Association of Ontario Health Centres Association des centres de santĂŠ de l'Ontario
410-5233 Dundas Street W., Toronto, Ontario M9B 1A6 Tel: 416 236-2539 Fax: 416 236-0431 Email: mail@aohc.org Web: www.aohc.org
mission To represent member centres in the promotion of healthy public policy, healthy individuals and communities through the creation and continuing development of health centres which embody principles of accessible quality primary care, health promotion and active community ownership and participation.
board of directors
vision
2000-2001
That Ontarians:
Chair: Robert Groves, Lanark
1
Live in healthy, vibrant communities
Executive Committee
2
View health centres as the preferred model of primary health care
Vice President: Susan Milankov, Toronto Secretary/Treasurer: Walter Weary, Toronto Past President: Pat McLean, Elmira
3
Have access to a health centre in their community which provides health and social service programs that address the determinants of health
That the membership:
1
Look to the Association of Ontario Health Centres for leadership both within the broad community health sector, and internally, advancing creative solutions to issues brought forward by members
2
Have a sense of ownership of AOHC and actively participate and contribute on province-wide initiatives
Directors
Richard Bissonnette, Cornwall Denise Brooks, Hamilton Liana Frinette, Thunder Bay * France Gélinas, Sudbury ** Joe Hester, Toronto ** Cathy Jordan, Ottawa Betty Kennedy, Thunder Bay * Jean-Gilles Pelletier, Toronto ** Randy Pitawankwat, Sudbury * Altaf Stationwala, Toronto Norm Tulsiani, Toronto *
That the Association:
* Left in med term ** mid term appointment 1
Has effectively positioned health centres in the overall health framework in Ontario
2
Is recognized and sought by health care providers as experts in primary health care through cutting edge policy development
staff list
3
Has fostered effective open two-way communication among member centres
Susan Arai, Researcher, Information Specialist * Rishia Burke, Co-ordinator, Centre Development Jayne Cardno, Researcher, Information Specialist ** Carole Elliott, Communications Coordinator * Charmaine Haddock, Receptionist/Secretary Arlene Herman, Coordinator Centre Development * Stephen Grenon, Communications Coordinator ** Marion Jones, Information Systems Assistant Cory LeBlanc, Executive Assistant (Maternity Leave) Joe Leonard, Executive Support Consultant Christine Miller, Administrative Assistant Gillian Nichol, Coordinator Centre Development Gary O’Connor, Executive Director Anne H. O’Neill, Interim Executive Assistant Anthony Powell, Information Technology, Coop Student Linda Stewart, Manager, Information Technology
APPROVED BY AOHC BOARD OF DIRECTORS, OCTOBER 1999
*Left mid-year ** Hired mid-year
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committees Advocacy and Public Policy Committee
Chair: Denise Brooks, Hamilton Urban Core CHC, AOHC Board of Directors Committee: Robert Groves, AOHC Board of Directors Eunadie Johnson, Women’s Health in Women’s Hands Marguarite Keeley, Centretown CHC Pat McLean, AOHC Board of Directors Cathy Jordan, AOHC Board of Directors Jocelyne Maxwell, CSC du Témiskaming AOHC: Gary O’Connor, Anne H. O’Neill, Cory LeBlanc
Conference Planning
Co-chairs: Gary O’Connor, AOHC Beth Beader, North Hamilton CHC Committee: Susan Bland, The Youth Centre Barbara Lupu, York Community Services Nancy Knudsen, Sandy Hill CHC Phil Moorman, Carlington Community and Health Services AOHC: Anne H. O’Neill, Cory LeBlanc
Information Systems Co-ordinating Committee
Chair: Barbara MacKinnon, Pinecrest-Queensway Health & Community Services Members: France Gélinas, Northern Region Cathy Paul, Toronto Region Jean-Gilles Pelletier, Toronto Region Wanda MacDonald, Northern Region Mac Redmond, Southwestern Region Ministry of Health Representatives: David Thornley Wayne Oake AOHC: Linda Stewart, Gary O’Connor, ex officio
2
Information Systems, User Support Sub-Committee
Chair: Jean-Gilles Pelletier Pam Ferguson, Eastern Region Suzanne Giroux Sheldrick, Francophone Simon Hagens, Southwestern Region John Hawkins, Eastern Region Michelle Hurtubise, Central Region Ella Litwin, Central Region Kay Marsh, Central Region Christine Randle, Central Region Jennifer Rayner, Southwest Region Lori Trelinski, Northern Region Sue Vieira, Southwest Region Karen Yik, Central Region AOHC: Marion Jones Linda Stewart, ISCC Representative
