Shaping our future
ANNUAL REPORT 2008-09
Tommy Douglas on the Second Stage of Medicare Annual report design by: Pass It On Communications, www.passiton.ca
Canadian Medicare founder Tommy Douglas
“I am concerned about Medicare – not its fundamental principles – but with the problems we knew would arise.” “Those of us who talked about Medicare back in the 1940s, the 1950s and the 1960s kept reminding the public there were two phases to Medicare. The first was to remove the financial barrier between those who provide healthcare services and those who need them. We pointed out repeatedly that this phase was the easiest of the problems we would confront. In governmental terms, of course, it would mean finding revenue, setting up organisations, organising controls over costs. But in the long-term it was the easiest problem.” “The phase number two would be the much more difficult one and that was to alter our delivery system to reduce costs and put an emphasis on preventative medicine…” “…The first phase has met with a great measure of success.…Canadians can be proud of Medicare, but what we have to apply ourselves to now is that we have not yet grappled seriously with the second phase.”
“Periodically, we ought to reexamine Medicare… to the end that we will be able to build in Canada a programme which will provide the maximum amount of good health, enable Canadians to enjoy good health, and provide them with remedial care when that good health is no longer present. And to do that, without any fear of financial burdens, which have crippled so many people in other places and other times.” “We must work to get Medicare as it was intended to be, a programme that would provide, in Canada, a society in which we would have freedom from fear and freedom from want.” Quotes excerpted from speech to the Canadian Labour Congress and other organisations advocating for a strong public healthcare system in Canada, November 1979
www.aohc.org
TABLE OF CONTENTS Shaping our future . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 Highlights of achievements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 AOHC Board and staff . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 Stronger connection with membership. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 Following through with branding. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Showing we care, and meaning it. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10 Hoping for a reason to smile . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11 Centre development key to completing the network . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12 AOHC becomes education and development hub for member centres . . . . . . . . . . . . . . . . . . . . 13 Supporting centres’ Board members . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13 Building on existing experiences. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Following the clinical management system Roadmap. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 Hoping for the best, preparing for the worst . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 Reasons to be proud, reasons to improve . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16 AOHC finances . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17 1
Shaping our future Welcome to AOHC’s 27th Annual Report. This year
EDs. To support this process, AOHC developed the CHC
erned primary health care.” AOHC also led the process
we have continued to honour Tommy Douglas’ origi-
Model of Care Manual including detailed descriptions of
to create and provide a new logo for both CFHTs and
nal ideas and vision, knowing that our model of care
its attributes, principles, underlying beliefs and values,
AHACs so they can have a common visual identity of
continues to be the key vehicle for the positive change
which together constitute the nucleus of who CHCs are
their own.
Ontarians want to see in our healthcare system.
and what they do.
We also remain resolute to ensuring our members are appropriately resourced and equitably equipped to
At our 27th Annual Conference, AOHC will recom-
In addition to the CHC Model of Care Manual, AOHC produced several reports including:
with a focus on the intersection of poverty and health.
provide non-profit, community-governed, interdisciplinary healthcare services to the people of Ontario
Poverty has a price tag for all Ontarians —– and its ren
who most need it. Those familiar with our 75 Community Health Centres (CHCs), 28 CHC satellites, 25
n
Community Family Health Teams (CFHTs) and 10 Aboriginal Health Access Centres (AHACs) continue to firmly believe they are manifestations of the innovations needed to reclaim Canada’s position as a global leader in health and social development.
mit to implementing the Second Stage of Medicare
n
Lessons Learned, for the development of
duction and eradication would benefit us all. There is a
new CHCs
moral imperative to rid ourselves of its scourge. There
Looking Back, Looking Forward, about the system-
is also an economic imperative: we can pay now or we
atic operational and funding issues facing CFHTs
can pay later with increased health care, criminal jus-
Resolution calling for equalisation funding
tice, and social services costs.
for AHACs A successful oral health campaign was also launched and carried out in partnership with the Ontario Oral Health Al-
AOHC MISSION:
The AOHC provides leadership for the promotion of non-profit, communitygoverned, interdisciplinary primary health care grounded in the social determinants of health.
liance and the Ontario Association of Public Health Dentistry, culminating with a successful press conference at Queen’s Park, and the swift distribution to MPPs of thousands of postcards signed by our member centres’ clients. Furthermore, AOHC clearly positioned itself as a hub of education and development for its member centres, providing them with the essential resources to make a difference within their communities.
Modelling client care In 2008-09 CHC Executive Directors (EDs) made a commitment to implement the CHC Model of Care in
2
Additionally, AOHC refreshed its logo and signage, reasserting what we all believe describes the core of what our members stand for. The result was an
their centres by endorsing the CHC Model of Care
improved and fully bilingual logo com-
Charter. This Charter was signed by 100% of the CHC
bined with the tagline “Community-gov-
Adrianna Tetley
www.aohc.org
Other ongoing challenges include MOHLTC incentive-based payment model for physicians that threatens the CHC model of care. However, there was a major breakthrough with the 2008 OMA agreement that requires a commitment to re-
AOHC VISION:
All Ontarians have access to non-profit, community-governed, interdisciplinary primary health care.
view the CHC and AHAC compensation model by October 2009. This is probably the most important policy issue facing the CHCs at this time. Nevertheless, considering the current economic situation, the communitygoverned primary healthcare sector knows that there has never been a more important time to make key investments into social capital to strengthen our communities using our unique model.
Simone Atungo
In the meantime, we continue calling on governments, health authorities and
Overcoming adversity Our sector currently navigates in the midst of a major international economic crisis that is particularly affecting its priority populations, and AOHC is dedi-
health providers to be more pro-active and responsive to diverse individual and community needs and to address population health and social determinants of health.
AOHC expects considerable progress on the implementation of many of these fronts in 2009-10 and remains faithful to the original vision for Medicare, even more so in this period of economic turmoil and massive change. Next year, at our 28th annual conference, AOHC and its member centres will keep moving towards this vision, with a clear focus and emphasis on access, equity and anti-oppression. We will remain fully committed to our efforts to improving Ontarians’ health, building more integrated and effective care and support within the Second Stage of Medicare. When we achieve this vision, we will have more vibrant communities, with healthier Ontarians. And we can make it happen. Together.
cated to continue firmly advocating on key issues that affect its member centres. Among others, the longoverdue release of oral health funding for dental care prevention and treatment services for low-income On-
Contemplating the road ahead One of AOHC’s key goals is ensuring that the
tarians as well as the important Community Health
CHCs, CFHTs and AHACs are fully supported, re-
Simone Atungo
and Social Service Infrastructure Fund.
sourced and expanding across the province and that
President
There are also clear challenges in maintaining a uni-
new and existing CHCs, CFHTs and AHACs have the
fied voice for our sector. MOHLTC’s restructuring and
political, financial, policy and administrative support
the emergence of 14 new LHINs continues to create a
to meet the needs of their clients and communities. In
lack of clarity, has made it more difficult to get official
this changing environment we need to be more vigi-
Adrianna Tetley
decisions in a timely way and has limited the ability of
lant than ever.
