Flying together… ASSOCIATION OF ONTARIO HEALTH CENTRES
2010-2011 ANNUAL REPORT
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Taking flight A MESSAGE FROM THE AOHC PRESIDENT
AOHC’s vision The Association of Ontario’s Health Centres (AOHC) is Ontario’s voice for community-governed primary health care. We represent over 120 community-governed primary health care organizations. Our membership includes Ontario’s Community Health Centres (CHCs), Aboriginal Health Access Centres (AHACs), Community Family Health Teams (CFHTs) and Nurse Practitioner-led clinics. For AOHC and its members, good health means a state of complete physical, mental, social and spiritual well-being and not merely the absence of disease or infirmity. And we believe community-governed primary health care is one of the best ways to deliver it. AOHC works hand in hand with member centres to ensure they are optimally resourced and equipped to fulfill their mandate to improve the health of individuals, families and entire communities. AOHC also advocates for many more people living in Ontario to have access to the Community Health Centre model of care. Our long-term goal is that one day all Ontarians who need access to CHCs, AHACs and CFHTs can access their benefits.
AOHC and its members are moving forward together, taking flight. This past year we’ve reached so many milestones. And we’ve also ventured into new areas of endeavour that will yield many high returns. A case in point: our new partnership with eHealth Ontario. This has been an unprecedented success. Over the coming year AOHC will oversee what is one of the largest ever Clinical Management System (CMS) procurements in Canada. What’s more, we’ll be working hand in hand with all 73 of Ontario’s CHCs as they deploy a single state-of-the-art CMS system. No other primary care model in Ontario is moving forward on ehealth in such a coordinated and systematic way. What a great illustration about the collective power and potential of CHCs. It’s a clear signal to decision makers that CHCs can play a gamechanging role in Ontario’s health care system. This year we also celebrated victory of a very different kind. Finally, after years of advocacy effort we succeeded in making our case that jurisdiction over AHACs should be transferred to the Ministry of Health and Long-Term Care. With this objective achieved we’re now much closer to reaching our ultimate goal that AHACs are resourced on an equal footing with CHCs. Meanwhile, we’re also starting to see some progress for CFHTs in resolving outstanding funding issues. Once again, it’s collective action and the mobilizing strength of AOHC that’s going to make a difference. With all our success this year, it’s exciting to think about what the coming year may hold. As you read this report you’ll see we have good reason for
optimism. You’ll see that we’re much better equipped to convincingly communicate the value and benefits of CHCs, AHACs and CFHTs. And our timing couldn’t be better. All the new Community Health Centres announced by the current government early in its first mandate are now up and running. With a provincial election in the fall, we must seize this moment and make our case that many more people living in Ontario need access to the CHCs and AHACs. It’s going to be an exciting and challenging journey over the next few months. What’s important is that we meet these challenges as a tightly knit team with a concerted focus on reaching our destination: better health for every individual, every family and every community in Ontario.
Joan Lesmond President, AOHC
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The value of teamwork A REPORT FROM AOHC EXECUTIVE DIRECTOR ADRIANNA TETLEY
Members and supporters:
AOHC Executive Director Adrianna Tetley (left) and Laura Albanese, MPP York South-Weston (right), at the opening of Parkdale CHC’s Healthy Smiles Ontario Oral Health Clinic.
If I had to pick one reason why AOHC moved closer to achieving our vision this year it would have to be teamwork. By partnering with our member centres, and by creating a wide range of working groups and committees to exchange ideas and mobilize energy, we’ve made huge gains.
• Thank you to members of our CHC Information Management System Committee as you lead eHealth transformational change in all 73 Ontario CHCs. You are truly champions in implementing a visionary information management strategy that will enable CHCs to speak and act with a united voice.
• Thank you to the AHAC Executive Directors Network as we continue to work together to ensure that AHACs receive equitable funding.
Without all of you we could not have achieved the successes of this past year. And it’s not only our members we need to thank. We must also acknowledge the positive efforts of our active partners, the Ministry of Health and Long-Term Care and eHealth Ontario. As you read this report you will see how these partnerships have positioned us for even greater progress this coming year.
