Association of Ontario Health Centres

History

Univi Health Centre is a member of the Association of Ontario Health Centres (AOHC). The AOHC was officially incorporated November 30, 1982, but the idea and spirit that lead to its formation started long before. In fact, its formation was natural and inevitable. The AOHC came into being as programs and funding systems evolved to promote primary health care and health promotion programs in Ontario.

The Beginning

Health centres in Ontario have existed since the mid-70s. A notable exception to this is the Group Health Centre in Sault Ste. Marie, which opened earlier in 1962. In 1975, there was no distinction between Community Health Centres (CHCs) and Health Centres and Community Health Service Organizations (CHSOs). At that time, all centres were considered experimental pilot projects and the Ministry of Health funding was based on that premise. All centres were funded through capitation payment mechanisms. However, centres that were not considered financially viable were given a program budget with the intent to convert into capitation as soon as a centre achieved financial viability. The latter, now operating as CHCs, stayed with the program budget as the preferred way to fund the type of programs, operation and philosophy by which these centres delivered their programs and services.

Getting Connected

Individuals representing a variety of “health centres” informally discussed the need to form an organization to enable them to address matters of mutual interest and concern. Committed to the concept of primary health care, representatives of health centres set up an association which, in their opinion, was “An Idea Whose Time Has Come” as highlighted by the same theme for the Association’s first Symposium and Meeting.

Period of Growth

In 1982, then Minister of Health, Larry Grossman, announced that CHCs and CHSOs were no longer “experimental pilot projects” but would be a part of mainstream health care services. Targets were set for annual growth rates so that the CHC and CHSO component of the system would grow across the province. Minister Grossman also provided financial support for the creation and activities of the Association of Ontario Health Centres.

Under then Health Minister Murray Elston and Elinor Caplan, health centres began to thrive. In 1987, Premier David Peterson announced the government’s intent to double within five years the number of Ontario residents receiving primary health care through alternative funding arrangements.

By November 30, 1989, 93.75% of the Premier’s target had been achieved. Back in 1985 there were 11 CHCs in operation serving approximately 29,000 people. By March 31, 1990 there were 76 HSOs serving 450,000 people and 32 CHCs serving a population of 110,000.

Period of Transition

In 1994, Ontario’s Auditor General posed questions about the CHC program in Ontario. It was decided that the province would freeze funding for the creation of new centres until CHCs were able to collect and submit data to demonstrate their purpose and effectiveness as a provincial program. Concurrently, AOHC had been working with member centres on evaluation assessments which produced five key themes on which the current Evaluation Framework is collecting data. This work is ongoing among all CHCs in partnership with AOHC and the Ministry of Health.

In 1997, Aboriginal Health Access Centres (AHACs) began to join the Association. These centres are funded through the Aboriginal Healing and Wellness Strategy, which is a partnership among a number of Aboriginal Political Territorial Organizations, the Ministry of Health, the Ministry of Community and Social Services, the Women’s Directorate, and the Solicitor General’s Office. AHACs were modeled after CHCs; however, they have made traditional healing practices an integral part of their work.

Early in 1999, satellites were funded in Chelmsford and Hanmer (Centre de santé communautaire de Sudbury) and Armstrong Health Clinic (Ogden-East End CHC). In May 1999, Minister of Health Elizabeth Witmer announced a lifting of the funding freeze. Soon after, two new CHCs and one satellite were announced, the Kitchener Downtown Community Health Centre, Grand Bend and Area Rural Community Primary Health Care Centre and Crysler, a satellite to Centre de santé communautaire de l’Estrie (Cornwall).

A Bright Future

In April 2004 and November 2005, the Ontario Ministry of Health and Long-Term Care recognized the tremendous achievements of CHCs and their critical role within the health system, announcing the largest ever expansion of the CHC program in the province’s history by announcing a total of 21 new CHCs and 28 new CHC satellites. As of 2010, there are 53 CHCs and 28 CHC satellites.

Since 2006 the Ministry also announced the creation of 200 Family Health Teams. After significant advocacy, the Government recognized community governed FHTs. Today we have 25 Community Family Health Teams in Ontario.

In 2009-10 the Government also announced 25 Nurse Practitioner clinics. To date one community governed NP Clinic has joined AOHC.

1947

• Tommy Douglas and the provincial Cooperative Commonwealth Federation government implement hospital insurance in Saskatchewan.

1962

• Saskatchewan implements medical insurance.
• First Ontario CHC Group Health Centre (Sault Ste. Marie).

1964

• Justice Emmett Halls federal Royal Commission recommends medical insurance as well as coverage for homecare, pharmacare, and other services.

1966

• Lester Pearson’s Liberals pass the Medical Care Act, covering doctors and hospitals.

1969

• Centretown CHC (Ottawa) opens its doors with the support of Provincial Ministry of Health and Federal LIP and OFY funding.

1975

• Ministry considers community Health Centres (CHCs) and Community Health Service Organizations (CHSOs) as experimental pilots.
• HSOs are funded through capitation payments.
• CHCs receive program funding.

