Wellesley Institute

Register now! November 17: Community Voices - The St James Town Initiative

2009-11-09T12:05:34-05:00

Research into action: Photo Exposition and unique community based research method release

You are invited to join the Wellesley Institute and the St James Town Initiative for a learning seminar, photo exhibit, and community panel discussion. Our latest research addresses the social determinants of immigrant health through innovative methods, partnerships, and community action.

Join us on Tuesday, November 17 at Oakham House, Ryerson University, Toronto, ON.

A look at the integration of Photovoices and Concept Mapping
Challenges and opportunities of working in Vertical Communities
Panel discussion: From research to action
Photo exhibit
Refreshments and networking

The St James Town Initiative is the Wellesley Institute's largest research and community capacity building initiative. The project is funded to continue until 2011. The Initiative focuses primarily on the health and wellbeing of immigrant residents in Toronto's North St James Town neighbourhood. Our goal is to help newcomers/immigrants maintain the good health that they enjoy when they arrive in this country.

For more information and to register, please contact Katherine Seiter at Katherine@wellesleyinstitute.com

www.wellesleyinstitute.com

Powerful day on Parliament Hill: National housing plan inches closer to reality

2009-11-05T21:07:51-05:00

A dynamic afternoon of testimony today from a series of expert witnesses (including the Wellesley Institute's Michael Shapcott, has helped moved Bill C-304 - the draft legislation that sets out a process to create a new national affordable housing strategy - a step closer to reality. The Assembly of First Nations, Federation of Canadian Municipalities, Federation of Canadian Apartment Associations, Canadian Housing and Renewal Association, Evangelical Fellowship of Canada and the Wellesley Institute all spoke in favour of a national housing plan. The bill passed second reading in the Commons with the support of the NDP, Liberals, Bloc and a lone Conservative. It will receive detailed, clause-by-clause review next Tuesday, and will then return to the House for third and final vote; before heading off to the Senate for ratification there. With the unanimous support of every expert witness at today's hearing, the bill appears poised to move forward.

Parliament should pass Bill C-304; Canada urgently needs national housing plan

2009-11-05T14:44:46-05:00

The time is right for Parliament to pass Bill C-304, which directs the federal housing minister to consult widely and develop a national affordable housing plan within 180 days. The Wellesley Institute’s Michael Shapcott offered expert testimony at the Commons HUMA committee on Nov. 5 on the four key reasons for a comprehensive national housing framework. Click here for the speaking notes for the HUMA presentation.

A Snapshot of Equity Initiatives on LHIN Websites--Waterloo Wellington LHIN

2009-11-05T11:01:57-05:00

Links

http://waterloowellingtonlhin.on.ca

Integrated Health Service Plan (note: it is in 6 sections)

Equity Highlights

Waterloo Wellington LHIN evaluates proposals based on "equity in the provision of services to recognizable populations"

Year in Review (2007-08 Annual Report)

The LHIN's urgent priorities fund is a new funding investment that allows each LHIN to address key local priorities
Priorities must improve the provisions of services (new or existing) and support activities that focus on improving access, equity, health outcomes, quality of care and efficiency
WWLHIN was allocated $1.38 million in funding to support urgent priorities in local care - to improve access and equity in areas identified through planning as pressure areas

Annual Service Plan (2008/09 - 2010/11)

Contains 5 strategic directions: renewed community engagement and partnership, health status, access and equity, quality, and sustainability

IHSP 2007-2010

WW LHIN's local priorities include encouraging equitable access to new and emerging clinical practice techniques and IT
A key system-wide priority is to improve accessibility to health services by promoting access to appropriate services, improving timeliness of service delivery and ensuring availability of appropriate services

Note: there is little else on the website explicitly regarding health equity

A Snapshot of Equity Initiatives on LHIN Websites--Toronto Central LHIN

2009-11-05T10:56:31-05:00

Links

http://torontocentrallhin.on.ca

Integrated Health Service Plan (2007-2010)

Equity Highlights

The Toronto Central LHIN states that health equity is woven into everything that the LHIN does.

