Each Ontarian has unique needs that may impact their access to health care services. This is especially true of Indigenous, Francophone and marginalized population groups across the province.
Through the Local Health System Integration Act, 2006, the Government of Ontario has mandated LHINs to “promote health equity, including equitable health outcomes, to reduce or eliminate health disparities and inequities, to recognize the impact of social determinants of health, and to respect the diversity of communities and the requirements of the French Language Services Act, 1986, in the planning, design, delivery and evaluation of services.”
Central LHIN criterion on equity is defined as:
“Impact on the health status and/or access to service of recognized sub-populations where there is a known health status gap between this specific population and the general population as compared to current practice/service. The absence of systematic and potentially remediable differences in one or more aspects of health across populations or population groups defined socially, economically, demographically, culturally, linguistically or geographically.
The Central LHIN embeds health equity as a guiding principle in all that we do and continues to strive to reduce health disparities as a shared responsibility with its Health Service Providers by integrating health equity into strategies and activities within its mandate and influence. Our commitment is to support and advance Ontarians in achieving equitable access to the right health care services at the right time, and in the right place. The Central LHIN’s planning for the local health care system is informed by the needs of the population that we serve.
Aligned with the social determinants of health, the Central LHIN recognizes that access and accessibility to health care can depend on factors that lie outside of the traditional definition of the health system, including whether or not people have access to housing, food, and education, and other factors including medication affordability, and recognizes the need for services to be linguistically and culturally safe.
Embedding a health equity orientation in health system policies and practices helps to reduce health disparities among diverse population groups, and reduces the likelihood that decisions and actions will increase existing disparities. Identifying and reducing barriers to access and quality of care for marginalized populations and those with the worst health and least access to resources will result in a more equitable and sustainable health system for all.
The Central LHIN supports the advancement of health equity through the use of the Ministry of Health and Long-Term Care’s Health Equity Impact Assessment (HEIA) decision support tool to better target health investment strategies and reduce avoidable health disparities between population groups (geographic or socio-demographic). The Central LHIN’s formal process additionally includes applying a Board-approved LHIN Priority Setting and Decision Making Framework to evaluate local priority initiatives and health system improvement proposals from Health Service Providers (HSPs).
Health Equity Update
To support its goals, Central LHIN relies on strong collaborations among our many system partners including: HSPs (funded and non-funded), Entité 4, Indigenous community leaders, Service Provider Organizations (SPOs), Public Health Units, municipalities, patients, families and caregivers. The following outlines some action areas and success in Fiscal Year 2018/19:
- Expanded funding for inter-professional primary care team services at the two Central LHIN Community Health Centres as well as a Markham-based Family Health Team to increase access to allied health services for solo-practitioners and their patients in underserved communities.
- Continued to invest in Indigenous Cultural Competency Training to support HSPs in better understanding the importance of adopting culturally safe practices. In addition to online training which has been offered to HSPs since 2016, Central LHIN has also funded Addiction Services for York Region in partnership with the Ontario Federation of Indigenous Friendship Centres to provide in-person cultural competency training. Additionally, Central LHIN collaborated with Georgina Island to host in-person Indigenous Cultural Sensitivity Training. Through these different format and training options, over 1,300 HSP staff participated in Indigenous Cultural Training since 2016.
- Continued to explore innovative and sustainable funding mechanisms to support Indigenous people living on and off-reserve. Central LHIN staff met with local Indigenous leaders to consult and co-design programs and services to meet local needs. Nin Os Kom Tin expanded their traditional drumming program and service provision to South Simcoe.
- To support equitable access to health care services in French across the province, the Ministry of Health and Long-Term Care engaged Le Réseau des services de santé en français de l’Est de l’Ontario (Le Réseau) to lead a province-wide data collection project. Le Réseau implemented a French Language Health Service (FLHS) reporting tool to collect quantitative baseline data on health sector capacity for the provision of services in French. Central LHIN and Entité 4 encouraged all local providers to participate in this data collection initiative, and completion rates of 100 per cent for French Language Service (FLS) identified organizations and 87.9 per cent for non-identified organizations were achieved.
- The FLHS reporting tool data gathered is being used to identify current availability and gaps in health services in French from geographical and sectoral perspectives, and inform planning to improve service capacity and patient access and experience. This data will also be used to support the ongoing process of identifying and supporting HSPs in the FLS identification and designation process.
- Conducted workshops/webinars and provided information and tool kits to HSPs, SPOs and LHIN staff on the Ministry’s Guide to Requirements and Obligations Relating to FLHS, the concept of Active Offer, and the City of Markham becoming a French Designated Community effective July 1, 2018. Internal processes included augmented LHIN staff recruiting processes, updating orientation, training materials and job aids in support of Active Offer.
- Expanded FLHS capacity through increased investment of inter-disciplinary care services at Black Creek Community Health Centre including adding reception, nursing, community health worker as well as a navigator with French Language competency.
- Under the leadership of the Central LHIN Dementia Strategy Advisory Committee, developed local recommendations for a dementia strategy to support the needs of people living with dementia that is aligned with the provincial Dementia Strategy. The local strategy will include recommendations and advice on programs and services required to meet the needs of people living with dementia and their caregivers over the next three years.
- Funded the Alzheimer Society York Region First Link program to support an additional 200 clients annually with patient navigation services.