Aohc annual report 2006 07 en

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‌keeping well

INCREASED CLIENT-CENTRED CARE ENSURES THAT EVERY DOOR WALKED THROUGH IS THE “RIGHT DOOR”

Leadership & growth to enhance Canada’s finest achievement – Medicare We have never given up on the original vision for Medicare, even in the face of heartbreaking setbacks, funding freezes and periods of seeming stagnation.

Welcome to AOHC’s 25th Anniversary Annual Report.

We celebrate by continuing to honour the original ideas and vision of Medicare’s founders, knowing that we are a key vehicle for the positive change Canadians want to see. We are taking our place in demonstrating concrete ways to realize Tommy Douglas’ original vision for the Second Stage of Medicare. And, we know that nonprofit, community-governed, interdisciplinary healthcare services such as those at Ontario’s CHCs, AHACs, and CFHTs are the type of solution needed to reclaim Canada’s position as a global leader in health and social development – the type of global leader that we became when we took that bold and courageous step forward to build Medicare in the first place.

First bold and courageous step Ontario’s CHCs, AHACs, and CFHTs are on the move, in the right direction, and part of a growing chorus. In fact, the AOHC family of members has nearly doubled in a year. This is a moment of growth that should rightly encourage all Ontarians.

AOHC and our members can proudly take our place with

those who have long called for increased local co-ordination of health care, for an increase in community involvement in the planning and delivery of services and for an integrated approach to care, illness prevention, health promotion and community capacity-building.

Our community-governed primary healthcare centres are the embodiment of Tommy Douglas’ idea that it is less expensive and more practical to keep people well than to fix them when they are sick.

Keeping people well At AOHC we have long incubated what Tommy Douglas referred to when he spoke of the need for increased “preventative medicine.” We have taken that vision to the next level. CHCs and AHACs have achieved excellence in developing and integrating the components of care and support required to keep people well and to avoid the onset of preventable complications. In doing so, we are with those who insist that health services must be universal and that health care must remain, in the words of Roy Romanow, a “moral enterprise, not a business venture.”

Our approach has always been bold and innovative. Our centres were the first to welcome Nurse Practitioners to our teams of other health providers, physicians and social workers.

And, we have always advocated locally-elected, community-based boards of directors as an essential vehicle to ensure that services and programs are responsive and customized to local needs.

Up toward the next stage In this special 25th Anniversary Annual Report you will see that we have never given up on the original vision for Medicare, even in the face of heartbreaking setbacks, funding freezes and periods of seeming stagnation. AOHC members have made both bold and gradual shifts in awareness. Like climbing a spiral staircase, we have not just gone round and round, we have climbed upward toward the next stage.

As we look to the future, we see how investing in population health and developing a primary healthcare-led system can halt the glaring disparities between different

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population and community groups. Key to this is the provision of services that are structured and designed to eliminate system-wide barriers to access such as poverty, geographic isolation, ethno- and culturo-centrism, racism, heterosexism, language discrimination, ableism and other harmful forms of social exclusion.

We will continue to build co-operation at the community and neighbourhood level, with empowered networks of local agencies, providing articulated primary health care to the specific and changing needs of the communities they serve.

Community capacity-building Just as reading, writing and arithmetic are the fundamental skills for opening doors to further learning, the

services we offer are essential tools for improving timely, accessible care, community health and community capacity. We will continue to do this in partnership with other local agencies that share a commitment to these grounding principles.

At this 25th Anniversary, AOHC recommits to increased client-centred care and to ensuring that every door that a person walks through is the “right door” to access or to be guided to the services they need. We will keep calling on governments, health authorities and health providers to be more proactive and responsive to diverse individual and community needs. We will continue to use best practices to inform healthcare interventions, for illness prevention and treatment. We will also aim to make better use of information technology, including electronic health records, so that healthcare providers can provide the most accurate and integrated care and support possible to clients.

We at AOHC will persevere in our efforts to improve Ontarians’ health, building more integrated, responsive and effective care and support within a Second Stage of Medicare framework.

Recommitment With our 25th Anniversary recommitment to non-profit, single-tier, interdisciplinary and community-governed primary health care, we continue to call on federal and provincial governments to confirm Canada’s commitment to health care as a moral enterprise, not as a business venture. Canadians, in the end, will accept no less.

And for that we are truly grateful.

France Gélinas, President

Adrianna Tetley, Executive Director

milestones This timeline documents the emergence of the community-based health movement in Ontario. It tells the story of our sector’s development, noting significant moments in our work for primary health care: keeping people well in our communities.

Tommy Douglas and the provincial Co-operative Commonwealth Federation government implement hospital insurance in Saskatchewan.

Saskatchewan implements medical insurance.

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1947

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1962

First Ontario CHC Group Health Centre (Sault Ste. Marie)

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Justice Emmett Hall’s federal Royal Commission recommends medical insurance as well as coverage for homecare, pharmacare and other services.

Lester Pearson’s Liberals pass the Medical Care Act, covering doctors and hospitals.

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1964

1966

membership nearly doubles in a year

Helen is a Board Member on the Greater Fort Erie Health Services Corp. She says that her emerging group received many concrete tools like templates, up-to-date information, guidelines and standards. But equally important, AOHC gave the group moral support.

