Access Alliance Annual Report 20172018-09-13T20:21:33+00:00

Access.Equity.Quality

Message from the Chair of the Board

Access Alliance Multicultural Health and Community Services improves health outcomes for the most vulnerable immigrants, refugees, and their communities

Erik Landriault – Chair of the Board

Axelle Janczur – Executive Director

The year past has been focused on consolidating and strengthening many of our core competencies and commitments to the people that we serve. As we begin preparations for our 30th anniversary celebrations we have seen that one of our most notable commitments is to working in collaborative partnerships – it is central to our ability to respond effectively and efficiently to the needs and issues of people and communities.

Some of our critical partnership highlights include our health equity project “Building Capacity for Equity Informed Planning and Evaluation”. In this project we worked with champions across the province to build organizational level knowledge, commitment and capacity to routinely use a health equity framework and evidence geared at overcoming systemic inequities in healthcare access, quality and outcomes. We developed excellent resources which are now publicly available to support ongoing capacity building. We continue to work across sectors to build a community of practice that inspires shared visions and actions for advancing health equity and the difference it can play in the health of all Ontarians.

Additionally, through work with partners in Scarborough, we have built a cycle hub that includes several satellite program sites. In this partnership, we focused on education for community members to make low carbon choices and reducing emissions by promoting cycling as well as training on all necessary skills (bike riding, repair, maintenance). Community members mentor newcomers (both to Canada and to cycling!); we’ve also done research to measure impact and support plans to scale up this project.

RIO is a program of our Language Services – it is a partnership network, providing real-time over the phone professional interpretation to health and community services in Ontario and beyond. This past year we have expanded our reach to include new partners in British Columbia and northern Ontario. In particular we have established a partnership with Meno Ya Win (Sioux Lookout) in order to provide our customers with access to Cree, Oji-Cree, and Ojibway speaking interpreters, both over-the-phone and via OTN.

Finally, in partnership with Sunnybrook Health Sciences, Language Services developed a tool and training kit for interpreters, along with recommendations for health service providers and the language services industry toward best practices in addressing language barriers in Medical Assistance in Dying.  This has been presented a number of times already through conferences and specific health sector meetings.

These are just some of the meaningful examples of how collaborative partnerships can result in meaningful and transformative outcomes – outcomes which strengthen our ability as an agency and a sector to improve health outcomes for all of the people and communities we work with and serve. We are excited to see that this past year emphasized and reinforced our core competencies and commitments. We are a strong organization and we look forward to the range of opportunities the next thirty years will bring!

Thank you!

Mission, Vision and Values

Mission

Access Alliance provides services and addresses system inequities to improve health outcomes for the most vulnerable immigrants, refugees, and their communities.

Vision

Toronto’s diverse communities achieve health with dignity.

Values:

Client Centered:
Our clients are encouraged and supported to make informed choices and decisions that relate to their health.

Collaboration:
Our partnerships increase knowledge, strengthen systems and maximize resources so we can take action effectively.

Equity, Access and Inclusion:
Our commitment is to challenge systemic barriers that reduce health outcomes for vulnerable populations.

Innovation and Excellence:
Our organization fosters a culture of continuous learning, quality improvement and best practice.

Accountability:
Our Stakeholders see a full and transparent use of evidence and resources that focus on positive client impacts.

Programs and Services

Access Alliance provides services and delivers programming to various locations across the City of Toronto. This access point model is an innovative approach that brings services into the areas where people are, for better and easier access to strengthen communities from within. Taking a client centered approach to service delivery means that we are continually evaluating the effectiveness with which we are breaking down the barriers to service, and looking for new partners and strategies to build capacity in our communities. Working together to broaden our reach and build leaders from within communities has proven to have the most effective impact on the individuals we serve.

Primary Healthcare Services

identifier-dark-pinkHealth Clinic
identifier-pinkNewcomers Cooking Together;
identifier-orangeDiabetes Education Program

Our interdisciplinary team includes diabetes educators, community health nurses and nurse practitioners, physicians, administrative support staff, interpreters, psychiatrists, registered dietitians, registered practical nurses and counsellor therapists.

Child and Family Program

identifier-women-childrenWomen & Children’s Programs
identifier-early-yearsEarly Years Outreach
identifier-expressive-artsExpressive Arts Program

A team of Health Promoters and Peer Outreach Workers provide community programs to women, men, children, and seniors. The Peer Outreach Model reaches families with children aged 0 to 12 years to create links with other newcomer women and children who speak the same language.

