Indigenous Transitions Facilitator

Indigenous Transitions Facilitator 126R4-24-3

Home and Community Care, Wellbeing

Full-Time

Applications will be received by Six Nations of the Grand River and Grand River Employment & Training (GREAT) up until the position is filled, for the Home and Community Care, Wellbeing department. The Six Nations of the Grand River Application for Employment Form, Job Posting and Job Description are available for printing from the www.greatsn.com website. Online applications accepted through My Job Search. NO LATE APPLICATIONS ACCEPTED. Applicants from Six Nations and other First Nations will be given preference to deliver programs and services in a First Nations community.

JOB SUMMARY: The Indigenous Transitions Facilitator reports to and works under the direction of the Manager of the Home and Community Care Program and the Director of Wellbeing.

To assist the Wellbeing Department in researching, developing, educating and developing strategies for improved discharges for aboriginal people from hospital to home.

System Navigation: Coordinate proactive continuity of care; collaborate referrals with circle of care partners; assist seamless care transitions and provider intersection.  Strengthen linkages in the delivery of comprehensive individualized wrap around services.  Ensure the early engagement of client identified caregivers in development of the care plan, and to determine any equipment, education or training they may require to support the client in their living arrangement of choice upon discharge.

*A competitive compensation package will be offered commensurate with qualifications. *

BASIC QUALIFICATIONS:

• Must be a Registered Nurse and in good standing with the College of Nurses of Ontario
• Minimum of two years’ experience in Case Management
• First Aid, CPR, and WHMIS certified or willing to become certified
• Must be familiar with relevant local and area services, hospital and community-based case management and health resources.
• Must be familiar with government funding and legislation related to public services
• Must be knowledgeable about Hodi:nohshoni culture and traditions

SUBMISSION PROCEDURE: (Choose one method ONLY):

Method #1:  Online

1. Please visit: My Job Search to access our job board and follow the directions to apply.
2. Please ensure all required documents are provided/uploaded with your application package, which include:
   1. Cover letter including your band name and number (if applicable). Please indicate in your letter how your education and experience qualifies you for this position.
   2. Recent resume clearly identifying that you meet the Basic Qualifications of this position as stipulated above.
   3. Copy of your education diploma/degree/certificate and transcript.
3. If you have any questions or need assistance please reach out to Eniola Owoso, HR Business Partner at 519-445-2223 ext. 5716 or via email at HRBP3@sixnations.ca.

Method #2: GREAT – Applications must include all of the following:

1. Printed, filled in and authorized Six Nations of the Grand River Application for Employment Form.
2. Cover letter including your band name and number (if applicable). Please indicate in your letter how your education and experience qualify you for this position.
3. Recent resume clearly identifying that you meet the Basic Qualifications of this position as stipulated above.
4. Photocopy of your education diploma/degree/certificate and transcript.
5. Place all documents listed above in a sealed envelope and mail to or drop off at:

 Indigenous Transitions Facilitator – Full Time – 126R4-24-3

                                         c/o Reception Desk

                                         Grand River Employment & Training (GREAT)

                                         P.O. Box 69, 16 Sunrise Court

                                         Ohsweken, Ontario N0A 1M0

POSITION DESCRIPTION – WELLBEING

POSITION TITLE:         Indigenous Transitions Facilitator

REPORTING RELATIONSHIP:

Reports to and works under the direction of the Manager of Home and Community Care Program and the Director of Wellbeing.

PURPOSE AND SCOPE OF THE POSITION:

To assist Six Nations Wellbeing to improve transitions of Six Nations community members between hospital, other care settings, and home.  The position will support the development of strategies to address gaps, education, and system navigation for home and community care services. 

 KEY DUTIES & RESPONSIBILITIES:

 Technical Functions:

• Review and revision of current discharge protocols, staff and programs involved in discharge planning
• Seek feedback and engagement from several internal and external stakeholders, including but not limited to administration, medical and nursing staff, hospitals, discharge planners, navigators
• Assess the outcomes of the current discharge plan, identify gaps in service and create an actionable plan for improvement
• Developing and implementing client service plans for the delivery of high-quality service and discharge planning
• Develop strategies for improved discharges for Six Nations community members from hospital to home

  Communication Functions:

• Collaborate with existing staff, discharge planners and other stakeholders to develop protocols and resources and increase engagement between agencies.
• Ensure the Service Plan is appropriate and required resources are available
• Advocate and assist clients in providing information, awareness and direction to promote independence and responsibility for their own care
• Ensure the early engagement of client identified caregivers in development of the care plan, and to determine any equipment, education or training they may require to support the client in their living arrangement of choice upon discharge.
• Attend meetings as assigned and required to allow open communication and dissemination of information.

