| A N N U A L | R E P O R T | 22 00 00 76 Sherbourne Health Centre
BOARD OF DIRECTORS Brigitte Witkowski, Chair Raj Sharda, Vice Chair Jack Darville, Treasurer Robert Witterick, Secretary Felicity Somerset, Past Chair Leona Earlington
OUR MISSION is to reduce barriers to health by working with the people of our diverse urban communities to promote wellness and provide innovative primary health care services.
OUR VISION is a healthy urban
Anton Hart Murray Jose Lisa Ker Krish Krishnan Peg Lahn Cassandra Lord
community in which all individuals
Neeru Mishra
are supported by wellness programs
Ron Rosenes
and health services including primary
Mike Tevlin
health care services that are welcoming,
Bob Wallace
inclusive and accessible.
CELEBRATING THE NEW BUILDING, NEW BEGINNINGS, & NEW LEARNINGS The 300 people who gathered under sunny skies to celebrate the official opening of the new Sherbourne Health Centre building on May 22, 2007 came from all walks of life. One person slowly emerged from this audience of clients, neighbours, volunteers,
staff, partners and community leaders, and timidly made her way to the podium.
“Thanks to Sherbourne,” she said, “I see the world in a much better light after finding the strength to make my leap of faith and unveil my secret.”
After taking a deep breath, she confidently delivered a message that brought tears to the eyes of many. “Thanks to Sherbourne,” she said, “I see the world in a much better light after finding the strength to make my leap of faith and unveil my secret.” For three years, Sherbourne has guided Sandy, 37, on her “gender journey.” Now was the time to tell her story.
“My connection to Sherbourne Health Centre has had a profound impact on my life. I have found a genuine concern here and a commitment to making people’s lives better. At Sherbourne, I have found more than a place, more than people. I have found a friend.”
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BRIGITTE WITOWSKI, Chair, Board of Directors, Sherbourne Health Centre
“I believe in the vision of health care without barriers. Particularly, for people who don’t always feel welcome, such as newcomers, people who are homeless and the LGBT communities. These three groups all share a similar need: accessible primary health care services. Sherbourne fills that need—and that’s why our mission matters. With our new building, we have the potential to provide more services and be even more innovative.” “Opening 333 Sherbourne was the big event of the year, and it took a lot of energy to do it. Now, we face the challenge of maintaining the spirit that got us to that goal.”
The welcoming new glass doors of Sherbourne’s renovated building finally opened this year, marking a new era in health care delivery in southeast Toronto. But the model of care provided inside those doors began developing a few years ago when volunteers and staff first began interacting with the diverse communities Sherbourne was designed to serve. Reaching out to the community and making connections is at the heart of Sherbourne’s distinctive approach to providing health care. In the year just completed, that spirit continued to infuse all services, from the well-established Health Bus program to its new Infirmary and to a range of expanding primary health care services aimed principally at three target populations: recent immigrants, people who are homeless and the city’s growing lesbian, gay, bisexual, transgender and transsexual (LGBT) communities.
Sherbourne’s program service area has a truly diverse client base, from those in sub-standard housing to the more empowered living in luxury condos. Many face barriers such as language, drug use and a history of emotional trauma. They may have had negative experiences with the health care system. They may have mental health or other coping issues that make it difficult for them to make or follow through on medical appointments. By the time of the official May 22 celebration, Sherbourne had been providing health services for four years and had occupied its new facilities for two months. “We moved in on a Wednesday and clinical operations resumed on Friday,” says Brad Harrington, Sherbourne’s Chief Financial and Information Officer, who oversaw all aspects of the capital construction and renovation. The move was no small feat since Sherbourne had been operating previously out of three locations.
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And the Centre was quick to accommodate the increasing number of people who are seeking out its programs and services. Harrington expects the total cost of the new building will come in just under its $20 million budget. The renovated facility is bright and airy with spacious client service areas. Bringing all the staff together under one roof has helped unify them in pursuit of Sherbourne’s objectives. The larger building also means an expansion of existing programs and the introduction of new ones. The number of full-time staff has grown from 39 to 61.