Research Advisory Sub-Committee
Chair: Rosana Pellizzari, Davenport Perth CHC Sue Arai, Brock University Michael Birmingham, Carlington CHC Alba DiCenso, McMaster University Jordie Fallis, Flemingdon CHC Karen Patzer, Sandy Hill CHC David Thornley, Ministry of Health Jack Williams, ICES AOHC: Linda Stewart
Membership Secretariat Committee
Chair: Susan Milankov, AOHC Board Members: Susan Bland, The Youth Centre Heather MacDonald, Woolwich CHC Peter Marshall, Mary Berglund CHC Peter McKenna, Sandy Hill CHC Marilyn Nadjiwan Rasi, Shkagamik-Kwe Health Centre Jocelyne Maxwell, CSC du Témiskaming AOHC: Rishia Burke
Nominations
Chair: Cathy Jordan, AOHC Board Doug Graham, West Elgin CHC Joy Thompson, Planned Parenthood of Toronto Ex-officio: Gary O’Connor, AOHC Executive Director
Resolutions
Chair: Richard Bissonette, AOHC Board Member Eunadie Johnson, Women’s Health in Women’s Hands CHC David Hole, South East Ottawa CHC Wanda McDonald, North Lanark CHC Pat McLean, AOHC Board Member Ex-officio: Robert Groves, AOHC President Gary O’Connor, AOHC Executive Director
partnerships Canadian Alliance of Community Health Centre Associations, CACHCA Health Determinants Partnership, HDP Ontario Health Providers Alliance, OHPA Ontario Healthy Communities Coalition, OHCC Ontario Public Health Association, OPHA The Coalition for Primary Care The Ontario Rural Council, TORC
AOHC
award
2001 Elizabeth Feltes, Toronto
EPIC
award 2000
Woolwich Healthy Communities Community Woolwich CHC Community Development Award and honorable mention in Community Partnerships Youth Employment Apprenticeship Program Somerset West CHC Health Promotion Award and honorable mention in Community Partnerships 7th Inning Education Program Langs Farm Village Association Programs and Services Award and honorable mention in Community Partnerships South Ottawa Community Justice Initiative South-East Ottawa Centre for a Healthy Community Community Development Award and honorable mention in
health is a community affair
award 2001
Mary Fligg, Barrie Hamilton Police Service, 611 Beat Officers, Hamilton St. Lawrence School, Hamilton David and Allison Witt, Hamilton City of Hamilton Real Estate Division, Hamilton Tweed’s Friends & Neighbours Group, Tweed Lise and Michel Raymond, Noëlville La’Briyut Wellness Centre, Toronto Vijaya Jeevaratham, Toronto Maria Antonieta Smith, Toronto
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table of
contents
Vision ........................................................................page 1 Board of Directors ......................................................page 1 Staff List ....................................................................page 1 Committees ................................................................page 2 Award Recipients ........................................................page 3 Partnerships ................................................................page 3 Executive Message ......................................................page 4
executive
message
Strategic Directions ....................................................page 6 The year 2000/2001 has been a key time of growth for the -Strengthen the role of health centres................... page 8 -Support development of existing members..........page 8 -Ensure financial stability....................................page 10 -Support new and emerging primary health care organizations and share goals and values............page 11
Association of Ontario Health Centres. We have grown to 80 members – 56 CHCs, 7 AHACs, and two HSOs as full members and 15 community and health organizations as associate members. We have also grown in our ability to affect public policy. By our count, six cabinet ministers have publicly supported CHCs.
-Strengthen relationship between member centres and AOHC....................................................... page 11
Our advocacy projects are starting to pay small dividends.
-Promote healthy public policy........................... page 11
In 2000/2001 CHCs saw funding to relieve pay equity cost pressures, a 4% increase in funding benefits and most centres
-AOHC Board Development............................. page 11
received base funding increased.
