Aohc annual report 2007 08 en

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Nurturing and expanding our model of care We hope the CHC circle of care “C” symbol will become as recognizable to Ontarians as the blue “H” on a hospital.

Honouring the vision Welcome to AOHC’s 26th Annual Report. We celebrate by continuing to honour the original ideas and vision of Medicare’s founders, knowing that our model is the key vehicle for the positive change Canadians want to see.

decision makers and Ontario’s Community Health Centres: Who we are and what we do, the first aggregate report for Ontario’s CHCs with baseline data on factors such as the number of active clients.

We are continuing to renew and interpret Tommy Douglas’ original vision for the Second Stage of Medicare.

We also launched the Ontario CHCs new brand “Every One Matters.” with the blue “C” logo that we hope will become as recognizable for Community Health Centres as the “H” is for hospitals.

And we are more convinced than ever that non-profit, community-governed, interdisciplinary healthcare services such as those at Ontario’s Community Health Centres (CHCs), Aboriginal Health Access Centres (AHACs), and Community Family Health Teams (CFHTs) are manifestations of the innovations needed to reclaim Canada’s position as a global leader in health and social development.

Another high was the announcement by the Premier of Ontario that CHCs will play a major role in the province’s new poverty reduction strategy by providing oral health and dental care to low-income families across the province. This announcement is the latest demonstration that the Government of Ontario understands the role of CHCs in delivering comprehensive health care to those who need it most.

Ontario’s CHCs, AHACs, and CFHTs are always changing and growing with our communities and diverse cultures.

AOHC now speaks with the voices of 75 CHCs and 28 CHC satellites, 10 AHACs and 25 CFHTs. And each month more CHCs and CHC satellites are opening their doors.

In 2007-08 we experienced many highs and lows.

We were buoyed by last year’s successful Second Stage of Medicare Conference and the release of three new publications, A Snapshot of Ontario’s CHCs, a graphic overview of the original 54 CHCs, Every One Matters., a case study of six clients for the general public and

Eliminating barriers In addition, this year the AOHC Board of Directors reviewed all of its core organizational documents, policies and procedures, ensuring that we live up to our commitment to anti-oppression. As we move into the implementation stage we are addressing the need to eliminate system-wide barriers to access. These include poverty, geographic isolation, ethno- and culturo-

AOHC Executive Director, Adrianna Tetley, toured Ontario to introduce “Every One Matters.”

centrism, racism, heterosexism, language discrimination, ableism and other harmful forms of social exclusion.

There are emerging challenges, however, in maintaining a unified voice. The Ministry of Health and Long-Term Care (MOHLTC) restructuring and the emergence of 13 new LHINs has created a lack of clarity and has hindered our ability to get official decisions made in a timely way.

Two other emerging challenges are the MOHLTC’s new incentive-based payment model for physicians, which

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AOHC continues to implement the Second Stage of Medicare with a focus on chronic disease prevention and management.

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need care will have access to it. So we are calling on LHINs to develop primary care plans for every community – especially those who face barriers to access and need Community Health Centres.

AOHC President Simone Hammond speaks at the Second Stage of Medicare conference in Toronto.

We are committed to the original vision of Medicare, even more so in this period of rapid growth and massive change. At our 26th Annual Conference, we continue to implement the Second Stage of Medicare with a focus on chronic disease prevention and management.

Addressing population health threatens the CHC model of care, and the Ministry’s decision not to fund the next generation of electronic client records in the foreseeable future.

One of AOHC’s key goals is to ensure that the CHC model of care is fully supported, resourced and expanded across the province. A second is that new and existing CHCs, AHACs and CFHTs have the political, fiscal, policy and administrative support to meet the needs of their clients and communities. In this changing environment we need to be more vigilant than ever.

We hold firm to our vision of a completed network of Community Health Centres, where all Ontarians who

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need it. Working together we believe we can complete this vision. When we do, Ontarians will be healthier, our communities will be stronger and we’ll have a better, more sustainable and more caring health care system.

Simone Hammond, President

Adrianna Tetley, Executive Director

We are calling on governments, health authorities and health providers to be more proactive and responsive to diverse individual and community needs and to address population health and social determinants of health.