Opening the new building turned one of Sherbourne’s long-term dreams into reality—a 20-bed infirmary for people who are homeless or underhoused. The infirmary is unique in Canada, meeting the medical and social needs of acute care patients who have been discharged from hospital and have nowhere appropriate to go for home care and recovery. The City of Toronto’s 1999 Task Force Report on the Homeless chaired by Anne Golden first highlighted the need for such a recovery facility.
Occupying Sherbourne’s third floor, the infirmary contains a mix of comfortable private and double rooms, therapy and treatment spaces, along with a communal inviting dining room overlooking Allan Gardens. It is a “beautiful place to recuperate in, especially when the alternative could be under a bridge,” says Mary Grondin, Program Director, Primary Health Care. “If we had good housing with appropriate support, the Infirmary would not need to exist,” says Alice
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SUZANNE BOGGILD,
Chief Executive Officer, Sherbourne Health Centre
“We moved into our newly renovated home thanks to the enormous commitment of staff and volunteers, the good will of the community, the generosity of the Ontario government and the patience of our neighbours.“ “The best thing about the opening ceremonies for the new building was looking out at the audience and seeing the diversity of people who otherwise might not meet. We all shared in the pride of accessible health care that Sherbourne represents. “ “Serving an urban population involves more than overcoming geographic barriers to service. Our clients have complex health needs, and many face barriers that people don’t see. It’s our job to ensure our clients get the services they need and to find innovative ways to promote their health and the health of the communities we serve.”
Broughton, who manages the area. “The staff always struggles with discharging our patients because of the living conditions they come from— and often have to return to.” Traci Noble, 26, had a short stay in the Infirmary after giving birth. The child’s father, whom she hoped to marry, had abandoned her, and she knew she would not be able to keep her child. A nurse at Women’s Residence, a shelter
“ It’s just awesome here,” she says. “The staff is so understanding, so caring. They helped me to get back on my feet again.” where Traci was living, told her about Sherbourne’s new infirmary and arranged for her to go there after the delivery. “I needed time to heal,” Traci says. While at Sherbourne, Traci took advantage of counselling services as well as receiving medical treatment. “It’s just awesome here,” she says. “The staff is so understanding, so caring. They helped me to get back on my feet again.”
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WAITING FOR THE BUS Claudio waits patiently in line for 20 minutes outside the bus before stepping inside. “What’s up?” asks Lee Cruz, the Sherbourne Health Centre intake worker on duty this muggy July night outside the Salvation Army’s Maxwell Meighen Centre, a shelter for homeless men. “I’ve got this pain in my chest,” says Claudio. As Cruz begins to ask Claudio some basic health and personal questions, he inputs Claudio’s full name into a laptop linked electronically to the Health Centre’s medical records. Claudio is an alcoholic who has just finished one rehab program and is about to embark on another. “I’m sober three months now,” he says, smiling proudly.
Part of Claudio’s new regime is exercise. He swims, runs and boxes. It’s the boxing that led to his current malaise. “I took a jab in the chest,” he explains, “and it really hurts. Is it my heart?” Volunteer nurse Bina Khandor examines him and assures him it’s probably just a bruise. If the pain gets worse, she says he should come back to the bus or visit a doctor for an X-ray. Relieved, Claudio steps down onto the street. “You guys do good work,” he says as he leaves.
This night there are two Sherbourne Health Centre Health Buses for the weekly two-hour visit to the Meighen Centre. It’s one of about a dozen regular weekly stops for the white RVs painted with Sherbourne’s distinctive green stripes and the blue and yellow logo of The Rotary Club of Toronto, sponsor of the buses.
“Congratulations,” says Cruz.
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For Sherbourne, these health buses are iconic. They bring primary health care to people who, for a variety of compelling reasons, rarely access the health care system in more traditional ways. “The buses are a much needed service that unfortunately has to exist,” says Lisa Crawley-Beams, another Health Bus volunteer nurse. “But we’re just scratching the surface,” she adds while handing out socks, vitamins, toothbrushes, shampoo and other toiletries, part of a better hygiene strategy to support Sherbourne’s goal of creating a healthy urban community. The free supplies also help to establish a rapport with people who may then feel comfortable returning for more serious health-care related issues.