Financial Statements ................................................page 12 Building on our Investing documents from earlier years, in 2000/2001 we released, Community Health Centre Expansion in Ontario: A Business Case for Strengthening Community-Based Primary Health Care Services, and its sister document the Phase I Business Case which have positioned the Association as players in the primary health The illustration on the cover is the artwork for AOHC’s Award for Excellence in Primary Health Care. Artist: Sue Todd
4
care reform debate. The Association’s adherence to the goals and objectives of
Designer: Millie Shale
our strategic direction enables the Board of Directors and
Copywriter: Heather-Ann Brown
the organization to remain focused and effective. These
Translation: HSN Linguistic Services, Gloucester
strategic directions are:
1. Strengthen the Role of Health Centres within the
AOHC’s Board of Directors has, again, held its meetings in
Broad Health and Social Services Delivery
centres around the province offering opportunities for our
System
Directors to gain an understanding of local issues and to provide
2. Actively Support Development of Existing Members 3. Support New and Emerging Primary Health Care Organizations that Share Our Goals and Values 4. Strengthen the Relationships Between Member Centres and AOHC 5. Promote Healthy Public Policy 6. Organizational Development This Annual Report outlines the major activities we undertook on behalf of our membership this year. These activities are only possible because of the funding and support we receive from our funders and the assistance provided by our volunteers and staff. In particular, in this the Year of the Volunteer, we want to say thank you to our member centres whose contribution of volunteers and staff time and energies enables us to work together on many projects. As well, we want to express our appreciation to the Ministry of Health, Community and Health Promotion Branch for its funding, especially of the Centre Development, Information Technology and Evaluation Systems projects. These have represented major contributions to the welfare of health centres. Our Making Connections projects-web site, booklet and posters-continue to make important contributions to the
local Boards of Directors with opportunities to network with provincial representatives. Thanks to host centres: Rexdale CHC in Toronto, South East Ottawa Centre for Healthy Living in Ottawa, and Shkagamik-Kwe Health Centre in Sudbury. The Association is fortunate to have such a dedicated groups of Board members. On your behalf, we express our thanks to AOHC’s 2000-2001 Board of Directors. We take this opportunity to say a special thanks to outgoing director Altaf Stationwala, Toronto. Member support is vital to AOHC’s ability to represent the interests of health centres with key leaders in health care and government. We want to recognize those who share their expertise on committees. Your participation in Association business enables our decisions to reflect the diversity and wisdom of our membership. This millennium will be a new era for health centres. All segments of the health care system acknowledge that reform is required. Many acknowledge that a model of care such as ours is integral to the public’s well-being. We believe that health centres are positioned to play a pivotal role in providing primary health care in Ontario. This year has been one of growth for us. In the years to come, we will continue to grow in ability and stature. The future presents excellent opportunities for our solution to the health care needs of the citizens of Ontario. Working together, we can grow in scope and in numbers.
public’s understanding of the determinants of health. We are indebted to Health Canada, Health Promotion and Programs Branch, Population Health Section, Ontario Region for funding this project.
Robert Groves
Gary O’Connor
Chair
Executive Director 5
AOHC strategic directions
Annually, AOHC’s Board of Directors meet to review and revise the organization’s strategic
directions in view of past accomplishments, future challenges and the current health care
environment. Association activities during the year are tested against these strategic directions
to ensure AOHC’s activities are focused. In June 2000, the Board of Directors affirmed these
strategies for 2000-2002.
1 2 3 4 5
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Strengthen the Role of Health Centres within Broad Health and Social Services Delivery System
Actively Support Development of Existing Members
Support New and Emerging Primary Health Care Organizations that Share Our Five Goals and Values
Strengthen Relationships Between Member Centres and AOHC
Promote Healthy Public Policy
Organizational Development
7
Salary Survey
1 strengthen the role of health centres Advocacy Projects
The overall objective of strengthening the role of health centres is to promote the health centre model of care and advocate for more resources. Our advocacy projects emanate from this initiative. The development and distribution of Community Health Centre Expansion in Ontario: A Business Case for Strengthening Community-Based Primary Health Care Services (released in October 2000) provided the foundation for AOHC’s advocacy projects this year. It contained a business case for the CHC model and re-stated our view that, for Ontarians to receive effective primary health care, the government should: a. increase the number of health centres from the current
65 to 130 in three years; and b. expand the programs and services at the existing
centres to enable more people to access the programs needed to maintain and enhance health.
In December 2000, AOHC released the updated Salary Survey results showing that salaries for all health centre staff are below the market level; middle and senior management ranks are most affected. Some of these positions are now 36 percent below market parity. We have used this survey to advocate for increased funding for salary and pay equity needs with the Minister of Health and cabinet members, as well as with various levels of the Ministry of Health staff. Influencing Public Policy
AOHC was actively involved in government relations over the past year with over 25 meetings with decision makers at the Ministry of Health and Long-term Care, the Minister of Health’s office and allied health organizations. The focus of these meetings was to promote health centres and to highlight the urgent needs at existing health centres. In addition, we made our positions clear - through letters, presentations or information briefs - on a number of other fronts: a. The Health Privacy Legislation b. Access to Housing a National Crisis c. The Employment Standards Act Changes d. Influenza Vaccination Campaign e. AOHC Response to the Proposed Ontario Privacy
Act f. AOHC Response to Ontario’s Proposed Personal
Health Information Act g. AOHC a member of the Provincial Influenza
Steering Committee h. AOHC a member of the Provincial Asthma Task
Force We distributed this business case to government representatives, allied health organizations and others. In addition, we mobilized the sector to educate their MPPs and other key leaders about the business case and their individual centre needs.
i. CHC representation at the OCFP Medicine in the
21st Century Consultation j. Federal positioning of health centres as part of the
solution to health care reform) k. HSRC Consultation- Next Steps in Health Reform
Business Case Phase I Proposal
In early winter, we received word that the Government might be receptive to a scaled down version of our business case. Accordingly, Community Health Centre Expansion in Ontario: Phase I Proposal A Business Case for Addressing Primary Health Care Needs in Some Key Communities was released in January 2001. This proposal listed 13 communities that were ready for a CHC and proposed an additional $15 million in funding to meet urgent needs in existing CHCs.
