Sherbourne Health Centre
ANNUAL REPORT 2010/2011
Operating since 2002, Sherbourne Health Centre provides quality primary health care and support to individuals and families living in southeast Toronto. In 2010, Sherbourne Health Centre improved health outcomes for individuals through more than 140,000 visits for innovative services and programs that address the urgent needs of its diverse clients, including newcomers to Canada, homeless and underhoused individuals, and members of the LGBT communities. Working with a range of community partners, Sherbourne Health Centre addresses the social determinants of health and reduces social, economic and other barriers to healthier lives and healthier communities.
Sherbourne Health Centre has set four core strategic directions to guide us:
• E xpand our Impact in the Community: a focus on improving access to primary family health services, and influencing public policy and health system decision making;
• I mprove Quality and Safety: a focus on delivering high-quality services through continual improvement and a culture of safety;
• I mprove Organizational Health: a focus on creating a healthy, sustainable workplace that supports our beliefs of an inclusive, accessible and non-judgmental atmosphere; and
• E nhance System Integration: a focus on creating an integrated health system that responds to the unique needs of our clients.
MessAge from the Chair
Message from the Chief Executive Officer
It is with great pleasure that I bring greetings and a degree of reflection from the Board of Sherbourne Health Centre. When I look back on 2010/2011 and my five years on Sherbourne’s Board of Directors, I see such remarkable growth and development. Perhaps nothing highlights this better than the recognition of excellence by our peers through the granting of Accreditation by Accreditation Canada and our response to the Wellesley fire. These examples look at the mosaic that is Sherbourne Health Centre from two very different and very important perspectives – impact and accountability. The view of Sherbourne’s response to the Wellesley fire was a very visible example of how we work in the community and very concretely impact people’s lives. The view of the accreditation process is a part of systems that are much less visible but which ensure a level of excellence and accountability that is essential in providing care in our community. These two views are critical for the Board’s role.
The 2010/11 Annual Report conveys the transformative nature of our work at Sherbourne Health Centre through inspiring client stories and colourful images from the community mosaic project we undertook this year. The seven themes in the mosaic serve as a wonderful framework for my report and I invite you to follow them with me.
This past year, the Board began a reflective process to consider the “Essence” of Sherbourne – what we do, who we serve, and how we might best position Sherbourne within the continuum of care, always ensuring we reach out to and serve those most in need. The Essence Project will guide our strategic planning and the course of community engagement around what is our Vision and Mission for the future. It will also further build on the amazing work of Sherbourne’s Staff in meeting the diverse and complex care needs of those who may be Homeless and Underhoused; Newcomers to Canada; and/or members of our LGBT Families. In particular, to the growth and emphasis on quality and the countless hours expended towards accreditation, I can only say what a remarkable achievement and well done to all! As the Executive Director of a community partner agency, a resident of Sherbourne’s catchment area and a gay man living with HIV, I also have a multi-faceted view of the mosaic that is Sherbourne Health Centre. I continue to be inspired by Sherbourne, the commitment and passion of staff and volunteers, as well as the ultimate accountability that exists in offering transformational, innovative programming that truly impacts our community.
Murray Jose Chair, Board of Directors Sherbourne Health Centre
Our Newcomer Health Program, formally launched this year, saw a remarkable growth in service. Sixty-four per cent of clients who registered to the Sherbourne Family Health Team identified as newcomers. Read the story of one newcomer, knowing she represents many more who come to us from many roads. At the core of our service delivery model is our commitment to safe, high quality care, as demonstrated by our first Accreditation award from Accreditation Canada, the leading accrediting body for health organizations. Sherbourne is proud to join the more than 1,000 organizations across Canada accredited by this body. Strong partnerships further strengthen our service delivery model. Examples of the support, connection and balance these partnerships afford our clients are particularly abundant within our LGBT Program. In this report, you’ll read about Rainbow Health Ontario’s remarkable work promoting lesbian, gay, bisexual and trans health. You’ll also see how our LGBT Parenting Network ensures all kinds of families get the support they need to raise happy, healthy children. This year also marked many achievements within our Urban Heath Program. Visits to the Rotary Club of Toronto Health Buses continued to increase and we responded by developing innovative approaches such as the Women in Need Klinic (WINK). Three chronic disease management programs for people with HIV, diabetes or hepatitis C also nourished our clients’ health and well-being. These programs and on-site partnerships for chiropody, naturopathy, and chiropractic care ensure Access 4 All who are in need. I invite you to visit Sherbourne Health Centre to see our beautiful community mosaic. But most importantly, I thank our volunteer board members, staff, program volunteers, donors, funding agencies or community partners for your incredible support, hard work and sense of community. You make the important work we do possible and show that Sherbourne is truly a mosaic of people as strong and diverse as the mosaics themselves.