• Thank you to the emerging CFHT Executive Director Network for your patience and perseverance as we slowly find solutions to your most pressing and difficult issues. • Thank you to the members of the new CHC Strategy Group and the CHC ED Network who are setting a strong and steady course for the strategic direction for CHCs. • Thank you to members of our new CHC Resource Management Committee for their vigilance and persistence in ensuring CHCs are optimally equipped to fulfill their mandates. • Thank you to members of the new CHC Performance Management Committee who are laying such a strong foundation as we press forward on quality improvement and having the evidence to better tell the story of the effectiveness of CHCs.
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Finally we need to thank our coalition partners as we continue together to advocate for healthy public policy. It’s been exciting to be at the centre of all this synergy. Read on to learn more about our key milestones.
TEAM WORK IN ACTION: FOR COMMUNITY HEALTH WEEK, SENIORS FROM THE REXDALE CHC TRAVELLED TO QUEEN’S PARK AND JOINED OTHER CHC CLIENTS IN CONGRATULATING THE GOVERNMENT FOR EXPANDING ACCESS TO CHCS. THEY ARE SEEN HERE WITH DEB MATTHEWS, MINISTER OF HEALTH AND LONG-TERM CARE (CENTRE).
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Transformation through innovation AOHC, in partnership with member centres, can report an array of achievements that have involved harnessing the power of information technology systems.
We’ve secured funding from eHealth Ontario to procure a new state-of-the-art Clinical Management System (CMS) system for all 73 Ontario CHCs. It’s going to be bilingual and it’s going to complement CHCs comprehensive approach to care. This summer AOHC will select the vendor and it is anticipated that deployment will start this fall with completion in 2013/2014. It is also expected that the CMS needs of AHACs will be covered as part of this same procurement.
We’ve laid the building blocks for a data warehouse to store sector-wide information. With this data warehouse, CHCs will be able to analyze data in ways that extend well beyond what is currently possible. The warehouse will be an invaluable tool in describing the value of CHCs.
We’re laying the foundation for common standards across CHCs. Our team leading the CHC Ontario Healthcare Reporting Standards/Management Information Systems (MIS) project is spearheading another important innovation that will enable us to develop an accurate snapshot of CHC operations. Once implemented, the common standards the team is developing, and then implementing, will provide detailed insight into the financial status and statistical profile of each CHC.
We’ve built a new tool to monitor and report on community capacity building efforts.
AOHC is overseeing the largest ever CMS procurement in Canada. Among those reviewing the proposals are: Tony Schieman, Project Manager, Laurie McCarroll, Vendor Agreement Manager, Anne Finlay, eHealth Alignment Executive Lead, and Gail Brathwaite, IMS Coordinator.
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A new online searchable inventory we’ve developed describes community initiatives across the province that addresses the critically important social determinants of health. During the next phase of the project, we will develop an evaluation tool to assess the effectiveness of community initiatives. Together these tools will promote the community of practice we are building amongst CHC interprofessional teams actively engaged in community capacity building activities. The new tools will also offer an effective platform to educate decision makers about how CHCs work to address the root causes of illness and injury.
Laying a strong foundation for quality improvement Our quality improvement agenda advanced in a major way this year with the announcement of funding from eHealth Ontario for a new Clinical Management System (CMS) system. The new generation system will support CHC interprofessional teams in delivering evidenced informed care as well as increasing relevancy, effectiveness and efficiency of programs. CHCs are also working together to produce timely information sourced from good quality data and decision-support tools. Two of these tools developed in 2010/11 will be disseminated next year: one to assess data quality and the other to gather information on socio-demographic profiles of CHCs. In addition, several CHCs and CFHTs are participating in the Quality Improvement and Innovation Partnership Office Practice Redesign Waves which is focusing on introducing, integrating and spreading quality improvement methods. As we move forward, next year will be a pivotal year for this area of our work as we release complexity of care and panel size studies. Already researchers are pointing to the fact that in areas of chronic disease management and health promotion, CHCs deliver a superior quality of care that connects services with those most vulnerable to illness. These new tools and standards will further enhance this superior care.