From accountability to bellwethers of social change: community development & governance

“You inspired us and motivated us to keep at it, despite the frustrations that we were experiencing. You shared our desire to bring this new collaborative way of delivering health care to our communities,” Helen says.

AOHC

“Thank you for persevering with us, for empathizing with our growing pains, and for showing genuine interest in the needs of our communities.”

Good news travels fast. News of a new Community Health Centre coming to town spreads like wildfire through networks of local agencies, organizations, schools, faith-based institutions and, above all, neighbourhoods.

In 2006, AOHC’s Emerging Group Team worked in a consulting capacity with a number of emerging Communitygoverned Family Health Teams (CFHTs) and Community Health Centres across the province. The work has lead to nearly a doubling of our membership and the growth of dynamic local teams committed to community governance.

Of the 25 new CFHTs, 21 are now emerging or full members. Of the 21 new Community Health Centres (CHCs), slightly more than half have signed on as emerging group members.

“It has been an exciting year in which we have had mul-

Centretown CHC (Ottawa) opens its doors with the support of Provincial Ministry of Health and Federal LIP and OFY funding.

tiple opportunities to say ‘Welcome to the family!’” says Lee McKenna, Provincial Coordinator, Emerging Group Team.

The massive expansion in community-based primary health care in Ontario, a series of Community Forum Days and other events have now connected a diversity of people in communities from Ottawa, Cornwall and Sturgeon Falls to Windsor, Tilbury and Midland. One of the thousands of Ontarians is Helen Clarke from Port Colborne, who heard about the centrality of community governance to the CHC/CFHT model.

Communities, like Helen’s, responded well to the invitation to serve on interim steering committees and boards to guide their new CFHT or CHC through its pre-operational phases. AOHC worked hard to ensure that all emerging CHC Interim Steering Committees truly represented their proposed priority populations.

Flemingdon Health Centre (Toronto) and Somerset West CHC (Ottawa)

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1969

1972

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1973

1974

The months on the road presented AOHC with many clarifying moments. Questions occurred, like the meaning and value of community governance and about what was actually going on in CHCs across the province.

After addressing the question in a survey, AOHC now has a much clearer idea of the current practice, history and evolution of community boards as well as the benefits of community governance – from meeting the needs of diverse communities, to improved health outcomes, to strong financial management, to sustainability.

Sandy Hill CHC (Ottawa) York Community Services (Toronto)

Lawrence Heights CHC (Toronto)

Regent Park CHC (Toronto)

When Community Forum Days or other events failed to attract participation, the AOHC Team dug deeper, sought invitations to talk and to listen in soup kitchens, youth drop-in centres, seniors’ residents, Francophone services coalitions, homeless shelters, women’s shelters, places of worship and First Nations friendship and healing centres.

Ministry considers Community Health Centres (CHCs) and Community Health Service Organizations (CHSOs) as experimental pilots.

HSOs are funded through capitation payments.

CHCs receive program funding.

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1975

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Emerging voices speak

AOHC was there to encourage us, provide resources and expertise and assist with the writing of our Business Plan.

The leadership that AOHC has shown in reaching out to community-governed FHTs cannot be matched by any other organization.

KAREN SMITH, CHAIR OF THE BOARD, TILBURY FAMILY HEALTH TEAM

Several of us probably would have given up the long hard quest to marry our two communities in this project had it not been for your moral support and encouragement.

BARBARA HUNT-NAYKALYK, PORT COLBORNE, VICE-CHAIR, GREATER FORT ERIE HEALTH SERVICES CORPORATION

The speakers you sent us were all excellent. You advocated with us and for us with the politicians to great effect.

Most of all it is you, the people who really believe in the CHC primary health care model, who make AOHC work.

GEOFFREY HARRISON, PORT HOPE COMMUNITY HEALTH CENTRE

The greatest benefit to being a member of AOHC, as an emerging community-governed Family Health Team, has been the co-operative support and networking that is genuinely-offered and freely-shared.

JOYCE ZUK, CHAIR OF THE BOARD, WINDSOR FAMILY HEALTH TEAM STEERING COMMITTEE

Steering committee for the Niagara Falls CHC Emerging Group. Front (L-R) David Nicholson – Vice-chair; Al Lucian; Renni Piscitelli – Chair. Back: (L-R) Keith Eady; Lee McKenna – Provincial Co-ordinator, AOHC Emerging Group Team; Sheila Hoskins; Joyce Morocco; Wendy Jones; Keisa Campbell – AOHC Emerging Group Team member.

AOHC has been for us like a parent, ever present, at the end of the phone or e-mail, to provide a caring tone and supportive direction in assisting me to arrive at the right decision.

EILEEN MOUNTAIN, PORT HOPE CHC

LAMP CHC (Toronto) South Riverdale CHC (Toronto)

• 1976

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Provincial government freezes funding to Community Health Centres.

Dr. Michael Rachlis of South Riverdale CHC invites Dr. John Hastings to address founding Convention of Community Health Centres of Ontario. The emerging organization was called the Provincial Association of Health Service Organizations.

S.O.S. Medicare Conference is organized by the Canadian Labour Congress with the participation of Tommy Douglas, Emmett Hall & Monique Bégin.

Ontario Minister of Health, Larry Grossman announces that CHCs and CHSOs are officially a program and part of mainstream health care services. Targets are set for growth across the province. Financial support is provided for the creation of the Association of Ontario Health Centres (AOHC).

