TURNING POINTSSherbourne Health Centre

Annual Report 2014-2015

Our Mission Advance the equity and quality of

care and services. Improve health for

underserved communities.

Our ValuesAt Sherbourne Health Centre, we:

Strive for excellence and quality;

Embrace diversity and difference;

Act with integrity and accountability;

Believe in equity and fairness;

Seek learning and innovation; and

Promote collaboration and teamwork.

Our Vision

Healthy People. Healthy Communities.

Contents

1 Introduction

Message from the Chair

Message from the CEO

2 2014-15 Brief Notes

3 Our Programs and Services Urban Health

Infirmary

LGBT Health

Newcomer Health

4 Thank You

5 Financial Statements

6 Looking Forward

1

Message from the Chair

2014-15 was a year of reflection, relationship-building and strengthening for Sherbourne

Health Centre.

The year focused on preparing for accreditation by Accreditation Canada, an independent,

peer-lead process that assesses health organizations’ standards to help them improve their

performance for their clients. I am thrilled to report that Sherbourne achieved Accreditation

with Exemplary Standing, an improvement on our previous standing which places us among

only 20% of organizations that achieve this stature! This wonderful result is the product of

myriad examples of teamwork and dedication to excellence by Sherbourne’s management, staff

and Board. In short, Sherbourne’s values at work. Quality improvement is a key strategic focus

area for Sherbourne, and the Board and management team held a Quality Summit in February,

which will inform quality priorities for coming years.

As the organization matures, with refreshed leadership, Sherbourne commenced a compre-

hensive series of program, services and operational evaluations. These studies will ensure that

Sherbourne keeps evolving and innovating to meet our community’s needs, both current and

future, through the safest, highest quality and most efficient programs and services. To this end,

Sherbourne also explored opportunities for strategic collaboration with partners in the com-

munity. We also made significant progress in improving our financial health.

On behalf of the Board of Directors I extend our sincere thanks to the committed staff, volun-

teers, donors and funders whose support helps Sherbourne advance toward our vision:

Healthy People. Healthy Communities.

Mark Warren

Board Chair

1 Introduction

2

Message from the CEO

Welcome to the Sherbourne Health Centre Annual Report 2014-15, which we have named ‘Turning Points’. These words

capture the strength and tenacity of our clients in facing down the challenges they’ve experienced in life, often having been

under-served by conventional health care.

For many clients, Sherbourne helps them when they reach a turning point in their lives: the juncture at which they start

the journey to being healthier, more engaged, more fulfilled people. After 14 years, Sherbourne is at its own turning

point – maturing and forging a bold, unique identity in the healthcare system.

This report highlights the progress we have made on the directions in our Strategic Plan and celebrates some special

accomplishments. Sherbourne clients tell in their own voices, their stories of Sherbourne’s role in helping them turn

around their lives. Sherbourne’s clients are as unique, bold and colourful as the tiles in the beautiful mosaic at our front

door. I’m sure you will find their stories as engaging and powerful as our Mosaic.

I want to thank Sherbourne’s volunteers, donors, staff and management for their commitment to our mission. In 2015-16

we will roll out various plans to continue moving Sherbourne forward, including budget, communications and fund

development strategies. We will also continue our work in partnership with Toronto Central LHIN to develop an innova-

tive Enhanced Community Space at Sherbourne, a dynamic, accessible ‘hub’ for health-related community programming.

I look forward to working with all of you next year to advance the equity and quality of our health care for the commun-

ities we serve. I know that our energy will continue to be unwavering.

Hazelle Palmer

Chief Executive Officer

3

Share & Learn Kitchen

After securing support from a group of generous donors

we were able to convert the cramped servery on our

second floor into a bright, functional programming kitchen. The Share & Learn Kitchen will be the venue for

programs like Monday Night Drop In and the Diabetes

Community Kitchen, as well as health promotion and nutrition groups yet to be envisioned!

Quality Champions

This year the winners of our Quality Improvement Award

were: RN Hemant Gohil for his outstanding contribution

advancing our Infection Prevention and Control program;

and the Infirmary Medication Management Committee, whose new policies and controls make our medication

administration safer and more cosistent. Congratulations.

