Association of Ontario Health Centres
Community-governed primary health care Association des centres de santé de l’Ontario
Soins de santé primaires gérés par la communauté
TRANSFORMATION IN PROGRESS Annual Report
2015–2016
Message from the Chair Last year, with a revised vision, mission and an ambitious five‑year strategic plan, the Association of Ontario Health Centres (AOHC) embarked on a new leg of the journey towards the best possible health and wellbeing for everyone in Ontario. The first year of the new strategic plan is now complete. It was a year of discovery and investigation focused on identifying what transformative change should look like in order to help improve the health and wellbeing of people facing barriers to health. Developing AOHC’s response to Patients First: A Proposal to Strengthen Patient-Centred Health Care in Ontario, a discussion paper released by the Minister of Health and Long-Term Care, Dr. Eric Hoskins, presented a great opportunity to engage with the entire membership and key partners to co-create a common agenda for a better healthcare system that truly puts people and communities first. It was an inspiring process — one that resulted in a substantial main response accompanied by stand-alone reports on Indigenous health, Francophone health, LGBT health and oral health as well as recommended changes to the Local Health System Integration Act (LHSIA). These reports contain a total of 97 recommendations reflective of AOHC’s transformation agenda, with a focus on health equity and the 3.5 million people in Ontario who face barriers to health.
Together, they form a powerful political and policy platform that will guide the work for the next four years. Last year was more than a year of discovery. It was also defined by impact. Working closely with members and partners, we achieved some significant gains. Years of persistent advocacy finally paid off, with new base funding for compensation and a new Community Health Capital Policy. While these only represent first steps forward, they are foundational to begin to address long-standing inequities. And members have had major impact across the province, rapidly responding to the needs of Syrian refugees as well as engaging clients and coalition partners using the Canadian Index of Wellbeing and Be Well Survey. Highlights of the Year One accomplishments are presented in these pages. And this is just the beginning. Guided by a shared vision, equipped with four actionpacked strategic directions, and with the strength of members and partners, we will continue championing, and achieving, transformative change for people and communities facing barriers to health.
Our Vision The best possible health and wellbeing for everyone in Ontario.
Our Mission We champion transformative change to improve the health and wellbeing of people and communities facing barriers to health.
Our Values Equity:
We champion an equitable, inclusive and respectful primary healthcare system.
Leadership:
We challenge the status quo with integrity and transparency and are catalysts for system innovation.
Collaboration:
We embrace community-driven cooperation and partner to influence change.
Knowledge:
We act and learn from a communityinformed and evidence-based approach. Cheryl Prescod Board Chair
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Champion health equity and population needs-based planning, and challenge systemic inequities to achieve improved health outcomes.
City of Vaughan Mayor Maurizio Bevilacqua delivering opening remarks at the release of "Measuring What Matters: The Vaughan Community Wellbeing Report 2015"
Executive Director Jack McCarthy (right) welcoming a Syrian refugee family at Somerset West Community Health Centre
AOHC Policy and Government Relations Lead Jacquie Maund presenting at the public dental health forum
VAUGHAN BECOMES ONE OF THE FIRST MUNICIPALITIES TO ADOPT THE CANADIAN INDEX OF WELLBEING
agencies, brought together a multi-stakeholder group that became Refugee 613, the coordinating and planning body for the whole city.
dental programs to low income adults by 2025. In partnership with Ontario Oral Health Alliance, AOHC helped gather over 2,000 signatures on the e-petition and generated an extensive social media campaign directed @DrEricHoskins. Over 10 articles published in local media, four CBC media stories and one hour-long radio show sharing AOHC’s research on the problem helped raise public awareness and build political support for this important issue.
In November 2015, the Vaughan Community Wellbeing Coalition released Measuring What Matters: The Vaughan Community Wellbeing Report 2015. The report compares the quality of life in Vaughan to the province and the country using the Canadian Index of Wellbeing (CIW), a comprehensive measurement framework that tracks wellbeing with respect to eight quality of life domains, and concludes with four policy recommendations. They focus on affordable housing, affordable transportation, air quality and local economic development. The multi-sectoral Coalition, convened in 2014 by the Vaughan Community Health Centre (CHC) and including City of Vaughan, United Way Toronto and York Region, York University, York Region District School Board, Catholic Community Services of York Region, Social Planning Council of York Region, Vaughan Public Libraries and Human Endeavour, continues to work together to keep pressure on policy change. The City of Vaughan is currently developing a municipal tool to assess the CIW impacts of each Council submission.