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1977

1978

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1979

1982

We have had multiple opportunities to say

“Welcome to the family!”

AOHC provided information in terms of research literature, templates, worksheets, guidelines, manuals and other materials that supported each stage of the CHC’s development. AOHC’s collaborative and facilitative leadership style allowed for the community’s understanding about CHCs and its role(s) within this new CHC to grow over time, especially the development of innovative programs to meet the complex needs of this socially and culturally diverse community.

ELAINE KACHALA, MEMBER OF THE STEERING COMMITTEE FOR BRAMALEA COMMUNITY HEALTH CENTRE, CONSULTANT, PLANNING AND INTEGRATION, CENTRAL WEST LOCAL HEALTH INTEGRATION NETWORK

Our community engaged the consulting services of AOHC’s team to facilitate the Community Engagement process . . . The detailed report findings and recommendations will serve us extremely well as we move towards the opening of the Bramalea Community Health Centre in 2007-2008.

AOHC provides information to support each stage of CHCs’ development. Sophie Bart, Emerging Group Team

RAYMOND APPLEBAUM, EXECUTIVE DIRECTOR, PEEL SENIOR LINK, A SPONSORING ORGANIZATION FOR THE NEW BRAMALEA CHC.

The philosophy of AOHC of getting strength and involvement from the community as the way to guarantee meeting local needs was the main reason why our FHT chose full membership this year.

One of the benefits of AOHC membership is the opportunity to bring staff to present to meetings of clubs and so on in Niagara Falls. The more I hear Lee McKenna speak, the better understanding I have of the CHC role in promoting primary health care in Ontario.

TREENA LEMAY, PRESIDENT OF THE BOARD OF DIRECTORS, PETAWAWA CENTENNIAL FAMILY HEALTH CENTRE

RENNI PISCITELLI CHAIR, STEERING COMMITTEE, NIAGARA FALLS COMMUNITY HEALTH CENTRE

The AOHC officially incorporates to promote primary health care and health promotion programs in Ontario. Don MacLean (Hamilton) becomes AOHC’s first President.

Back (L-R): Lee McKenna – AOHC Provincial Coordinator, Emerging Group Team; Mary Chudley – Emerging Group Team (Maternity Leave); Katie Taylor – Board, Tilbury District FHT. Front: Sandy Sheahan – Emerging Group Team; Leslie Sorensen – Med-Emerg staff, and Karen Smith – Board Chair, Tilbury District FHT.

Planned Parenthood of Toronto (CHC)

The Trudeau Liberals pass the Canada Health Act that prevents provinces from allowing hospitals or physicians to charge user fees.

One of the most important things that AOHC is offering in its community engagement work is consistency in the development of these CHC. This is so critical to the CHCs and so good for us to know that we have a high standard product that is being developed consistently across the region.

1st rural CHC Merrickville CHC Parkdale CHC (Toronto)

GEORGINA THOMPSON, CHIEF EXECUTIVE OFFICER, SOUTH EAST LOCAL HEALTH INTEGRATION NETWORK

12 CHCs serve approximately 29,000 Ontarians.

Joe Leonard (LAMP) succeeds Les Lee (Hamilton) as AOHC President

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1983

1984

1985

1986

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Ten new satellites announced in 2004

21 * new CHCs announced in 2005

East

East

Street Health (Kingston) • Whitewater Bromley & Rainbow • Valley sites (Renfrew County)

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GTA • •

Dixie Bloor (Mississauga) Scarborough West Community Health

North •

Kirkland Lake (Temiskaming)

South West LIHC North East (London) CHC • North Dumfries Twp • Sandwich CHC Satellite (Windsor) • Wellesley • West Lambton CHC (Sarnia) •

Belleville CHC • Brock CHC • Port Hope CHC • Sea Valley CHC (Cornwall)

GTA Bramalea CHC • TAIBU CHC (Toronto) • Vaughan CHC •

North CSC Sturgeon Falls CHC • CSC Sudbury East CHC • Kapuskasing CHC •

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1987

25 New Community Family Health Teams (CFHTs) announced in 2005-06

The first seven on the following list are in Toronto neighbourhoods, established in response to urgencies cited in the 2005 United Way Strong Neighbourhoods report.

East

Crescent Town Don Mills Finch • Gooch-Cooper Mill • Jamestown • Junction High Park • Weston Mount Dennis • York Centre • •

Centre de santé Chigamik CHC The People's Place/ La Place du peuple • Chatham Kent CHC • Fort Erie/Port Colborne CHC • Grand River CHC (Brantford) • Greater St. Catharines CHC • Markdale CHC • Niagara Falls CHC • South Georgian Bay CHCs (Collingwood) • St. Thomas CHC • Woodstock CHC •

CANES FHT (Etobicoke) Carefirst Seniors FHT • Sherbourne FHT • •

Bourget Napanee • Nepean • Smiths Falls • Trenton •

North

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• 1988

Dilico FHT (Aboriginal) East End FHT (Timmins) • Red Lake/Ear Falls FHT •

South West

GTA

North •

Thunder Bay (First mobile satellite)