And we continue to use best practices to inform healthcare interventions for illness prevention and treatment. To these ends we are making better use of information technology so that healthcare providers can provide accurate and integrated care within a Second Stage of Medicare framework.

For AOHC it means non-profit, single-tier, interdisciplinary and community-governed primary health care for all who

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Completing the Second Stage of Medicare “Let us not forget that the ultimate goal of Medicare must be to keep people well.”

Canadian Medicare founder Tommy Douglas

Over 600 Canadians gathered in Toronto last year for Completing the Vision: the Second Stage of Medicare, a conference to kick-start Medicare’s Second Stage.

Co-sponsored by The Canadian Alliance of Community Health Centres (CACHCA) and the Association of Ontario Health Centres (AOHC), it represented more than 300 Community Health Centres across Canada.

Health providers and policymakers agreed that it was time to stop hiding the light under a basket and to vigorously promote Second Stage of Medicare innovations already in place at CHCs, AHACs and CFHTs. Health centre hallmarks include population-based planning, more effective care, better health and illness prevention, improved access to quality client-centred care.

Completing the Vision: The Second Stage of Medicare was a feast of health innovation. The conference honoured the original vision which gave Canada its publicly-financed health insurance system and pointed to the bridges still to be crossed to get to the Second Stage — improved health and well-being.

Dr. Michael Rachlis, one of AOHC’s founders, has chronicled scores of initiatives which are already improving health outcomes in his book Prescription for Excellence, How Innovation is Saving Canada’s Health Care System.

Rachlis told conference participants that adjusting the funding formula according to socio-economic and illness factors would be a good next step.

Right now the LHIN funding formula is based on what happened in the past. Some LHINs are better funded than they should be, while others are seriously under-funded making disparities worse.

Danielle Martin, chair of Canadian Doctors for Medicare, said that completing the Second Stage of Medicare protects and strengthens the First Stage.

“The source of ongoing angst in regard to single tier publicly-funded health care resides in the fact that we’ve got problems with the system that need to be fixed. And the only way to fix them is to move towards more prevention and health promotion, better attention to the social determinants of health and better organization.”

France Gélinas, Canadian Alliance of Community Health Centre Associations and former AOHC President, said that completing the Second Stage of Medicare is as important as starting the First Stage of Medicare.

“Fifty years ago a prairie giant talked about removing the financial barriers between physicians and their patients and having publicly-funded hospital care. It was a big idea. People thought: how could anybody do this – think of the opposition! But the idea caught on.”

“They wanted the financial barriers to health care removed. They talked to their neighbours, who talked to

Allison Fisher, of Women of Wabano, performed with Bev Souliere and Carlie Chase at the AOHC 2007 conference. At Ottawa’s Wabano Centre for Aboriginal Health, programs and services are grounded in the teachings of the Aboriginal medicine wheel.

each other. Then they talked to their politicians, and the politicians had no choice. Province after province and government after government, all had to agree.”

“Fifty years later when we go to the hospital, when we go to see a physician, it doesn’t enter our mind that we should have to pay. But fifty years ago it was a huge idea.”

“Well, the Second Stage of Medicare is just as big an idea.”

For a full conference report, go to: www.aohc.org/ aohc/index. aspx?CategoryID=23&lang=en-CA 3

Every One Matters.

“C” is for Community Health Centres

The circle of care symbol, shown here at North Lambton, Gateway and Davenport-Perth Community Health Centres, identifies CHCs throughout Ontario. It aims to reach out visually and connect with those who most need its care.

In February 2007, the CHCs decided that they needed to increase their visibility across Ontario. A year later on March 18, 2008 the CHCs unveiled their united vision and voice to better tell their story.

The opening was held at Queen’s Park when over 100 clients, board and staff from Community Health Centres launched the “Every One Matters” campaign. They held meetings with MPPs. All three political parties made supportive CHC statements in the legislature and a successful reception concluded the day.

The Queen’s Park launch was followed by regional launches in Kingston, Ottawa, Toronto, Forest, Woodstock

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and Welland. Over the next few months, many centres did individual launches with staff and clients.