AOHC SUPPORTS THE CAMPAIGN FOR PAID SICK DAYS AOHC has been working with the Decent Work and Health Network to build the Campaign for Paid Sick Days, which calls for a minimum of seven paid sick days for full-time employees and no requirement for a sick note. The campaign gained a lot of momentum over the past year, with AOHC members participating in public education events and meetings with MPPs. In December, a group of healthcare providers met with the Minister of Health and Long-Term Care, Dr. Eric Hoskins, presenting him with a petition signed by over 900 health professionals, including AOHC member staff. Minister Hoskins expressed support for the campaign asks and pledged to raise the issues with Labour Minister Kevin Flynn, whose Ministry is currently reviewing labour legislation. A final report on Ontario’s labour laws is due in October 2016.
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Over the last year, AOHC and national pharmacare coalition partners continued advocacy work for a national drug coverage plan that is public, safe and affordable. Together, we developed a statement of principles for the design of a universal pharmacare plan, which was then endorsed by the AOHC Board. AOHC’s active role in the coalition also led to the creation of the Campaign for National Drug Coverage aimed at making national pharmacare a federal election issue in 2015, which resulted in three federal parties committing in varying degrees to a national drug coverage plan.
AHACS REFRESH THEIR MODEL OF WHOLISTIC HEALTH AND WELLBEING
MEMBERS STEP UP TO SUPPORT SYRIAN REFUGEES In mid-October, AOHC’s CEO Adrianna Tetley wrote Minister of Health and Long-Term Care Eric Hoskins assuring him that AOHC’s members are “committed to step up to provide a one-stop solution to meet the healthcare needs of refugees arriving in our communities.” Since then, Community Health Centres, who have a long history of serving refugees, as well as Community Family Health Teams and Nurse Practitioner-Led Clinics, have mobilized in many different ways. Not only have members opened doors to refugees in their individual centres, they also set up clinics in the hotels where refugees were staying and provided other supports, including system navigation, play groups for children and more. In many cases, they played a leading role in system-wide planning. For example, in Ottawa, Somerset West CHC, along with two settlement
AOHC HELPS BUILD SUPPORT FOR UNIVERSAL PHARMACARE
Healthcare providers and MPP France Gélinas with the Campaign for Paid Sick Days petition at the Queen’s Park press conference organized by AOHC
AOHC’S CAMPAIGN TO EXPAND PUBLIC DENTAL SERVICES TO ADULTS ON LOW INCOMES BUILDS MOMENTUM AOHC’s advocacy efforts over the past year have also been focused on convincing the Ontario Government to act now on their promise to extend public
The AHAC Circle refreshed and endorsed the Model of Wholistic Health and Wellbeing (MWHWB). The MWHWB is adapted from the Aboriginal Healing and Wellness Strategy (AHWS) framework that led to the creation of Aboriginal Health Access Centres (AHACs) nearly 20 years ago and captures the essence, as well as the evolution, of a unique Indigenous health service delivery model in Canada. This is a living testament to Indigenous practices that demonstrates the successful blend of western and traditional ways of knowing and being.
Advance people-centred, high quality primary health care as the foundation of the universal and publicly funded health system to increase access to appropriate services, especially for populations facing barriers.
AOHC’S RESPONSE TO PATIENTS FIRST PROPOSAL PRESENTS A BLUEPRINT FOR ONTARIO’S HEALTH SYSTEM TRANSFORMATION In December 2015, the Minister of Health and LongTerm Care, Dr. Eric Hoskins, issued his long-anticipated discussion paper, Patients First: A Proposal to Strengthen Patient-Centred Health Care in Ontario.
AOHC then embarked on a series of consultations with members and partners. The result was an 89page response entitled People and Communities First that provided recommendations for a health system that is better equipped to respond to the complexities of peoples’ lived experiences, to keep people and communities well, and to deliver high-quality primary health care using interprofessional teams. In the response, AOHC called on the Ministry of Health and Long-Term Care (MOHLTC) and other actors to:
Shift the conversation to people and communities Ensure the Minister serves as a strong steward for our health system Embed health equity throughout the system Expand the Local Health Integration Networks' (LHINs) mandate, but keep them out of the business of service delivery Strengthen primary care and access to interprofessional teams.
We supported the main submission with standalone reports on Francophone health (prepared by eight Francophone CHCs and a number of provincial stakeholders including the Francophone Planning
Entities); Indigenous health (prepared by the AHAC Circle) and LGBT health (prepared with Rainbow Health Ontario). We also provided significant support to the Ontario Oral Health Alliance on their response. As a supplement to the response to Patients First, we submitted recommended changes to the Local Health System Integration Act (LHSIA). Achieving amendments to this Act are most critical to success.