South West • •

Six Nations of the Grand River FHT (Aboriginal) • Tilbury District FHT • VON Sauble Beach FHT • Bluewater FHT (Grand Bend) • Chatham Kent FHT • Delhi Community FHT • East Elgin FHT • East Wellington FHT • Harrow FHT • Huron FHT (Seaforth) • Rapids FHT (Sarnia) • Windsor FHT •

Kipling Dixon (Toronto) • Milton • Pickering •

Shelldale Wallaceburg

Country Roads CHC (Portland) Davenport Perth CHC (Toronto) Kingston CHC NorWest CHC (Thunder Bay) South East Ottawa CHC

1st clinical teaching CHC North Hamilton CHC

Algonquins of Pikwakanagan FHT (Aboriginal) • CPHC Brockville FHT • CPHC Gananoque FHT • Equipe de Santé Familiale d’Ottawa-Est • Fenelon FHT • North Hastings FHT • Petawawa Centennial FHT •

GTA

East

South West

* Location of one additional CHC to be determined by MOHLTC

Premier David Peterson announces intent to double the number of Ontario residents receiving primary health care through alternative funding arrangements within five years. CHCs begin to thrive.

18 New CHC satellites announced in 2005

1st Aboriginal CHC Anishnawbe Health (Toronto)

Access Alliance Multicultural CHC (Toronto) Black Creek CHC (Toronto) London InterCHC Mary Berglund CHC (Ignace)

1st Francophone CHC Centre Francophone de Toronto

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1989

1989

Towards an anti-oppression framework After struggling for many years with the issue of implementing initiatives to address systemic patterns of racism, homophobia/heterosexism and ableism, AOHC is now meeting with members to discuss embedding the new framework in all aspects of its governance policies, processes and practices.

“We are seeking to foster an AOHC Board that is reflective of our membership and inclusive of racialized and minoritized groups,” says AOHC Executive Director Adrianna Tetley. “It is critical to change core organizational culture, institutional structures and personal attitudes to ensure optimum organizational effectiveness and membership accountability.”

Reviews of current literature and environmental scanning indicate that much organizational development work focuses on diversity and inclusion at an operation level only and that few membership associations purposefully address issues of oppression in governance.

Growing with AOHC toward the Second Stage of Medicare and the Anti-oppression Framework since 1991.

The AOHC’s new Anti-oppression Framework, which acknowledges the pervasiveness and impact of racism in society at large, also recognizes that Aboriginal and Francophone communities have distinct and specific histories, needs, legal rights and constitutionally-protected rights.

Cory LeBlanc, Office Manager (Maternity Leave) with son Daniel (6) and 11-month twins Matthew and Nicole.

“You are on the right track, don’t get sidetracked” and “Thanks for taking the risk!” are some of the membership responses to the AOHC’s new Anti-oppression Framework, adopted by the Board in February.

Pinecrest Queensway CHC (Ottawa) Sandwich CHC (Windsor) Teen Health CHC (Windsor) Women's Health in Women's Hands (Toronto) Woolwich CHC

The current AOHC initiative is being viewed as groundbreaking by other organizations who are interested in adopting and implementing similar processes.

Peter Scott (Parry Sound) becomes AOHC President.

Barrie CHC East End CHC (Toronto)

31 CHCs serve 110,000.

The AOHC Anti-oppression Framework includes the following two new words used by the Ontario Human Rights Commission to further anti-oppression practice in all aspects of its governance policies and processes.

Racialized: Race is a social construct, not a biological trait. Biological notions of race have been discredited, but the social construction of race remains a potent force in society. The process of social construction of race is termed “racialization.” The Report of the Commission on Systemic Racism in the Ontario Criminal Justice System defined “racialization” as the process by which societies construct races as real, different and unequal in ways that matter to economic, political and social life.” When it is necessary to describe people collectively, the term “racialized person” or “racialized group” is preferred over “racial minority”, “visible minority”, “person of colour” or “non-White” as it expresses race as a social construct rather than as a description based on perceived biological traits.

Minoritized: The term “minoritized” acknowledges that social, economic, cultural and political factors serve to actively and systemically disadvantage, oppress and marginalize, thus “minoritizing”, specific categories of people in relation to more privileged and or dominant groups, i.e., women, Gay, Lesbian, Bisexual, Transgendered, Trans-sexual, Two-spirited, Inter-sexed and Questioning (GLBTTIQ), among others.

Carlington Community & Health Services (Ottawa) CSC l'Estrie (Cornwall) CSC Sudbury

The Ministry of Health issues a moratorium on HSO development. The OMA wins the right to negotiate on behalf of the HSOs and all but 3 HSOs cease membership in AOHC.

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1990

1991

Four Villages CHC (Toronto) Gateway CHC (Tweed) Guelph CHC Oshawa CHC

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Taking action on Aboriginal health AOHC has a clear ongoing commitment to support Aboriginal health centre members and to make a lasting impact on access to Aboriginal-led, culturally-competent, and community-governed primary health care for First Nations, Métis and Inuit communities. It is a matter of justice and equity.

Anita Cameron, Executive Director of the Aboriginal Health Access Centre in Kenora, says that a major change has happened.

“In the past, although Aboriginal presence was invited, our participation was largely token.”

Aboriginal health centre members continue to provide leadership in advocating for their communties.

“There was very little reciprocity and very little in the AOHC advocacy agenda that reflected the urgent needs of Aboriginal communities.”