Electronic Medical Record

We completed the roll out of our Electronic Medical

Record system to our Infirmary program. With all of Sherbourne’s clinical programs and services now on one

system, we can provide more integrated, safer care and use our data to ensure we are meeting the needs of our

clients. Vinita Shah, who managed the implementation, also received the Quality Improvement Award.

2014-15 Brief Notes

2

4

New Leaders

Chantel Marshall came on board as Director of

Urban Health and Nursing Practice Lead. Chantel is

a Registered Nurse with over twenty years experi-

ence in Canada and the US, with focus on serving homeless and street-involved clients, and people with mental health and addictions.

Mosaic Pride

Over 60 Sherbourne clients, volunteers and staff walked together in the parade at World Pride, bring-

ing together all of our programs for the first time ever to show our pride with the world watching!

5

Sherbourne’s Urban Family Health Team provides primary health care and mental health counselling, with focus

on those who are homeless or under-housed. There are more than 5,000 homeless people in Toronto, including

people on the street and in shelters. For homeless people the cycle of unemployment and lack of housing that

creates extreme poverty often leads to stress, poor nutrition, social isolation and disconnection from health care. This

makes them susceptible to more frequent and more serious physical and mental illness. Our urban health programs

emphasize outreach and community engagement to help homeless and under-housed people address their often

complex needs.

The Rotary Club of Toronto Health Buses deliver on-the-spot care and health promotion at community locations across

Toronto. A team of Outreach Workers and Registered Nurses provided 18,935 healthcare encounters in 2014-2015. Last

year the Health Bus was integrated into the Urban Health team to better coordinate services for clients. In January an

evaluation was launched to assess the program against its original goals, and the shifting landscape of services for home-

less and under housed people.

Last year, there were 898 WINK (Women in Need ‘Klinik’) visits. WINK is a safe, welcoming space for homeless or

under housed, low-income, and street-involved women (including trans-women). The women were provided a healthy

breakfast, health education, and direct access to primary care including an NP, RN, MD, and Mental Health

Counsellor. The extended pilot was adopted as an ongoing Urban Health program.

Urban Health

3 Our Programs and Services

6

I left home at 16. I’d been abused by my mother, who eventually told me: ‘Get out and never come back’. I got

put in a group home when the police found me sleeping

rough in a car, but I got a good work ethic from my dad. I worked in an automotive factory for 35 years, until I slipped and seriously broke my ankle in 2012. Then I

couldn’t work any more.

I was with my ex for 23 years and we got into crack and

all sorts of bad stuff. He threw me out and I was living on

the street, then in shelters for three years. It was an experience I wouldn’t wish on anyone- full of women

who’d been abused or on drugs. I met the Health Bus

staff and they gave me confidence, when sometimes I was my own worst enemy. They referred me to a doctor

and a counsellor at Sherbourne, who I still see.

Today my health’s good. I can run like a deer to catch

the bus. I’ve made new friends and can work well with

people.

I’m in TCH housing and I have my cat. She scratches the

life outta me but I love her. I’ve been volunteering with

WINK, preparing food for the group. I like to give some-

thing back.

I’ve seen a change in myself. Now I do what I gotta do to

make me happy. I look in the mirror and I like what I see.

”

“

Annie, 58

Underhoused, unattached, until…

I’ve seen a change in myself...

and I like what I see.

77

Our Hepatitis C program is for people facing difficulty

accessing mainstream services, primarily those who use

drugs, are experiencing mental health issues, or have

HIV/Hep C co-infection. In partnership with South

Riverdale CHC and Regent Park CHC, our staff engage

in outreach activities, testing, treatment, counselling,

and support groups for people living with, or at risk of

contracting Hepatitis C. Last year the program readied

itself for exciting changes in treatment options that will

fundamentally improve outcomes for people with Hep C.

Sherbourne’s Street Medicine initiative brings in-the-

moment care like health promotion, assessments, health

care, and referrals to street-involved people in the most

responsive and accessible way. A Nurse Practitioner and

Community Resource Worker visit local parks, laneways,

drop-in centres on foot. They helped 76 people last year

with care such as immunizations, wound care, and sun

safety education.