Youth Program

identifier-youth-programPrograms and services for youth aged 13 to 24 years range from primary health care to one-on-one counselling, peer mentorship, social and life skills workshops, educational sessions, arts, field trips, cultural and recreational projects.

Settlement Services

identifier-settlement-servicesThrough one-on-one settlement support and group workshops, Settlement Workers provide orientations to the Canadian systems, information about rights and entitlements, assistance completing forms and applications, referrals to programs and services, support and advocacy to deal with the effects of migration.

Language Services

identifier-language-services

This program is a social enterprise and works to help individuals and companies manage the language barriers they face in the delivery and receipt of services. It is an independent fee-for-service program offering high-quality interpretation and translation services. The RIO Network is a product of Language Services providing immediate over the phone and video interpretation.

Green Access Program

identifier-green-accessPrimarily located at the 6,500 square foot Green Roof at AccessPoint on Danforth, this program strengthens the health outcomes of our programs and services. The broader goal is community engagement, increasing access to healthy foods, community gardens in which to grow them, and environmental education that’s relevant to an inner city context.

Community-Based Research Program

identifier-community-based-researchResearch on the types of health issues faced by newcomers (e.g., diabetes, mental health issues) and about the social and economic factors that cause these health issues (e.g., poverty, access barriers, language barriers) conducted by, for and with communities with the goal of bringing positive social change.

LGBTQ + Services

identifier-lgbtqWorkshops and one-on-one support in an LGBTQ+ knowledgeable environment that recognizes that LGBTQ+ newcomers face particular challenges when settling in a new country. Working from an anti-oppressive framework is key to the services provided, creating safe, welcoming spaces to foster healthy communities.

Service Locations

Access

Our approach to Healthcare

People face barriers to being able to access healthcare. These can include housing, education, income, access to health benefits, and preferred language. Access operates through an equity lens looking at the various barriers that people face and developing ways to address them. Our Non-insured Walkin Clinic is an example of how we continue to address barriers that affect peoples ability to access healthcare.

JOE

Joe is a 59-year old male who moved to Canada in hopes of achieving financial security. He had no major health complaints and had not visited a healthcare professional in several years. However, one day he visited the Non-Insured Walkin Clinic (NIWIC) after experiencing shortness of breath and chest pain for three weeks. He was diagnosed with pericardial effusion, which was reducing his heart function. With the assistance of an interpreter, the NIWIC advised him to go to the nearest ER. However, Joe chose not to visit the ER for fear of hospital bills.

The NIWIC’s consulting physician stressed to Joe the severity of his illness and wrote an advocacy letter on his behalf explaining the need for emergency care and a payment plan. Joe finally agreed to visit the emergency department. Joe was admitted immediately upon arriving to the ER and the doctors agreed that surgery was necessary. However, the hospital requested confirmation of payment before they initiated treatment. Because Joe was unable to provide this and appeared relatively healthy, they suggested postponing treatment until he could afford it. Subsequently, NIWIC managers began to liaise with administrators at Toronto hospitals and ultimately found a hospital willing to perform the surgery immediately. Nevertheless, there was a three-week delay between the date surgery was recommended and performed.

As soon as Joe presented to the NIWIC, a high-risk referral was made to a CHC, to connect Joe to a primary care provider (PCP) within three weeks. The first CHC where Joe was referred to declined Joe as a client due to financial constraints in serving uninsured clients, shortages of PCPs, and long wait-lists. Joe was eventually accepted by another CHC to obtain a family doctor, diabetes nurse, diabetes dietician and settlement worker two weeks after his heart surgery and days after his discharge from the hospital. He has continued to visit this CHC for the past year. Joe’s settlement worker managed to help lower his overall hospital bill as well as his expected monthly payments for a few months while he took time off work to recover from his procedure.

Equity

Health Equity Project

In 2017/18, Access Alliance Multicultural Health and Community Services led the Building Capacity for Equity-Informed Planning and Evaluation (Health Equity) Project in partnership with the Alliance for Healthier Communities and seven Champion community health centres, located throughout Ontario. The overarching aim of this project was to build organizational level knowledge, commitment and capacity to routinely use a health equity framework and evidence geared at overcoming systemic inequities in healthcare access, healthcare quality and health outcomes.

Each Champion had a unique work plan based on identified needs and their baseline capacity around equity-informed planning and evaluation. They received training and coaching support to execute this work plan over the course of the project cycle, a capacity-building intervention which also enabled them to build leadership and an institutional commitment towards health equity, drive their equity agenda forward, and strengthen partnerships and forge new ones.