Suzanne Boggild Chief Executive Officer Sherbourne Health Centre
Sherbourne Health Centre - Annual Report - 2010/2011
Other highlights for me this past year include signing a new funding Agreement with the Local Health Integration Network (LHIN), a new Family Health Team Agreement with the Family Health Team Branch of the Ministry of Health and Long-Term Care, and our first Physician Agreement for Service. All will ensure stability of our programs and services, but moreover, these Agreements will hold the Board, Physicians and Management (who are the Stewards of Care) accountable to those we are charged to care for.
In 2010/11 we received 147,720 visits from clients – an annual increase of almost 30 per cent. We welcomed many new clients to the Sherbourne Family Health Team – greatly improving access to family physicians and nurse practitioners within our community.
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Transforming Lives Sherbourne Health Centre has always had strong connections with the community and the people it serves. This past year, that connection was expressed through art as Sherbourne partnered with local artists to produce a mural that shows how the organization has a transformative influence in people’s lives. “We were very excited to move into our current space in 2007,” says Sherbourne Health Centre CEO Suzanne Boggild. “We knew we wanted to make our building not just physically accessible, but also emotionally. That’s why we were very excited to work on this mosaic project as a way to really involve our clients and their communities.” The project involved asking Sherbourne’s clients, volunteers, community partners and staff to express what the centre means to them, what creates healthy communities and what that looks like. After consultations with more than 100 individuals, lead artist Anna Camilleri and Artistic Co-Director of Red Dress Productions, produced seven vibrant illustrations that together are the blueprint for the large-scale public artwork that will greet people as they approach Sherbourne’s main entrance. “People really wanted to let us know that this place is important to them,” says Anna. She and collaborator Tristan R. Whiston had been working with Sherbourne Health Centre for the past year on the project. No strangers to Sherbourne, Camilleri and Whiston have volunteered with the centre and also live in the neighbourhood. “It’s exciting to enter a project where we have some connection. We know how exciting the programs are and how they’re unique.” In the consultations, participants were asked to express their ideas and feelings in words and images. Many sessions involved making art with pastel, mixed media, and printmaking on fabric and paper. “We heard over and over how responsive Sherbourne is,” says Whiston. “And the actual process of making the mural is reflective of its approach in involving the people it serves.” It was no surprise that common themes came up throughout the consultations. People connected to Sherbourne indicated that they feel welcome, that the centre offers a safe space, and that it often transforms their lives. Camilleri says that each panel featured throughout the pages of this annual report focuses on an element of Sherbourne’s work and its values, including respect for the individual, access for all, and inclusion. And making a real difference in people’s lives happens every day at Sherbourne. In this report are some stories that illustrate so well why Sherbourne is at the heart of the community.
Red Dress Productions’ artistic leadership team for the Sherbourne Health Centre Mosaic project includes lead artist and designer Anna Camilleri, co-lead artist Tristan R. Whiston, and youth apprentices Heidi Cho, Rafaela Vidinha Dominici, Daniel Jelani Ellis, and Jay Stewart. Red Dress Productions gratefully acknowledges the support of Sherbourne Health Centre, the Toronto ArtsCouncil, and the Ontario Arts Council.