Scott Wolfe, AOHC Senior Policy Analyst

the Ministry of Health and Long-Term Care as a critical stakeholder group. Beginning in 2007-08, we will take a permanent seat on the Aboriginal Health Council that will advise the Minister on matters related to Aboriginal health and LHINs.

Anita says that somewhere along the line it has changed and that now it feels like AHACs are really being heard.

In 2006-07, AOHC and its Aboriginal centre members (two Aboriginal CHCs, nine Aboriginal Health Access Centres, and two Aboriginal Community Family Health Teams) made important strides in this direction.

In 2006-07, AOHC also moved forward on advocacy for equity between AHACs and other primary care models and submitted a policy paper to the Ontario government called Fulfilling the Vision of the Aboriginal Health Policy for

AOHC moved closer to developing an Aboriginal primary health care network, and are now acknowledged by

Anne Johnston Health Station (Toronto) CSC Hamilton/Niagara Stonegate CHC (Toronto) West Hill CHC (Toronto)

Rosana Pellizzari succeeds Mauricio Perez (Toronto) as AOHC President.

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1991

1992

Lanark Health & Community Services Rexdale CHC (Toronto)

• 1993

Denise Albrecht, former Sandy Hill ED, becomes AOHC President.

Ontario: Recommendations to Eliminate the Second Class Status of Ontario’s AHACs. Important increases in mental health funding for a number of Ontario’s AHACs and Aboriginal CHCs and development of a new Aboriginal mental health planning table were realized.

Looking to 2008, AOHC and its Aboriginal health centre members will continue to provide leadership in advocating for the communities they serve.

Misiway CHC, an Aboriginal CHC (Timmins)

First Pan-Canadian CHC Conference takes place in Winnipeg.

After a joint AOHC Ministry of Health Strategic Planning and Evaluation Project of the CHC Program, Health Minister Ruth Grier announces Strategic Directions for the CHC Program. This leads to the approval of eight new CHCs.

Local Health Integration Networks (LHINs) A healthier landscape of local health care services AOHC’s LHIN Action Group is pro-actively defining the potential benefits of LHINs in Ontario’s new health system landscape.

paper calls on the Ontario government to build a responsive system that meets the needs of clients accessing care at different entry points.

Since 2005 we have called on the expertise of member centres and made numerous recommendations to the MOHLTC, and to LHINs themselves, to ensure that the principles and vision of interdisciplinary, community-governed, not-for-profit primary health care are upheld as Ontario transitions to this new stage in the history of its health system.

Significantly, AOHC members have secured permanent seats on LHIN advisory councils, giving Francophone and Aboriginal communities stronger voices.

We have submitted relevant and useful briefs, position papers and fact sheets, including Planning Primary Health Care for Ontario: Moving from Patchwork to System, Checklist for Review of LHIN Integrated Health Service Plans and regular updates in AOHC’s e-letter LHINtegration. These are helping guide the MOHLTC and LHINs to develop and refine their various policies and strategies.

In partnership with the Ontario Community Support Association and Ontario Federation of Community Mental Health and Addiction Programs, we have also tabled a discussion paper called EVERY DOOR LEADS TO SERVICE: Enhancing Access and Building a Culture of Service Integration for a Made in Ontario Health System. The

West Elgin CHC

• 1994

After an Auditor General’s report, Ontario freezes funding for the creation of new centres until CHCs are able to collect and submit data to demonstrate their purpose and effectiveness as a provincial program. The Evaluation Framework for the CHC program is developed.

LHIN Transition Fund Projects

New to AOHC and Medicare’s Second Stage Corinne Christie, Receptionist

The following four priorities for transition to LHINs were adopted at the February 2007 CHC Provincial Executive Directors’ meeting: – strong visual identity with CHCs and common messaging; – retention and recruitment strategy that focuses on fair and equitable compensation and entrenches the salaried model; – First Annual CHC report for LHINs; and, – a CHC sector chronic disease prevention and management strategy.

10 Aboriginal Health Access Centres are announced. AHACs are funded through the Aboriginal Healing & Wellness Strategy and integrate traditional health practices into the CHC model.

Creating a strong, united CHC visual identity and common messaging Over the next few years we believe that a shared brand identity will enhance our opportunity to grow It is AOHC’s goal to ensure every community in Ontario has access to the type of services we provide.

To varying degrees, most of the existing CHCs have already developed individual brand identities as models of care.

The CHC sector as a whole, however, is not yet there.

AOHC hosts the Second Pan-Canadian Conference of CHCs in Toronto. The Canadian Alliance of Community Health Centre Associations (CACHCA) is created to improve health services across the country as a cost effective method for providing primary health care.

Barbara Black Centre for Youth Resources (Oshawa) CSC Temiskaming North Lambton CHC (Forest)

N’Mninoeyaa Community Health Access Centre (North Shore Tribal Council)

• 1995

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Since AOHC believes the absence of this unifying brand identity is an obstacle to growth and recognition, we have hired Scott Thornley and Company to develop a strong CHC sector visual identity with a complementary logo, a tag line, a visual look and messaging for release in the spring of 2008.

The following CHCs have contributed approximately $270,500 towards achieving the goals identified in the four priority areas.