Building capacity We’re building organizational capacity with staff and boards. Boards are being equipped to map out strategic objectives aligned with the CHC model of care and to engage meaningfully with the communities they serve. Model of care workshops for boards and staff are deepening understanding and commitment about how to maximize effectiveness. We’ve also launched a series of professional learning groups so health promoters, community developers, clinical teams and data managers can build communities of practice in order to share experiences and skills.
New centres and new Executive Directors are getting a head start. Starting a new Community Health Centre is a complex and challenging undertaking. Starting a new job as an Executive Director of a Community Health Centre is equally complex. In both cases, AOHC steps in, provides resources and plays a supportive role.
A COMPLETE APPROACH TO COMMUNITY HEALTH: THE DAVENPORTPERTH NEIGHBOURHOOD AND COMMUNITY HEALTH CENTRE HAS JUST LAUNCHED A NEW BIKE PROJECT TO PROMOTE INCREASED PHYSICAL ACTIVITY AND A HEALTHIER ENVIRONMENT. 7
Advocating for CFHTs As a new model of care Community Family Health Teams face complex challenges but are making sure and steady progress. They are distinguishing themselves as a sector within a sector. CFHT teams are delivering top quality collaborative clinical care that addresses the social conditions which give rise to ill health. Meanwhile, CFHT boards are increasingly urging their teams to deepen their collective understanding about the overall health needs of the communities they serve.
AHACs will soon release a new report called Our health, our future. Readers will learn their stories of health and healing.
Within the Ministry of Health and Long-Term Care, persistent advocacy efforts have secured improvements to the capital approvals process and also to some long outstanding funding issues. There is still much work to do to ensure the blended salary model for physicians works for clients served in CFHTs.
We reached a major milestone for Aboriginal Health Access Centres Finally, after years of effort, we’ve broken down a major barrier standing in the way of equitable funding for Aboriginal Health Access Centres (AHACs). Effective April 1, 2011 oversight for AHACS was transferred to the Ministry of Health and Long-Term Care (MOHLTC) clearing the way for equitable funding with CHCs. The transfer was accompanied by modest increases to their base funding. Moving forward, AHACS will also be eligible for community capital funds.
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In 2010, the Windsor Family Health Team was the recipient of AOHC’s Early Leader Award. At our conference banquet, Executive Director Mark Ferrari received the award from then AOHC Vice-President Jocelyne Maxwell.
One of this year’s most exciting developments for CFHTs is that they are in preliminary discussions with the Institute of Clinical Evaluative Studies about a study to determine the complexity-of-care needs of their clients. This will be essential to CFHT advocacy around flexibility with respect to enrollment and appropriate roster size for individual CFHTs.
Paving the way for more integrated care Ontario has prioritized an integration agenda for health and social service delivery. AOHC and its members are leading by example. In November we announced the formation of Community Health Ontario, a strategic partnership with the Ontario Community Support Association (OCSA) and the Ontario Federation of Community Mental Health and Addictions Programs (OFCMHAP). Together we represent the majority of the not-forprofit home and community support, mental health and addictions and community-governed primary health care providers in Ontario. Our common cause: to advocate for strong and integrated communitybased services that address the social determinants of health which are also tightly coordinated across the continuum of care. The development of a joint integration statement will guide our efforts this coming year. Watch for a heavy advocacy focus for capital funding for community health and social services hubs – a model that forms the future evolution of primary health care in Ontario. Leading by example: to promote integrated primary health care integration AOHC meets regularly with its strategic partners, the Ontario Community Support Association (OCSA) and the Ontario Federation of Community Mental Health and Addiction Programs (OFCMHAP). Here AOHC Executive Director Adrianna Tetley (centre) meets with OFCMHAP’s Executive Director David Kelley and OFCMHAP board members Jon Thompson (far left), Mary Davis (second from the right) and Barney Savage (far right).
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Extending the reach of Ontario’s Community Health Centres
Demonstrating effectiveness and raising recognition Slowly but surely more decision makers and members of the public are recognizing the power and potential of Ontario’s Community Health Centres and Aboriginal Health Access Centres.