There is now a sense of excitement in the air with centres, clients and staff proudly displaying the new logo and tag line. Centres are installing new signs on their buildings and it is appearing on websites, t-shirts and brochures.

And people are very excited with the new tagline: “Every one matters.” “Every individual. Every community. Every staff person.”

The logo represents the CHC holistic vision: a circle of care, at the centre of which are the people and communities

served. When the public sees the “C” it will know it has found the circle of care. CHCs don’t just provide excellent heath care to individuals and families, they also look after the health of entire communities because they are the communities they serve.

When people see this sign on an individual centre, they will know it is part of a larger effort happening in scores of communities across Ontario – an effort that is now supported by our current provincial government.

It is our hope that this effort will continue and that this symbol will become as recognizable to Ontarians as the blue H on a hospital.

Two supporting documents were released as part of the branding launch: Every One Matters., a booklet outlining six case studies and illustrating community initiatives, and Ontario’s CHCs: Who we are and what we do, the first report on CHCs in Ontario.

The report’s five-point message is simple. CHCs prevent and manage chronic disease, enable seniors to age in the dignity of their homes, make it easy for clients to connect with other parts of the health care system, increase access to underserved communities, and develop health programs that improve the health of the whole community.

Completing the Network At Queen’s Park and the regional launches across Ontario, AOHC thanked the provincial government for funding new CHCs and acknowledged the efforts of community members who are in the process of creating new centres and new satellites.

However, AOHC also called on government to develop a plan to “Complete the Network of CHCs.” Although the current expansion underway increases Ontarians access to CHC programs and services, there’s still a long way to go before all Ontarians who need CHCs can access them.

All Ontarians, no matter what LHIN they live in, should have access to programs and services at CHCs if they need it. Existing centres could have the resources to eliminate their waiting lists and maximize their full potential.

Opposition Leader Stéphane Dion and Clinical Nurse and Lactation Consultant Diana Warfield take part in a round-table discussion during Dion’s visit to Ottawa’s Somerset West Community Health Centre on May 16th, 2008, during National Nursing Week.

Oral Health and Community Health Centres In the latest demonstration that the Government of Ontario understands the role of CHCs, Ontario Health Minister, the Honourable George Smitherman, says that CHCs will play a major role in the Province’s poverty reduction strategy.

“Over the next three years, the Government of Ontario will invest $135 million in a plan involving CHCs along with Public Health units, dentists and

dental hygienists to deliver oral health and dental care to low-income families across the province,” Smitherman says.

AOHC is committed to working closely with the Government to ensure that the new oral health programs will be located in the communities with the highest need.

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Quality Improvement: a culture shift for AOHC’s members

Working with Ontario LHINs means continually improving the delivery of primary health care services.

We know the value of interdisciplinary teamwork, internally and for our members.

Our members in CHCs and AHACs are already recognized for creating the most effective model to improve health outcomes for aboriginal, francophone, racialized and minoritized communities, disabled and other vulnerable populations. But we also understand that a betterorganized health system will help health professionals to constantly improve the care, services and programs they deliver.

But saying is easier than doing.

Today “better delivery of care” means that AOHC members must be comfortable making changes that call for evidenced-based care guidelines, electronic charts, improved human resources strategies to support health professionals, better communications between different parts of the health care system and eliminating systemic flaws that may be endangering safety for both clients and providers.

Currently CHCs, AHACs and CFHTs are involved in quality improvement on a sector-wide basis for the first time. It is a major cultural shift. Traditionally CHCs have focused on measurement for judgment (how good CHCs are) as opposed to measurement for improvement (how we

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The Education and Development Team during needs assessment training in a gap analysis session, from left to right: Sandra Wong, Carolyn Poplak, Lee McKenna, Vindu Balani (from the London InterCommunity Health Centre), Jean Emond (from The Anne Johnston Health Station), Laurienne Ring (consultant), Loralee Gillis and Roohulah Shabon.

need to improve.) The report “Ontario CHCs: Who We Are and What We Do,” provides some baseline data, but it is mostly what is called “a measurement for judgement”

report. According to a survey conducted by the Ministry of Health and Long-Term Care, CHCs have the fewest dedicated resources to quality improvement compared to

The ultimate goal of AOHC’s education and development program is to provide the skills CHC staff require to improve quality of care and have a positive and lasting impact on the lives of their clients.

other health care sectors. Improving this perception means another massive cultural shift!