Anne Johnston Health Station

Fair and equitable compensation for all CHC staff

Barbara Black Centre for Youth Resources

The ability of CHCs to retain and recruit staff is imperative. AOHC is currently developing compensation strategies to meet the needs of all staff in CHCs. As well, specific strategies are being developed for physicians and nurse practitioners. The following three-point retention and recruitment strategy strives for equity: – CHC staff receive fair and equitable compensation, including salaries and benefits, as compared to other primary care models; – Compensation models support the integrated model of care; and, – Compensation includes internal and external equity.

First Annual CHC Sector Report The LHINs have been requesting a variety of information from individual CHCs. The goal of this project is to produce a first annual CHC sector report for LHINs that will be delivered in September 2007.

CHCs and Chronic Disease Prevention and Management

Barrie CHC Centre Francophone de Toronto

Putting CHCs on the Chronic Disease Prevention and Management map. Lisa Tisdel, Administrative Assistant

Unfortunately not enough people know about the tremendous potential that CHCs have to contribute to this province’s Chronic Disease Prevention and Management Strategy.

Although many of CHCs have developed chronic disease management and prevention programs, the CHC sector has not as yet developed a shared strategy to frame our work in this area. To this end, we are planning to document the work we are doing and to better coordinate our efforts across the province.

Merrickville District CHC. North Hamilton CHC North Lambton CHC NorWest CHC Pinecrest Queensway CHC Planned Parenthood Toronto

Centretown CHC

Regent Park CHC

Country Roads CHC

Rexdale CHC

CSC l'Estrie

Sandwich CHC

Davenport Perth CHC

Sandy Hill CHC

East End CHC

Somerset West CHC

Flemingdon Health Centre

South Riverdale CHC

Four Villages CHC

Stonegate CHC

Gateway CHC

Sudbury CSC

Hamilton Urban Core CHC

West Elgin CHC

Kingston CHC

West Hill CHC

Kitchener Downtown CHC

Women's Health in Women's Hands

Lang's Farm CHC London ICHC

Woolwich CHC

Mary Berglund CHC

Thanks to all for supporting our LHIN Transition Work.

The purpose of this project is to put CHCs on the Chronic Disease Prevention and Management map.

Kanonhkwa’tshero:io AHAC (Cornwall)

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Charlotte Rosenbaum (Kingston) becomes AOHC President.

Central Toronto CHC Hamilton Urban Core CHC

Langs Farm CHC (Cambridge)

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1996

1997

The Federation of local Community Health Centres (CLSC) of Quebec organizes the first international CHC conference in Montreal. 1200 representatives from 34 countries attend. Sponsors include the World Health Organization (WHO), the Organization for Economic Co-operation and Development (OECD) and the World Bank.

Pat MacLean (Woolwich) becomes AOHC President

Noojmowin Teg Health Care Centre (Manitoulin Island) Southwest Ontario AHAC (London)

Growing Primary Health Care Research and Evaluation Loralee Gillis, AOHC’s Manager, Research & Evaluation knows that many find it difficult to get excited about evaluation and indicators. She says, however, that they are absolutely critical for success. Although research and evaluation often moves at a much slower pace than policy work, Loralee always keeps the long-term view in mind.

Together they contribute to sector accountability and provide a great foundation for a succinct framework to describe the work that the community health sector does, as well as the contributions the sector makes to the broader system.

Often the community health centre model is compared to other models on purely anecdotal information. Our current work helps us to collect the data we need to compare ourselves fairly to other models and to document the unique role that we play in the health care system.

This year AOHC produced three new publications – Connecting the Dots, Options for Consensus and Evidencebased Indicators and Proposed Results-based Logic Model to Support Performance Measurement, Accountability and Evaluation.

Connecting the Dots proposes a limited number of domains, which are common to the our sector’s Strategy Map,

De dwa da dehs dye>s AHAC (Hamilton) Gizhewaadiziwin Access Centre (Fort Frances) Wabano Centre for Aboriginal Health (Ottawa) Wassay-Gezhig-Na-Nahn-DahWe-Igamig AHAC (Kenora)

Third Pan-Canadian Conference hosted

by British Columbia’s CHCs takes place.

Collecting and analyzing data that lets us fairly compare models of care and document our unique role. Loralee Gillis, AOHC Manager, Research & Evaluation

Accountability Framework, and Evaluation Framework, as well as the MOHLTC System Strategy map and the MOH Primary Health Care Strategy Map. Options for Consensus and Evidence-based Indicators provides a menu of possible indicators for each of the domains identified in Connecting the Dots. All of the included indicators are both evidence-based and selected through a consensus process. It is AOHC’s plan to use these “menus” to identify a common set of indicators for our sector next year.

AOHC forms an independent Community Organizational Health Inc. COHI owns and administers an accreditation program called Building Healthier Organizations for community-governed health and social service organizations.

AOHC forms a self-administered Group Benefits plan for members.

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Proposed Results-based Logic Model to Support Performance Measurement, Accountability and Evaluation provides a revised Logic Model for our sector, one that is consistent with both the Strategy Map and Accountability Framework.

On another front, AOHC has received funding from the Wellesley Institute in Toronto to develop a database of CHC Research. The database is available on our website, and all centres are encouraged to add examples of research that they have conducted.

Cathy Jordan (Ottawa) becomes AOHC President.

Minister of Health Elizabeth Witmer lifts CHC funding freeze and announces two new CHCs.