URBAN HEALTH STATISTICS

Total actual

Program 2014-15 volume

Urban clinical team 13,065

Mental health/counselling 860

Hepatitis C program 3,202

Health buses 18,935

TOTAL 36,062

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9

Infirmary

Sherbourne’s Infirmary provides short term medical respite care for individuals

experiencing homelessness who need a safe space to recuperate/recover and a

hospital stay is not needed. Unique in Canada, it is a 24/7 client-centred, holistic

and collaborative model of service provided by a multi-disciplinary team.

Last year 191 clients accessed the Infirmary to prepare for or recover from surgery,

recuperate from an acute medical condition, or provide respite for individuals under-

going treatment for cancer. The average length of stay for clients was 11 days.

In 2014-2015, the Infirmary undertook an evaluation, working with staff and commun-

ity stakeholders. Based on the study we began implementing changes to improve client

access by working with community partners to refine and clarify the program’s service

model and admission criteria. These steps will position the program for future growth,

in keeping with our strategic goals to take the Infirmary to the next level.

10

I was a heavy drinker by the time I left high school.

Eventually, drinking cost me my marriage and as I took more and more time off work, my job as well. I was spending most of my benefits on beer and cigarettes – 65 a day – even though I had chronic bronchitis. I was depressed and living in a pig sty.

I was born again – not spiritually,

but physically.

I went to the emergency department because I’d been

throwing up and had severe pains in my stomach.

Turned out I had an abscess that had infected my

intestine, liver and lungs. I was basically a dead man walking.

Surgery saved me, but I had to turn my will power toward healing myself. But I had no place to live. My old

apartment was in such a bad state that I couldn’t go

back, so the hospital referred me to Sherbourne’s In-

firmary. The Infirmary nurses and health workers were more than helpful, they were superb. The Case Worker was on the phone every day advocating with the City

to get me into housing. I was born again – not spiritu-

ally, but physically. My cholesterol and blood pressure normalized and I’d had my last smoke. I lost 80lbs. I

graduated from a scooter, to a walker, then a cane. I just bought a bike for exercise.

I know there may be tough times ahead but I’m ready. I

have my family doctor and a counsellor at Sherbourne.

I live by the motto: Never go to the past, always go forward.

Malcolm, 63

Unmotivated, unwell, until…

”

“

11

Sherbourne’s LGBT Family Health Team

primary care services are culturally sensi-

tive to the particular needs of LGBT

(lesbian, gay, bisexual and trans) people.

Last year we complemented established social

support groups like Gender Journeys, The

B-side, Mature Trans Sisters and Trans Partner

Network with new groups to respond to needs

that we heard from clients. These include a

Cognitive Behavioural Therapy group for

LGBT individuals dealing with anxiety and

depression, and support groups to help Trans

women and men cope and build resilience

through the challenging process of sex re-

assignment surgery.

Supporting Our Youth (SOY) is our commun-

ity development program designed to improve

the lives of LGBT youth by actively engaging

youth and adult communities. SOY creates

healthy arts, culture and recreational spaces

for young people and enables youth access to

adult mentoring and support.

There continued to be high demand for SOY

programs, which grew and changed to meet

youths’ needs. Flagship programs like Black

Queer Youth, CLICK Mentorship, Trans_

Fusion Crew, Express and Monday Night

Drop-In, have been joined by newer programs

like Get Out!, an outdoor recreational program

offering activities like dog-sledding and wilder-

ness expeditions. 2014-2015 saw the launch

of Our Mad Selves, a group for queer and

trans youth to explore their mental health and

develop resilience and self-care skills through

telling their stories, and challenging percep-

tions and oppression related to mental health

stigma.

During World Pride, participants in SOY’s

H.E.A.T. (Human Rights, Equity, Access

Team) program presented Queer Jeopardy

and led a panel discussion on LGBT Issues in

Canada and the World Today for Dentons, a

major law firm, sparking a conversation that

continues to make waves on Bay Street.

Sherbourne’s LGBTQ Parenting Network pro-

motes the rights and wellness of LGBTQ pro-

spective parents, parents and children through

education, research, outreach and community

events like the International Family Visibility

Day Picnic. The program also hosts support

groups like Still Trying, a group to help people

trying to conceive.