Learning Group (PLG) on the latest developments for all DMCs.

We are, however, undaunted and taking steps to lay the groundwork for this new future. AOHC’s Chronic Disease Working Group is developing a collaborative project with some assistance from the Ontario Health Quality Council.

CFHTs are developing a project to improve collaborative practices in interdisciplinary teams. Both CHCs and CFHTs are participating in the collaborative practice initiative funded by the Ministry of Health and Long-Term Care.

At the training helm is Roohullah Shabon. He brings a background in education, health and management and 20 years of experience in the USA, Canada and other countries around the globe. With a wealth of experience in primary health care and community-based programs, his focus is now Ontario’s primary health care sector.

New Education and Development Team But what is really exciting is that in September 2008, AOHC was funded by the Ministry of Health and LongTerm Care to implement a CHC training strategy that will enable us to move more quickly on all new fronts.

We are conducting a training needs and gap analysis to determine priorities. Preliminary results show that our member centres want model of care training and training for data management coordinators (DMCs) on the evaluation framework and quality of care, as it relates to working with the new software.

Still in its early days, AOHC has successfully conducted two training sessions for new DMCs and held a Program

He is applying his extensive knowledge and skills to the development of AOHC education and development.

Long term strategies include improving the delivery of quality care through building capacity and development competency through CHC training, program learning and exchange of best practices.

Shabon works with training manager Carolyn Poplak, administrative assistant Sandra Wong and the Centre Development Team.

The role of the Education and Development team is to strengthen the members’ capacity from within and enable the organization to grow. In the midterm it aims to make AOHC a training and education hub for new and existing member centres. The ultimate goal is to make sure AOHC’s education and development program is needs-based and provides the knowledge, skills and practice CHC staff require to improve quality of care and have a positive and lasting impact on the lives of their clients.

The Education and Development team will be supporting advocacy, training for effectiveness and efficiency in the community-based model of care. It will support the startup and integration of new CHCs, from the community engagement stage through pre-operation to full operation.

The team will provide opportunities for board, management and health workers to exchange knowledge, experience and best practices through Learning Group Sessions, strengthening the CHCs sustainable organizational capacity and staff competency.

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The Centre Development Team The Centre Development Team and emerging CHCs have benefited from the team’s nurturing of high quality, collegial relationships with LHIN staff.

Lee McKenna, Manager, Centre Development Sophie Bart, Centre Development Team Member Keisa Campbell, Centre Development Team Member Mary Chudley, Centre Development Team Member Lisa Tisdel, Administrative Support

experiencing difficulties accessing the care they need.

These include sex-trade workers and mental health survivors in Niagara Falls, fragile, isolated seniors and lesbian, gay, bi-sexual and trans-gendered individuals in greater St Catharines, farmers in Clearview, at-risk youth

in Collingwood, Francophone, Aboriginal and hard-ofhearing populations in Midland, Penetanguishene and Christian Island to migrant workers, low Germanspeaking Mennonites and low income families at risk in Woodstock, Tillsonburg and Ingersoll.

Last year, the Centre Development Team (CDT) continued to work with new CHCs, their steering committees and boards as they moved through community engagement and mobilization to pre-operations and service delivery.

Community engagement Community engagement is a multi-faceted process designed to increase awareness and understanding of the CHC model. Its aim is to encourage both community members and service providers to contribute their input in a variety of ways: focus groups, key representative interviews, partnership consultations, community presentations and forum days, and an online survey for service providers.

Quantitative data combine with qualitative data to produce a clear picture of the community’s needs and those populations whose needs will be prioritized by the new CHC or satellite. In the last year, Sophie, Keisa and Mary have engaged with a variety of people who are

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The Honourable George Smitherman, Ontario Minister of Health and Long-Term Care, presents the Innovation in Health Care Award to Wendy Talbot, Susan Alexander and Shaun Peirce in recognition of NorWest Community Health Centres’ Mobile Unit.