Executive Director
our member centres to speak as one.
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Highlights of achievements While progress is being made on many objectives, this report will only highlight the achievements. A full report presented to the AOHC Board in February 2009 is available upon request.
Strategic Direction AOHC exists so that the CHC, AHAC and CFHT models of care are fully supported and resourced and are expanded across the province so that all Ontarians
Goals
n
GOAL 1 CHC, AHACs and CFHTs are appropriately resourced and equitably equipped to deliver effective, primary healthcare service to our clients.
mitted to the Physician–LHIN Tripartite Committee. n
Open Prescribing for Nurse Practitioners n
In February, in a submission to the Minister of Health and Long-Term Care, AOHC responded to the recommendations of the
The priorities under this goal are set in consultation with the CHC ED Network, the AHAC ED Network and
Health Professions Regulatory Advisory
the CFHT ED Network.
Council with a strong call for open prescrib-
n
ing for NPs.
CHC Model of Care (see the “Showing We Care
who need them eventually access their benefits. The
and Meaning it” section of this report)
member centres have the capacity to improve clients’
n
n
the LHIN Multi-Sector Service Accountability
to justify the cost/investment.
Agreement.
ments for NPs and other health professionals. n
The CHC Model of Care Manual was developed and over 1,400 copies have been distributed.
n
the legislation as the Bill goes through the Legislature process. n
A Day in the Life of an NP n
Stabilisation Funding n
across 23 CHCs participated and 466 clinical days of data were analyzed. Data show NPs
crease to their base funding. The CFHTs
role in Chronic Disease Management, Com-
received a 2.25% increase to salary lines only.
prehensiveness, Access and Prevention.
The focus is now on 2009-10 to ensure that our n
member centres receive the same stabilisation increase as other LHIN-funded communitybased organisations. n
n
On the Road toward Electronic Health Records n
and Inventory of Resources to assist CHCs in
CHC and AHAC physician compensation be include a consideration of a return to a fully salaried model. This is probably the most important policy issue facing CHCs today.
In consultation with the five early adopter CHCs, AOHC developed a Roadmap, Checklist
The 2008 OMA Agreement requires that the reviewed by October 2009. This review is to
Data analysis results will be shown to June 2009 CHC EDs Network meeting.
A return to full salary for Physicians n
AHOC contracted with PSTG Consulting to document the work of NPs. Thirty-five NPs
The CHCs, AHACs, NPs and Diabetes programme received a 2.25% stabilisation in-
n
However, the legislation does not go far enough. AOHC will call for amendments to
The CHC Executive Directors endorsed and signed the CHC Model of Care Charter.
n
In April 2009, the Government introduced legislation to permit a broader range of acts and treat-
The CHC Model of Care was incorporated into
health outcomes and sufficient resources are invested n
4
A submission has been prepared and sub-
their transition to full ECR status. n
Community Health and Social Services Infrastructure Fund n
AOHC in partnership with the Ontario Community Support Association (OCSA) and the
www.aohc.org
Ontario Federation of Community Mental
n
Health and Addiction Programmes
CFHTs: Looking Back, Looking Forward n
veloped a report entitled Looking Back, Look-
ministries and the LHIN CEOs for the estab-
ing Forward. This report documents and
lishment of a Community Health and Social
prepares recommendations on the systemic
Services Infrastructure Fund (CHSSIF) for CHCs
funding and operational challenges facing
and AHACs. The Toronto Star also provided pos-
CFHTs.
itive coverage. n
In consultation with CFHTs, the AOHC de-
(OFCMHAP) received formal support from key
n
After a presentation to the FHT Action Group,
The Ontario Government will be announc-
MOHLTC committed to meeting with the
ing a 10-year $60 billion infrastructure strat-
CFHT ED Network to discuss and seek resolu-
egy in the Fall. We are hopeful that the
tion to the recommendations.
CHSSIF proposal will receive positive support in that process. n
New CHC Report: Lessons Learned n
AOHC undertook a study to document the start up and operational issues facing the emerging CHCs. This report made several recommendations to the MOHLTC re: community engagement process, pre-operational issues, capital process and ensuring that new CHCs are
n
n
CHCs, AHACs and CFHTs adopt a culture of continuous quality improvements so they can improve their delivery of primary healthcare services for clients they serve. (See the “AOHC becomes education and development hub for member centres” section of this report.) n
In 2008-09 AOHC has built its capacity to deliver
funded equitably with existing CHCs.
education and centre development to new staff
AOHC continues to meet with MOHLTC to
and Boards.
resolve these recommendations. n
GOAL 2
n
Highlights of the year include:
A Capital Workshop was held with new CHCs
n
CHC Model of Care Training
to understand the MOHLTC capital approval
n
DMC Training
process.
n
Programme Learning Groups for different staff
AOHC received a grant to support the strengthening of the AHAC ED Network, begin the
n
Boards in the Changing LHIN Environment. n
with recommendations to change the wording as follows: “CHCs and AHACs are recognised and can demonstrate effectiveness of their models of care to improve health outcomes of people facing barriers to access with a focus on aboriginal, francophone, racialised and minority communities, disabled and
Emergency Preparedness. In addition, the Preparation Guide for an Influenza Pandemic was developed,
The AHACs have developed a united strategy
which has proven very helpful in assisting centres
to request equalisation funding of $1.5 million
in the development of their own emergency plans.
level of CHCs.
with the Board at its February 2009 meeting
AOHC conducted two workshops in 2008-09 on
provide information for decision making.
Not a lot of work was accomplished under this goal in 2008-09. This goal had much discussion
In response to member centres’ requests a Board
Healthier Organisations” (BHO) and to develop
per centre to bring them up to the funding
n
Adoption of ECR
workshop was developed called, The Role of
the purposes of improving quality of care and to n
n
process towards accreditation through “Building a training strategy to improve data quality for
CHCs and AHACs are recognised as the most effective model to improve health outcomes for aboriginal, francophone, racialised and minority communities, disabled and other vulnerable populations.
disciplines
Strengthening of Aboriginal Health Access Centres n
GOAL 3
other vulnerable populations.” n
The Board has identified this goal as their third priority going forward and several objectives have been established for 2009-10, including endorsing “Access, Equity and Anti-Oppression” as the theme for the June 2010 conference.
