cultural ceremonies and teaching, as well as health care referrals. Since the chiropractic clinic opened at MCC, Toth has received referrals from the Mothering Project. Mackenzie Kein, a registered nurse, is the primary health services manager at Mount Carmel Clinic and has been working with Toth for several years now. “The collaboration and cross referrals between our programs and available services bring a unique dynamic health approach for our clientele,” she comments. “We love that we have a chiro-practor under our roof to offer assistance to patients who are also challenged by addiction. “Some of our physicians have commented that patients who were taking opioid medications have required reduced dosages after seeing the chiropractor here.” Collaboration The province of Manitoba, via the department of family services, has fully funded the chiropractic clinic at MCC for six years, including the initial clinic set-up, capital costs and continued operations. The clinic’s chiropractor receives hourly wages regardless of the number of patients she cares The goal was to improve access and coverage of chiropractic services for low-income Manitobans. Outreach The MCC recognizes that health and well-being are achieved only in part by the provision of health care services. Health is determined by a combination of many factors such as: income level, employment status, type of employment, level of education and training, environmental conditions, social supports and contacts, healthy child development, and ac-cess to health-care services at all stages of life. The MCC strives to focus on the needs of people who are living with the effects of poverty, while working toward improvements in the health of the community through community development, early childhood development and care, primary health for the economically disadvan-taged and integrated programming. It provides quality services to meet professional standards, while maintaining strong external relationships with communities, associa-tions, businesses and government agencies. An example of this cooperative spirit is in the Manito Ikwe Kagiikwe/Mothering Project, which has been estab-lished in the MCC, but will eventually be housed in a new building that is still under construction. The program specifically serves any woman who is pregnant or who is early parenting a child under the age of three and who has a substance use problem. The outreach program provides one-on-one support, access to prenatal care, advocacy, www.canadianchiropractor.ca for. The hourly wage is set at the same rate of entry-level physicians. Toth is contracted to work two five-hour shifts per week. During the initial funding contract, the project was con-sidered to be a pilot project for the first three years. In the second funding contract – years four through six – the clinic shed the “pilot” title, and became a recognized clinic by the provincial government. Manitoba Family Services just recently approved an additional three-year contract begin-ning April 1, 2016 running through March 31, 2019. During hours of operation of the Chiropractic Care Program, Toth is on site at the MCC. She provides services, which include conducting an initial intake, case history, physical examination, providing a diagnosis, treatment – including supportive modalities when appropriate – and recording her findings and patient progress on the clinic’s electronic medical record program (EMR). The clinic uses the Accuro EMR system, developed by QHR Technologies Inc. in Kelowna, B.C. The same EMR system is utilized throughout the Winnipeg Regional Health Authority. Training on the EMR was lengthy but well worth it. “Our providers in the clinic share access to the entire patient file. Dr. Toth can see the treatment provided by the medical staff and she has access to lab work and special studies,” says Jay Bodner, director of primary health. “Our physicians have access to her intake history and narratives, May 2016 Canadian Chiropractor 31
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