In the course of development work, the Centre Development Team has been building capacity in areas such as governance, anti-oppression, inter-disciplinary teams and the CHC model of care.

Communities across the province are hearing about the Second Stage of Medicare, about Community Health Centres where “Every One Matters.” Many new CHCs are already incorporating the new logo into their local communications and signage.

The Centre Development Team facilitated the participation of new CHCs in regional launch events in Erie-St Clair, Niagara, Toronto, Ottawa and Kingston. A South West LHIN event, hosted by the emerging Woodstock and Area Communities Health Centre, combined the launch with an opportunity for networking and information sharing amongst new and existing CHCs as well as staff and board from the LHIN.

Collegial relationships The Centre Development Team and local emerging CHCs have benefited from the team’s nurturing of high quality, collegial relationships with LHIN staff. Our work makes good use of LHIN research and seeks to align local priorities with those of the respective LHIN’s Integrated Health Service Plans.

A half dozen of the 2005-announced CHCs are temporary or permanent quarters, have hired Executive Director (ED) and begun work with full partial teams in place, such as a diabetic team Bramalea.

in an or in

The new francophone centres in the north are leading the way – Le Centre de santé communautaire (CSC) de Kapuskasing and le CSC de Sudbury de l’est. ‘Kap’ staff is

half way to its projected full complement of staffing, with a physician, nurse and nurse practitioner, three administrative and two health promotion staff working in two temporary sites. ED Yves Barbeau is guiding the new CSC through renovations for an early 2009 occupancy of the permanent site, at which point they will launch a wide range of community services. Jacqueline Gauthier, ED of Sudbury East, is operating with 70 per cent of staff in place in two communities, St Charles (permanent) and Noëlville (temporary), with construction underway.

Health promotion and community development activities are well under way.

A majority of new CHCs are somewhere along the continuum of community engagement and preoperations. Grand River (Brantford), South Georgian Bay (Wasaga Beach/Collingwood), CHIGAMIK (Midland/ Penetanguishene), Greater St Catharines (including Thorold) and Niagara Falls are aiming for spring 2009 openings.

The CDT played a significant role in AOHC’s Queen’s Park Day, with many emerging CHC board members participating in interviews and meetings with media and dozens of MPPs. CHIGAMIK’s co-chairs, Ernest Vaillancourt and Nena LaCaille, francophone and Aboriginal respectively, told the crowd gathered in front of the Legislature a unique story that has been playing out in Midland and area. They spoke of the creation of overlapping circles of communities into a steering committee that is driving a dream to address the primary health care needs of mainstream, Aboriginal, Métis and Francophone people of North Simcoe.

Community-governed Family Health Teams We continue to support the development and particular needs of community-governed Family Health Teams (CFHTs), of which two dozen are AOHC members, through advocacy and policy work, membership services and hosting such gatherings as the second annual CFHT Fest.

Most of the CFHTs are now up and running, delivering services from Ear Falls to Tilbury, Bancroft to Sauble Beach.

In the course of this development work, the CDT has been building capacity in areas such as governance, antioppression, inter-disciplinary teams and the CHC model of care. Increasingly, those skills and experience are being honed for use in existing CHCs and CFHTs. The CDT contributed to the Physician Assistant pilot project with training in the role of AOHC, the CHC model of care and the determinants of health. The Team is also building capacity in the area of collaborative practice in interdisciplinary teams, making use of the Building Better Teams Toolkit and working with the EDs’ working group on a charter for CHCs based on the Model of Care.

We are sharpening our advocacy tools with research projects on current issues of concern to CFHTs and lessons learned in the recent CHC expansion. We have worked with a half dozen Executive Director volunteers who formed the EDs’ Mentoring Circle. The circle provides regular training, workshop and networking opportunities for new EDs, along with support for new colleagues.

In January 2008, the Centre Development Team was integrated into the Education and Development Team.

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Three new publications which describe the CHC sector with baseline data:

Click, click Our Snapshot displays the breadth of Ontario’s Community Health Centre programs and services

A Snapshot of Ontario’s CHCs A three-page fold out that provides an overview of the original 54 CHCs.