5
n
In February, the AOHC Board met with the Anne
GOAL 5
Johnston Centre to get a better understanding of
Social determinants of health inform legislation and policies in support of the model of care so that CHCs, AHACs, and CFHTs can provide high quality primary care for clients they serve and improve the health of communities.
issues facing the barrier-free population and the Rainbow Health Ontario to get a better understanding of issues facing the Lesbian, Gay, Bisexual and Trans (LGBT) communities. n
As a result of this meeting, a Think Tank co-
n
Eradication Strategy culminating in the June
sponsored with Rainbow Health Ontario and
2009 conference, At the Intersection of Poverty and
AOHC was held to begin to determine strategies
Health and the Poverty Eradication Resolution at
on how to improve access to primary care for the LGBT communities at CHCs, AHACs and CFHTs. n
As well, AOHC is supporting St. Catharines CHC
the June 2009 Annual General Meeting. n
In addition AOHC made presentations to the Ontario cabinet committee on poverty reduction,
in their work to establish LGBT as a priority
calling for a Poverty Free Ontario and continues to
population for their new CHC.
build strategic alliances with 25-5 Coalition and other anti-poverty groups.
GOAL 4
AHACs, CHCs and CFHTs are expanded across the province so that all Ontarians who need them have access to their benefits. n
AOHC’s work in 2008-09 focused on a Poverty
n
In 2008-09 AOHC conducted an audit of poverty reduction and mitigation initiatives and programmes currently underway in CHCs and AHACs. The report A Journey Through Poverty will be released at the conference.
New CHCs and CHC satellites announced in 2004-05 are all in either pre-operational stage, capital development or are operational. (See the
GOAL 6
“Completing the network, one centre at a time”
The Second Stage of Medicare (SSM) is publicly and politically supported as the solution to ensure that all Ontarians live longer and healthier lives. In addition, the CHC, AHAC, and CFHT model of care is seen as one of the key implementation vehicles for the SSM.
section of this report.) n
The New CHCs are facing several operational issues where they are not treated equitably with existing CHCs, including access to non-insured funds, funding for on-call, equitable physician compensation levels, and overall insufficient op-
n
MOHLTC to resolve these issues one at a time. Access is also defined in terms of new programmes for existing CHCS and AHACs, including ensuring CHCs and AHACs have access to oral health funding through their centres. (See the “Hoping for a reason to smile” section of this report.)
The SSM continues to be incorporated as a framework in all AOHC’s policy, training and commu-
erating budgets. AOHC is advocating with the n
n
nication work. n
The SSM language is beginning to have some resonance. n
At least six CHCS included SSM in their annual reports, opening of centres and AGMs.
n
The media (Metroland Toronto, Ottawa Sun and Sudbury Star) used the SSM language in articles.
n
The NDP has spoken on more than one occasion in the Legislature on the SSM.
n
AOHC applied for Trillium funding to develop a short video clip and develop training materials for Boards and staff on the SSM. If successful this will be come a bigger focus in 2009-10.
AOHC made presentations to the Students for Medicare, Medical students at McMaster, and Masters students at University of Toronto to name a new.
To obtain submissions, proposals or reports named in this report, contact François L’Ecuyer, Communications Manager at Communication@aohc.org.
6
www.aohc.org
AOHC Board and staff AOHC Board of Directors
AOHC Staff
Simone Atungo, President, Central Constituency Director Paulos Gebreyesus, Vice President, Member-at-large Margaret Hedley, Secretary, South Central Constituency Director David Orman, Treasurer, Eastern Constituency Director Almaz Reda, Member-at-large Anita Cameron, Aboriginal Constituency Director Elizabeth Beader, South Central Constituency Director (resigned April 2009) Jeannie Taylor-Page, Member-at-large Jill Marzetti, Central Constituency Director Joan Lesmond, Member-at-large Karen Smith, CFHT Constituency Director Marc Beaulieu, Francophone Constituency Director Marsha Stephen, Eastern Constituency Director Mary Ellen Parker, Southwest Constituency Director (elected December 2008) Ron Ballantyne, Central East Constituency Director (elected April 2009) Vincent LaCroix, Northern Constituency Director
Adrianna Tetley, Executive Director Aynur Gurbanova, Manager, Performance Measurement* Brian Sankarsingh, Clinical Management System Lead* Carolyn Poplak, Training Manager Corinne Christie, Receptionist/Administrative Assistant, AHAC Programmes Cory LeBlanc, Executive Assistant/Office Manager Danielle Kurchak, Administrative Assistant* François L’Ecuyer, Communications Manager Lee McKenna, Manager, Policy and Government Relations Lisa Tisdel, Administrative Assistant Martine Hinton, Translator* Mary Chudley, Centre Development Project Lead Roohullah Shabon, Director, Education and Development Sandra Wong, Administrative Assistant Sheri Doxtator, AHAC Project Manager* Slavka Angelova, AHAC Clinical Management Systems Lead* Sophie Bart, Centre Development Lead
Many thanks and much appreciation to Marc Beaulieu, Paulos Gebreyesus, Marsha Stephen, and Jeannie Taylor-Page for their ded-
First row: Carol Smith, Simone Hammond, David Orman Second row: Jeannie Taylor-Page, Karen Smith, Almaz Reda, Jill Marzetti, Marsha Stephen Third row: Marc Beaulieu, Paulos Gebreyesus, Anita Cameron, Vincent Lacroix, Joan Lesmond Absent: Elizabeth Beader, Margaret Hedley, Mary Ellen Parker and Ron Ballantyne
* New team member
ication and commitment to the Board of Directors. Their terms
A fond farewell to…
expire in June 2009 and they will not be seeking re-election. Spe-
Chantal Pinard, Administrative Assistant Keisa Campbell, Centre Development Team Scott Wolfe, Senior Policy Analyst
cial thanks also to Elizabeth Beader who resigned in April 2009.