Shkagamik-Kwe Health Centre (Sudbury)

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Interdisciplinary Teamwork The Association of Ontario Health Centres (AOHC) believes interdisciplinary teamwork marks the way of the future in primary health care.

It is only in recent years that most Canadian policymakers have recognized the value of an interdisciplinary approach. But in Ontario’s Community Health Centres, an interdisciplinary approach has been a fact of life for the past 30 years. In fact, interdisciplinary teamwork has been identified by Ontario’s Ministry of Health as one of the key reasons it has recently chosen to double the number of Community Health Centres across the province.

This year the AOHC completed a large study that described the factors that support and impede collaboration in CHCs. Some of the core competencies identified in this work include: – the importance of building a shared vision and philosophy;

– developing strong leadership, top down and bottom up; – promoting team decision making; – establishing clear team objectives ; – defining clear roles and responsibilities; – setting regular team meetings;

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Kitchener Downtown CHC

– developing strong skills in conflict resolution and management; and,

In rich detail, this research reveals that interdisciplinary teams do not easily emerge naturally in the complex world of primary health care. Instead interdisciplinary teams must be constantly and carefully cultivated.

AOHC developed a practical toolkit based on the research to support Primary Health care managers and providers:

– creating clear lines of reporting;

Anishnawbe Mushkiki AHAC (Thunder Bay)

Marion Jones, Coordinator, AOHC E-Health Projects

– building team-sustaining activities such as professional development and social events.

– creating the kind of physical space where teams can function effectively;

Grand Bend CHC

Creative spaces let everyone shine their light on Interdisciplinary Teamwork.

The MOHLTC conducts a Strategic Review of the CHC Program to ensure CHCs are aligned with Ministry priorities and primary care reform.

• 2001

Robert Groves (Ottawa) becomes AOHC President.

Denise Brooks (Hamilton) becomes AOHC’s first African Canadian President.

• 2002

Building Better Teams: A toolkit for strengthening teamwork in Community Health Centres. It is for use by anyone who works in an interdisciplinary primary healthcare setting and is intended to promote dialogue between all healthcare providers. Workshops based on the toolkit were delivered across the country to rave reviews. This resource is available in French and English from AOHC. In addition to developing practical tools for providers, the findings of the research were presented at a number of academic meetings and were used as the basis for a peerreviewed publication.

The Romanow Commission recommends more federal funding, more provincial accountability and limited coverage for homecare and pharmacare.

AOHC adopts the recommendations from the Renewal Action Plan to become a more focused policy and advocacy organization. Members approve a constituencybased board to ensure geographic, aboriginal, and francophone representation.

Leaders in eHealth & Change Management Adoption of the Electronic Health Record can benefit us in our efforts to enhance quality of care, expand client access and add overall efficiencies.

Adoption of the Electronic Health Record (EHR) is central to the eHealth strategy of Ontario’s Community Health Centres. AOHC, in partnership with the Ministry of Health and Long-Term Care, conducted an evaluation of EHR systems to support the CHC model of care. The project resulted in agreement to proceed with formal investigation of new systems and services for CHCs. Phyllis Wharton, Manager, eHealth Projects at AOHC reports, “EHR can benefit us in our efforts to enhance quality of care, expand client access and add overall efficiencies. A standard EHR, common to all CHCs is essential to furthering integration with LHIN and other provincial health organizations.”

CHCs are currently in a period of vast transition and growth which especially requires a strong change management strategy. “We surveyed Executive Directors and key staff,” reports Phyllis, “to better understand their needs and concerns about technology, training and

54 CHCs and 10 AHACs serve approximately 390,000 Ontarians.

• 2004

MOHLTC Minister George Smitherman announces 10 new satellite CHCs.

workflow.” The result was the creation of the EHR Transition Team under Dr. Miriam Wiebe, consisting of eight physicians and nurse practitioners. The group has received extensive training and is meeting with peers across the province to assist them in adapting system use to meet their specific requirements.

With this greater use and reliance on technology, AOHC began a project 2006 to assess current training capacity and develop a strategy that best meets current and future needs. In 2007/8, CHCs will see the delivery of a revised and much-expanded training program.

Marion Jones, Project Coordinator, explained that the new programs will incorporate standard adult education principles, with built-in mechanisms for ongoing adaptation and refinement.

Communications has been central. The eHealth Projects group has written numerous reports and posi-

AOHC board adopts the recommendations from the Anti-Racism and Systemic Barriers Working Group including the development of an anti-oppression framework for AOHC.

MOHLTC Minister George Smitherman announces 150 new Family Health Teams (FHTs). After successful advocacy by AOHC, the Ministry recognizes communitygoverned FHTs (CFHTs).

Electronic health records enhance quality care, expand client access and add overall efficiencies.

Phyllis Wharton, Manager, AOHC E-Health Projects

tion papers to facilitate communication for our members, particularly with their LHINs. Watch for the upcoming newsletter eHealth News on current strategy, activities and issues.

MOHLTC Minister George Smitherman announces 60% CHC expansion ($74.6 million over three years) for 21 new CHCs and 18 new satellite CHCs.

By the third wave of announcements 25 of 150 FHTs are announced as communitygoverned FHTs. Tilbury that tried to form a CHC for over 13 years is among the first to be announced.