Health Equity Vision

The health equity vision for the TC LHIN is "to create and sustain a healthcare system in Toronto where all have equitable access to a full range of high-quality healthcare and support, and systemic and avoidable health inequities are steadily reduced"

IHSP 2007-2010

In the IHSP, TC LHIN recognizes that "when planning services and programs, equity of access needs to be front and centre especially given TC LHIN's diverse population"
New initiatives are to focus on equitable access to services for all residents of the LHIN
In September 2007, the TC LHIN also struck a Health Inequalities Task Force

2008/09 TC LHIN Year in Review

Health Equity is a system performance goal
The hospital collaborative on marginalized populations designed the first hospital health equity plans
All 18 hospitals in the TC LHIN submitted health equity plans to the LHIN
The TC LHIN is also working with the MOHLTC and the Wellesley Institute on a Health Equity Assessment Tool
Anticipated results include more equitable access to services in the community for those with addictions or mental health problems
The TC LHIN has also developed an Aboriginal Diabetes Treatment Pilot (recommendations from the pilot are to be implemented in 2009/2010
The Flemingdon CHC Initiative provided 158 South Asian seniors with diabetes-related services (like screening and culturally specific diabetes education

Health Equity Discussion Paper

The TC LHIN's website links to Dr. Bob Gardner's "Health Equity Discussion Paper"
The Paper made 12 recommendations including: (1) create a powerful equity vision, (2) set equity requirements, (3) build equity into performance management, (4) target barriers, (5) target disadvantaged populations, (6) enhance services with high equity potential, (7) build equity into key directions for health reform, (8) patient-centred care through an equity lens, (9) up-stream through an equity lens, (10) address the wider social determinants of health, (11) innovation through an equity lens and (12) making this happen

Health Equity Pilot Project (Status Update Feb 8, 2008)

On August 29, 2007, a board motion directed council to identify 1-2 sustainable pilot projects that would reduce access barriers for populations with lower health statuses
The goal of the pilots was improved access to health care for marginalized populations who experience barriers to care (including cultural, linguistic, socioeconomic and geographic barriers) and underserved populations such as those who are homeless or those who are uncomfortable and discouraged from using services as they exist
Equity projects were initiated in 4 areas: (1) mental health and addictions, (2) seniors, (3) rehabilitation and (4) joint disease and health management
Deliverables included: identification of the marginalized population to be targeted and identification of specific barriers to address (language, population, neighbourhoods)
Identification and implementation of strategies to address barriers include training models, communication plans, project evaluations, sustainability plans and final reports
Pilot deliverables will be incorporated into routine health service provider operations through accountability agreements
Projected outcomes from the project included improved access to care for marginalized populations and improved awareness of marginalized populations and their access to appropriate health care

Healthy Connections 2008 - Health Equity: From Challenges to Solutions (Report of Proceedings and Outcomes)

The TC LHIN developed a mental health and addictions steering committee whose goal is to improve the accessibility and equity of mental health and addictions services

A Snapshot of Equity Initiatives on LHIN Websites--South West LHIN

2009-11-05T10:52:34-05:00

Links

http://www.southwestlhin.on.ca

Integrated Health Service Plan 2010-2013

Integrated Health Service Plan (2006)

Equity Highlights

The LHIN promotes increased equity of access to services regardless of geographic location or means of transportation

IHSP (2006)

Strategic Goals: establish a single system of providers that offers equity in access to quality services
Partners within SW LHIN need to identify innovative solutions to support equity of access for rural and urban communities
The LHIN will define and strengthen the delivery of equitable, timely and appropriate service and improve service coordination with a focus on implementing innovative approaches to support rural community providers
Year 1 Deliverables included: gaining an understanding of the level of equity and timeliness of access to services through data analysis and comparing the results to the perception of these factors held by consumers and providers

IHSP 2010-2013 Priorities

Increased support for people who have or at risk of developing chronic diseases (these people are disproportionately from minority and low socioeconomic status backgrounds so this priority is equitable without explicitly mentioning "equity")
The LHIN will implement CDPM strategies with an initial focus on diabetes strategy and will include other chronic illnesses when relevant

Increased continuity of care and in-home service capacity

A Snapshot of Equity Initiatives on LHIN Websites--South East LHIN

2009-11-05T10:47:48-05:00

Links

http://www.southeastlhin.on.ca

Integrated Health Service Plan (2006)

Equity Highlights

2009-10 Annual Business Plan (Awaiting Ministry Approval)