AOHC WORKS IN PARTNERSHIP WITH THE ONTARIO PRIMARY CARE COUNCIL TO DELIVER JOINT CALL TO ACTION AOHC CEO Adrianna Tetley speaking at the Patients First event at Women’s Health in Women’s Hands Community Health Centre
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Over the past year, AOHC continued working with the Ontario Primary Care Council (OPCC), comprised of six provincial primary care associations and
Demonstrate the value and impact of the Model of Health and Wellbeing on the improved health outcomes and experience of people and communities.
LHINS CAN NOW ACCESS BIRT DATA This year, three Local Health Integration Networks (LHINs) completed a pilot of the electronic dashboard based on the Multi-Sector Service Accountability Agreement (M-SAA) performance indicators and developed using the Business Intelligence Reporting Tool (BIRT). The dashboard will provide near real-time data for individual centres, and will allow LHINs to view the performance of other CHCs from across the province, allowing for comparison between CHCs of similar size, complexity, and client population. The M-SAA dashboard supports the CHCs’ commitment to accountability and efficiency, and will help CHCs and LHINs work together to meet performance goals.
tool more and more AOHC members are using, is part of the larger Community Health and Wellbeing Strategy aimed at establishing standardized measures and evidence that captures members’ contributions to better health outcomes through health promotion, community development and poverty mitigation. Phase I results provide members with new information about the health and wellbeing of the people that access their services and participate in their programs and community initiatives. The survey data also creates a baseline that can be used for evidence-based planning and to demonstrate the impacts of programs, services and initiatives over time.
CIHI-AOHC DEMONSTRATION PROJECT HELPS IMPROVE DATA BE WELL SURVEY REPORT PROVIDES QUALITY SNAPSHOT OF THE HEALTH AND WELLBEING OF PEOPLE SERVED BY Over the past year, 10 CHCs participated in a pilot project with the Canadian Institute of Health AOHC MEMBERS
Information (CIHI) and AOHC to evaluate the Electronic Medical Records (EMR) minimum data set for primary health care. The use of a minimum data set will increase the availability of structured coded data in EMRs, supporting practice management, quality improvement, and performance measurement for clinicians and decision makers.
In January 2016, AOHC released the Phase I results of the Be Well Survey. The report presented data from 20 member centres that had implemented the survey in seven languages and collected a total of 2,332 surveys. The Be Well Survey, a powerful new
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currently co-chaired by AOHC along with the Ontario College of Family Physicians, to positively shape the evolution of primary care in Ontario. Together, the Council members developed a joint response to Patients First urging Minister Hoskins to serve as a “steward of the health system as a whole” and actively direct LHINs to follow a common set of principles and expectations. The response was informed, and accompanied, by the OPCC Framework for Primary Care in Ontario and the OPCC Care Coordination in Primary Care position statement. These foundational documents, finalized and approved by the Council members last year, guide its work to advance primary care as the strong foundation of our health system.
Participating CHCs received both centre-level and provider-level performance reports in different areas, such as chronic disease, diabetes, and
immunizations, allowing participants to assess their data quality. Feedback from this project will help inform CIHI’s refinement of the EMR Content Standard, and BIRT will be enhanced to include more of the 45 data elements identified by CIHI to enhance clinical value and comparability.
SYRIAN REFUGEE TEMPLATE MEETS URGENT NEEDS In December 2015, AOHC added two standardized templates to the Electronic Medical Records (EMR) to assist with the intake of Syrian refugees. The forms were developed by CHC primary care providers and other clinicians involved in refugee care. The use of a common EMR allowed AOHC members to quickly respond to the urgent need to serve Syrian refugees and seamlessly integrate this template into the intake process.
AOHC RE-ORGANIZING TO BETTER SUPPORT ITS STRATEGIC PLAN After the adoption of the new strategic plan, AOHC went through a re-organizing process to ensure the staffing complement is aligned with all four strategic directions. As a result, we created two new positions: Research and Evaluation Lead and Writer/ Reporter. Both will focus on demonstrating the value and impact of the Model of Health and Wellbeing and will enable us to better tell our story.
Advocate for appropriate policies, processes and resources to ensure members are equipped to operate healthy organizations and realize their potential as effective catalysts in system transformation.
ONTARIO GOVERNMENT COMMITS $85 MILLION IN NEW FUNDING FOR COMPENSATION
funds, and will continue to diligently advocate for the outstanding funds that are still needed to address inequities in compensation.
This year marked another milestone achievement. After years of advocacy by AOHC, Nurse Practitioners’ Association of Ontario (NPAO) and Association of Family Health Teams of Ontario (AFHTO) regarding retention and recruitment challenges in primary care, the government has committed to a cumulative investment of $85 million over three years for compensation in the primary care sector. This is an important first step in working towards the goal of funding the 2012 Hay recommended rates. Without the united voice of all three associations, as well as tireless advocacy by members, this milestone would not have been achieved.