Many of the Health Bus clients lack a health card, usually a barrier to receiving treatment in the more formal setting of a hospital. Outside of their emergency rooms, hospitals usually don’t admit patients unless they make an appointment beforehand. Not so on the Health Bus. Many of the Health Bus clients find it challenging to both make and keep medical appointments; they would rather show up when the bus is parked near where they live. In the 2006 calendar year, 24,665 clients visited the Health Buses, nearly 2,300 or 10 per cent more than in the previous year. Part of that increase can be attributed to the acquisition in May 2006 of two new buses to replace the single vehicle that had been serving partner agencies such as the Meighen Centre.
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Another factor boosting the numbers is the addition of a formal 11th stop to the six-day per week schedule. But word of mouth also plays a role as Sherbourne builds a track record of providing compassionate primary health care to people who are homeless and under-housed. Some of the Health Bus patients have more serious conditions than an apparent bruised rib. “We look at the best option for a client in need of further care,” continued on page 10
Ever since she was a male child, Sandy, now 37, says she knew she was different. Six years ago, Sandy decided to come out of the closet. Three years later, she found a welcome embrace at the Sherbourne Health Centre. “Sherbourne was the helping hand that I needed,” she says now. At Sherbourne, Sandy undertook counselling and therapy, and found guidance in a support group for her “gender journey.” A hormone replacement therapy program followed. Living full-time as a woman since February, Sandy spoke about her Sherbourne experience at the Centre’s May 22 Opening Ceremonies. Excerpts: “From a very early age, my life was a series of lies and spin-offs of the truth to protect myself from the world and protect the world from me. I had created a functional closet that kept me safe. “A major life turning point was waking up one day, throwing a bottle of Prozac into the garbage and making the choice and commitment to be happy and find out who I really was. By word of mouth, I came to Sherbourne about three years ago. My first visit, I was nervous.
“Upon arriving, I was made to feel comfortable and given a generous amount of time to talk about my life and lifelong questions. “Something inside me had been touched, something had been stirred, and I was full of thoughts and feelings that I had kept down for so long. Arriving home, I broke down and cried, overwhelmed by emotion after what seemed to be just a simple interview. For once, I felt truly understood. “I never thought it could be like this, and now I see that life can be even better than our dreams.
“I am aware that the future will have its own struggles that will take patience and work. But with my new friend, the love I feel and the tools I have gained, I feel confident that no matter what happens, life will be a beautiful place— and that I will never be alone again. “Thank you so much Sherbourne Health Centre for your daily outstanding service. You are an inspiration, a blessing to me and the many others who visit and also call you a friend.”
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says Amele Zewge-Teffera, Sherbourne’s Health Bus Program Coordinator. “That option could be bringing them to Sherbourne for follow-up or making arrangements for them to visit another health care facility.” Providing effective services on the buses has improved in the past year with the introduction of electronic record keeping just as the
cramped buses’ paper filing cabinets began to literally overflow. Indeed, explains Harrington, Sherbourne is “one of Canada’s leaders” in using the latest technology to track patient records. Being on the leading edge means that Sherbourne’s medical records system is more efficient with fewer errors than traditional paper-based systems. “Across the country, countless health system errors occur because clinicians lack critical information on their patients,” says Richard Alvarez, the president and CEO of Canada Health Infoway, a
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not-for profit organization that invests in new health information systems. This year, Canada Health Infoway provided Sherbourne with almost $900,000 to establish a state-of-theart electronic medical records system linking the buses to the Family Health Team and the Infirmary at Sherbourne. For Sherbourne CEO Suzanne Boggild, this major electronic medical records initiative “ensures good communication among clinical providers and improves health outcomes for patients.” The generous Infoway investment still requires additional support before the new electronic system can become fully operational. Sun Life Financial understood the
“ I felt so lonely before, I thought I was going to die on the street,” says Carl. “But here, they really looked after me. They even got me an electric scooter.” importance of the system, donating $100,000 this year. “To have buses providing medical attention to people who otherwise wouldn’t receive it is terrific,” says Linda MacKenzie, Sun Life’s Director, Philanthropy. Launching the new, integrated electronic records system was one of three major highlights for Sherbourne during the past year. The others were the move into newly renovated facilities at 333 Sherbourne and the provincial government’s approval of Sherbourne as a site for a Family Health Team.