1977

• Provincial government freezes funding to Community Health Centres.

1978

• Dr. Michael Rachlis of South Riverdale CHC invites Dr. John Hastings to address founding Convention of Community Health Centres of Ontario.
• The emerging organization was called the Provincial Association of Health Service Organizations.

1979

• S.O.S. Medicare Conference is organized by the Canadian Labour Congress with the participation of Tommy Douglas, Emmett Hall, and Monique Bégin.

1982

• Ontario Minister of Health, Larry Grossman announces that CHCs and CHSOs are officially a program and part of mainstream health care services.
• Targets are set for growth across the province.
• Financial support is provided for the creation of the Association of Ontario Health Centres (AOHC).
• The AOHC officially incorporates to promote primary health care and health promotion programs in Ontario.
• Don MacLean (Hamilton) becomes AOHC’s first President.

1984

• The Trudeau Liberals pass the Canada Health Act that prevents provinces from allowing hospitals or physicians to charge user fees.
• 1st rural CHC opens in Merrickville.

1985

• 12 CHCs serve approximately 29,000 Ontarians.

1987

• Premier David Peterson announces intent to double the number of Ontario residents receiving primary health care through alternative funding arrangements within five years.
• CHCs begin to thrive.
• 1st clinical teaching CHC opens in North Hamilton (CHC).

1989

• 1st Aboriginal CHC opens – Anishnawbe Health – Toronto
• 1st Francophone CHC opens (Centre Francophone de Toronto)

1990

• 31 CHCs serve 110,000.
• The Ministry of Health issues a moratorium on HSO development.
• The OMA wins the right to negotiate on behalf of the HSOs and all but 3 HSOs cease membership in AOHC.
• First Pan-Canadian CHC Conference takes place in Winnipeg.
• After a joint AOHC Ministry of Health Strategic Planning and Evaluation Project of the CHC Program,
• Health Minister Ruth Grier announces Strategic Directions for the CHC Program. This leads to the approval of eight new CHCs.

1994

• After an Auditor General’s report, Ontario freezes funding for the creation of new centres until CHCs are able to collect and submit data to demonstrate their purpose and effectiveness as a provincial program.
• The Evaluation Framework for the CHC program is developed.
• 10 Aboriginal Health Access Centres are announced.
• AHACs are funded through the Aboriginal Healing and Wellness Strategy and integrate traditional health practices into the CHC model.

1995

• AOHC hosts the Second Pan-Canadian Conference of CHCs in Toronto. The Canadian Alliance of
• Community Health Centre Associations (CACHCA) is created to improve health services across the country as a cost effective method for providing primary health care.

1997

• The Federation of local Community Health Centres (CLSC) of Quebec organizes the first international CHC conference in Montreal.
• 1200 representatives from 34 countries attend.
• Sponsors include the World Health Organization (WHO), the Organization for Economic Cooperation and Development (IECD) and the World Bank.

1998

• The Third Pan-Canadian Conference hosted by British Columbia’s CHCs takes place.
• AOHC forms an independent Community Organizational Health Inc.
• COHI owns and administers an accreditation program called Building Healthier Organizations for community-governed health and social service organizations.

1999

• AOHC forms a self-administered Group Benefits plan for members.
• Minister of Health Elizabeth Wilmer lifts CHC funding freeze and announces two new CHCs.

2001

• The MOHLTC conducts a Strategic Review of the CHC Program to ensure CHCs are aligned with Ministry priorities and primary care reform.

2002, 2004

• The Romanow Commission recommends more federal funding, more provincial accountability and limited coverage for homecare and pharmacare.
• AOHC adopts the recommendations from the AOHC Renewal Action Plan to become a more focused policy and advocacy organization.
• Members approve a constituency based board to ensure geographic, aboriginal, and francophone representation.
• MOHLTC Minister George Smitherman announces 10 CHC satellites.

2005

• MOHLTC Minister George Smitherman announces 150 new Family Health Teams (FHTs). After successful advocacy by AOHC, the Ministry recognizes community-governed FHTs (CFHTs).
• MOHLTC Minister George Smitherman announces 60% CHC expansion ($74.6 million over three years) for 21 new CHCs and 18 new satellite CHCs.

2006

• AOHC board adopts the recommendations from the Anti-Racism and Systemic Barriers Working Group including the development of an anti-oppression framework for AOHC.
• 1st CFHT member, Tilbury FHT joins AOHC.
• AOHC membership almost doubles, increasing to 114 members.
• New communities wanting CHCs are applying for emerging group membership.

2007, 2008, 2009

• AOHC organizes the Second Stage of Medicare conference in Toronto.
• AOHC approves CFHT representation on AOHC Board.
• AOHC adopts the Anti-Oppression Commitment.
• AOHC adopts the CHC Model of Care.

2010

• 1st NP Clinic Member, Sudbury NPC joins AOHC.
• 120 members including 97 Full Members, 16 Associate Members, and 7 Emerging Group Members.