BOARD OF DIRECTORS
STAFF First row: Corinne Christie, Adrianna Tetley, Roohullah
970 Lawrence Ave. West, Suite 500, Toronto, ON, M9A 3B6 Tel: 416-236-2539 Fax: 416-236-0431 E-mail: mail@aohc.org www.aohc.org
Shabon, Danielle Kurchak Second row: Aynur Gurbanova, Slavka Angelova, Lisa Tisdel, Carolyn Poplak, Martine Hinton Third row: Sandra Wong, Mary Chudley, François L’Ecuyer, Lee McKenna, Cory LeBlanc Absent: Brian Sankarsingh, Sheri Doxtator and Sophie Bart
7
Stronger connection with membership In response to our members, AOHC will prepare three “Board-to-Board” reports per year on the highlights of our achievements and major developments in our work. With 2008-09 has come a wide array of new tools
Strengthening AHAC Network The AHACs have also developed a
Communications Manager position last year, as well as those of a Policy and Government Relations Manager and of a Translator last September, have considerably enhanced AOHC’s capacity to better connect with cen-
logo in order to increase the visibility of their work and
the communication between the AOHC Board of Directors and the Boards of Directors of our member centres, AOHC
now been officially formed in order to give a united voice
will prepare three “Board-to-Board”
on common issues. AOHC has recently received a grant
reports per year on the highlights of
that will provide the resources for the Executive Directors
our achievements or major develop-
to meet at least three times in the next year with the goal
ments in our work.
stituency has welcomed its AHAC members who have
The first report, released March 25, 2009, was very appreci-
participated in the last two meetings. Hopefully over the
ated by the membership. AOHC
next year the other AHACs will participate in their re-
would like to thank everyone for
gional constituencies as well.
their feedback. In the future, it will be issued in April, October and January. AOHC will continue to welcome your feed-
tres at many levels.
back directly at any time and through your constituency
A great majority of member centres have been visited by AOHC staff or given the opportunity to participate, whether over tele-, video-conferencing, or in
At the request of some of its members and to improve
the clients they serve. As well, the AHAC EDs Network has
to strengthen this network. Finally, the Northern Con-
and resources for the membership. The creation of a
New Board-to-Board report
Bringing Synergy back to life
representative in order to make the next ones even better.
The annual conference in June
person in important constituency meetings through-
last year marked the much needed
out the year. Your unique contribution and active par-
return of the fully bilingual Synergy
ticipation have helped AOHC better understand your
newsletter after one-and-a-half
needs and become better at what it does.
years of absence. AOHC has since
keep apprised of the latest initiatives as well as receive
then released seven monthly edi-
all important requests from AOHC staff from one sin-
Starting up the CFHT constituency This year, in addition to adopting a common logo, CFHTs were able and will continue to strengthen their network through the CFHT constituency meetings. Representatives shared their concerns and laid the foundation for what will certainly be the opportunity for discussion of the unique challenges they face. In addition, CFHTs are in the process of forming a CFHT EDs Network to share common solutions for many of their operational challenges.
New EDs Weekly bulletin Executive Directors can now count on a new tool to
tions, all produced in-house. The
gle source! Thanks to months of preparation and hard
Synergy newsletter is and will con-
work, the news bulletin will continue to be sent to Ex-
tinue to be an effective means of ongoing communica-
ecutive Directors on a weekly basis.
tion with member centres’ Board members and staff. It
The content consists of short news or information
offers the latest on AOHC’s advocacy initiatives and
about resources that either cannot wait to be published in
training events for member centres on a monthly basis.
the monthly Synergy newsletter or that do not fit its for-
It also reports on important events held by our member-
mat and purpose. In addition to providing valuable infor-
ship from across the province, such as opening a new
mation for the EDs, many other staff can benefit from the
centre, a logo or programme launch, laying the founda-
information provided. It also provides an opportunity to
tion of a new site, or an open-house, among others.
share relevant information and resources from other or-
Thank you to all the members who have kindly con-
ganisations. EDs Weekly provides a general section for all
tributed to its quality content since last year.
plus a specific section for AHACs, CHCs and CFHTs.
For additional information about membership communication and networks, contact François L’Ecuyer, Communications Manager at Communication@aohc.org.
8
www.aohc.org
Following through with brand identity New look for AOHC In October 2008, AOHC started consulting with the Board of Directors to refresh its logo and officialise a tagline that would best represent our members and de-
Centres have reported that clients commented extremely positively on the new brand identity, and were still very clear about the identity and purpose of the centre within the community.
scribe the core of what AOHC stands for. The result was an improved and fully bilingual logo combined with the tagline, “Community-governed primary health care.”
sign was picked because of its lively and active look, to accurately reflect the identity of the centres it stands for.
CHC logo family has new members The blue swirl has considerably grown in size: not the logo but its use. More than 32 CHCs proudly dis-
AHACs and CFHTs each adopt a common logo Also as a result of a branding exercise that started in the Fall of 2008, both AHACs and CFHTs adopted a common logo to identify their group of centres. The groundwork for the AHAC logo was created by Michael Chokomoolin, a local Cree-artist from Mani-
played it in their 2007-08 Annual Reports and 17 of them have posted the newly adopted official logo on their website. AOHC expect these numbers to go up significantly next year. Fourteen centres now use the CHC blue swirl as their one and only logo:
These centres have proven to be able to retain their identity at the community level, while identifying with the larger movement at the provincial level. In fact, most have reported that clients commented extremely positively on the new brand identity, and
toulin Island,
n
Estrie
were still very clear
paramedic and
n
Gateway
about the identity
member of the
n
Grand River
and purpose of the
Board of Direc-
n
Greater
centre within the
St. Catharines
community. Five
tors at Noojmowin Teg AHAC. The logo incorporates traditional
n
Kapuskasing
more centres have also requested AOHC’s support to
aboriginal symbols. The Bear and the colour Burgundy
n
London
adopt it as their only logo.
respectively symbolise the keeper of the medicine and
n
Mary Berglund
the healing in the aboriginal culture.
n
Merrickville
centres that use the CHC logo as a secondary logo to
We would also like to acknowledge the over 40
District
complement signage on all office supply such as letter-
“Community-
n
North Lambton
head, envelopes and business letters.
governed” com-
n
Oshawa
ponent, which
n
Port Hope
will certainly pave the way for many more centres to adopt
clearly differen-
n
Seaway Valley
it as well. With a stronger and more uniform CHC logo
tiates CFHTs
n
Sudbury East
presence across the province, AOHC will be better able to
n
The Youth Centre
advocate on behalf of the network of Ontario’s CHCs.
The CFHT logo was created with a focus on their
from their FHT cousins. The beautiful Spring Green de-
The leadership of our CHCs that have adopted the logo
For additional information about usage of the logos and customised artwork design, contact François L’Ecuyer, Communications Manager at Communication@aohc.org.