The LHIN's goal is for the local health care system to autonomously monitor and adapt service provision to meet the changing needs of our population, and implement solutions that achieve equity of access and high quality outcomes within our region
The LHIN is also actively engaged with the roll out of a new community health centre and the expansion of existing CHCs through the introduction of 3 satellites (this should increase access to primary care for residents of Napanee, Belleville and Quinte West)
The Napanee and Belleville sites should also improve access to primary care services for the Tyendinaga Mohawk Territory and Deseronto residents (discussions with First Nations leadership to further improve the health care of these residents are ongoing)
The CHCs' Program objectives are to "improve equity of access to primary health care services"

IHSP (October 2006)

The LHIN is committed to equity and respect for diversity in communities, including respecting the requirements of the FLSA and recognizing the role of First Nations and Aboriginal peoples in the planning and delivery of health services in their communities
Opportunities for improvement include centralized wait list strategies that could improve access and equity for specialist services
The LHIN is also developing data sets to demonstrate the effectiveness of community mental health services for improving equity
After the IHSP, 2 CHCs were opened (improving access to primary care) and a new CHC and satellite were approved
Residents often have difficulty accessing care geographically (because of multiple appointments that require extensive travel). So the LHIN plans to develop regional strategies to increase supply of medical specialists and improve access to specialists for consultation
The LHIN also developed integrated multi-disciplinary models of primary health care to help people with their chronic disease management
The LHIN also planned to engage with Aboriginal communities to identify issues and opportunities to improve services; the plan is to develop and implement a framework for ongoing dialogue with First Nations and off-reserve communities

IHSP Draft (2010/11 - 2012/13)

The LHIN recognizes the needs of specialized groups such as the French Language and Aboriginal communities

Local Priorities (primary health care, mental health and addiction, supportive care, and specialized care and emergency) recognize and support equity with a focus on French language and Aboriginal peoples

A Snapshot of Equity Initiatives on LHIN Websites--North West LHIN

2009-11-05T10:43:54-05:00

Links

http://www.northwestlhin.on.ca

Equity Highlights

The Northwest LHIN has recently created an Aboriginal Health Services Advisory Committee (it is currently looking for members)

IHSP

The LHIN is committed to equity and respect for diversity in communities, including respecting the requirements of the French Language Services Act and recognizing the role of First Nationals and Aboriginal peoples in the planning and delivery of health services in their communities
The LHIN understands that local communities best understand their local health care needs and priorities; the LHIN is committed to ongoing community engagement and will continue to seek knowledge and input in developing local solutions
The goal is to improve quality and accessibility to health care services for residents of NW Ontario
Equity across providers is a guiding principle
Participants in the IHSP discussions identified the need for services in Ojibway, Cree and Oji-Cree (or appropriate translation services that include options for traditional healing and medicines)

The LHIN’s goal was to increase and improve local delivery of health services and improve cultural sensitivity and linguistic accessibility of services provided in district and regional centres

A Snapshot of Equity Initiatives on LHIN Websites--North Simcoe Muskoka LHIN

2009-11-05T10:18:04-05:00

Links

http://www.nsmlhin.on.ca

Integrated Health Service Plan

Equity Highlights

The NSM LHIN board has set 3 strategic directions and 9 strategic goals

One of the key goals is "addressing inequities for those populations most likely to experience systemic barriers"

IHSP 2007-2010

The LHIN recognizes the importance of the social determinants of health (the "factors that affect people's health") which include: income and social status, education, employment and working conditions, as well as biology and genetics, gender, culture, healthy child development and access to health services
A key IHSP goal is to improve Aboriginal health status; the health care system must respect Aboriginal culture
The NSM LHIN established the Aboriginal Health Circle supported by a small Secretariat to address Aboriginal health priorities (including mental health and addictions services and the integration of holistic healing practices into mainstream health care services)
There were also plans to partner in the development of 2 new CHCs in NSM
Reducing barriers to care was also a key goal à the LHIN hosted a 2 part forum in November 2007 to identify and prioritize systemic barriers to accessing health services (2008-09 Annual Service Review); the LHIN determined the two priority barriers on which the LHIN focused its future planning: housing and poverty. These barriers have been incorporated into NSM LHIN planning principles which will underpin the work of LHIN Regional Action Groups
The LHIN also launched an education campaign to raise public awareness of the various visible and invisible barriers to accessing health care to help everyone understand and reduce them
The LHIN also endeavoured to understand the needs of: (1) Francophones, (2) the frail elderly and (3) Women
The LHIN promised to establish a regional action group (in 2008/09) to address women's health care needs
The action group was intended to help assess the current state of women's health issues in the region, complete an inventory of resources and identify additional resources, programs and services that are required (note: I cannot tell from the website if this group was ever formed)
The LHIN has also requested new ongoing resources where there has been historical inequity or underfunding (i.e. services for those with addictions, supportive housing for the housing)
The LHIN recognizes that people in the community report a range of barriers to accessing health care, including transportation, information, culture and language barriers as well as stigmas related to illnesses or lifestyle