Although the project is officially completed, the goal is to sustain momentum by moving beyond the level of the individual organization (its culture and practices), towards creating a shared vision and best practices at the sector or cross-sector level. This will help to create a foundation for promoting the uptake of an equity framework among decision makers such as HQO, the Ministry, and the LHINs.

The products of the Health Equity Project are housed online (see the Alliance for Healthier Communities project page), and are geared towards supporting community health centres and social service agencies to:

  • Improve knowledge, skills and attitudes among regarding equity informed planning and evaluation, including capacity to routinely collect relevant socio-demographic indicators and conduct disaggregated, intersectional analysis to understand and overcome health disparities that exist within or between client populations
  • Enhance available resources regarding evidence informed planning and evaluation
  • Promote the use of an organizational framework to establish and operationalize a commitment towards health equity
0x

regional workshops delivered by Champions to partners around their unique learnings

0x

organizations reached by this project, through active knowledge mobilization at regional workshops, planning tables, conferences, etc.

0x

training sessions delivered to Champions, partners, and other interested members

0x

established sector commitment of the Provincial Performance Management Committee (PMC) of the Alliance for Healthier Communities, to facilitating a “Community of Practice” where they will look at operationalizing health equity informed practices with a focus on quality improvement, and support on-going knowledge sharing for the project Champions and interested members.

Quality

Volunteer-Led Cooking Program

Providing a nourishing meal to the participants of the LGBTQ+ Newcomer program was greatly appreciated by participants but the costs were not sustainable and were inequitable when compared to other programs at Access Alliance. It was costing $120/week to feed approx. 40 participants and this put pressure on the Community Health Worker LGBTQ+ Newcomer Programs to fundraise to maintain this type of meal.

To address this problem, a PDSA was developed and tested based on the model of the Community Dining Program: Would the LGBTQ+ Newcomer program be able to continue to eat a healthy meal while reducing costs through the development of a volunteer led cooking program?

The PDSA was successful and this program currently engages LGBTQ+ newcomers to cook dinner for program participants of the Weekly LGBTQ+ Newcomer Workshop at APOD at a significantly reduced cost – $70/week. The program has an added benefit of engaging participants as volunteers, providing capacity building opportunities. It also provides opportunities for clients to cook foods from their own country to share with the program. The food is always healthy and is rich in whole grains, protein and vegetables.

Since completing the full cycle the following improvements have been made:

We have 2 volunteers that are not program participants taking the lead on this initiative in order to provide consistency with limited staff resources. A student also offers support during placement months.

We have developed a training procedure for new program participants that are volunteering to orient them to safe food handling, meal preparation and respecting the rules of the shared kitchen space. This training is delivered at the commencement of the program each week.

The group has been formalized as a NOD group separate from the Weekly LGBTQ+ Newcomer Group and we are engaging 6-10 participants on a weekly basis.

The food for the Pride event this year was mostly prepared by participants.

One volunteer, Ken Olson, won the June Callwood Award for Volunteerism from the Provincial Government for his efforts in leading this program.

This process has saved Access Alliance over $2,500

Access Alliance undertook a quality improvement intervention for Health Equity data collection. In 2016, the performance was 53% completion of the Health Equity data, for 8 demographic questions on the intake form. The sector target was set as 75% completeness (for all clients) by March 2018.

In order to achieve the target, we implemented a number of interventions for all new clients in October 2016, including:

  1. The registration process for new clients was changed in a couple of ways (e.g. on the form, there was the addition of required sign-off by staff collecting data and staff entering data into NOD); this was communicated to the secretary and service provider teams by the ED about the change management and the expectation of 100% completeness for all new client registration forms.
  2. Training was held for staff on cultural competency, and on the purpose and importance of data collection.
  3. We also used a staff incentive model to encourage the process, where staff were praised and received ‘Golden Mouse’ awards.

The result was that by the end December 2017, we reached 83% completeness.

In this case, an evidence-informed intervention made a significant change. Also, an equity lens was applied in that there was a team approach of relevant staff from all levels, representing an inclusive model of work. Everyone had the opportunity to identify the flaws and contribute to the process of improvement.