Administrative Functions:

• Follow established reporting procedures as laid out by Six Nations Health Services
• Quarterly reports on progress, failed discharges, and outcomes of services by hospital and community as it relates to discharge provided to Health Senior Leadership
• Ensuring that the external institutions are aware of the resources of Six Nations and how to access them.
• Provides information and coordinates meetings as required for discharge planning
• Assist clients and their circle of care in case conferencing when necessary
• Develop and implement policies and procedures for improved discharge planning between hospital and home
• Regularly assess client care and discharge outcomes to ensure the right care is delivered to the right client at the right time
• Consider client safety and liability issues

Other Functions:

• Functions as a component of the Six Nations Health Services Home and Community Care Case Management Unit and Palliative Care Team which may include but are not limited to: On Call, attending rounds, and meetings with funders, Hospitals, Hospice, and other partners.
• Participate in the Community of Practice for Indigenous Transitions Facilitators.
• Performs other job-related duties as may reasonably be required by the Manager of the Home and Community Care Program or the Director of Health Services.
• Provides support for the Six Nations Emergency Measures Plan by ensuring awareness of the Emergency Measures Plan and assistance as instructed by the Director of Health Services
• It is the responsibility of the employee to be aware of and adhere to all policies and procedures, including those that relate to client safety, staff safety and risk management

WORKING CONDITIONS:

• External contact with referring agencies requires extensive interaction with the public and is subject to deadlines, interruptions, mental stress and unscheduled hours of work.
• Direct client contact, in the clients’ homes and the presence of the client in the office
• Some travel in and outside the community as required using their own transportation.

WORKING RELATIONSHIPS:

With the Manager/Director:

Receives direction, guidance, discusses plans, and priorities, or interacts to ensure tasks are done efficiently and effectively; receives instruction; and supervision.

Other staff:

Works closely with the Home Care Staff

Promotes courtesy, cooperation, and teamwork with all team members, respecting lines of authority.

With External Agencies  

Represents and promotes Six Nations interests relative to health services; maintains awareness of legislative policy and program changes; seeks to develop and maintain working relationships.

With the Public:

Represents and promotes the health services interests of Six Nations; develops positive working relationships with individuals, families, and leaders of the Six Nations Community; works in a courteous, cooperative positive, and proactive manner, provides information and advice.

KNOWLEDGE AND SKILLS:

QUALIFICATIONS:

• Must be a Registered Nurse and in good standing with the College of Nurses of Ontario
• Minimum of two years’ experience in Case Management
• First Aid, CPR, and WHMIS certified or willing to become certified
• Must be familiar with relevant local and area services, hospital and community-based case management and health resources.
• Must be familiar with government funding and legislation related to public services
• Must be knowledgeable about Hodi:nohshoni culture and traditions

   Other preferred requirements:

• Experience working at a system level including system navigation, and knowledge of relevant legislation
• Excellent written and verbal communication skills and public relations skills
• Proficiency in the use of computers and various software applications including electronic medical records and Microsoft Office
• Demonstrated experience working within a multi-disciplinary team
• Demonstrating the ability to understand the importance of confidentiality and the ability to work with tact and discretion.
• Demonstrated problem solving and critical thinking
• Capacity to work well with a team independently.
• Must have favorable vulnerable sector criminal record check
• The ability to speak an Indigenous language is an asset.
• Must have an insured vehicle and minimum Class “G” driver’s license.

IMPACT OF ERROR: 

Errors in judgment and in the conduct of duties could lead to loss of credibility, poor public relations, confusion, duplication of effort and misinformation being given to the Manager, Director of Health Services, Human Services Committee, Six Nations of the Grand River Elected Council, Government agencies and the public

CONTROL:

Guiding principles set by the Wellbeing Department and Six Nations of the Grand River Elected Council. Works within the administrative policies and procedures established by the Six Nations of the Grand River Elected Council for the Health Services Department and other legislation provided by the respective governments.