9
The CHC Model of Care: A Statement of Principles CHCs offer a range of comprehensive primary healthcare and health-promotion programmes in diverse communities across Ontario. Services within CHCs are structured and designed to eliminate system-wide barriers to accessing health care. As Community Health Centres, we will:
Showing we care, and meaning it “While it may seem small, I fully recognise the significance of incorporating the CHC Model of Care in the LHIN/CHC Multi-Sector Service Accountability Agreement.” ~A CHC Board member
n
Advocate on issues of public policy and on matters that affect
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Adhere to the principles of social justice;
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Be efficient and effective vehicles of primary health care and
diversity of the communities that we serve. Yet what
accountable to
binds us together is our deep commitment to the
both communi-
CHC Model of Care and the underlying principles of
detailed descriptions of the attributes, principles,
ties and funders;
social justice that guide our work.
underlying beliefs and values of the CHC Model
the well-being of individuals and communities;
n
Strive to provide
CHC implement all eight attributes. n
The updated CHC Model of Care Manual includes
of Care, which together constitute the nucleus of
In 2008-09 the Ontario Network of CHCs took
fair, equitable
major steps forward on the integration and recogni-
who CHCs are and what they do as Ontario’s
compensation
tion of the CHC Model of Care in our centres and
Community Health Centres. Over 1,400 copies of
and benefits
with our funders. Since the 2008 AGM when mem-
for our staff.
ber centres formally endorsed the CHC model of care
Carolyn Poplak and Sandra Wong of the Education and Development Team hold a copy of the CHC Model of Care.
ion
Client and Community Centred Client
in ild bu
Community
Interprofessional
o
Community Governed
ro
o de l o g M
Inclusive of Social Determinants of Health
Accessible
m
f Care CHC Mod el Service in of teg rat
Community Development Approach
Model of C CHC Commu are C nit HC y re c a pac Ca tion it y Integrated
Model of Care orientations has been delivered to new data management coordinators (DMCs), new
forward have been taken:
executive directors, Boards of Directors, providers,
n
At the November Ontario’s CHC EDs Network meeting, the Executive Directors made a commitment to implement the CHC Model of Care in their centres by endorsing the CHC Model of Care Charter. This Charter was signed by 100% of the CHC Executive Directors. It is es-
es
Care CHC Mo d l of e lo de on i t H e alth f Mo s preven p
lln
the Manual have been purchased by CHCs so far. n
through a unanimous resolution, significant steps
Model of Ca CHC imary car re C HC e Pr re Ca Comprehensive I
10
of Care and are required to ensure that each
Each CHC is unique. Each CHC reflects the great
n
management, and front-line workers through our programme learning groups, Governing CHCs in the LHIN Environment workshops, and other workshops currently being delivered and facilitated by the Education and Development Team. As we move forward, it will be important that CHC
sential that new EDs fully understand the
Boards and staff have an updated understanding of his-
Model of Care and its fundamental role before
tory, concept, approaches and attributes of the Model of
signing the Charter.
Care. As such, AOHC will be working closely with CHCs in
The CHC Model of Care was incorporated into
organising workshops available in both English and
the 2009-11 Multi-Sector Service Accountability
French and Programme Learning Groups centred around
Agreement that was signed by individual CHCs
the Model of Care for Board members and staff. The inten-
and their LHINs (Local Health Integration Net-
tion is to integrate the Model of Care training as part of all
work). The significance of this inclusion is that
other trainings to ensure a deep sense of understanding of
the LHINs formally recognise the CHC Model
the Model of Care at all levels of the organisation.
For additional information about the CHC Model of Care, contact Roohullah Shabon, Director of Education and Development at Education-Development@aohc.org. To order copies of the CHC Model of Care, contact François L’Ecuyer, Communications Manager at Communication@aohc.org.
www.aohc.org
Hoping for a reason to smile In January 2009, the first $10 million was disbursed
More than a year ago the Government of Ontario announced an Oral Health initiative that would be one
for CINOT expansion. The remaining $35 million for
of the ‘kick-off’ pieces of the Poverty Reduction Strat-
08-09 remains unspent as various Ministries consult to-
egy that took shape over the course of 2008. In the
gether to come up with a plan. AOHC has been a part of
original announcement — $135 million over three
the consultation, along with Toronto Public Health Den-
years — the first third was to flow with the 2008-2009
tistry Programmes and the Ontario Oral Health Coalition. Along with its coalition partners, AOHC launched a
budget, with the funds going to Public Health Units and implemented through Community Health Centres
postcard campaign that featured the ‘before’ photo of
and Aboriginal Health Access Centres where appropri-
Jason Jones, whose story had first been told in the press
AOHC will continue to urge the Government of Ontario to make good on its 2008 promise to deliver dental care prevention and treatment services to those who truly need it.
ate. Ten million dollars each year was to go towards
a year earlier. Thousands of postcards were signed at
the expansion of the Children in Need of Treatment
CHCs, AHACs and CFHTs across the province and sent
cause of the embarrassment; or skate with them on the
(CINOT) programme to include children up until their
to the AOHC office for a mass delivery to MPPs legisla-
outdoor rink because of the cold.
18th birthdays; the remaining $35 million was to be ex-
ture desks at Queen’s Park. At the March 11, 2009, press
pended in the creation of new oral health sites and the
conference the media were particularly drawn to a
lems, Jim Albani, who had come to our attention
expansion of existing programmes to deliver preven-
young woman who had come into Toronto from West
through the Parkdale Health Network, of which Park-
tive and emergency care, as well as additional screen-
Elgin CHC. After the formal press conference that fea-
dale CHC is a part, became our symbols of what needs
ing, education and outreach.
tured Adrianna Tetley, Executive Director, AOHC, Dr.
to be done. They stood in for those hundreds of thou-
Hazel Stewart, Chief of Dentistry programmes,
sands of Ontarians who are experiencing the excruciat-
Toronto Public Health and Stephanie Gordon,
ing economic, emotional, physical and social pain that
President-elect, Ontario Association of Public
comes with a broken smile.
Health Dentistry, the media sat down to listen to Chrissy Johnson tell her tale. ‘My back teeth are falling apart,’ she said.
The story had legs; photos and column inches dedicated to their plight brought an edge of reality to the facts and figures being sifted and sorted on the way to
The 28-year-old mother of two young children
an oral health strategy. By the end of the day, Parkdale
has a mouth full of broken and rotting teeth.
Health Network and the dentistry programme at
During her two pregnancies, her teeth started
George Brown College decided that they would like to
to chip and fall out. The $1,500 cost of extrac-
help Chrissy and Jim.
tion is beyond her modest means. Chrissy
Adrianna Tetley, Executive Director at AOHC, Stephanie Gordon, President-elect at the Ontario Association of Public Health Dentistry and Hazel Stewart, Dental Officer of the Public Health Unit of the City of Toronto reach out at Queen’s Park on March 11th to urge the Government of Ontario to make good on their one year old promise to deliver dental care to low-income Ontarians.
Chrissy and another person with oral health prob-
As of March 31 2009, the process for new teeth and
takes pills daily for the pain and has had to
a reason to smile were under way for Chrissy and Jim.
quit her job at an automobile assembly plant
The campaign to provide by public policy and through
because the vibrations in the floor made her
public dollars what Chrissy and Jim got through phi-
mouth pain unbearable. Her life is circum-
lanthropy continues. Their stories are two of too many,
scribed by her oral health. She can’t get her
and AOHC will continue to urge the Government of
teeth fixed without a job, but can’t get a job
Ontario to make good on their 2008 promise to deliver
with her mouth in such bad shape. She can’t
dental care prevention and treatment services to those
accompany her children on school trips be-
who truly need it.