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Once again, AOHC Board members and member centres have worked to keep our solution to the health care needs of Ontarians in the forefront with key decision makers.
CHC Program Strategic Review
The two most frequently used reasons, why funding for CHCs could not be considered over the past few years, has been the need for the Government to develop its primary health care strategy and the need for a CHC Program Strategic Review. The government has developed its primary care strategy and in November 2000 it started the Strategic Review. AOHC participated in the Review Steering Committee along with two CHC Representatives and various Ministry of Health staff.
The review has been completed and will be released at the Minister’s call. AOHC predicts that the sector will be pleased by the results of the review.
2 support development of existing members AOHC Supports Centres
Evaluation Systems
The CHC Program Evaluation System was originally implemented in CHCs in 1997/98. CHCs have been collecting client demographic, as well as individual and group services data, since that time last year, data for Community Initiatives started to be collected, following the development of a community development data model for CHCs. The User Support Committee played an active role this year in supporting data quality for the Evaluation System. They responded to many data entry questions and provided feedback to CHCs to ensure consistency in data entry across all Centres.
AOHC supports member centres through: a. Information Technology Support; b. Evaluation Systems; c. Exploration of an Aboriginal Caucus; d. Various Centre Development programs:
- Executive Support, - Best Practices Project, - Building Healthier Organizations Quality Management and Accreditation, - Board Development Workshops, - Satellite Discussion Paper; f. Salary Survey; g. Annual General Meeting Resolutions Actions. Information Technology Support
AOHC continues to plan a key role in providing information technology support for Community Health Centres. The focus of this year’s work has been preparing for a major upgrade to the software installed in Centres last year. CHCs, through the User Support Committee, have been involved in the development of an extensive list of enhancements for the new software that will be installed next year. The AOHC Help Desk, which is in its third year of operation, is now well established and accessed regularly by CHCs to gain assistance with information technology and data entry questions. Also during this year, work began to formally establish technology support standards and protocols.
Work continued on the development of a set of CHC Program Indicators that will use Evaluation System data. Starting with a draft set of indicators, CHCs were involved in reviewing and further developing the indicators in two workshops held in October and December. Exploration of an Aboriginal Caucus
The Membership Secretariat Committee has been actively working on a recommendation to the Board on the potential development of an Aboriginal Caucus within the Association. This work is ongoing at the time of this report. CENTRE DEVELOPMENT PROJECTS Executive Support
Our Executive Support program has become well established over the last year and a half. This program has two streams: a. Workshops and seminars for health centre Executive
Directors, Managers and Board Members, which will be included in the ‘Learning Centre’; and b. Executive Consulting services provided to centres to support their decision-making and planning processes. The intent of the program is to: a. support Executive Directors’ and Boards’ decision
making and long-term planning; b. stabilize the operation of health centre organizations; c. strengthen the position of health centres in response
to health care reform; Over the past year, AOHC undertook to provide CHCs with better access to the data they have been collecting. To that end, report queries were developed for CHCs that could be run on their data to provide information for operational and planning purposes.
d. reduce personal stress for participants; e. increase resolution of organizational and human
resource conflicts; f. support experimentation with program initiatives,
local partners and alliances, new funding streams and other financial supports;
9
g. increase recognition of the role of health centres in
local health service delivery; and h. respond to emerging issues.