Every One Matters A case study of six clients with illustrations of community initiatives.

For the general public and decision makers who do not know what a CHC is.

Ontario’s Community Health Centres: Who we are and what we do The first aggregate report for Ontario’s CHCs with baseline data on factors such as the number of active clients. Highlights the Model of Care and describes some of its attributes.

To order copies, contact AOHC at: mail@aohc.org.

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In 2007 AOHC produced a visual snapshot to display the breadth of Ontario’s Community Health Centre (CHC) programs and services. The large format document highlights some of the innovations already underway in CHCs across the province. It is packed with information.

The Snapshot shows that Ontario CHCs and their interdisciplinary teams are integrated into their unique communities, acquainted with their local LHIN and committed to delivering accessible, fiscally responsible services in the spirit of continuous quality improvement.

At a glance, it names all the CHCs and shows how their structure and design have put them first in the provision of integrated approaches to health care, illness prevention, health promotion and community capacity-building.

It breaks the centres into their LHIN regions as well.

For example, this is handy for someone in the South East LHIN region who wants to know about the services available at the relatively rural Merrickville District CHC. All they need to do is scan the menu at the top of the page and follow the dots down Merrickville’s pastel blue line to discover that the CHC offers programs and services in clients’ homes and in the community, as well as at the centre.

Someone in the south may not know that the Centre de sante communautaire de Sudbury serves a large

Francophone client base, or that the Norwest Community Health Centres in Thunder Bay, Longlac and Armstrong cover vast areas and underserved populations.

Another person in the Toronto Central LHIN Region may want to know what’s happening at Lawrence Heights CHC. The Snapshot shows them that Lawrence Heights offers services in 52 languages. In the South West LHIN region, West Elgin CHC scores equally high in the partnership category.

The Snapshot also lists the basics of client-centred primary health care that address clinical and medical needs within the broad framework of the social determinants of health.

Beautiful enough for a bulletin Board, the Snapshot shows which centres foster community integration and eliminate system-wide barriers to access such as poverty, geographic isolation, ethno- and culturocentrism, racism, heterosexism, language discrimination, ableism and other forms of social exclusion.

Whether creating individualized self-care or group programs, Ontario’s CHCs reduce the burden of acute care and emphasize chronic disease prevention and management.

AOHC Staff

AOHC Board

Adrianna Tetley, Executive Director

Simone Hammond, President, Central Constituency Director

Cory LeBlanc, Office Manager Scott Wolfe, Senior Policy Analyst Lisa Tisdel, Administrative Assistant Corinne Christie, Receptionist Lee McKenna, Manager, Centre Development Team Sophie Bart, Centre Development Team

CHC teams test out new position

Carol Smith, Vice President, Central Constituency Director Margaret Hedley, Secretary Member-at-large David Orman, Treasurer, Eastern Constituency Director

A demonstration project enables CHCs to employ the training and expertise of International Medical Graduates

Keisa Campbell, Centre Development Team Mary Chudley, Centre Development Team

Elizabeth Beader, Southwest Constituency Director Marc Beaulieu, Francophone Constituency Director

Welcome aboard: François L’Ecuyer, Communications Manager Chantal Pinard, Administrative Assistant Carolyn Poplak, Training Manager Roohullah Shabon, Director of Education and Development Sandra Wong, Administrative Assistant

A fond farewell:

Anita Cameron, Aboriginal Constituency Director Michelle Joseph, Central Constituency Director Vincent LaCroix, Northern Constituency Director Katherine Pigott, Southwest Constituency Director Marsha Stephen, Eastern Constituency Director

Loralee Gillis, Manager, Research & Evaluation Marion Jones, Coordinator, eHealth Projects Laurel Service, Office Manager (acting) Sandy Sheahan, Centre Development Team Phyllis Wharton, Director, E-Health Projects

Paulos Gebreyesus, Member-at-large Almaz Reda, Member-at-large Karen Smith, Member-at-large Jeannie Taylor-Page, Member-at-large

Five Physician Assistants (PAs) are now delivering care in five Community Health Centres throughout the province, as part of a demonstration project AOHC helped launch this year in collaboration with HealthForceOntario.