For additional information about AOHC’s oral health campaign, contact Lee McKenna, Policy and Government Relations Manager at Policy-Government@aohc.org.
11
Completing the network, one centre at a time Over the past few years, we have witnessed and supported the emergence of 21 new Community Health Centres (CHCs) that have now reached different levels of operations. While AOHC continues to advocate for more community-governed primary healthcare centres across the province, it is pleased to officially acknowledge the progress of these emerging member centres as they become part of our growing family and network.
Centre development key to completing the network AOHC also provides support to emerging and existing member centres to foster their own development, and supports member centres to adapt to their developing environments. AOHC provides a wide range of serv-
OPERATIONAL: n n n n n n n
Bramalea Brock (Cannington) Kapuskasing Port Hope Sudbury East TAIBU (Scarborough) Vaughan
ices to support the ongoing development of both emerging and existing member centres. Over the past year, it has worked with members to develop community health needs assessments, conduct community engagement projects, plan programmes and services, develop partner relationships and recruit senior organisational management, in-
EXECUTIVE DIRECTOR/STAFF HIRED: n n n n n n n
Bridges (Fort Erie/Port Colborne) Grand River (Brantford) Greater St. Catharines Kawartha Lakes Niagara Falls Seaway Valley (Cornwall) West Nipissing (Sturgeon Falls)
PRE-OPERATIONAL:
cluding Boards of Directors and Executive Directors. AOHC also continues to support community groups in their work to secure new Community Health Centres (CHCs) or Community-governed Family Health Teams (CFHTs) for their communities as part of its objective to complete the network of community-governed primary healthcare
Sophie Bart (third from left) meets with the Board Development Advisory Committee of Misiway Milopemahtesewin Community Health Centre to help recruit Board and CHC members and plan a special meeting for the Misiway CHC membership.
centres across the province. In addition, AOHC provided centre
n n n n n n n
Belleville Central CHC (St. Thomas) Centre de santĂŠ communautaire Chigamik CHC (Midland) Chatham Kent Markdale South Georgian Bay (Collingwood) Woodstock
development support to five CHCs and a number of emerging community groups whose objective is to secure community-governed primary health care for their communities.
For 2009-10, AOHC intends to continue supporting the development of emerging and existing member centres in order to ensure the successful implementation of community-governed primary health care across the province.
For additional information about Centre Development, contact Roohullah Shabon, Director of Education and Development at Education-Development@aohc.org.
12
www.aohc.org
AOHC becomes education and development hub for member centres One of AOHC’s key objectives is to strengthen a culture of continuous quality improvement to our member centres — at the staff and Board level. The main focus of AOHC support is to improve quality in the delivery of primary healthcare services for its members’ clients.
AOHC will continue to provide invaluable expertise and resources, providing CHCs, CFHTs and AHACs with the tools they need to support their work and improve health outcomes.
To achieve this objective and to deliver continued support to the member centres, AOHC has developed the Education and Development Team (EDT). Over the past year, we have increased our capacity to deliver effective education and training in the areas of CHC Model of Care, Board Governance, eHealth/Clinical Management Systems, Centre Development, and Emergency Preparedness and Planning. To improve effectiveness, efficiency and integration of its activities, the EDT works in close coordination with the Performance Measurement and Communication Teams, and with all member centres and stakeholders.
Supporting centres’ Board members
One of the frequent requests from our member centre Board members was to provide support to foster their own development, especially as they need to adapt to their developing environment. In response,
The Role of Boards in the Changing LHIN
the AOHC launched the Board stream workshops at
Environment has been delivered across the
the 2008 Conference. Based on the success of those
province and offered in both English and
will be provided at 2009 Conference.
French to Board members and Executive Directors of CHCs and AHACs.
workshops another round of Board stream workshops Another top priority learning area identified by CHC Board members in a 2008 needs assessment want the role of Boards in the changing LHIN environment. To respond to this request, we worked with
Through organisation of different trainings, workshops and Programme Learning Groups (PLGs) for sharing of information, experience and best practice, AOHC is strengthening knowledge, skills and capacity of its member centres. It also provides direct support to emerging centres to help them move from community engagement and pre-operational phase to fully operational status.
David Hole, former Executive Director of the SouthEast Ottawa CHC to develop a workshop on The Role of Boards in the Changing LHIN Environment. The objective of the workshop is to strengthen the knowledge and understanding of Boards of Directors about the Board role in the Local Health Integration Network (LHIN) environment.
As we continue to increase our capacity, it is our goal that we will provide Board members and staff of CHCs, CFHTs and AHACs with invaluable expertise, resources as well as the tools they need to support their work and improve health outcomes. AOHC will continue working closely with its members to organise regular training needs assessments, and conduct inventory of existing and new resources as well as best practices to share and exchange information and knowledge.
During these workshops facilitated by members of the Education and Development Team with the support of a CHC Executive Director, participants have: n
Strengthened their knowledge and understanding of the role of LHINs, the relationship between
Key Board members and staff from Sudbury, Témiskaming, Kapuskasing and Sudbury East Community Health Centres get together for a “Role of the Board in the changing LHIN environment” workshop.
their organisation and the LHIN, and their role as Directors when managing this relationship; n
Developed a deeper understanding of collaborative governance and integration;
For additional information about education and development resources in this section, visit www.aohc.org/education-development or contact Roohullah Shabon, Director of Education and Development at Education-Development@aohc.org.
13
n
Developed a deeper knowledge of several tools and mechanisms available to Directors when managing the relationship with the LHIN; and
n
Networked with Directors of other AOHC Member Centre Boards
ment. Through the delivery of a variety of methodolo-
AOHC will continue to look for ways to fulfil its
gies (hands-on workshops, programme learning groups,
commitment to improve quality of care through
question and answer sessions) and using practical re-
strengthening knowledge, skills, best practices and
sources (Model of Care handbook, Frequently Asked
support data quality and information management
Questions documents, ECR Roadmap and Guideline),
improvements. Through PLGs, Online forums and
AOHC’s Education and Development Team works to ful-
other innovative methods, and with creative and fo-
fil this commitment. It also collects evaluations from
cused tools and resources, AOHC continues to be the
Changing LHIN Environment have been delivered across
participants at every workshop to ensure that workshops
hub for education and development for our sector.
the province. These training sessions have been offered
and handouts are appropriate and that needs are met.