Evaluations show that participants gained useful information from the program and support the need for its expansion. The next phase is to develop the ‘Learning Centre’ concept to provide centres with a wide range of training options. The Board of the AOHC has requested that staff develop some entrepreneurial programmes in order to reach the goal of diversifying AOHC funding resources. Member services will be maintained, of course, but these entrepreneurial programmes will go beyond our basic services. Best Practices Project
The focus of this year’s best practice project was the piloting of the model and workbook, as well as the development of ‘The Interdisciplinary Team Tool Kit for the Development of Best Practices’. Many thanks to the staff at Grand Bend CHC and South-East Ottawa Centre for a Healthy Community for their participation in the pilot study. Other work included focus groups on the paper ‘Unpacking the Evidence in Health Promotion’ and the subsequent revision of that work based on the feedback. The year was capped off with the very successful AOHC Best Practices Summit, in which 97 staff from CHCs and AHACs participated. The highlights of the day included: a. a key note address from Dr. Ralph Masi; and b. an afternoon spent in health issue groups, dialoguing
with colleagues on best practice approaches to health issues such as diabetes, cancer screening, as well as target populations such as youth and seniors. Both documents mentioned above can be found in the members section of the AOHC web site at http://www.aohc.org and will be available shortly in French. Building Healthier Organizations Quality Management and Accreditation Program
Building Healthier Organizations (BHO) was developed by AOHC in co-operation with member centres and the Ministry of Health, to: a. promote continuous quality improvement throughout
the sector; b. provide an objective measure of health centre
performance; and c. identify and share examples of excellence. 10
The accreditation process is administered and managed by Community Organizational Health (COH). The first phase of accreditation implementation will be completed by March 2002 with about 60 percent of Community Health Centres having participated in a review. Association staff have worked closely with the COH team to integrate peer review and centre feedback into the BHO model. In addition to the many modifications made throughout the year, to simplify and add clarity to the tool, there was a specific focus on changes required to meet the needs of various Board governance models. The diligent work of all centre staff involved in this modification process is very much appreciated. AOHC has continued to support health centres in the pursuit of continuous improvement. Throughout the year, this has taken the form of BHO readiness workshops, individual consultation, and making resources available to facilitate the development of centre practices, policies and processes. Our growing reference library remains a key source of ongoing support to members in the provision of information and materials to facilitate the development of their organizations. Board Development Workshops
AOHC recognizes the unique challenges of volunteer community-based Boards in executing their governance role. In support, the AOHC remains committed to the ongoing development of all Board members to build upon their knowledge base and maximize the contribution they make to their centres. Building upon the success of previous year’s workshops and specific member recommendations, AOHC offered a fall series of workshops on Board Self Assessment in eight different locations across the province. The 80 participants who attended received Board self-evaluation and other support tools to share with their centres in both French and English. (Many thanks to the South East Ottawa Centre for a Healthy Community and Centre Medico Social Communautaire who provided some of the resources shared!) Participants took full advantage of the opportunity to network with other centres and learn from each other’s experiences. The spring seminar series offered options to attendees covering eight different topics. These included: Board & Staff Roles and Relationships, Teamwork & Effective Meetings, Community Accountability, Strategic Planning, and Appraising & Supporting the Executive Director. The materials and content, again, were well received by the 45 workshop participants across the province.
In the coming year, the range of seminar options will be expanded based upon Board member needs identified and incorporated into the aforementioned ‘Learning Centre’. Satellite Discussion Paper
The Community and Health Promotion Branch funded AOHC to conduct research on the use of the term "satellite" in Community Health Centres; to develop a definition that everyone can use, ensuring common understanding among CHCs and the Community and Health Promotion Branch. Consultants were hired to interview ten CHC Executive Directors who reported having satellite services. A draft of the final discussion paper was circulated to all CHCs for feedback in March. The final version of the paper defines the following three terms for CHCs: a. Satellite, b. Access Point, and c. Outreach Activities.
The paper is now available on line on the AOHC website (www.aohc.org) or in hard copy from the AOHC office. Annual General Meeting Resolutions
Voting Delegates approved these eight resolutions at the 2000 Annual General Meeting: a. AOHC Beliefs and Principles; b. OHIP Eligibility of Canadian Born Children
Resident in Ontario; c. Housing as a Determinant of Health d. Oral Health e. Anti-Racist Framework f. Advocacy g. Protecting the Community Health Centre Name h. Ontario Government Proposal Calls and Submission
Process for New Services AOHC Beliefs and Principles ... that the members of the AOHC adopt the AOHC Beliefs and Principles as revised by the AOHC Board of Directors in January 2000. Action: The updated AOHC Beliefs and Principles are being added to AOHC documents as new print runs are ordered. OHIP Eligibility of Canadian Born Children Resident in Ontario ... that the AOHC, in collaboration with member centres, works to:
1) Coordinate a unified response by the AOHCs and member centres to the issue of OHIP denial to children born in Canada. 2) Strategize as to how the AOHC and member centres can lobby all levels of government to ensure that all Canadian born children receive free adequate health care. ... and that the AOHC report back to the membership throughout the year. Action: At the June retreat, the AOHC Board referred this resolution for action to the newly formed Advocacy and Public Policy Committee, which began meeting in September 2000. The Committee resolved to write the Ministry of Health to clarify what status these children have, what rules, criteria, waiting periods apply to them, etc. If the reply is not clear and unequivocal, the Committee will investigate obtaining a legal review. Housing as a Determinant of Health ... that the AOHC: 1) Bring together a coalition of organizations to advocate for housing as an essential determinant of health. 2) Communicate with all levels of government in Ontario concerning their responsibility for the current crisis in affordable housing, the extent of the resulting problem of homelessness and insecure housing, and its determining effect on the health of low income individuals and families as well as the consumption of scarce health care resources. 3) Urge the federal and provincial governments to reconsider their current policies and agreements with respect to social housing, to examine the broad societal and health costs implications of the worsening crisis in affordable housing, and to develop a national housing strategy. Action: At the June retreat, the AOHC Board referred this resolution for action to the newly formed Advocacy and Public Policy Committee, which began meeting in September 2000. Upon investigation, it was decided that the AOHC could not afford to bring together a coalition, but will support other coalitions and groups working on this issue — the AOHC supported the Toronto Board of Trade Paper on Homelessness, for example. The Committee wrote to the Federal Government and the Provincial Government, and developed a draft letter for CHCs to send to regional and municipal levels of government. 11
Oral Health ... that the AOHC advocate for the Ministry of Health to make oral health an integral component of the portfolio of Community Health Centre health promotion services, and accept oral health as a fundable activity and position within health centres. Action: At the June retreat, the AOHC Board referred this resolution for action to the newly formed Advocacy and Public Policy Committee, which began meeting in September 2000. In December the Committee asked Hamilton Urban Core CHC to take the lead role on this resolution. There will be a workshop on this topic at the June 2001 Conference and a paper and brochure are being prepared. Anti Racist Framework ... that the AOHC, in collaboration with all member centres, work to: 1) Develop and implement an anti-racist framework which will act as a lens through which all decisions, organizational activities and programs are viewed, critiqued and developed. 2) Organize and lobby government bodies collectively in order to challenge the status quo, influence change and ensure that all community members receive full access to health care. 3) Maintain an ongoing analysis of the health care system in terms of racial barriers to care recognizing that cultures subcultures within a system will change and evolve in response to the challenges of the existing system. ... and that the AOHC report back to the membership throughout the year. Action: At the June retreat, the AOHC Board referred this resolution for action to the newly formed Advocacy and Public Policy Committee, which began meeting in September 2000. The Advocacy and Public Policy Committee has developed advocacy guidelines to be used as a guide for any future work in addition to the organizations anti-discrimination policies. Advocacy ... that the platform upon which the advocacy work of the AOHC is conducted incorporates critical issues of equity, antiracism, anti-oppression and social justice;
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... and that a specific strategy be developed to highlight equity, anti-racism, anti-oppression and social justice issues and their
involvement with, or impact on AOHC advocacy work, the membership and client communities; ... and that the AOHC report back to the membership throughout the year about the implementation of this strategy. Action: At the June retreat, the AOHC Board referred this resolution for action to the newly formed Advocacy and Public Policy Committee, which began meeting in September 2000. The Advocacy Guidelines have been drafted for use as a guide in all future work. Protecting the Community Health Centre Name ... that in addition to trade marking efforts, AOHC explore the options available to protect Community Health Centre and Centre de santé communautaire; and that AOHC involve member centres in a task group to plan how to implement trademark or other protection in a way consistent with the AOHC beliefs and principles. Action: At the June retreat, the AOHC Board referred this resolution for action to the newly formed Advocacy and Public Policy Committee, which began meeting in September 2000. In December the committee referred this resolution to AOHC staff for action. Staff are recruiting the working group to work on this issue. Ontario Government Proposal Calls and Submission Process for New Services 1) Inform membership organizations of the potential for contracted management of ‘Call for Proposals’ by the government; 2) Provide the membership with information, education and support about these processes; 3) Research this method of soliciting proposals, and advise the Ministry of ways to improve the process to ensure that the principles of access to services and meeting community needs are recognized and addressed through any ‘Call for Proposal’ process. Action: At the June retreat, the AOHC Board referred this resolution for action to the newly formed Advocacy and Public Policy Committee, which began meeting in September 2000. In December the committee referred this resolution to AOHC staff to take action on. Staff are recruiting the working group and the work on this issue.
3 support new and emerging primary health care organizations and share goals and values
Finally, at the request of the Board, the Committee has begun to tackle the issue of AOHC membership diversification, and in particular they are considering other membership models from across Canada. Final recommendations will be provided to the Board early in the summer.
The number of communities wanting a CHC has grown dramatically over the past year and AOHC has actively supported their development. At last count there were close to 90 communities pressing for a CHC.
Other activities include: a. developing a standing column in AOHC’s newsletter, healthLINK, that addresses issues of interest to governance volunteers; b. reviewing new membership applications; c. providing information on AOHC’s newly designed web site; and d. responding to emerging membership issues.
AOHC supported the Ministry of Health and Long-term Care Needs Based Planning for new CHCs. Through this initiative the Ministry hopes to develop demographic, access and health indicators that will help them identify locations for new CHCs.
5 promote
Supporting Communities wanting to start a CHC
We continue to support the development of Aboriginal Health Access Centres (AHACs) and are encouraged that all but one of these centres have now joined the Association. We have met with, talked to and/or corresponded with over 200 community groups over the year. Close to 90 groups are interested in the health centre model of care and await the availability of funding to pursue their development.