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2010 Highlights This past year, Sherbourne Health Centre received 147,720 visits from clients accessing our many services and programs – an annual increase of almost 30 per cent. At the core of our services is the Sherbourne Family Health Team, supported by the Sherbourne Health Centre Physician Group. Their great impact is evident right across the organization, including in many of the achievements outlined in the following pages. We hope that these “snapshots” will provide an interesting insight into some of the ways in which we are working and connecting with clients and community members from so many different backgrounds to improve their health and well-being. The stories of the people who come through Sherbourne are of course as diverse as the population of our city itself.*
| Supporting newcomers The dramatic growth in newcomers registered with Sherbourne over the past year has required considerable program development to handle the complexities and unique needs of this client group. Some newcomers face a daunting combination of multiple physical health issues, mental health issues and settlement concerns. There are also cultural and language considerations, and many struggle to navigate the Canadian healthcare system. Ayesha, a 45-year-old Eritrean woman, is just one such newcomer, but her situation is representative of many more. Her country’s long and tragic history of wars and disputes has taken its toll on hundreds of thousands. Lucky enough to reach Canada with two of her four children in 2010, Ayesha is nevertheless still struggling to cope with immense physical, emotional and practical challenges. Her other two children, separated from her during the war, are in Turkey; her husband’s whereabouts are unknown. Ayesha herself has four gunshot wounds, which were infected when she first came to Sherbourne. A victim of rape, she still has flashbacks to the attack, as well as enduring war trauma; and she has tested positive for TB. One of her children has also been suffering from uncontrolled seizures. Registering Ayesha and her children with a physician, addressing their primary health needs, sourcing a pediatrician and providing counselling were immediate priorities. But just as important was helping to connect them to other services that they needed – including legal and settlement services and an English as a second language course. Although these aren’t typically seen as healthcare issues, Sherbourne recognizes the social determinants of health that impact on an individual’s well-being. For this reason, we partner with other agencies to provide settlement services, source interpreters where necessary (though our staff speak multiple languages) and constantly explore new partnerships to ensure that clients are able to access the all-round support they need.
* The names of the clients who have shared their stories in this report have been changed to protect their privacy.
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| Promoting LGBT health in Ontario Rainbow Health Ontario (RHO) continued its work to improve access to services and promote the health of Ontario’s lesbian, gay, bisexual and trans (LGBT) communities. More than 60 training sessions helped service providers increase their understanding of LGBT health issues and disparities, as well as their skills in providing health education, disease prevention and treatment for the LGBT communities. This past year, a virtual store was launched to offer resources including brochures, posters, stickers and manuals providing information about LGBT health – healthcare providers, students, community services and clients can already access over 70 products. The next step is better access for francophone audiences – a francophone services coordinator has already translated RHO’s core materials and is working on a French version of the website.
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SOY Mentoring – connecting youth with adult mentors
Last fall, 22-year-old Jen moved to Toronto after having been estranged from her family and dropping out of school. Feeling isolated and disenfranchised she connected with Sherbourne Health Centre’s Supporting Our Youth (SOY) program, which, among other things, matches queer youth like Jen with volunteer adult role models. Jen describes her mentor Susan as “one of the coolest individuals I have ever had the pleasure of meeting,” and places tremendous value on the relationship. Hanging out together is “an immense joy” for Jen, but Susan has also encouraged Jen to think more positively about herself. Susan’s best advice has been that “you can’t be a failure at 22,” says Jen. “It gives it a whole new meaning when someone I respect, someone who is older and successful in her life and career, agrees with that truth.” Jen adds that one of the biggest strengths of the mentoring program is “to connect youth to an adult they can respect and not feel judged by, or better yet, someone who is living life openly and honestly in a world that isn’t falling apart, living queerness and thriving.” And she describes SOY as “an amazing force” and a positive space for youth and adults to interact “for all of us on the margins trying to understand ourselves, hear our own voices, and stand in solidarity with each other.”
Marathoner gives back
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Runner Kyle Jackson chose to raise funds for SOY when he ran the GoodLife Marathon in May, both as an extra incentive and because it “clearly leads the way in terms of providing services and support to LGBT youth in Toronto.” It’s estimated that up to 40 per cent of homeless youth in Canada’s major urban centres identify as LGBT. Kyle says he was particularly impressed that SOY’s support to youth includes housing and employment guidance, referrals to sheltered accommodation, and opportunities for oneto-one and group support, including a weekly drop-in.
| Strengthening families Last year, the LGBTQ Parenting Network launched a new study exploring discrimination against trans parents, and trans parents’ perceptions of their parenting strengths. A report on the findings is underway, but emerging themes from focus groups identify the need for greater visibility and community-building. One positive and empowering step towards this One of the many I ♥ My LGBTQ Family cards will be a short documentary video (illustration by Willow Dawson) about trans parents. The new resource will be showcased in the coming year and made available on the internet for use in schools and in trainings with service providers. In May 2010, the LGBTQ Parenting Network at Sherbourne also launched a series of free celebratory “I ♥ My LGBTQ Family!” cards illustrated by local artists. The cards were created as part of the network’s developing work with kids who have lesbian, gay, bisexual, trans and queer parents (also affectionately termed “queer spawn” by the kids themselves). They not only recognize and celebrate families and caregivers in their many diverse and extended forms, but are also designed as a practical tool for talking about LGBTQ family issues in schools.