Participating centres include Anishnawabe Health Toronto, Hamilton Urban Core Community Health Centre, North Hamilton Community Health Centre, Le Centre de santé communautaire de Temiskaming and Somerset West Community Health Centre.

By participating in this project, CHCs have the opportunity to expand and enhance their existing teams and improve access to clinical services. Evidence from other countries where PAs are used shows this position can help primary health care teams serve more clients, more efficiently.

The demonstration project also enables CHCs to employ the training and expertise of International Medical Graduates and to support them as they establish themselves in Canada. Of the five PAs participating in the CHC demonstration, two are International Medical Graduates trained in Pakistan and India. Finally, by participating in the PA demonstration project, AOHC and CHCs are helping to determine how the new Physician Assistant position can best be introduced throughout Ontario’s health care system.

In addition to the AOHC demonstration project, there are 52 PA positions being demonstrated in 21 Ontario hospitals and seven in physician-led clinics and nursing homes.

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France Gélinas: Recipient of the 2008 AOHC Award “It’s worth fighting for a province-wide network of community-governed, not-for-profit primary health centres.” France Gélinas starting to be seen as not only issues affecting the marginalized, but as strong determinants of health for all Ontarians.

She remembers two clear and relevant advocacy resolutions passed by AOHC in 2006. One addressed the urgent need for improved access to childcare, a key determinant in supporting healthy families. The second focused on recent immigrants and called for an end to the absurd three-month waiting period for health insurance. The wait was contrary to policies encouraging immigration and ensuring newcomers a safe and welcoming environment.

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France Gélinas was chosen by AOHC members to lead these changes partly because she was bringing many years of frontline and management experience to her new calling, but also because of the innovations she had brought and the passion she had for completing the Second Stage of Medicare.

France Gélinas at AOHC’s 2007 Second Stage of Medicare Conference.

The purpose of the AOHC Award is to exemplify the commitment and dedication that has created and nurtured the community health movement. The establishment of an annual award is intended to provide a forum through which the membership of the AOHC can celebrate the contribution of those who have espoused the broad view of health and have worked to influence, either directly or indirectly, awareness of the role of the determinants of health.

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It was 2007 when Denise Brooks handed over the torch to France Gélinas, as President of the AOHC. France Gélinas had been on the board of AOHC for five years and became President under the banner of Taking Action on the Social Determinants of Health. She was AOHC’s first Francophone president and ready to make changes.

Remembering the moment, France said in a recent interview, that poverty, social inclusion and equity were

“We managed to achieve consensus with health providers and policymakers from across Canada that we must start working together on the Second Stage of Medicare. Our Completing the Second Stage of Medicare conference in 2007 was part of this larger effort to re-unite Canadians around the values that gave birth to Medicare in the first place, over 50 years ago.”

Under her historic leadership AOHC also adopted the Five Principles for Provision of Quality French Language Primary Health Care that empowered French language community-driven centres and emerging groups to

EPIC Awards improve health and access to French language health and social services, as guaranteed in Ontario’s French Language Services Act.

Recipient of the EPIC AWARD in the Health Promotion and Communication Category

France started her career as a physiotherapist. She went on to hold a variety of administrative positions at Sudbury’s Laurentian Hospital before moving to the Ministry of Health to participate in the restructuring and the amalgamation of hospitals.

The Youth Centre created and implemented a unique sexual health program called “Girl Talk”, an innovative evening program for grade 7 and 8 girls and their mothers.

Consistent with the CHC model, Girl Talk has been led by a team of Nurse Practitioners and Health Promoters. The purpose of the project is to provide an opportunity for young women to participate in an emerging, meaningful and open discussion about relationships and sexual and reproductive health issues with their peers, their mothers and other adult women. Girl Talk has been very successful since 2005.

In 1994, she left the Ministry to start working as a health promoter at the Centre de santé communautaire de Sudbury, becoming the Executive Director in 1996. Under her leadership her Centre grew from one site, twelve employees and less than 300 clients to seven sites, more than 60 employees and 10,000 clients.