Financial Statements (Audited)

Total 2017 Expenditures

$0
  • 21.1% Operating Expenses

  • 26.4% Service Delivery

  • 52.5% Personnel Expenses

Total 2018 Expenditures

$0
  • 17.0% Operating Expenses

  • 30.4% Service Delivery

  • 52.6% Personnel Expenses

Total 2017 Revenue

$0
  • 1.4% Municipal Grants

  • 3.5% United Way Toronto

  • 4.0% Foundations

  • 6.8% Other

  • 9.1% Federal Grants

  • 24.1% Fees for Interpretation

  • 51.1% Provincial Grants

Total 2018 Revenue

$0
  • 2.8% Municipal Grants
  • 3.1% Foundations

  • 4.7% United Way Toronto

  • 5.0% Other

  • 8.8% Federal Grants

  • 24.2% Fees for Interpretation

  • 51.4% Provincial Grants

Our Impact

0
Total

Number of Clients by Site

  • 21.4%(3,886): College

  • 43.4%(7,883): Access Point on Danforth (APOD)

  • 35.2%(6,391): Access Point on Jane (APOJ)

In the 2017/18 FY, a total of 3,848 unique clients had 20,908 visits with primary care service providers (MD/RN/NPs) for 2,673 different reasons.

Students and Volunteers

0

Student and Volunteers

0

Hours Contributed

Client Experience Survey

0%

Overall satisfaction with Care and Services

0%

Would refer family and friends

0%

Felt a positive impact on their community

0%

Agreed that hours meet their needs

0%

Access Alliance helped improve my health and well-being

Langauge Services

AALS as a service provider (internal and external customers)

0

Pre-scheduled interpreting requests processed

0

Immediate, on-demand over-the-phone interpreting calls completed

0

Languages supported

Top 5 languages at each site:

College: Portuguese, Spanish, Farsi, Arabic, and Tigrinya

APOD: Arabic, Tigrinya, Hungarian, Nepali, and Farsi

APOJ: Portuguese, Spanish, Tigrinya, KAREN, and Hungarian

Staff, Partners, Funders

The volunteers and students that contributed their time over the past year are an essential part of the Access Alliance community. Volunteering provides invaluable experience, meaningful connections, and the opportunity to contribute to the community in a truly impactful way. Without the combined effort of our students and volunteers, Access Alliance would not be able to do all that we do.

Thank you!

Staff

Adose, Orit
Ahmed, Munifa
Akbari, Arman
Akbary Basir, Khatol
Al Bitar, Amani
Alamgir, Akm
Aleluia, Antonia
Ali, Honey
Aliraj, Yasmin (PR)
Alito, Yetnayet
Amoroso, Bice
Ansari, Saira
Anwar Ali, Naghma
Aponte, Abigayhil Vera
Arian, Khosraw (PR)
Atkins, Jennifer
Azami, Shaheda
Azevedo, Anabela
Baird, Drew
Balendra, Shankari
Barczay, Violetta
Basu, Anita J.
Beckford, Morris
Chan, Christine
Cooke, Keisha Tamika
Crawford, Candace
Da Silva, Andrea
Dabbouk, Yousra
Dalmacio, Monika
Darr, Tayyeba
De Leon, Jobelle
De Oliveira, Helena
Debessai, Betiel
Debessai, Winttana
Diaz, Monica
Duchesne, Martin
Eagan, Alexandra Grace
Eby, Duncan
Fernandes, Jennifer J.
Fortig (Sub), Rebecca
Fortig, Rebecca
Fortuno, Anita
Fukushima, Tomoko
Fung, Joyce
Galvez, Alejandra
Garel, Robert S
Gomez, Thushari
Gori, Zainab
Gudeta, Lalisee
Haji Elmi, Sumeya A
Hall, Shaneik (PR)
Htoo, Julie Anna
Htoo, Saynay
Huang, Chun Yan
Huynh, Victor H.
Inam, Shaista
Jalal, Syed
Jamil, Nadia
Janczur, Axelle
Jayakumar, Helen Sofia
Kadan, MHD
Karim, Rejwan
Karunanithy, Mathura N
Kaur, Anantpreet
Khan, Saleha
Kifle, Abeba
Kulatilake, Ranjith P.
Kulvi, Fizza
Langford-Pezzo, Alexandra
Le, Khanh
Ledwos, Clifford
Legasto, Araceli
Legasto, Araceli (sub)
LI, Jasmine
Lukenda, Michael A
Macaraig, John Marvin
Mahmud, Kawkab
Mbulaheni, Adetola F
McIntyre, Amanda
Mensah, Justin
Mentuch, Neil
Mistry, Sajel
Mohamed, Maha PR
Mohamed, Shadwa Ibrahim Hassan
Monsalve, Maritza
Morris, Elaine (Sub)
Moses, Carla
Mrosovsky, Lara
Murphy, Julia A
Musonye, Gloria Maraga
Mussa, Fatima
Narayan, Sideeka
Nitti, Nicole
Nudel, Serena
Nudel, Serena Nwaka, Sopuluchukwu I.
Omary, Ahmad Shah
Oyarzun, Ana Maria
Poblacion, Elena Mae
Pu, Naw Lorna
Purcell, Erin Chiara
Rabbani, Ziadh
Ramsaroop, Adesh Avinash
RANA, Fouzia
Rysava, Jaroslava
Saeed, Muhammad Salman
Safi, Hirah
Saroli, Miranda
Shackleton, Hilary A
Shakya, Yogendra
Soberano, Amy
Spasevski (PR), Megan
Sulieman, Tusma Mohamed
Takallum, Haseeba
Titi, Chimurenga (Chimu)
Tjipto, Yatti
Tran, Thuy
Tranter, Claire
Trotman, Christopher
Vanzaghi, Gisela
Vimalesan, Kalyani
Volyev, Natalia
Wahidi, Diana
Wiredu-Adjei, Jeffrey
Yong, Donna