LGBT Health

12

Total actual

Program 2014-15 volume

LGBT clinical team 13,292

Mental health/counselling 4,507

SOY 15,631

Parenting Network 3,982

TOTAL 37,412

”

“

Rainbow Health Ontario (RHO) is

Sherbourne’s unique, province-wide program

with the mandate to improve access to services

and to promote the health of Ontario’s LGBT

communities, through capacity-building

initiatives and partnerships with mainstream

organizations across the system. Last year

RHO launched Breakthrough Projects, a new

program to support grassroots LGBT health

and wellness projects in communities across

the province. Inaugural projects include

an initiative to identify what services are

needed for trans populations in Northeastern

Ontario, and a French language community

radio show on LGBTQ health and wellness.

2,580 health professionals also participated

in RHO training, everywhere from Belleville

to Sudbury.

I grew up in a small town in Russia. I told my parents I am gay when

I was 14. School was difficult. I was sent to a psychologist, who told me it wasn’t normal, that gays were just spies for America and that I could be committed to a mental hospital. The teachers were homo-

phobic. They would grade me at the bottom of the class, but when I took tests on the computer I would be at the top. So their bias was

obvious – they wanted me out of the class.

Three times I was arrested at LGBT rights protests. I was thrown in

jail and beaten twice so that I had to be put in hospital. I thought that I could be killed. My mother sold her apartment to buy me a visa to

come to Canada.

I arrived speaking no English. Other refugees [in a settlement pro-

gram] called me a faggot and for a year I didn’t speak to another gay

person, until someone told me about SOY Express. It was a place to meet real gay people, to share information about resources I need-

ed, to make friends. SOY referred me to Legal Aid and helped me through my refugee hearing.

Since coming to SOY I feel really good, just like fish in the sea. I can be myself and feel free, equal, normal…I can live my life as an activist and a gay person. I have a place in the east end, work is good and I’m applying for university. I want to be a lawyer and work in LGBT issues.

Piotr, 19

Undocumented,

unsafe,

until…

LGBT HEALTH STATISTICS

Since coming to SOY...I can be

myself and feel free, equal, normal.

13

Newcomer Health

Sherbourne’s Newcomer Family Health Team provides accessible, culturally-appropriate services to meet the

diverse needs of newcomer, immigrant, and refugee communities in Sherbourne’s neighborhood. Services are

provided at 333 Sherbourne Street and at a satellite clinic at 200 Wellesley Street, within the St. James Town

Community Corner. St. James Town is the most densely populated neighborhood in North America, with a high

concentration of newcomers from over 100 countries. Many experience challenges with resettlement, trauma and

systemic barriers like racism and discrimination that can affect health and well-being.

The team offers twice-weekly drop in clinics for clients who find it difficult to keep scheduled appointments. Weekly

settlement services are offered at 333 Sherbourne through a partnership with Thorncliffe Neighbourhood Office.

Sherbourne also provides weekly primary care, diabetes management and mental health counselling and groups at the

St. James Town Community Corner Health Clinic. In 2014-2015, 101 new clients were attached to services at our

St. James Town Community Corner clinic.

The team also includes the Diabetes Education Program, which serves all of Sherbourne’s clients and the community,

and is particularly relevant to newcomer populations, who have a higher risk of Type 2 diabetes. Last year, shopping

tours and workshops focused on high risk populations such as South Asian communities and seniors.

14

As lead agency in the Health Access St. James Town

(HASJT) project, Sherbourne works with partner organ-

izations to provide collaborative, coordinated care and

initiatives for high needs, unattached St. James Town resi-

dents facing barriers to health and social services. HASJT

has successfully connected 700 residents (of whom 95 are

considered high-needs) to services. Thirty residents have

also been trained as peer leaders and community ambas-

sadors to provide system navigation and promote healthy

living in the community.

Sherbourne’s participation in a new initiative with

Women’s Health in Women’s Hands, Canadian Centre

for Victims of Torture and CAMH helped create better

access to mental health services to immigrant, racialized

and refugee communities. Flu shot clinics targeting high

risk seniors were offered at various community locations,

through which 109 seniors were vaccinated.

Total actual

Program 2014-15 volume

Newcomer clinical team 4,152

Mental health/counselling 1,697

Diabetes education 1,392

Health promotion 2,758

TOTAL 9,999

NEWCOMER HEALTH STATISTICS

15

Thank You

Every year committed volunteers and donors give time, energy and financial support. On behalf of everyone at Sherbourne we thank our supporters and allies, whose generosity makes it possible to keep

Sherbourne’s services uniquely innovative, equitable and responsive.