CHANGES TO CAPITAL POLICIES BETTER REFLECT MODEL OF HEALTH AND WELLBEING AND MODEL OF WHOLISTIC HEALTH AND WELLBEING
The three associations are currently working closely with the Ministry of Health and Long-Term Care (MOHLTC) on the implementation details of these
In December, thanks to sustained and coordinated advocacy by AOHC and its members, the MOHLTC’s Health Capital Investment Branch (HCIB) made changes to its capital policies and procedures. The revised policies and procedures are more closely aligned with our models, enabling more community spaces, more exam rooms, more space for staff funded by other ministries and more growth. The new policy facilitates the construction of both stand-alone as well as co-located or otherwise
integrated facilities, like Community Health Hubs. The capital process has been streamlined from six to four steps. And, for the first time, there is a funding stream in place for repairs and infrastructure renewal. AOHC has been working with HCIB for over a decade to make these changes happen. In addition to persistence, we also credit Premier Kathleen Wynne’s commitment to Community Hubs.
AHACS RECEIVE $1.3 MILLION FOR DECISION SUPPORT The 2016 provincial budget included good news for the Aboriginal Health Access Centres (AHACs) with new base funding of $1.3 million to support information management strategy (IMS) fees, data management coordinators and a decision support specialist. In addition, one-time funds of $586,000 were approved to enable the AHACs to access their collective data through the Business Intelligence Reporting Tool (BIRT).
Financial Report 2015–2016 AOHC has a solid financial picture, with total revenues of $7.2 million Total revenue of $2.4 million contributes to our core operations including advocacy, policy, communications and resource support for our members. This revenue was earned from membership fees, meeting registrations, learning events, including our annual conference, and funding for special projects such as the AHAC Decision Support Specialist and the Trillium CIW project. Additional revenue of $4.8 million contributes to our Information Management and Performance Management Program. This revenue was earned from Information Management Strategy (IMS) participation fees and from eHealth Ontario for the ongoing deployment of the electronic medical records. $1.98 million of these fees flow directly through to vendors.
As of March 31, 2016, AOHC’s surplus totaled $58,982:
$2.4 M
$28,982 was transferred to our general reserve which now has a balance of $192,029. The target is $250,000 by March 2018. $30,000 was transferred to our IMS Program reserve as an initial contribution. The target is $250,000 by March 2024. AOHC operates on a principle of fiscal transparency through the leadership of our member organizations.
Core operations
$4.8 M Information Management and Performance Management Program
Audited statements are available upon request.
$7.2 M
Total revenues
Board of Directors 2015–2016 Cheryl Prescod
oard Chair and Member-at-Large B Executive Director, Black Creek Community Health Centre
Sarah Hobbs-Blyth Vice-Chair and Central Constituency Executive Director, Planned Parenthood Toronto Marina Hodson Secretary and Community Family Health Team Constituency Executive Director, Kawartha North Family Health Team Robert Fletcher Treasurer and Eastern Constituency Board Member, Lanark Renfrew Health and Community Services Constance McKnight Aboriginal Constituency Executive Director, De dwa da dehs nye>s Aboriginal Health Centre Martha Lowrie Central Constituency Board Member, The Four Villages Community Health Centre Catherine Danbrook Central East Constituency Chief Executive Officer, Community Care City of Kawartha Lakes Cameron MacLeod Eastern Constituency Executive Director, Carlington Community Health Centre Nicole Levesque Francophone Constituency Board Chair, Centre de santé communautaire de Kapuskasing et région Denis Constantineau Northern Constituency Executive Director, Centre de santé communautaire du Grand Sudbury Marcel Castonguay South Central Constituency Executive Director, Centre de santé communautaire Hamilton/Niagara Richard Gerson South Central Constituency Board Member, Woolwich Community Health Centre Allan Madden South West Constituency Executive Director, South East Grey Community Health Centre Bonnie Burke South West Constituency Past Board President, Chatham-Kent Community Health Centres Clara Tsang Member-at-Large Board Member, HF Connecting Health Nurse Practitioner-Led Clinic Robert Walsh Member-at-Large Board Member, Sandy Hill Community Health Centre
500-970 Lawrence Ave W. Toronto, ON M6A 3B6 Association of Ontario Health Centres
Community-governed primary health care
Association des centres de santé de l’Ontario
Soins de santé primaires gérés par la communauté
For more information about AOHC and how you can get involved: Visit our website: www.aohc.org Follow us on Twitter: twitter.com/AOHC_ACSO Connect with us on Facebook: facebook.com/AOHC.ACSO Email us: mail@aohc.org Call us: 416-236-2539