Five regional workshops on The Role of Boards in the
in both English and French to Board members and Ex-
In 2008-09, AOHC launched the Programme Learn-
COMMENTS FROM PARTICIPANTS:
ecutive Directors of CHCs and Aboriginal Health Ac-
ing Groups (PLG) sessions with a focus on staff of our
cess Centres (AHACs). Participants also received
member centres. The objective of PLGs is to facilitate
training materials and a resource manual to support
knowledge transfer, information sharing, best prac-
them in their ongoing relationships with their LHINs.
tices and networking. In the demanding and complex
In 2009-10 AOHC will continue to offer regional
environment of the CHC, getting CHC Boards, man-
and indicators, data entry scenarios helpful to standard-
and centre-based workshops on The Role of Boards in the
agement and staff together for an opportunity to share
ise data entry.” (Data Management Coordinators PLG)
Changing LHIN Environment based on the sector’s needs.
experiences, challenges, solutions and opportunities can be difficult at best. PLGs provide the ideal forum
COMMENTS FROM PARTICIPANTS: “A good overview of the Board’s role and environment they’re part of. I particularly enjoyed strategic planning.” “A really great overview of the Board’s role and the environment they work within.” “Great discussions and networking.”
and opportunity for this type of interaction.
“There is a need for this PLG to be held quarterly because of how fast things are changing.” (Physicians PLG) “Information shared about performance management
“The Model of Care and Evaluation Framework sessions were extremely valuable.” (New DMC Training)
This year, 270 participants attended 13 PLGs facilitated by AOHC, in the following areas: physicians, Executive Directors, Data Management Coordinators (DMCs) and Centre-based PLGs (offered upon request). Based on the resounding success of each of these PLGs, AOHC plans to conduct Nurse Practitioners, Clinical and Programme Directors, Health Promoter and Pre-Operational Centres, and inter-professional PLGs between various providers.
Following the clinical management system Roadmap AOHC intends to continue to support all CHCs transitioning to full ECR status through a variety of methods.
Building on existing experiences This past year, eHealth —
The objective of Programme Learning Groups (PLGs) is to facil-
which includes the use of a clini-
itate knowledge transfer, information sharing, best practices
cal management system (CMS) to manage client care — has become
and networking. This year, 270 participants attended 13 PLGs.
an increasingly important priority for the health sector as a whole. AOHC has provided support to CHCs transitioning to full Elec-
AOHC is committed to improving quality of care through strengthening knowledge, skills, best practices, the support of data quality and information manage-
14
Brian Sankarsingh (right) stands with the group of Data Management Coordinators during an Advanced Format Editor training at the AOHC office.
tronic Client Record (ECR) status. By March 31, 2009, eight centres had full ECR status.
www.aohc.org
A good example of AOHC’s support to the sector is the development of ECR Roadmap & Guideline to assist CHCs in their transition to full ECR status. AOHC visited five of
Hoping for the best, preparing for the worst
the early adopter CHCs and drew from their lessons learned, challenges, opportunities and risks to develop ECR Roadmap & Guideline. This document is intended to be an evergreen resource which will be updated from the lessons learned by each CHC during their own transition. In 2009-10 AOHC intends to continue to support
AOHC intends to support members in prevention, preparedness planning and implementation, and to coordinate an emergency management programme in accordance with its mandate.
all CHCs transitioning to full ECR status through a variety of methods: 1 Centre-based PLGs to facilitate the transition process and discuss best practices. 2 Development of a Frequently Asked Questions (FAQ) document focused on transition, CMS and best practice. 3 Development of Lunch-N-Learn webinars (to be conducted via the web bi-weekly) to facilitate discussion on best practices in use of the CMS, workflow and other transition topics. 4 Updates to the FAQ on Dossier, Practice Management (PM) and Shadow Billing. 5 Revision of the ECR Roadmap & Guideline after the first phase of the project. 6 Continuous access to training in areas such as Format Editor. Resources and materials available: n
Roadmap: addressing the challenges, opportunities and processes faced during transition
n
Checklist: providing a high level checklist of ‘must-do’ deliverables during transition
n
Inventory of Resources: including all sample documentation, workflows, process charting and sign offs from the early adopters
n
FAQs: a collection of questions on Dossier, Practice Management, Shadow Billing and Enrolment as answered by the relevant SMEs.
In 2007, AOHC was asked by the Ministry of Health and Long-Term Care (MOHLTC) to act as a liaison organisation during a provincially declared emergency, and by its members to support preparedness initiatives. To achieve these objectives, AOHC established the
Nicole Nitti, Physician at Parkdale CHC, and Tom Appleyard, Consultant with Preparedness (both left on picture), meet with AOHC staff François L’Ecuyer, Danielle Kurchak and Roohullah Shabon for an Emergency Preparedness and Response Initiative committee meeting. AOHC also developed the Preparation Guide for an In-
Emergency Preparedness and Response Initiative
fluenza Pandemic, which has proven very helpful in assist-
(EPRI). The EPRI has support and representation from
ing centres in the development of their own emergency
the sector through membership in AOHC’s Emergency
plans. Additionally, in order to better support coordination
Planning and Preparedness Committee.
and communication during an emergency, AOHC created
The initial purpose of this initiative was to outline
and maintains a list of emergency contacts for all of its
how AOHC is preparing for coordination with its mem-
member agencies. The existence of an emergency contact
bers in the event of a flu pandemic, as well as how it
list is vital for AOHC in playing its role as liaison success-
will respond and recover in such an instance. Its long-
fully, especially in regards to timely communications dur-
term purpose however is to support its members in pre-
ing the Novel Influenza A (H1N1) situation.
vention, preparedness planning and implementation, as
Considering the positive outcome of recent confer-
well as the coordination of an emergency management
ences on the topic combined with the H1N1 situation,
programme for AOHC in accordance with its mandate.
AOHC plans to organise another emergency prepared-
As a step to achieving this purpose, and as a follow-up to two previously held conferences in May 2007 and Decem-
ness conference where best practices will be shared for future emergency preparedness and response.
ber 2007, AOHC organised the Pandemic Preparedness Conference in January 2009. At the event, experts in the field presented the general principles and approaches of preparedness while representatives from the sector shared their experiences and best practices with over 90 participants. Those attending found the conference very useful as a learning experience which gave them information and ideas on how to become prepared themselves, in addition to provid-
COMMENTS FROM PARTICIPANTS: “I expected to leave here informed and empowered and I feel the Conference met both my expectations.” “Good to share with CHC colleagues and access to how they manage the same situation.”
ing them with an opportunity to network with each other.
15
Reasons to be proud, reasons to improve Our Model of Care truly is more than interdisciplinary practice; it is a model built on the social determinants of health. If we had to summarise the 2008 annual conference in one line, it would be: we have reasons to be proud, and we have reasons to improve. Dr. Chan of the Ontario Health Quality Council (OHQC) confirmed that CHCs are doing a better job than most other models. We heard from Dr. Bell of the Sunnybrook Health Science Centre that CHCs are leading inter-professional practice and in quality of care for the last 30 years, and we are leading it because of our model of care. And that our model of care truly is more than interdisciplinary practice; it is a model built on the social determinants of health.