Strong research and data, linked to a vigorous communications campaign, are demonstrating the important role CHCs play in Ontario’s health care system. Preliminary results from a study we conducted in partnership with the Institute of Clinical Evaluative Studies reveal that compared to other primary care models, CHCs serve a higher proportion of people living in poverty and their clients have more chronic diseases and other ailments. The results will be made public over the next few months.
Our message is reaching a broader audience. Recognition of our members’ successes is also on the rise. We’re getting the message out using a new state-of-the-art website, coupled with social media platforms like Twitter and Facebook. This means many more new audiences are learning about the benefits of community-governed primary health care. New videos, promotional materials and an increased uptake of the CHC logo are also increasing recognition.
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This year CHCs and some CFHTs secured strong participation in one of the province’s key poverty reduction programs. As part of the Ministry’s Stakeholders’ Advisory Group, AOHC advocated for the inclusion of as many Ontarians as possible, including the non-insured, in the new Healthy Smiles Ontario program. We believe the program is a good start, with children up to the age of 17 years and from families with an adjusted income level of $20,000 per annum or lower eligible
to receive services designed to establish and maintain good oral health. More than three dozen CHCs and CFHTs around the province are already or will be delivering HSO services in partnership with their respective Public Health Units. AHACs were excluded, as were low-income adults. AOHC is continuing to monitor the roll-out of HSO while advocating for the inclusion of currently excluded low-income Ontarians.
Getting closer to achieving our vision…
Successes this year put us on course towards • We’re sitting at policy tables and activating achieving our vision: that one day all people grassroots networks. AOHC is currently chairing living in Ontario who need access to a a Primary Health Care Access Working Group made Community Health Centre (CHC) or an Aboriginal up of senior primary care decision-makers. This is Health Access Centre (AHAC) can get access to one of five working groups planning primary health their services. care for Ontario and is led by Susan Fitzpatrick, But we’re not taking anything for granted. Major work lies ahead to make our case. This past year we began in earnest. • We established the urgent need for more
Ontarians to access CHC and AHAC services.
Assistant Deputy Minister of Health. Meanwhile, at a grassroots level we are actively encouraging and supporting the efforts of a wide range of community groups who have identified a need for CHC services in their communities.
AOHC believes many more people in Ontario need access to Community Health Centres. Newcomers to Canada, and other populations which face barriers accessing services, benefit greatly from CHCs’ comprehensive, community-centred care.
Late last fall we released a new report called Ontario’s Community Health Centres: Addressing the great health divide which outlined how CHCs are effectively serving populations vulnerable to poor health. The report also contained socio-demographic data which revealed an enormous gap between the need for CHC services and current numbers served. • We developed targets for expanded access. At our June conference we’ll formally call on each of Ontario’s three political parties to make a commitment to support plans for 250,000 more Ontarians to access CHC and AHAC services. By 2020 our goal is for one million Ontarians to have access to CHCs and AHACs. And, over the long term, we are calling for 15 per cent of Ontarians to have access to CHCs and AHACs. As planning for expanded access moves forward, the focus must be on populations most in need.
Healthy Smiles: our member centres are playing a major role in Ontario’s oral health strategy. 11
Advancing Health equity and healthy public policy Expanded access to Community Health Centres is an important solution, but it’s not the only solution in creating better health for all. To reach a complete solution, a wide range of attitudinal and public policy barriers have to fall.
work on Put Food in the Budget dovetailed with successful advocacy across the sector and beyond for retention of the Special Diet allowance for low-income Ontarians. The program’s new format and schedules will require continued vigilance and advocacy.
Making this happen is a joint effort between AOHC, its members and coalition partners.
Over the course of close to a year AOHC has created a “Commitment to Health Equity” with a goal ‘to create a powerful and inspiring vision of our sector as agents of health equity who identify and take action on attitudes, behaviours, policies and practices in order to reduce and eliminate health inequities’. The commitment emerged from our June 2010 conference Health Equity: Pushing the Boundaries which tackled the complex and difficult issues of equity, oppression and the social determinants of health. Plenaries and workshops validated, empowered and uplifted. Health providers left the two-day gathering equipped with ideas and renewed energy to advance healthy equity at their centres.