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AOHC Group Benefit Plan The most affordable alternative for AHACs, CHCs and CFHTs The AOHC Group Benefits Plan is run and managed by the AOHC and plan members. Over the past year, there has been a three percent membership increase. This is expected to grow as new CHCs and CFHTs join the plan.

Through our plan, Green Shield offers a comprehensive benefits package. In 2006, the plan was in a surplus position with no rate increases on the horizon. The plan retains the surplus and members decide on how to use it.

Desjardins Financial Security, which underwrites the Life, Accidental Death and Dismemberment, Short Term Disability and Long Term Disability parts of the program also give it a clean bill of health. The transition to upgrade the administration system will be complete by the end of June 2007.

In 2007-08, the AOHC Group Benefits Plan, changed benefit consultants to A. W. Schreiber Benefits Consulting Inc. While the transition was time consuming, our members have expressed high levels of satisfaction with our new consultants.

The AOHC Group Benefit plan happily continues to be the most affordable alternative for Community Health

Centres, Community Family Health Teams and our associate members. Some of the significant advantages to the plan include: – The price of the plan is competitive with benefits offered to much larger employers.

– The employees are eligible for up to $500,000 of Life Insurance and up to $7,500 per month of Long Term Disability Insurance without the requirement of medical evidence of insurability.

– The plan is based upon a buying group of over 1,400 employees.

– The lower administration charges levied by both Desjardins and Green Shield are those normally reserved for the larger employers With more new Community Health Centres and Community Family Health Teams now eligible to join, the prospect for the plan looks good.

If interested in joining AOHC’s Group Benefit plan, contact A. W. Schreiber Benefits Consulting Inc. at 1-800-267-4983.

Nearly doubling our membership in a year makes the prospects for AOHC’s Group Benefit Plan look good.

Laurel Service, Acting AOHC Office Manager

AOHC hosts Taking Action on the Determinants of Health conference in Kingston.

• 2006

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1st CFHT member Tilbury FHT joins AOHC

France Gélinas becomes AOHC’s first Franco-Ontarian President.

AOHC membership almost doubles, increasing to 114 members. New communities wanting CHCs are applying for emerging group membership.

THE NEAR FUTURE NorWest CHC opens up 1st mobile satellite CHC for the District of Thunder Bay.

AOHC organizes the Second Stage of Medicare conference in Toronto.

10 AHACS, 75 CHCs, 28 satellite CHCs, 25 CFHTs will serve approximately 720,000 Ontarians.

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2008

AOHC Finances

AOHC Staff

AOHC Board

Adrianna Tetley, Executive Director

France GĂŠlinas, President, Member-at-large

AOHC is on track financially, for two reasons.

Cory LeBlanc, Office Manager (Maternity Leave)

For the first time in many years our membership fees have grown, partly because of our 2006 AGM decision to increase fees paid by larger member centres and partly because of the healthy increase in new members this year. This growth is expected to continue as new member centres receive their operating budgets.

Laurel Service, Office Manager (Acting)

Simone Hammond, Vice-President, Central Constituency Director

Scott Wolfe, Senior Policy Analyst

Marg Hedley, Secretary, Member-at-large

Loralee Gillis, Manager, Research & Evaluation

David Orman, Treasurer, East Constituency Director

Last year AOHC was still carrying a debt of $37,447, leftover from the 2003-2004 debt of $130,000. AOHC eliminated the debt and set aside a small $12,922 surplus. Our goal is to grow this reserve to $150,000 by 2012.

Lisa Tisdel, Administrative Assistant

AOHC’s main focus remains on advocacy and policy. As our financial resources increase, however, our next step is to build our capacity in the communication and campaign areas.

Our current research and eHealth.projects continue to be self-funding and contribute to our overall operations.

In addition, we have established a consulting team working with new CHCs and CFHTs on community engagement, board and business plan development and governance workshops. In this capacity, AOHC continues to engage in direct contracts in partnership with individual new CHCs, satellite CHCs and CFHTs.

Phyllis Wharton, Manager, E-Health Projects Marion Jones, Coordinator, E-Health Projects

Elizabeth Beader, Southwest Constituency Director

Corinne Christie, Receptionist

Marc Beaulieu, Francophone Constituency Director

Lee McKenna, Provincial Coordinator, Emerging Group Team

Anita Cameron, AHAC Constituency Director

Sophie Bart, Emerging Groups Team

Patricia Dupon-Martinez, Member-at-large (resigned April 2007)

Keisa Campbell, Emerging Groups Team Mary Chudley, Emerging Groups Team (Maternity Leave) Sandy Sheahan, Emerging Groups Team

Kathy Hamilton, Member-at-large Michelle Joseph, Central Constituency Director Vincent LaCroix, Northern Constituency Director Harold Martin, Southwest Constituency Director

Welcome aboard: Rose Gavrilov, Administrative Assistant

Carol Smith, Central Constituency Director Marsha Stephen, Eastern Constituency Director

A fond farewell: Vathsala Wickrama-Varathan, Administrative Assistant, who joined CAMH in April 2007.

Jeannie Taylor-Page, Member-at-large

Audited statements are available upon request.

PRODUCED AND DESIGNED BY MACLEOD PRODUCTIONS AND RED SETTER STUDIO 2007. AOHC WORK PHOTOS BY CATHERINE MACLEOD

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