Current Equity Initiatives

Five working groups (including a "utilization and equity working group") are developing action plans to create an integrated system of care for mental health and addictions
The utilization/equity working group is going to: (1) ensure that services are accessible at the appropriate level and to all population groups, (2) identify and develop tools and processes to enhance consumer involvement throughout the system, (3) ensure continuity of care and (4) develop central access and "no wrong door" policies
Another key LHIN objective is to understand the health needs of women; expected outcomes include: improved gender equity in access and outcomes for cardiac and cancer care
Finally, the LHIN is promoting increased equity of the health system for Francophone communities

The Aboriginal Health Circle will play a leading role (in partnership with the NSM LHIN) in developing an environment of collaboration between health stakeholder groups in order to ensure effective delivery of health services to the Aboriginal community.

A Snapshot of Equity Initiatives on LHIN Websites--North East LHIN

2009-11-05T09:42:34-05:00

Links

http://www.nelhin.on.ca

FLS HAPS: “Toward Equitable Services in French”

2008/09 Operational Plan

Equity Highlights

The North East LHIN's equity strategies focus almost entirely on increasing access for Francophones and Aboriginals

IHSP

NE LHIN has identified Francophone services as a priority
Planning and research to address the needs of Francophones needs to be consistently applied to all areas
Engagement of Francophone community through 2 French Health Services Networks was recommended
Aboriginal health planning reference groups were proposed to frame issues and opportunities identified by Aboriginal groups in the LHIN and reach an agreement on the most appropriate method of engagement of First Nations Chiefs, Metis Council Presidents and the LHIN Board
Action items include information and communication towards a productive dialogue and a common understanding (determining the roles and responsibilities of the LHIN and addressing the concerns of Aboriginal groups)

Towards Equitable Services in French (September 2007)

French Language Service (FLS) Hospital Annual Planning Submissions (HAPS) are the planning tool to be used by hospitals identified and designated for the provision of French services
The FLS HAPS are used to inform the hospitals' decision-making process towards equitable access and accessibility of quality professional services in French on a permanent basis for Francophone clients in their catchment area
For hospitals designated under the FLSA, patient-centred care includes providing equitable access to quality professional services in French on a permanent basis
One of the LHIN's main achievements was the inclusion of a French Language Service Equity Index in the Hospital Service Accountability Agreement

2008/09 Operational Plan

The LHIN held an Aboriginal, First Nations and Metis Summit (May 14-15, 2008
It also held a French Language Health Services Summit (April 1-3, 2008)
These summits led to community engagement with both groups

Among the LHIN's emerging local priorities is "surgery optimization" à the NE LHIN surgery optimization plan is designed to "achieve equitable distribution of surgery across NE LHIN hospitals"

A Snapshot of Equity Initiatives on LHIN Websites--Mississauga Halton LHIN

2009-11-04T17:30:43-05:00

Links

http://mississaugahaltonlhin.on.ca

Equity Highlights

IHSP 2007-2010

The IHSP notes that culturally sensitive service delivery requires significant learning and development to meet the needs of the current and future population
The IHSP also mentions transportation as a significant barrier to equitable service access
The LHIN also runs ongoing community engagement which supports a commitment to equity and support for diversity in communities

IHSP 2010-2013 Revised Strategic Priorities and Enabling Strategies

The LHIN's strategic priorities include: improving access, quality and sustainability of the health system
The LHIN has special plans for Francophone and Aboriginal communities

The website contains a link to MOHLTC Effectiveness Review which discusses the importance of equity but there is very little else on the LHIN's website explicitly regarding equity