We’re working in common cause with coalitions advocating for stronger policies to reduce poverty, the most important social determinant of health. This year we put a special focus on healthy public policy regarding food. We forged new alliances with groups in common cause and were especially active participating in the Put Food in the Budget campaign. We provided financial and social media support, and also coordinated efforts with members participating on the frontline of the campaign. Our
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An activist agenda: Put Food in the Budget was one of several anti-poverty campaigns AOHC and its member centres worked on this year.
Strengthening one of Canada’s finest achievements As 2012 approaches, we’ve got added impetus to build on our successes. That’s because 2012 marks the 50th anniversary of the birth of Medicare in Canada. What a great time to rededicate ourselves to this core value of Medicare: that as Canadians we must care for one another. It’s also a great time to remind ourselves that with hard work we can reach our vision.
And our big idea – what Tommy Douglas called the Second Stage of Medicare – to positively transform primary health care delivery in Ontario, can be achieved. But only if we keep on pulling together in common cause to reach our shared vision. This kind of teamwork certainly worked for us this year. And based on that success we’re certainly feeling confident about the next.
Decades ago, when Medicare’s founder Tommy Douglas proposed a publicly-funded health care system most people thought it could never happen.
But it did because people who believed in Medicare did not give up on their dream.
Adrianna Tetley Executive Director, AOHC
Welcome to new members Don Mills Family Health Team (2010) The Greenhouse Heartland Community Health Centre (2011) Emerging Group Member L’Alliance de la francophonie de Timmins (2011) Emerging Group Member
“Let us not forget that the ultimate goal of Medicare must be to keep people well. It seems to me that is the task before us.”
Mel Lloyd Family Health Team (2011) Community Family Health Team Mohawk Council of Akwesasne (2011) Aboriginal Health Access Centre
Canadian Medicare founder Tommy Douglas
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Our Staff
Our Board
Administration
Information Management
Adrianna Tetley, Executive Director
Ian Brunskill, CIO, Acting
Sophie Bart, Manager, Membership and
Catherine Nagora, IMS PMO Lead
Anita Cameron, Vice-President and Aboriginal Constituency Rep
Gail Brathwaite, Bilingual IMS Coordinator
Executive Director – Kenora Health Access Centre
Organizational Health Sandra Wong, Office Manager Lisa Tisdel, Administrative Assistant Corinne A. Christie, Administrative Assistant Azada Rahi, Administrative Assistant
Anne Finlay, eHealth Alignment, Executive Lead
Mary Chudley, Centre Development Team Lead
Communications Mary MacNutt, Strategic Communications and Campaigns Manager Danielle Deptuck, Communications Coordinator
Project Manager Senior Business Analyst (Security Profiles) Nolan Yearwood, eHealth Alignment,
Carolyn Poplak, Manager of Education and Capacity Building Heidi Schaeffer, Facilitator, Education and Capacity Building Leah Dunbar, Education & Research Coordinator
Cate Melito, Secretary and South West Constituency Rep Executive Director – Woodstock and Area CHC
Almaz Reda, Treasurer and Member-at-large Board Member – Black Creek CHC
Notisha Massaquoi, Central Constituency Rep Executive Director – Women’s Health in Women’s Hands
Project Advisor Laurie McCarroll, eHealth Alignment, Vendor Agreement Manager Lou Anne Meloche, eHealth Alignment, Sr. BA, Legacy & AHACs Brian Sankarsingh, eHealth Alignment, Clinical Management Systems Lead Nasreen Visram, NORA Business Lead / C.ontract Manager
Education and Capacity Building
Board Chair – Regent Park CHC
Tony Schieman, eHealth Alignment, Graeme Abrahams, eHealth Alignment,
Centre Development Team
Joan Lesmond, President and Member-at-Large
Diane Johnson, NORA Technical Lead Steven Chiu, NORA Technical Analyst Eileen Dixon, NORA Business Analyst
Performance Management
Ron Ballantyne, Central East Constituency Rep Executive Director – Brock CHC
Mark Ferrari, CFHT Constituency Rep Executive Director – Windsor Family Health Team