4 strengthen relationship between member centres and AOHC Strengthen Relationships
The Membership Secretariat Committee members have been active in consulting with groups of Executive Directors and Boards as to how the Association is doing, particularly in its strategic directions. That information, collected throughout the year, will be provided to the AOHC Board to assist with their planning for the upcoming year. In addition, the Committee has been actively addressing a recommendation to the Board on the potential development of an Aboriginal Caucus within the Association. This work is ongoing at the time of this report.
healthy public policy Most activity related to promoting healthy public policy has been done through our alliances with other organizations, i.e. a. Coalition for Primary Care; b. Ontario Health Providers Association; c. Ontario Public Health Association; d. Canadian Alliance of Community Health Care Associations; and e. The Ontario Rural Council. We have tried to raise the profile of health reform issues in the membership through the Board Development Workshops.
Organizational
6 development We have: a. reviewed organizational roles and responsibilities for committees, board and staff; b. developed the board and documented the AOHC’s board policy governance model; c. worked to ensure financial stability for the organization; and d. conducted quarterly board development sessions to increase the board capacity for advocacy, media literacy and governance.
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AUDITOR’S report C H A RT E R E D A C C O U N TA N T 5805 WHITTLE ROAD, SUITE 209 MISSISSAUGA, ONTARIO, L4Z2J1 TELEPHONE: (905) 502-7660 FAX: (905) 502-7662 e-mail grclow@netcom.ca
To the Members of the Association of Ontario Health Centres:
I have examined the balance sheet of the Association of Ontario Health Centres as at March 31, 2001and the statements of revenue, expenses and fund balances and of changes in financial position for the year then ended. These financial statements are the responsibility of the Association’s management. My responsibility is to express an opinion on these financial statements based on my audit.
I conducted my audit in accordance with generally accepted auditing standards. Those standards require that I plan and perform an audit to obtain reasonable assurance whether the financial statements are free from material misstatement. An audit includes examining, on a test basis, evidence supporting the amounts and disclosures in the financial statements. An audit also includes assessing the accounting principles used and significant estimates made by management, as well as evaluating the overall financial statement presentation.
In my opinion, these financial statements present fairly, in all material respects, the financial position of the Association of Ontario Health Centres as at March 31, 2001 and the results of its operations and the changes in its financial position for the year then ended in accordance with generally accepted accounting principles.
Graham R. Clow C.A. May 15, 2001 Mississauga
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ASSOCIATION OF ONTARIO HEALTH CENTRES BALANCE SHEET - MARCH 31, 2001
2001 Operating Fund
2001 Special Purpose Fund
2001
2000
Total
Total
$138,643 21,162 28,997 188,802
$627,468 1,180 628,648
$766,111 21,162 30,177 817,450
$461,387 211,144 37,581 710,112
16,797 16,797 -
33,424 33,424 -
50,221 50,221 -
43,313 43,313 -
$188,802
$628,648
$817,450
$710,112
$26,890 85,625 112,515
$210,559 22,363 376,767 609,689
$237,449 22,363 462,392 722,204
$509,172 21,001 87,682 617,855
76,287 $188,802
18,959 $628,648
95,246 $817,450
92,257 $710,112
ASSETS
Current assets
Cash and short term deposit Accounts receivable Prepaid expenses
Office equipment
Cost Less: Accumulated depreciation
LIABILITIES AND FUND BALANCES
Current liabilities
Accounts payable and accrued liabilities Unused grants repayable Deferred revenue
Fund balances
Approved by the Board
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ASSOCIATION OF ONTARIO HEALTH CENTRES STATEMENT OF REVENUE, EXPENSES AND FUND BALANCES FOR THE YEAR ENDED MARCH 31, 2001
2001 Operating Fund
2001 Special Purpose Fund
2001
2000
Total
Total
$175,400 1,068 151,376 40,545 58,727 20,826 447,942
$1,706,771 64,262 16,633 1,787,666
$1,706,771 64,262 175,400 1,068 151,376 40,545 58,727 37,459 2,235,608
$1,506,186 128,509 176,687 9,600 678,988 102,540 19,008 19,006 30,920 2,671,444
166,217 82,722 34,991 146,836 14,187 444,953
682,287 400,705 368,027 259,198 77,449 1,787,666
682,287 566,922 450,749 294,189 146,836 91,636 2,232,619
1,270,696 513,505 517,733 187,984 85,047 103,583 2,678,548
2,989
-
2,989
(7,104)
73,298
18,959
92,257
99,361
$76,287
$18,959
$95,246
$92,257
Revenue
Grants from Ministry of Health, Ontario Grants from the Federal Government Memberships Special contributions CHC computer systems upgrade Annual Conference Secretariat Fees Revenue from equipment and facilities use Other revenue
Expenses
Hardware and software Salaries and related expenses Administrative expenses Consulting Annual Conference Meeting expense
Excess of revenue over expenses (expenses over revenue)
Fund balances, beginning of year
Fund balances, end of year
::
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ASSOCIATION OF ONTARIO HEALTH CENTRES STATEMENT OF CHANGES IN FINANCIAL POSITION FOR THE YEAR ENDED MARCH 31, 2001
2001 Operating Fund
2001 Special Purpose Fund
2001
2000
Total
Total
$2,989
$-
$2,989
$(7,104)
2,989
6,908 6,908
6,908 9,897
(7,104)
(152,952)
454,687
223,952
140,737
(149,963)
461,595
233,849
133,633
-
(6,908)
(6,908)
-
288,606
172,781
461,387
327,754
$138,643
$627,468
$688,328
$461,387
Operating activities
Excess of revenue over expenses (expenses over revenue) Add: Non-cash expenses Depreciation expense
Changes in non-cash elements of working capital
Cash provided by operating activities
Investing activities Purchase of computer equipment Cash and term deposit, beginning of year
Cash and term deposit, end of year
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ASSOCIATION OF ONTARIO HEALTH CENTRES NOTES TO THE FINANCIAL STATEMENTS MARCH 31, 2001 1.
