Home and Community Care Support Services Champlain is one of 14 Home and Community Care Support Services organizations in Ontario. We are dedicated to ensuring our more than 64,000 patients annually receive the highest-quality health care and services at home. Our patient-care coordination teams help develop care plans for people of most ages, focused on maintaining each patient's independence and dignity. We also provide long-term care home placement services, and facilitate our patients’ access to the community-based services they need.

Position Summary:

Under the general direction of the Manager, Home and Community Care and in accordance with provincial and HCCSS Champlain standards, legislation, policies and guidelines, the Geriatric Assessor (GA) will be responsible for performing multi-dimensional assessments based on referrals from external and internal health care professionals and ensuring the appropriate follow-up is completed in a timely manner. The Geriatric Assessor is committed to the health and independence of seniors in the Champlain region and is the gateway for the admission of patients into local geriatric clinics. He/she also regularly co-ordinates and communicates with the Regional Geriatric Program of Eastern Ontario.

Primary Responsibilities:

• Based on a referral from a primary care physician or other health care provider, conduct pre-assessment via a telephone triage process to determine eligibility for programming and book a follow-up home visit if required.
• Perform a multi-dimensional assessment in the patient’s home which includes, but is not limited to: sensory pre-assessment, social and physical environment checklist, medical history report, medication review, functional (ADLS/IADLS), cognition, and caregiver concerns.
• Prepare suitable preliminary recommendations for services based on the outcome of each assessment and when necessary, facilitate a pre-consult with Geriatrician via telephone to obtain recommendation for services.
• Provide resulting assessment documentation to appropriate external contacts for admission to pre-arranged Geriatric Clinic(s).
• Support Geriatric Clinic and patient by attending the clinic with the patient and conducting appropriate follow-up calls and/or visits post clinic visit.
• Link and facilitate contact on behalf of the patient to appropriate community supports and services outside the scope of Specialized Geriatric Services.
• Discharge non-complex patients with little need for follow up from the GA caseload and advise them of the recall process.
• Process recall referrals via Telehealth as needed.
• Participation on internal and external committees as required.

Education and Experience:

• Registered Nurse (BScN or diploma) with a current Certificate of Registration from the College of Nurses of Ontario; or
• Degree or diploma in Physiotherapy and registered with the College of Physiotherapy of Ontario; or
• Degree or diploma in Occupational Therapy and registered with the College of Occupational Therapy of Ontario; or
• Degree in Social Work and registered with the Ontario College of Social Workers and Social Service Workers.

• A GNC certification is considered an asset
• A minimum of four (4) years’ experience in a community care setting that includes client counseling, case management and discharge planning with at least one year providing related geriatric assessment services
• Experience working with, collaborating and linking with other community health and social service agencies

Knowledge:

• Knowledge and understanding of the broader health care delivery system and community resources specific to Geriatric Services within the Champlain region
• Good knowledge of primary care services and other community resources in the HCCSS Champlain, as well as the roles of health care professionals
• In-depth knowledge of tools, systems, and databases used in client service delivery and management (e.g. UPP database; Internal Physician and client data base etc.)
• Knowledge of health care delivery system and community resources within the Champlain region
• Medical conditions and cognitive/psychiatric disorders
• Client centered, multi-disciplinary team approach to client care
• Proficient in the use of computerized processes including the use of mobile (laptop) technology

Skills and Abilities:

• Demonstrates effective time management and organizational skills
• Effective decision-making and problem-solving in crisis situations
• Ability to negotiate and implement an effective goal-oriented, client-centered care plan
• Team player with ability to accept and adapt to change
• Ability to maintain a positive attitude in stressful situations
• Ability to organize daily workload in the presence of frequent interruptions
• A valid Ontario driver’s license (or provincial equivalent) and access to a vehicle is required
• Fluency in English and French is an asset

Pay Rate: Wages are in accordance with the collective agreement between Home and Community Care Support Services Champlain and OPSEU and starting salaries range from $40.409/hr. - $43.169/hr.
Shift: Monday to Friday, 8:30am to 4:30pm
Location: 709 Cotton Mill Street, Cornwall ON

This position is temporary until approximately November 2024

All applications will be reviewed; however, only those selected for an interview will be contacted. Home and Community Care Support Services Champlain welcomes and encourages applications from people with disabilities. Accommodations are available on request for candidates taking part in any aspects of the selection process.

Home and Community Care Support Services has implemented a mandatory vaccination policy across the province that requires all staff to be fully vaccinated against COVID-19. Applicants being considered for employment will be required to provide proof of vaccination documentation confidentially to Human Resources upon hire. Any medical or human rights exemption requests will be reviewed and validated prior to an offer of employment.