Pat Capponi, Mental health care and poverty advocate, will be Honorary Chair of AOHC’s annual conference 2009 on Poverty and Health.
We have reasons to be proud, and we have reasons to improve. We heard from the OHQC that there were over 8,000 preventable deaths in Ontario last year. We also heard from our sister organisations — community health centres in Saskatchewan and the United States who have the same model and the same kind of clients as we do — that we can do better.
AOHC President Simone Atungo poses with The Honourable Madeleine Meilleur, MPP for Ottawa-Vanier.
We learned from the Saskatoon Community Clinic that emergency room visits and alternate care levels have decreased by 20% for their senior groups as a result of a quality improvement collaborative. We have also heard in different workshops that there are proven methodologies, there is a lot of experience to build from and we need to start small, test often and celebrate our successes. Let’s remember Tommy Douglas when he said “Let’s not forget that the ultimate goal of Medicare is to keep people well, rather than just patching them up when they get sick.” Now as we reflect on that quote and on what we have shared together at the 2008 annual conference, we would like to say again “We have reasons to be proud, and we have reasons to improve.” MPP and Former AOHC President France Gélinas with her family after being awarded the 2008 AOHC Award. For additional information about the annual conference or to receive a copy of the conference report, contact François L’Ecuyer, Communications Manager at Communication@aohc.org.
16
www.aohc.org
AOHC finances The addition of a translator on staff is increasing our capacity to meet the needs of our bilingual and francophone members and is subsidised by providing translation services at a significantly reduced rate.
GOAL 1:
CHCs, AHACs, and CFHTs are appropriately resourced and equitably equipped to deliver effective, primary healthcare service to our clients.
45% finances and 32% staff time Primary Funding Sources: Core, CHC Provincial Projects, MOHLTC
GOAL 2:
CHCs, AHACs, and CFHTs adopt a culture of continuous quality improvement so they can improve their delivery of primary healthcare services for clients they service.
13% finances and 30% staff time Primary Funding Sources: Registration Funds, MOHLTC
GOAL 3: Over the past four years, AOHC eliminated its debt, developed solid financial practices and established a General Purpose reserve fund. Last year AOHC had a small General Purpose surplus of
CHCs and AHACs are recognised as the most effective model to improve health outcomes for aboriginal, francophone, racialised and minority communities, disabled and other vulnerable populations.
1% finances and 4% staff time Primary Funding Source: Core
$40,402. This year the General Purpose surplus grew to $73,949. The AOHC Board 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 — in-
GOAL 4:
CHCs, AHACs, and CFHTs are expanded across the province so that all Ontarians who need them have access to their benefits.
11% finances and 16% staff time Primary Funding Sources: Core, Contracts
creasing from $363,200 in 2007-08 to $491,725 in 2008-09. This increase is due to the continuing growth of our membership with new CHCs and
GOAL 5:
CFHTs joining AOHC and moving from emerging
Social determinants of health inform legislation and policies in support of the model of care so that CHCs, AHACs, and CFHTs can provide high quality primary care for clients they serve and improve the health of communities.
group member to full member. As well, the membership fees were increased as approved by the 2007 AGM. However, this growth is not as much as was
14% finances and 11% staff time Primary Funding Source: Core
forecasted, largely due to the slowness in the development of new CHCs and CHC satellites and the fact that not all CFHTs have approved operating budgets. At the same time we are experiencing financial readjustments. Historically, the Ministry of Health and Long-Term Care (MOHLTC) provided a travel
GOAL 6:
The Second Stage of Medicare is publicly and politically supported as the solution to ensure that all Ontarians live longer and healthier lives; and the CHC, AHAC, and CFHT model of care is seen as one of the key implementation vehicles for the Second Stage of Medicare.
1% finances and 3% staff time Primary Funding Source: Core
17
p Ap
fund of $110,000 per year for Board and committee travel. In 2006, MOHLTC announced that this fund would be eliminated over a three-year period. By 2008-09 this fund was reduced to $55,000 and it will be eliminated entirely for 2009-10. Therefore over a three-year period, AOHC absorbed the elimination of a $110,000 travel fund by reducing travel and absorbing costs into the core budget.* At the June 2008 AGM, the membership approved a OneYear plan that was based on an overall strategic direction and six goals. An analysis of our finances in relation to our goals was conducted at year end. (See chart.) In February 2009, the AOHC Board reviewed the
rop
ely ir at
& e &D
ve
n me p lo
t Ne ion t e a c AOHC’s 2008-2009 cost analysis of goals vs. staff time andufinances f th o Ed n sio an n in2% a of Medicare p m SecondEStage x ter e D Effective Modelsal3% ci GovernanceSo9% e nc a n r els ve d o o G of Health M Social Determinants ve 13% of M i t ec e Eff tag S nd o c Se
goals and established priorities. The goals are now
Expansion of the Network 14%
listed in order of priority. As a result of this process the finances for 2009-10 will be reallocated to reflect the revised priorities as established by the Board. The remaining 15% of finances and 4% of staff time spent on Governance include Board, committee and
Education & Development 21%
constituency meetings, audit, annual report, governance-related translation, Board development, Board-related consultants and annual general meeting.
Appropriately & Equitably Resourced 38%
As our financial resources increased in 2008-09, we were able to continue to build our communication capacity by hiring a full-time communications manager and a translator. The addition of a translator on staff is increasing our capacity to meet the needs of our bilingual and francophone members. This position is subsidised by providing translation services to our members at a significantly reduced rate. In 2008-09, the Primary Care branch, MOHLTC continued to provide AOHC with ongoing funding for staff and projects. In 2008-09 AOHC was funded to
take on an increased training role. All projects funded
Finally, late in 2008-09, AOHC received funds from
by MOHLTC continue to be self-funded and contribute
the Aboriginal Health Adaptation Fund, a jointly
to our overall operations.
funded project from Health Canada and MOHLTC.
In addition, MOHLTC continues to fund AOHC to
These funds will allow Aboriginal Health Access Cen-
provide project management support to the five CHCs
tres (AHACs) to build their capacity through advocacy,
participating in the Physician Assistants Demonstra-
networking, accreditation and improving data quality
tion Project. This project will continue in 2009-10.
and reporting capacity. This is a two year project and will continue into 2009-10.
* The core budget is comprised of membership fees, centre development fees and management fees from projects. To obtain a copy of the audited statement, contact Cory LeBlanc, Executive Assistant and Office Manager at Mail@aohc.org.
18
www.aohc.org