INNOVATIVE CARE For Dr. Jamie Read, Sherbourne’s medical director, the Family Health Team is at the heart of Sherbourne’s goal of broadly defining health care and wellness. “Our concept goes beyond the traditional health care model of chronic disease management with patients visiting the doctor or a hospital,” Read explains. “We stress health promotion, disease prevention and the social determinants of health.” By social determinants, Read means factors known to effect one’s
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I sat in your waiting room downstairs yesterday while I waited to talk with the interview subject and found myself hoping she’d be really late. I just wanted to stay and soak it all in and can’t imagine saying that about any other waiting room I’ve ever been in. It’s welcoming and calming and comfortable, both physically and emotionally. I had a chance to observe a number of arrivals, questions and confrontations and the reception staff were unfailingly calm and clear, patient and polite without appearing to make any effort at all. They treated everyone with the highest level of respect and humanity and it always seemed to come from the heart. I can only imagine how cared for this must make all your patients feel. What you are all doing at the Sherbourne is or should be a model for healthcare providers everywhere. Congratulations to everyone concerned for getting it so right, beginning at your front door. Alison Moss Frontline Health Narrative Mapping Project
well-being such as housing, income, education, nutrition, social inclusion and early childhood development. With the move to the new building in March and the launch of the first phase of the Family Health Team in April, Sherbourne is now entering a new era of increased and improved care for the diverse communities it serves. “Our goal has always been to provide innovative primary health care,” Read says. “If we do it right with our Family Health Teams, we won’t have as many people going to hospital for treatment; we won’t have as many people with chronic diseases.” He commends the provincial health ministry for endorsing concretely Sherbourne’s mission by approving the Centre’s Family Health Team
application and backing it with additional funds. “Thanks to the province’s support,” Read says, “we can now start to make a real difference.” As Sherbourne’s lead physician, Read is responsible for all medical services provided by
the Centre. About half his time is taken up with administration, but he still finds time to see patients. One of them is Carl West, 69, who credits Read and his team with saving his life. “If it weren’t for Sherbourne, I wouldn’t be here today,” says West who has had a stroke and three heart attacks in the past four years. Four years ago, West was living at the Maxwell Meighen Centre and had been visiting hospital emergency rooms regularly with chest pains. But the lack of a health card kept him from getting the treatment he badly needed. A friend recommended Sherbourne and Carl, who could barely walk because of his condition, saw Read on his first visit as a dropin patient. Appointments with specialists, help in obtaining a health card and a referral for an operation to repair his veins followed.
