by Adrianna Tetley, Chief Executive Officer of the Association of Ontario Health Centres

Happy New Year, Minister Hoskins! We hope it will be a healthy one, too. In fact, let’s resolve to make it the healthiest year yet for everyone living in Ontario. To help focus your efforts, we have taken the liberty of preparing nine New Year’s resolutions for you to take action on during 2017.

1. Get serious about health equityMinister, in 2017, follow up on your new Patients First legislation’s direction to the Local Health Integration Networks (LHINs) to reduce health disparities and combat all forms of systemic racism and discrimination, including anti-Indigenous racism, anti-black racism, Islamophobia, homophobia/transphobia and ableism. For starters, LHINs need to collect socio-demographic data to guide equity-informed population needs-based planning. It also means LHINs need to work across areas of the health sector and government ministries alike to ensure populations facing barriers to good health are better served and gaps to accessing care are closed. Evidence-informed decision-making is one of the many ways our member centres make sure people who face barriers to health get the services they need (here are some examples in action). This rigorous approach to health service delivery must be applied much more consistently across the province.

2. Follow through on Indigenous health reconciliationMinister, as you know, all Indigenous people, including those in urban, rural and remote areas, and regardless of “status”, have a right to culturally safe and integrated care, as outlined in the existing Aboriginal Health Policy (1994).  Aboriginal Health Access Centres (AHACs) and Aboriginal Community Health Centres (ACHCs) are part of the solution to ensuring this happens. Put a fair share of the $222 million First Nations Action Plan into supporting all Indigenous health care, including allocations for AHACs’ and ACHCs’ core and program funding. Give AHACs and ACHCs a formal seat at LHIN, bilateral and trilateral technical tables. And let’s see true reconciliation in action.

3. Provide clear direction to the LHINs to implement the requirements of the French Language Services (FLS) ActMerci for instructing the LHINs to implement the FLS Act in the planning, design, delivery and evaluation of services. To make sure LHINs fulfill these requirements, in 2017, please provide clear and precise language in their accountability and performance agreements. In addition, we call on you to ensure that the person or entity that provides services will be subject to the FLS Act, including Regulation 284/11 (Provision of French Language Services on behalf of Government Agencies).

4. Prevent more to treat less Your new Patients First legislation instructs LHINs to work with primary health care organizations to develop and implement health promotion strategies. To maximize the potential of this approach, make sure LHINs prioritize the type of strategies that promote the overall health of the community and address the determinants of health. Check out what’s happening in the North Simcoe Muskoka Health Link, where, in one year, a strong focus on social determinants of health reduced expensive emergency department visits and hospitalizations by more than a third.

5. Fully support and strengthen interprofessional primary care teamsResearch shows interprofessional primary care teams deliver the best health outcomes. However, they are underfunded and face challenges recruiting and retaining key health providers. Last year, you allocated a $31.1 million base funding increase. While appreciated, this is only a down payment towards what is needed. In 2017, invest the additional $130 million annually to get interprofessional teams to the 2012 rates recommended by the Hay Group, and narrow the gap with hospitals, Community Care Access Centres (CCACs) and public health.

6. Embed care coordinators in primary careCare coordination for each and every patient is a fundamental function of primary care. This year, we call on you to embed CCAC care coordinators within primary care settings. As these transitions roll out, keep in mind that care coordinators and system navigators working in and with Indigenous communities must be managed by Indigenous governed primary health care agencies to ensure culturally safe and appropriate care. Our member centres, including AHACs and ACHCs, are ready to work with you to support this transition.

7. Expand access to interprofessional primary care teamsOnly 25 per cent of people in Ontario have access to interprofessional primary care teams. Across the province, Community Health Centres already lead a ground-breaking initiative called “People in Need of Teams” (PINOT). It connects 370 primary care physicians and more than 4,500 of the people they serve, with 17 Community Health Centres who have decades’ worth of in-depth of experience serving people with complex needs. To make access to interprofessional teams more widely available, fund initiatives that connect physicians not working within teams to primary care organizations equipped to care for people with complex needs. If PINOT were scaled up across the province, this approach could be a game-changer for our health system. 8. Expand access to oral health care You’ve promised to extend public dental programs to adults living on low incomes by 2025. But, Minister, people in pain can’t wait that long. Every nine minutes someone in Ontario visits an emergency department because they can’t afford a dentist to treat their dental pain. End this suffering and needless cost now: invest $10 million so that CHCs and AHACs can serve more people in need of dental care.

9. Follow up on your commitment to support supervised injection services We were pleased to see this week’s statement reiterating your support for Toronto’s supervised injection services (SIS) proposal and confirming your commitment to provide financial support. What a great way to start the year! We look forward to the provincial framework for responding to current and future SIS proposals, which you promised to release in the next few weeks. And let’s see funds for supervised injection services in Toronto and Ottawa flowing as soon as possible to ensure the services are up and running to help prevent avoidable deaths.

Minister, you have just two years left in your government’s mandate, so it’s important to move quickly on these resolutions. Are you up for the challenge? AOHC members are ready to roll up our sleeves. Together, we’re certain we can create a health system that supports the best possible health and wellbeing for everyone living in Ontario.