AccessTO – ensuring access for all
The City’s Access to City Services for Undocumented Torontonians (AccessTO) policy outlines that all Torontonians, regardless of immigration status, have the right to access City services without fear. Through the Toronto Newcomer Strategy 2022-2026, the ongoing implementation of the AccessTO policy remains a key priority.
In March 2025, the City Council directed the development of a renewed public education campaign to increase awareness of the scope of the AccessTO policy and available support. View video of the City Council discussion on the broader motion – Identifying and Addressing Pressures in the Refugee and Emergency Shelter System:
Access Alliance is working with the Toronto Newcomer Office and other community organizations to conduct in-person and virtual consultations with undocumented residents to strategically inform the City of Toronto about their experiences and determine strategies to better support the population.
The City will use data from the community-based research to inform the ongoing implementation of AccessTO. In addition to seeking insight into barriers to City services, the research will also be used to better understand the current profile and needs of undocumented Torontonians to inform service delivery, including unmet needs, systemic causes of precarious immigration status, and recent trends in service demand.
In the coming months, along with our other community partners, we will
- Provide feedback on new City of Toronto-developed public education materials on the City’s AccessTO policy, to increase awareness of the scope and supports available. We’ll consult internally with staff who work with uninsured and undocumented clients and communities, and externally as needed. We have begun this process, and it will continue into March 2026.
- Provide recommendations to the Toronto Newcomer Office on the ongoing implementation of AccessTO, including advising on existing and new staff training approaches and materials. This has also begun and will continue into June 2026.
- Conduct community-based research with undocumented Torontonians (and potentially agencies serving undocumented Torontonians) to identify unmet needs and barriers to accessing City services to inform the continued implementation of AccessTO. This will involve hosting a number of community focus groups in May 2026.
- Support the dissemination of pubic education materials among undocumented clients and partner agencies to increase awareness of AccessTO and support available (e.g. host information sessions). As materials are created and made available, we will support outreach efforts within Access Alliance, with our partner agencies, and add multilingual materials to our RioMix.ca website – a collaborative, centralized and accessible repository of translated materials and multilingual websites relating to health and community care and support.
We bring our extensive primary health care work with people without health insurance, including non-status immigrants and refugees.
Related work
Exploring the Perspectives of Non-insured Individuals Utilizing Emergency Departments in Toronto: A Qualitative Study
Non-insured individuals face unique challenges when accessing emergency department (ED) care in Canada. This qualitative study explores the firsthand experiences of non-insured patients in the ED to understand how we can improve the care system.
Healthcare service needs for refugees, asylum seekers, and residents with precarious immigration status in Canada: A scoping review
This study sought to understand trends in influx and vulnerabilities, and to identify the unique healthcare and well-being needs of these equity-deserving immigrants living in Ontario. Study findings underscore the necessity for targeted healthcare services in Canada to meet the identified needs of refugees and residents with precarious status. The findings impact the planning of the current healthcare system to accommodate population dynamics and to train healthcare service providers.
A qualitative study on the Virtual Emergency Department care experiences of equity-deserving populations
Patients from equity-deserving populations, such as those who are from racialized communities, the 2SLGBTQI+ community, who are refugees or immigrants, and/or who have a disability, may experience a unique set of challenges accessing virtual models of care. The objective of this qualitative study was to describe the experiences of patients from equity-deserving communities and their family members who received care from a Virtual Emergency Department (ED) in Toronto, Canada.
What is the price of human life? Cutting off uninsured is ‘irresponsible’
Is health care priceless? Not quite. For hundreds of thousands of Ontarians, a visit to the emergency department will now cost hundreds of dollars just to walk through the door. Need someone to run a lab or take a CT scan? Add another few hundred dollars. A routine visit can easily cost nearly $1,000. Uninsured patients must weigh their ability to pay against meeting their other basic needs. Groceries for the family, or going to the emergency room for a possible heart attack? Paying this month’s rent, or getting a CT for worsening abdominal pain? Diapers for the new baby, or seeing someone for postpartum depression?
Undocumented.Stories: Hand-written stories from Torontonians living without permanent status
In 2022, Access Alliance collected over 125 anonymous stories from Toronto residents, describing their daily realities of living without permanent immigration status. Many of them were patients of our Non-Insured Walk-In Clinic in West Toronto. We share some of these stories to highlight the systemic barriers and exploitation these residents face based on their status.
Non-Insured Clinic
The Non-Insured Clinic (NIC) offers confidential primary care services to people without health insurance. Established in 2017, the Non-Insured Walk-in Clinic (NIWIC) at Access Alliance has addressed a critical gap in healthcare provision for uninsured individuals, including non-status immigrants and refugees. NIWIC is transitioning to the Non-Insured Clinic (NIC), opening February 23, 2026.