| Urban Health The Urban Health team supports clients who are homeless or marginally housed. This includes those reliant on shelters, sleeping on friends’ couches, and those who sleep anywhere from storage spaces to internet cafes. Like the community mosaic, the team is the sum of many parts. The Rotary Club of Toronto Health Buses provide mobile healthcare at homeless shelters and drop-ins around the city; the Infirmary frees up hospital beds by providing short-term care to those with acute medical conditions who don’t have a safe, appropriate place to stay or be monitored; an Urban Health client resource worker and the Infirmary both work with community partners to help clients obtain secure housing and get connected to – or avoid getting cut off from – the services they need; and medical staff provide primary healthcare and counselling, as well as more specialist medical attention for those with or at risk from HIV/AIDS, hepatitis C and diabetes. This year, the Urban Health team became the provincial pilot site for a new quality improvement initiative focused on increasing and fast-tracking client access to care through more collaborative inter-disciplinary teamwork. Staff were re-grouped into “mini-teams,” sharing a work area and offering more cover for one another; and clients are introduced to each team member and their role. Other initiatives included the development of new partnerships by the Infirmary enabling it to be part of ongoing care for cancer patients, while the Women In Need Klinic (WINK) now offers a weekly safe space for street-involved women and trans women, with access to medical staff, counselling and a healthy breakfast.
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Living well with diabetes
Diabetes literally affects people from head to toe, and can have significant social and emotional impacts. That’s why Sherbourne’s diabetes education team developed a program that not only focuses on treatment of the disease itself, but also on food access and knowledge, cooking skills, lifestyle changes and stress management. A participatory pay-what-you-can community kitchen encourages healthy eating and skillbuilding, while one-to-one sessions with a nurse and dietitian can cover everything from checking blood sugar levels to working with limited food budgets and raising awareness of food banks and other community resources. The program also has strong links with other Sherbourne services and external partners. Referrals are often made to the chiropody clinic, which Sherbourne runs in partnership with the Michener Institute, since diabetics are prone to foot infections, and nerve damage in the feet can lead to serious safety issues. Cross-referrals between the program and The Rotary Club of Toronto Health Buses and local homeless shelters, as well as workshops in the local St. James Town community, where many newcomers and low-income families live, have also been key to reaching individuals who may be particularly at risk. Around 350 individual clients were seen over the past year, with still more engaged via community outreach and community kitchen sessions.
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New team to advance hep C work
When the hepatitis (hep) C clinic at Sherbourne started in 2008, Toronto Public Health ranked the disease as the fourth most-reported sexually transmitted and bloodborne disease in Toronto. Many clients diagnosed with hep C need extra support such as counselling, help with addictions and practical support around housing. That’s why Sherbourne strengthened its team helping people with hep C by adding counsellor Callum Anderson and outreach worker Amy Muli to join Mugove Manjengwa, the hep C clinic’s treatment nurse. A coordinator will complete the team in 2011 to take a more holistic and integrated approach to help clients prevent serious or even fatal liver damage. Under the East Toronto Hep C Partnership Program, a peer educator is shared with Regent Park and South Riverdale community health centres, offering psycho-educational peer support groups and expert one-to-one treatment. And the new team will work with Sherbourne’s treatment physicians, as well as an infectious disease specialist and psychiatrist from local hospitals, to provide increased care and support to clients at risk of and living with hep C.