A Snapshot of Equity Initiatives on LHIN Websites--Hamilton Niagara Hadimand Brant LHIN

2009-11-04T17:25:56-05:00

Links

http://www.hnhblhin.on.ca

Integrated Health Service Plan

Aboriginal Health Search Conference Community Report

Equity Highlights

Equity-related Advisory Committees:

(1) Health Opportunities for Aboriginal People (HOAP)

HOAP is a group of First Nations, Metis, urban and rural health and social service providers who meet regularly
They held a search conference (Feb 29-March 2, 2008) which included an Aboriginal Health Search Conference Community Report
The report discusses systemic health system barriers to Aboriginal people as well as community approaches to Aboriginal health including: using cultural identity as medicine, encouraging people to learn and follow traditional ways, using more traditional medicine, reducing isolation and offering choices of traditional, conventional or naturopathic care
The report also recognizes the need to improve preventive care and implement culturally appropriate care for the LHIN's Aboriginal residents

(2) French Language Health Services Advisory Committee

This advisory committee will advise the LHIN on how to: (1) increase knowledge and awareness of health needs of the Francophone population, (2) build capacity in HNHB LHIN communities to provide quality French language health services and (3) integrate principles of the French Language Health Services Act (FLHSA) in the LHIN's health transformation initiatives and decision-making

IHSP

The IHSP focuses on Aboriginal health and French Language health
The LHIN focuses in part on using telehealth to help overcome barriers of geography, transportation infrastructure and socioeconomic disparities (i.e. using e-health to reduce disparities)
The LHIN wants to enable equitable access to e-health solutions for all providers
There is a focus on achieving equitable and timely access to care for a range of populations (including First Nations, children and youth, and seniors)

Specialized services for frail seniors

The Geriatric Access and Integration Network (GAIN) will be strategic and purposeful, collaborative among stakeholders, and will propose and coordinate LHIN wide strategies to optimize the quality of life for frail seniors

The primary goal is to develop an inter-connected network of specialized geriatric health care services that will promote (among other things) "equitable access to specialized geriatric services in hospitals and the community"

A Snapshot of Equity Initiatives on LHIN Websites--Erie St. Clair LHIN

2009-11-04T17:21:30-05:00

Links

http://www.eriestclairlhin.on.ca

Integrated Health Service Plan

Equity Highlights

The LHIN is committed to ensuring equity and access for patients requiring mental health services
The LHIN is also focusing on geographic equity

Current Initatives

(1) Chatham-Kent Community Health Centre

CHCs use a community development approach to health care to identify and provide services to those who face access barriers such as language, poverty, disabilities or geography and who have a higher risk of developing health problems
A programs and services plan for the Chatham-Kent CHC was recently approved by the LHIN
The plan calls for more than 19 staff to provide primary care services plus administrative support and a budget of $3.7 million
Staffing includes physicians, nurse practitioners, nurses, social workers, a dietitician, health promoters and other allied health professionals
Priority populations include: seniors, the economically disadvantaged, children and youth, individuals with mental illness and addiction, First Nations, people with disabilities, victims of abuse and violence, individuals who face communication barriers to access services and seasonal workers

(2) Essex County Community Health Centre

The LHIN is launching a review of the CHC in Windsor/Essex to (1) realign CHC resources and processes that will be the foundation for primary care services in Windsor/Essex and (2) to design a future model and staged implementation plan for the Windsor/Essex CHC over the next 5 years
This system will focus on delivering sustainable, integrated and coordinated services that meet the needs of the local population

IHSP

The LHIN's guiding principles for decision-making include a commitment to service equity, innovation and diversity
Equity and respect for diversity is a key principle
The LHIN recognizes the social determinants of health and the need to develop integrated health promotion (including cultural diversity)
Integrated health promotion attempts to close equity gaps by recognizing that cultural diversity creates inequalities, supporting social networks, developing and advocating health public policies and strengthening community capacity

The LHIN's commitment to service equity and diversity is a guiding principle for decision-making and decision criteria