She remembers some of the innovative second stage programs her centre developed, such as building the first skate boarding park, laying the ground work for a biodiesel plant to create employment for homeless people and celebrating Ste-Catherine Day with 1000 youngsters making toffee.

For France Gélinas, today’s mission is to use her new position as MPP for Nickel Belt and NDP health critic to spread the word about the Second Stage of Medicare and CHCs. “It’s worth fighting for a province-wide network of community-governed, not for profit primary health centres that adheres to the hard-won AOHC principles and the Tommy Douglas vision for the Second Stage of Medicare.”

When Denise Brooks handed over the President’s torch, France Gélinas entered the arena running. Up until now she has shown no sign of slowing down. “We can help realize Tommy Douglas’ original vision to keep people well,” she says.

Nominee: The Youth Centre, “Girl Talk” Nominated by: Ellen Jones, The Youth Centre

Recipient of the EPIC Award in the Programs and Services Category Nominee: Street Health Centre, Satellite of Kingston CHC Nominated by: Kingston Community Health Centres Sandy Hill Community Health Centre South Riverdale Community Health Centre The Street Health Centre in Kingston is open 365 days per year. It operates with an integrated team of nurses, nurse practitioners, physicians and counseling staff who are involved in developing best practices documents for needle exchange programs, as well as new hospital and psychiatry services for addicted populations. As quoted

by Ron Shore, “Street Health is all about people; accepting and caring for people as they are… The continued growth of Street Health from a one person operation in 1991 to a full multi-service community health centre and community lead now is because there is something fundamentally righteous about our mission: caring for the insulted and injured of society.”

Three Honorable Mentions in the Programs and Services Category • North Lambton Community Health Centre “Let’s Get Active Together” • Sandwich Community Health Centre “SKID Safe Kids” • Langs Farm Village Association “Retired, Ready and Roving”

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AOHC Finances AOHC’s focus continues to be on advocacy and policy. As our financial resources increase, our next step will be to continue to build our capacity in the communication and campaign areas.

Over the past three years, AOHC has eliminated its debt, developed solid financial practices and established a reserve fund. Last year AOHC had a small surplus of $12,922. This year this surplus has grown to $40,402. The AOHC Board has established a goal to grow this reserve to $150,000 by 2012. We are on target to reach this goal.

Our membership fees continue to grow – increasing from $322,000 in 2007-08 to $363,200. This increase is due to the continuing growth of our membership with new CHCs and CFHTs joining AOHC plus the increase in overall membership fees approved at the June 2008 Annual General Membership meeting. However, this growth is not as much as was forecasted largely due to the slowness in the development of new CHCs and CHC satellites and the fact that many new CFHTs still do not have approved operating budgets.

At the same time we are experiencing financial readjustments. Historically, the MOHLTC provided a travel fund of $110,000 per year for board and committee travel. In 2007-08, this fund was reduced to $99,000.

In 2008-09, it is being reduced to $55,000 and will be eliminated entirely by 2009-10. Therefore over a three year period, AOHC is absorbing the gradual elimination of a $110,000 travel fund by reducing travel and absorbing costs into the core budget.

AOHC’s focus continues to be on advocacy and policy. As our financial resources increase, however, our next step

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will be to continue to build our capacity in the communication and campaign areas. One of the key issues identified by the members was our need to improve internal communications with our members.

AOHC is delighted that, with the increase in membership fees and adjusting other priorities, we have been able to hire a full time communications manager.

In 2007-08, the Ministry of Health and Long-Term Care (MOHLTC) continued to provide AOHC with ongoing funding for staff and projects, especially in the area of eHealth. A shift in the focus occurred in 2007-08, however, with the MOHLTC requesting that AOHC take on more of a training role, especially as it relates to eHealth.

All projects funded by MOHLTC continue to be selffunded and contribute to our overall operations.

In addition, we have established a centre development 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. 2007-08 also marked a change in location for AOHC. Our new offices are more centrally located and are shared with Community Organizational Health Inc. (COHI), the CHC accreditation body.

Audited statements are available upon request.