Community Partners

Mid-West Toronto Sub Region
COSTI – Ralph Chiodo Reception Centre
DCIT/Greenwood Secondary School
West End Midwives
Toronto Public Health
FCJ Refugee Centre
Midwives Collective of Toronto
Progress Place
City of Toronto
Flemingdon Health Center
Working Women Community Center
Mid-West Toronto Sub-Region
Toronto Central Local Health Integration Network
Davenport Perth Community Health Centre
4 Villages Communty Health Centre
Planned Parenthood of Toronto
Women’s Health In Women’s Hands
Unison HCS
Stonegate Community Health Centre
Scarbourough Centre for Healthy Communities
Parkdale Queen West CHC
City of Toronto
TDSB- Crescent Town School
Warden Woods Community Centre
EYET Family Resources
Family Service Toronto
Culture Link Settlement and Community Services
York Town Family services
Greenwood Secondary school
South Riverdale Community Health Centre
Unison HCS
Parkdale Queen West CHC
The 519
Spring Tide Resources
Black Coalition for Aids Prevention
OCASI
Unison HCS
North Lambton CHC
Rideau Community Health Services
Centre de santé communautaire du Témiskaming
Humber College
COSTI – Immigrant Services
Somerset West CHC
McMaster University
Institute for Work and Health

Board List

Priyanka Debnath
Erik Laundriault – Chair
Tania Hossain – Vice-Chair
Arman Hamidian – Secretary
Henry Ngan
Linda Nicolson – Director
Sarah Vanderburg – Director
Alfred Chuang – Director
Ida Hersi – Director
Mohamed Malik – Director
Vanessa Redditt –Director

Funders

CHUM Charitable Foundation
Citizenship and Immigration Canada (Federal)
Citizenship and Immigration Canada (Provincial)
City of Toronto
Employment and Social Development Canada
Green Shield Canada Foundation
Home Depot
Local Health Integration Network (LHIN)
Metcalf Foundation
Ministry of Health and Long Term Care (MHLTC)
Ministry of Seniors Affairs
Ontario Trillium Foundation
Scarborough Bike Hub
Service Canada (HRSDC)
St. Michael’s Hospital
TD Financial Literacy Grant Fund, Prosper Canada
The Institute for Work and Health
The McLean Foundation
Toronto Public Health
United Way Toronto and York Region

CENTRAL OFFICE
340 College St., Ste. 500
Toronto, ON M5T 3A9
Tel: 416.324.8677
mail@accessalliance.ca

ACCESSPOINT ON DANFORTH
3079 Danforth Ave.
Toronto, ON M1L 1A8
Tel: 416.693.8677

ACCESSPOINT ON JANE
761 Jane St., 2nd Floor
Toronto, ON M6N 4B4
Tel: 416.760.8677

ACCESS ALLIANCE LANGUAGE SERVICES
340 College St., Ste. 500
Toronto, ON M5T 3A9
Tel: 416.324.2731, press “0”
languages@accessalliance.ca

Get In Touch

Looking to make a difference? Consider a charitable contribution to Access Alliance!
Charitable Registration No. 12363 6664 RR0001