“I felt so lonely before, I thought I was going to die on the street,” says Carl. “But here, they really looked after me. They even got me an electric scooter.” A rapid pace of growth can also be seen in Sherbourne’s Mental Health program. In the past year, 253 new clients have registered, bringing the total to 2,242. Those clients logged 3,600 visits, up from 3,000 in the previous year. “Mental health is the number one diagnosis in our Family Health Team,” says Read. “And many of these patients have other conditions such as addiction, making treatment a challenge.” Trauma-based counselling is a major component of the mental health program, reflecting Sherbourne’s program service area that is home to many refugees from war-torn nations
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previously reluctant to access the health care system. Last year, LGBT primary care, counselling and health promotion activities all saw increasing client numbers. And this year Sherbourne became home to the LGBT Parenting Network – a support program operated in partnership with the 519 Community Centre and Family Service Association of Toronto. such as Somalia and Sri Lanka. Nearly one in four of Sherbourne’s mental health clients have experienced trauma related to such conflict. For its LGBT clients, Sherbourne offers a wide range of programs in the spirit of providing a sensitive welcome for individuals
“Our clients are often overwhelmed by a sense of shame, guilt and isolation because of their sexual orientation,” says LGBT counsellor Rupert Raj, a transgendered male and leading expert in the field. “For the younger ones, especially, it is heart-wrenching when they have to choose between living their lives as they want,
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or trying to please their families.” Raj helps his clients build their self-esteem, but acknowledges that it can take several months to create a trusting relationship and several years before they work through their inner conflicts and begin to feel better about themselves. In addition to counselling, Raj links his clients with doctors as required, outside support groups and mentor-
“ I’m deeply grateful to SOY,” says Leo. “It has helped me at all levels: professional, personal, spiritual and health.” role models. “We help them identify and build upon their strengths,” he says. This year, some 250 clients and their families, partners and friends participated in Sherbourne’s annual Trans Pride Day, a celebration of trans culture. Sherbourne is also home to the popular LGBT initiative Supporting Our Youth (SOY). Last year, SOY recorded some 8,800 contacts, up 28 per cent from the previous year. Several outside agencies and 200 volunteers support its efforts in a variety of programs. “We are trying to help young
people who feel isolated in their sexuality feel more comfortable with themselves,” says Grondin. The SOY program in action is a perfect demonstration of how, by broadly defining health care, Sherbourne attempts to build healthier communities. Individual mentoring, support groups, arts and recreation activities all help LGBT young people build and maintain healthy lives. Clearly, it succeeded with Leo Zuniga, 25, who came
to Canada from Mexico in 2004 seeking refuge from sexual discrimination. “What hasn’t SOY done for me,” he answers when asked how the program has helped him adjust to life in Canada. Leo’s first contact with Sherbourne was the Health Bus. Living on social assistance at the time, he availed himself of the bus’s free vitamins, socks and toiletries. On the bus, he
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learned about SOY and joined its support group for “queer newcomers.” That led him to SOY’s mentoring program, and he now has two adult gay mentors “who are a huge part of my family in Canada.” To improve his English and gain work experience, Leo became a SOY volunteer. Now, he works for Sherbourne full-time as a mail assistant. “I’m deeply grateful to SOY,” says Leo.
“It has helped me at all levels: professional, personal, spiritual and health. I was isolated and depressed when I came to Canada. SOY helped me settle in and to accept my sexual orientation, to realize we are all beautiful beings.”
Toronto People with AIDS Foundation, the Canadian College of Naturopathic Medicine and the AIDS Committee of Toronto, is responsible for Sherbourne’s Naturopathic Clinic for HIV/ AIDS treatment.
Sherbourne’s many and unique programs could not exist without the support of volunteers and community partner agencies. One such tripartite partnership, with the
Another such joint venture is the Centre’s Chiropractic Clinic, staffed six days a week by students and interns from Toronto’s internationally renowned Canadian Memorial
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Chiropractic College. And this past year, Sherbourne launched a Chiropody Clinic in partnership with the Michener Institute, University of Toronto. Financial support from all three levels of government and donors large and small are essential to funding Sherbourne’s programs. The Paloma Foundation, for one, is dedicated to supporting
Sherbourne’s efforts to “serve the most underserved”. Angelo DeLuca, a sales specialist with IBM, is among the hundreds of individuals who volunteer their time to help Sherbourne meet its mission. DeLuca, a member of the Centre’s Finance Committee, has also succeeded in putting Sherbourne on IBM’s Employee Charitable Fund list and secured two notebook computers from
his employer for use by the Centre. “As a volunteer,” DeLuca says, “I saw some of the great things being accomplished at Sherbourne. I felt the need to act.” It’s that spirit of dedication that fuels Sherbourne. “We have a wonderful staff, wonderful volunteers, a supportive provincial government and fantastic involvement from the community,” says CEO Boggild. Adds Medical Director Read: “It’s been an amazing year. With our new building, we now have a launch pad to realize our phenomenal potential.”