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Client visits for programs and services for 2010-2011
Program
Total Actual 2010-11 volume
Sherbourne HEALTH CENTRE (SHC) ProgramS Family Health Team (All Teams)
39,761
Infirmary
13,117
Health Buses
28,444
SOY
9,430
Parenting Network
31,021
Mental Health Counselling Total SHC
4,800 126,573
Partnership Joint CMCC/SHC Chiropractic
13,958
Joint CCNM/PWA/ACT/SHC Naturopathic Chiropody Clinic Total Partnership Grand Total
2,422 4,767 21,147 147,720
ACKNOWLEDGMENTS People and organizations give to and support Sherbourne and its programs in so many different ways. Some offer their time and services, expertise and enthusiasm, including our many volunteers and community partners; others are able to contribute financially too. High quality core services are generously supported by the Government of Canada, the Government of Ontario and the City of Toronto. The full range and depth of our programs rely on additional donations. In 2010, The Rotary Club of Toronto Health Buses continued to offer their vital services around the City, and The Paloma Foundation and The Geoffrey H. Wood Foundation again generously helped us to provide vital care to homeless and uninsured clients who are often overlooked; BMO Financial Group continued its loyal and generous support; and Blake, Cassels & Graydon LLP presented a special award to their employee and Sherbourne Board Member, Marianne Smith, which was also kindly directed to Sherbourne. Many other initiatives would also not have been possible without funding or sponsorship from: The RBC Financial Group; The City of Toronto; TD Bank Financial Group; Toronto Arts Council; Community One Foundation; Pink Turf Soccer League; PRIDE Toronto; Outer Layer Ltd; Toronto Gay Ski and Snowboarding Club; XTRA; Campbell Company of Canada; United Food and Commercial Workers. And a range of employee groups, unions, gay sports organizations, venues/events and interest groups gave much appreciated support. Individual donors play such a key part too. Monthly donors are essential in helping us to maintain innovative programs and plan ahead; and those making bequests to Sherbourne programs in their wills help to ensure the continued success of programs for future generations. Fundraisers – whether through the SOY Bowlathon, holding their own or participating in local competitions, races and events – also make great efforts to support programs as well as providing much-needed funds. We thank every one of our generous supporters.
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Financial Statements Sherbourne Health Centre Corporation
Statement of Operations Year ended March 31, 2011
Revenue
2011
2010
$ 7,388,267
$ 6,616,879
Amortization of deferred capital contributions (Note 6)
1,288,109
1,451,339
Family Health Team
2,366,617
2,020,697
Fundraising
115,640
79,713
MOHLTC Health Research Grants
916,065
732,700
67,037
63,629
-
25,608
53,420
52,373
103,316
655,110
13,626
-
$ 12,312,097
$ 11,698,048
2011
2010
$ 1,633,613
$ 1,622,215
Finance
356,037
334,725
Information systems
517,623
460,425
Administration
483,434
439,046
Communications
28,191
-
Human resources
359,677
255,950
77,361
71,001
Primary care and Family Health Team
3,342,123
3,000,117
Infirmary
1,323,027
1,092,114
LGBTT primary care
1,958,156
1,931,022
Health bus/mobile
611,612
498,245
Mental health
477,050
387,443
Naturopathic clinic
38,648
42,900
-
25,608
1,308,948
1,477,627
$ 12,515,500
$ 11,638,438
($ 203,403)
$ 59,610
Ministry of Health and Long-Term Care (“MOHLTC”) and Central Local Health Integration Network (“Toronto Central LHIN”) funding (Note 7)
Other grants and guarantors Atkinson Foundation Grant Supporting Communities Partnership Initiative (“HPI”) Other revenue and recoveries
Sherbourne Health Centre - Annual Report - 2010/2011
Interest
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Expenses Building services and utilities
Fundraising Clinical service
Atkinson Foundation Grant Amortization of capital assets Excess of revenue over expenses
Financial Statements Sherbourne Health Centre Corporation
Statement of Financial position As at March 31, 2011
Assets
2011
2010
Current
Cash
$ 77,689
$ 147,903
Accounts receivable
316,325
701,264
HST receivable
235,287
564,794
Prepaid expenses
113,572
82,136
Inventory
86,762
64,589
$ 829,635
$ 1,560,686
$ 22,222,396
$ 23,362,764
$ 23,052,031
$ 24,923,450
2011
2010
$ 1,313,923
$ 1,895,881
441,849
360,238
$ 1,755,772
$ 2,256,119
$ 21,470,781
$ 22,638,450
$ 23,226,553
$ 24,894,569
2011
2010
Invested in capital assets
$ 751,615
$ 724,314
Unrestricted
(926,137)
(695,433)
($ 174,522)
$ 28,881
$ 23,052,031
$ 24,923,450
Capital assets (Note 4)
Liabilities Current Accounts payable and accrued charges
Deferred revenue (Note 5)
Deferred capital contributions (Note 6)
Fund balances
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www.sherbourne.on.ca Front and back cover photos of mosaic project and mosaic illustrations, Š Red Dress Productions, 2011