A Snapshot of Equity Initiatives on LHIN Websites--Champlain LHIN

2009-11-04T17:16:24-05:00

Links

http://www.champlainlhin.on.ca

Equity Highlights

IHSP 2007-2010

The IHSP is a blueprint to create a more effective, compassionate, equitable and responsive health system to meet the unique needs of the Champlain region
Equitable access to services is a fundamental principle of all the LHIN's project plans
Access and equity issues; areas of concern included: (1) reducing wait times, (2) breaking down barriers to access and (3) more effective health resources planning and management with a particular concern for culturally diverse communities
The LHIN also developed a community engagement strategy that included an Aboriginal Health Circle Forum

Lessons Learned from 2007-2010 IHSP

The lessons learned included: (1) the need for community engagement, (2) more emphasis and services were needed for Francophone communities, (3) improving services for Aboriginal communities, (4) improving access for disadvantaged groups and (5) improved CDPM

Draft IHSP (2010-2013)

The draft IHSP contains no mention of "equity" although it does note that the LHIN is focusing on 4 key populations (and will give these populations extra resources and attention)
These key populations include: (1) people with diabetes or pre-diabetes (with more effort on prevention); (2) people with mental illness and/or substance addictions and particularly target initiatives for MI/SA in Aboriginal communities; (3) People with complex health conditions (by increasing community-based outreach programs and expanding availability of affordable housing) and (4) Champlain residents
These 4 groups face "significant barriers" to accessing quality and coordinated care (the LHIN will focus on coordination of care) and they have unique needs. The health system can, therefore, make a positive difference for these particular groups

The LHIN will also address the issue of fragmentation and disparities in health care delivery (i.e. people not being able to access services in either official language)

A Snapshot of Equity Initiatives on LHIN Websites--Central West LHIN

2009-11-04T17:11:04-05:00

Links

http://www.centralwestlhin.on.ca

Diversity and Inclusivity Workshop

Responsiveness to Cultural Diversity: Building Equity In Health Services

Diversity Core Action Group Terms of Reference

Health System Plan Report

Aging at Home Strategy

Equity Highlights

Responsiveness to cultural diversity is a key health service priority for the Central West LHIN
Central West LHIN developed an Action Plan for Culturally Relevant Health Care Services which includes integrating diversity into organizational culture, celebrating diverse perspectives and developing local diversity initiatives
Promoting the local health system's responsiveness to cultural diversity is one of the overarching priorities of the IHSP
Another key goal is to increase connectivity across the LHIN to address the inequity of IT access and to train patients and create patient portals

Diversity and Inclusivity Workshop

On November 8, 2007, the Central West LHIN held a Diversity and Inclusivity Workshop in Brampton with more than 125 health service providers, which focused on the theme of "Building Equity in Health Services"
The workshop helped Central West LHIN better understand the attendees' priorities for moving forward and where they see opportunities to collaborate on initiative to create culturally appropriate, sensitive and competent services that will ensure all residents in the LHIN have equitable access to health services
The CW LHIN is committed to providing the necessary support and assistance to health service providers to enable them to implement organizational initiatives that will "build culturally competent health service provider organizations, eliminate health service disparities and improve access to health services for diverse communities"

Diversity Core Action Group

The Diversity Core Action Group is mandated to assist the LHIN (1) engage ethno-cultural organizations that reflect and represent the LHIN's diverse communities, (2) undertake appropriate local engagement strategies, (3) facilitate a compilation of a comprehensive inventory of diverse organizations, initiatives, services, education and training resources, (4) oversee the completion of a detailed needs assessment and (5) educate and train organizations about culturally competent services
The group meets once a month and the Chair then meets with the LHIN board of directors when requested to provide updates and address issues
The Group's main responsibility is to design a more integrated system of services that leverages multiple providers in mutually beneficial partnerships, all focused on ensuring equitable access to patient/client and family-centred care

Health System Plan Report

The Report focuses on "equity of access" (based on patient/client need) and cultural diversity for the LHIN's visible minority population
Cultural competence reduces disparities in service, addresses inequalities in access to care and services, and requires an understanding of the communities being served as well as the cultural influences on an individual's beliefs and behaviours
Therefore, the LHIN is increasing its emphasis on culturally competent service delivery

Aging at Home Strategy

The Central West LHIN's Aging at home strategy is aimed at providing seniors and thief families and caregivers with an integrated continuum of community-based services to enable them to stay healthy and live more independently in their homes. As part of the Strategy, Central West LHIN will receive $21.5 million

The Strategy is designed to provide more equitable access to health care by matching the needs of the local senior population with the appropriate support services