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SHERBOURNE COMMUNITY
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STATEMENT OF FINANCIAL POSITION as of March 31, 2007
ASSETS
2007
2006
CURRENT Cash and cash equivalents
$3,103,521
$6,533,275
Accounts receivable
$790,459
$304,159
GST receivable
$182,452
$130,632
Prepaids
$193,880
$122,349
CAPITAL ASSETS
$4,270,312
$7,090,415
$26,448,104
$15,939,613
$30,718,416
$23,030,028
LIABILITIES CURRENT Accounts payable and accrued charges
$3,573,092
$1,622,771
Deferred revenue
$1,040,994
$5,603,320
DEFERRED CAPITAL CONTRIBUTIONS
$26,122,440
$15,939,613
$30,736,526
$23,165,704
FUND BALANCES Invested in capital assets Unrestricted
$325,664
-
$(343,774)
$(135,676)
$(18,110)
$(135,676)
$30,718,416
$23,030,028
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STATEMENT OF OPERATIONS & CHANGES IN NET ASSETS as of March 31, 2007 REVENUE
Ministry of Health & Long-Term Care Funding
2007
2006
$5,926,755
$4,440,278
Family Health Team
$112,182
-
Trillium Foundation
-
$32,100
$222,082
$269,936
Other grants & guarantors
$26,772
$15,880
Supporting Communities Partnership Initiative (SCPI)
$47,529
$73,314
Atkinson Foundation Grant
$102,757
$101,627
Canadian Breast Cancer Foundation Grant
$42,484
$78,123
Interest
$162,300
$80,601
Fundraising
$198,527
$309,755
$560,869
$107,674
$838,551
$437,764
$8,240,808
$5,947,052
OHIP
Other revenue and recoveries Amortization of deferred capital contributions
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EXPENSES
2007
Administration
2006
$393,133
$357,990
Finance
$288,948
$273,093
Human Resources
$277,664
$180,924
Information Systems
$439,371
$345,796
$249,883
$223,685
Building Services and Utilities
$1,274,111
$707,585
Fundraising
$112,552
$89,975
Community Relations and Communications
Clinical Service Client Registration
$299,636
$258,141
Health Bus/Mobile
$461,000
$413,534 $472,762
Mental Health
$464,088
LGBT Primary Care
$1,190,423
$956,919
Primary Care and Family Health Team
$1,307,189
$977,398
InďŹ rmary
$374,281
$170,989
Naturopathic Clinic
$49,655
$66,791
Atkinson Foundation Grant
$102,757
$101,627
Amortization of Capital Assets
$838,551
$437,764
$8,123,242
$6,034,973
$117,566
$(87,921)
EXCESS (DEFICIENCY) OF REVENUES OVER EXPENSES FUND BALANCE, BEGINNING OF YEAR FUND BALANCE, END OF YEAR
$(135,676)
$(47,755)
$(18,110)
$(135,676)
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COMMUNITY SUPPORT Sherbourne Health Centre is deeply grateful to the many funders and donors whose generous support makes it possible to care for some of Toronto’s most vulnerable people.
Ministry of Health and Long-Term Care
Supporting Community Partnerships Initiative
Rotary Club of Toronto Foundation
Clinicare, IBM Canada, IBM Employees Charitable Fund, LGCA Foundation, Mr. Leatherman Toronto, Toronto Arts Council BMC Canada, Steamworks, Titans Softball Insense Limited, Kimberley-Clark Inc., Mologic Limited, Pink Triangle Press, Pride Toronto, Royal Bank of Canada, University of Toronto OSA CUPE 2316, Factory Appliance Parts & Services, IBI Group, Integrated Assessment Services, KCI Company, Know Your Body Best, Sign-a-Rama, Toronto-Dominion Bank
And over 1,500 generous individual donors Charitable Business # 86577 6827 RR0001 S H E R B O U R N E H E A LT H C E N T R E | A N N UA L R E P O R T | 2 0 0 6 / 2 0 0 7 |
333 Sherbourne Street Toronto, ON M5A 2S5 Services: 416.324.4180 Administration: 416.324.5062 Email: info@sherbourne.on.ca
www.sherbourne.on.ca Charitable Business # 86577 6827 RR0001