Regional health Authorities (RHAs). The RHAs will have responsi-bility for regional health planning, within a provincial framework of aspect of the framework is core health ON NORTHERN/RURAL health RENEWALMANITOBA health GOALSnImprove general health status of all ManitobansnReduce inequalities in health statusnEstablish public policy that promotes healthnFoster behaviour that promotes healthnFoster environments that promote healthnProvide appropriate, effective and efficient health servicesnDevelop mechanisms to assess and monitor quality of care.

3 Utilization and cost-effectivenessnFoster responsiveness and flexibility in the health -care delivery systemnPromote reasonable public expectations of health carenPromote delivery of alternative and less expensive do we mean by core health services ?Core health services include the full range of health services now funded byManitoba health and to which all Manitobans must have access. If a corehealth service is not provided within a region, it must be available in anotherregion or through a program that serves the whole province. As is now thecase, not every service will be provided in every community in a health core health services will remain the primary responsibility of centralagencies or Manitoba health , as they can be more safely and efficiently admin-istered centrally.

4 Some responsibility with respect to these services may beassigned to RHAs. For example, specialized treatment services such as angio-graphy and radiotherapy will remain the responsibility of central agencies suchas the health Sciences Centre and the Manitoba Cancer Treatment andResearch Foundation, but the RHAs will be responsible for ensuring thatappropriate referral systems to these services are in place in their encompass the broad range of services needed to promote health , pre-vent illness and injury, facilitate diagnosis and provide treatment, care andsupport as required. They range from health education and promotion to pal-liation, and are provided for the entire life cycle, from preconception to list of core health services is a comprehensive continuum, which recog-nizes the importance of providing population health services .

5 These servicesare intended to improve the health status of communities and optimize thehealth of individuals and list specifies broad core health -service categories and some more narrow-ly defined required components within the categories . To meet the corerequirement, an RHA must ensure that specified services under each category(and, where applicable, under each more specific component) are provided ormade available to residents of the planning of health services incorporates the core health services , an ongo-ing Community health Needs Assessment (CNHA) and provincial objectivesand priorities. The CHNA involves the ongoing collection, analysis and inter-pretation of information about the health needs, strengths and resources incommunities.

6 The goal of the CHNA is to lay the foundation for evidence-based health planning. This will facilitate the selection and prioritization ofhealth policy, services and programs for the region, and ensure the needs of at risk (vulnerable) populations are , CHNAs are carried out in relation to selected groups and program and technical support is provided to communities throughconsultation, the provision of population health profiles and RHA will be required to conduct an ongoing, comprehensive CHNA forits health do core health services include?4 The core health services forNorthern/Rural Regional HealthAuthorities are as follows:1. health Promotion/Education2. health disease prevention and environmental health protection services Officer of health Services3.

7 Prevention & Community health health , pregnancy/childbirth and to of injury, chronic diseases and substance education4. Treatment, Emergency and Diagnostic services (acute and chronic care services ) health services5. Developmental & Rehabilitation Support childhood intervention6. Home-Based Care planning and for managing long-term care placement57. Long-Term personal care home care home services for residents with special care in personal care homes8. Mental health care crisis intervention stabilization housing and family rehabilitation, including vocational case care/treatment and public education services9. Substance and Palliative care in care in the homeMany of the core health service categories overlap.

8 Some programs that poten-tially fall under nutrition education, a core component of Prevention andCommunity health services , logically also fall under the component repro-ductive health , or the core service categories health Promotion and HealthProtection. For example, pregnancy outreach programs for high-risk mothersincorporate nutritional counselling, health education, substance abuse coun-selling, prenatal services and disease prevention. Thus, in many cases, it willnot be necessary for RHAs to offer independently administered programs foreach category or component. Instead, the emphasis should be on providingintegrated client services . 6 health promotion/education is the process of enabling individuals and com-munities to increase control over and improve their health .

9 It focuses onachieving equity in health by providing equal opportunities and resources toenable people to achieve their optimum health potential. This includesimproving life skills, encouraging healthy choices and increasing the oppor-tunities for individuals to make healthy choices. health promotion/educationactions deal with factors in social, economic, physical and other environmentsthat affect the health of promotion/education services will be required in every isexpected that public and professional education and community consultationwill be an integral component of services in every health PROMOTION/EDUCATIONCore health ServiceCategories and Inventoryof Existing ServicesThis section presents descriptions of the core health service categories and the components that will be required in every the description of each core health service category is an inventory of existing health services funded or operated by Manitoba list of existing services also shows the distribution of services .

10 Three levels are defined:nServices provided in most or all health regions (the services may be provided in one or many communities in a region);nServices provided in some communities refer to projects funded in individual communities; andnServices provided through a central site ( , Manitoba health , Manitoba Cancer Treatment and Research Foundation, health Sciences Centre, etc.).7 Provided in most or in all health regions:nPromotion of healthy lifestyles and practicesnSupport for community groupsnPromotion of smoke-free environmentsProvided in some communities:nHealth promotion in communities, schools and the workplacenHealth promotion with specific groups ( , seniors, multicultural groups, healthy communities, street youth)nHealth promotion for specific risk factors ( , tobacco control, heart health )Provided through a central site:nSupport to regions in areas of health promotion/education, research, planning and program development2.