Status of the Association The Association was incorporated, without share capital, in 1982 by Letters Patent, as amended in 1996, under the Corporations Act of Ontario. In addition, the Association is registered as a charity under the federal Income Tax Act. The mission of the Association is to represent member centres in the promotion of healthy public policy, healthy individuals and communities through the creation and continuing development of health centres which embody principles of accessible quality primary care, health promotion and active community ownership and participation.
2.
Significant accounting policies: Basis of accounting and financial statement presentation The Association reports revenue and expenses using the accrual basis of accounting. It follows the deferral method of accounting for revenue from specific projects, whereby funding is recognised as revenue in the year in which the related expenses are incurred.The financial statements separately disclose the activities of the following funds maintained by the Association: Operating fund – Reflects the various activities associated with the Association’s day to day operations Special purpose fund – Reflects the activities associated with grants received for specific projects. Fixed assets Fixed assets are recorded at cost, or, where contributed, at the fair value at the date of contribution. Those assets that are acquired from specific project funding are depreciated over the term of that project. Other assets are depreciated over their estimated useful lives using the straight line method as follows: computer hardware and software is depreciated over a period of two years and other equipment is depreciated over four years. Deferred revenue Deferred revenue consists of cash received by the Association that will not be recognised as revenue until a future fiscal period and includes membership dues for the following fiscal year and the unspent portion of grants and other funding in respect of projects in progress. Contributed services Without volunteers contributing a substantial amount of time each year to the Association’s activities, it would cease to operate effectively. However, because of the difficulty of determining the fair value of these contributed services from an accounting standpoint, they are not recorded in these financial statements.
3.
Community Organization Health (COH) Inc (COHI) To carry out the accreditation process of the Building Healthier Organizations program, the Association’s material, developed in conjunction with the Ministry of Health, has been licensed for a nominal annual fee to Community Organization Health (COH) Inc, (COHI) the organization now responsible for the accreditation review.
4.
Funding by the Ministry of Health The Ministry of Health funds many of the Association's projects and such funding is provided on the basis that amounts not spent on the particular project are to be refunded to the Ministry. At March 31, there was $22,363 (2000 - $21,001) repayable to the Ministry in respect of projects completed but for which a portion of the funding remained unspent.
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As the Ministry funds most of the special projects undertaken by the Association, it is in a position to significantly influence the operations of the Association in this respect. This risk is managed by closely defining relationships through contracts and funding letters. 5.
Financial instruments The carrying value of cash and short term deposit, accounts receivable, accounts payable and accrued liabilities reflected in the balance sheet approximate their respective fair values due to their short term maturity or capacity for prompt liquidation. Cash and the short term deposit which matures on April 27, 2001, have been placed with a major Canadian chartered bank and the credit risk is therefore considered insignificant.
6.
Commitments The Association has committed to a lease, expiring in 2005, for office equipment. Minimum quarterly charges will amount to $2,498 for each of the fiscal years through to 2005.
7.
Contingent liability In the prior year, the Association was served with a statement of claim relating to alledged abuses of the procedures used in the selection of a software supplier. In the view of the Association's board of directors, its management and its solicitors, the statement of claim is without merit and is being vigorously contested. As no subsequent liability is anticipated other than legal fees incurred to defend the Association against this claim, no provision has been made for this matter in these financial statements. In the opinion of the Association's board of directors, its management and its solicitors, costs of contesting the claim will either be recoverable from the plaintiff or from the carrier of the Association’s general liability insurance policy or both.
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