Janet Bowes, Eastern Constituency Rep Program Director – Carlington CHC
Jocelyne Maxwell, Francophone Constituency Rep Executive Director – CSC du Temiskaming
David Orman, Eastern Constituency Rep Board Member – Lanark Health & Comm. Services
Lynda Roy, Member-at-large Sexuality Co-ordinator – Anne Johnston Health Station
Anjali Misra, Manager, Performance Management
Joyce Helmer, Northern Constituency Rep Board Member – Shkagamik-Kwe Health Centre
Policy & Government Relations Lee McKenna, Manager of Policy & Government Relations
Charles Nichols, South Central Constituency Rep Board member – Kitchener Downtown CHC
Peter Szota, South Central Constituency Rep Executive Director – Grand River CHC
Mary Ellen Parker, South West Constituency Rep Board Chair – West Elgin CHC 14
AOHC Strategic Priorities
AOHC’s financial report AOHC has a robust financial picture with a total revenue in 2010-11 of $4.8M. Revenue was earned from a variety of sources: membership fees, centre development fees, our annual conference, program learning groups, meeting registrations and educational workshops. We also received project funding from the Ontario Trillium Foundation, the Aboriginal Health and Transition Fund, the Physician Assistant project, as well as a total of $1.9M from the LHINs, eHealth Ontario and Ministry of Health to support the CHC information system management strategy. In 2011-12 the funds from eHealth Ontario will increase significantly as we implement the CMS project in CHCs and other eHealth alignment projects.
AOHC exists so that the Model of Care is fully supported and resourced and is expanded across the province so that all Ontarians who need CHCs, AHACs and CFHTs eventually access their benefits; our members have the capacity to improve clients’ health outcomes; and sufficient resources are invested to justify the cost/investments.
55% of budget
Goal 1: Appropriate & Equitable Resources to deliver effective primary health care services to our clients. The MOHLTC and the LHINs effectively resource CHCs, AHACs, CFHTs, and NP-led Clinics.
Goal 2: Quality Improvement and Building Capacity. CHCs, AHACs and CFHTs build internal capacity to adopt a culture of continuous quality improvement to improve delivery of primary healthcare services.
This past year AOHC has once again achieved a balanced budget with an additional $24,008 added to the reserve for a total of $125,990. By March 2012 we will reach our target of $150, 000 for our reserve fund. With respect to budget allocation, 93% of our budget was allocated towards meeting the AOHC’s six strategic priorities. The remaining 7% was allocated to Governance.
Goal 3: Demonstrating Effectiveness and Raising Recognition. 8% of budget
CHCs and AHACs are recognized by decision makers and the public as effective models to improve health outcomes of people facing barriers to access, with a focus on aboriginal, francophone, racialized and minoritized communities, disabled and other vulnerable populations.
Goal 4: Expanding Access. AHACs, CHCs and CFHTs are expanded across 12% of budget
Audited Statements are available upon request.
the province so that all Ontarians who need them have access to their benefits.
Goal 5: Social Determinants of Health are reflected in legislation and 5% of budget
healthy public policies so that Ontarians have healthier lives and live in healthier communities. This allocation was influenced by the fact that our 2010-11 conference focused on health equity.
Goal 6: The Second Stage of Medicare is publicly and politically 12% of budget The Ontario Trillium Foundation provided valuable support.
1% of budget 7% of budget The Ontario Trillium Foundation is an agency of the Government of Ontario.
understood and supported as the solution to ensure that all Ontarians live longer and healthier lives; and that CHCs, AHACs, CFHTs and NP-led Clinics are recognized as one of its key implementation vehicles.
Governance: Includes board, committee and constituency meetings; audit; annual report; governance related transition; board development and the annual general meeting. 15
Association of Ontario Health Centres (AOHC), 970 Lawrence Ave. West, Suite 500, Toronto, ON M6A 3B6 Tel: 416-236-2539 Fax: 416-236-0431 Web: www.aohc.org Email: mail@aohc.org Twitter: @AOHC_ACSO Facebook: AOHC.ACSO