“CHCs Help More Than Target Audience” (OpenFile)

chcJohn Sanduski, 24, has lived in Toronto for less than a year. Already he has found a doctor, a counsellor and a dentist. What’s unusual is that all three services are located under one roof, and are completely free.

Sanduski, who has no health benefits beyond OHIP, has been accessing health care through two of the city’s Community Health Centres, nonprofit organization that provides primary health and health promotion programs to individuals and communities.

In the central Toronto area there are 17 CHCs, each catering to a different geographic area. Initially a client of the Regent Park CHC, where he received eight months of counselling, after moving to a new neighbourhood Sanduski is being served by the Queen West CHC.

He only had to wait a few weeks apiece to become a client at the CHCS and wasn’t, during his intakes, asked in-depth questions about his income level or health status. Sanduski’s experience, however, may actually be quite anomalous: he is middle-class, homed, Canadian-born and possesses no serious mental or physical health issues. He in no way fits the profile of the typical CHC client.

The centres, funded by the Toronto Central Local Health Integration Network (knows as the Toronto Central LHIN) are often in priority areas, and usually prioritize clients who are low-income, homeless, recent immigrants or refugees, or have complex health or substance abuse issues. So why did Sanduski enter the CHC system so easily?

Michelle Jospeh, executive director of Central Toronto Community Health Centres, says for middle or upper-middle class individuals to use CHCs is quite rare. Middle-income Torontonians, she estimates, account for about 5 to 10 per cent of clients.

While each centre functions somewhat differently, all have priority groups that they, as part of their mandate, primarily target. Still, Joseph acknowledges that intake is always dependent on capacity. Potentially anyone living in an appropriate area could be accepted as a client if they applied at an opportune time.

“In theory, if we had all the capacity in the world, we wouldn’t turn anyone down. But in reality, we do quite frequently, because other people…like those without a job, a home or someone marginalized… have priority over [middle or upper-income people ].”

Aside from support from the Central Toronto LHIN, each centre can have different sources of funding, some tailored towards very specific priority groups. Access Alliance Multicultural Community Health Centre was developed to serve immigrants and refugees, while Anne Johnston Health Station largely serves people with physical disabilities.

What Joseph calls “more generic CHCs,” such as Regent Park and Queen West, still prioritize socially vulnerable people over those with fewer barriers to health care, and often develop a sort of niche according to the neighbourhood they occupy.

“In Parkdale, a place where a lot of new refugee claimants come, their local centre probably deals with a lot more settlement issues than a centre located where there aren’t a lot of refugees.”

That some people who don’t meet the priority criteria choose, assuming they can get in, to use CHCs instead of single-doctor offices or family health teams, does have certain implications.

Continue reading here: http://www.openfile.ca/toronto/story/community-health-centres-help-more-target-audience