The Government of Ontario and the City of Toronto and

Aston Family Foundation

Canadian Council for Refugees

CIBC

Canadian Memorial Chiropractic College

Community One Foundation

CReATe Fertility Centre

Dentons LLP

First Steps Fertility

Hospital Centre for Fertility and Reproductive Health,

Mount Sinai Hospital

Intact Foundation

The Gordon & Ruth Gooder Charitable Foundation

K.M. Hunter Charitable Foundation

The Robert Kerr Foundation

LIFEQUEST Centre for Reproductive Medicine

Lotus Yoga Centre

McCarthy Tétrault Foundation

Ontario REALTORS Care® Foundation

Paloma Foundation

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16

Pink Turf Soccer League

Pride Toronto

Raising the Roof

RBC Foundation

ReproMed - Toronto Institute for Reproductive Medicine

Second Harvest

TD Bank Group

TELUS Toronto Community Board

The St. George’s Society of Toronto

Tippet Foundation

Toronto Arts Council

An Anonymous Fund and the Vital Toronto Fund at the Toronto Foundation

Bruce Blackadar Last Call Fund at the Toronto Foundation

Toronto Gay Ski Club and Snowboarding Club

Toronto Real Estate Board

Toronto Spartan Volleyball League

United Steelworkers

The Katharina Weger Foundation

The Marjorie and Joseph Wright Memorial Foundation

Xtra and DailyXtra.com

And 1,300 generous individual and community supporters.

17

Ministry of Health and

Long-Term Care (“MoHLTC”)

and Toronto Central Local

Health Integration Network

(“Toronto Central LHIN”)

funding

Family Health Team

MoHLTC Health Research

Grants

Fundraising

Other grants and guarantors

Supporting Communities

Partnership Initiative

Other revenue and recoveries

Amortization of deferred

capital contributions (Note 6)

Primary care and Family

Health Team (Note 8)

LGBT primary care

Infirmary

Building services and utilities

Rainbow Health Ontario

Health bus/mobile

Information systems

Administration

Human resources

Finance

Fundraising

Communications

Naturopathic clinic

Amortization of capital assets

Excess of revenue

over expenses

2015

$8,021,665

2,888,026

1,019,043

341,268

186,095

64,104

211,131

985,926

13,717,258

2015

$4,284,414

1,880,874

1,500,873

1,372,162

875,243

560,812

575,280

489,006

315,709

266,252

81,233

22,609

856

1,029,487

13,254,810

462,448

2014

$7,421,485

2,859,107

1,100,000

319,131

67,883

49,146

296,991

1,060,111

13,173,854

2014

$4,070,567

1,665,688

1,453,821

1,214,205

1,083,149

554,751

549,456

453,106

345,760

294,127

96,134

13,802

12,000

1,095,828

12,902,394

271,460

Financial StatementsStatement of operations year ended March 31, 2015

REVENUE EXPENSES

5

18

Current assets

Cash

Accounts receivable

Prepaid expenses

Inventory

Capital assets (Note 3)

Current liabilities

Accounts payable and

accrued charges (Note 4)

Deferred revenue (Note 5)

Deferred capital

contributions (Note 6)

Invested in capital assets

Internally restricted (Note 7)

Unrestricted

2015

$1,021,402

452,622

288,602

7,053

1,769,679

18,798,525

20,568,204

2015

$1,713,387

517,797

2,231,184

18,062,479

20,293,663

$736,046

50,000

(511,505)

274,541

20,568,204

2014

$20,232

317,516

219,820

11,405

568,973

19,531,798

20,100,771

2014

$1,044,322

492,165

1,536,487

18,752,191

20,288,678

$779,607

50,000

(1,017,514)

(187,907)

20,100,771

ASSETS LIABILITIES

FUND BALANCES (deficit)

19

Looking Forward

We will launch an Urban Health strategy that better integrates our programs and services

for homeless and under-housed people, and considers the role of mobile delivery in

serving our clients.

Working with staff and partners, we will develop a harm reduction framework with an initial

focus on developing resources for providers working with people with substance use issues,

based on best practices.

We will implement new technologies to improve our clients’ experience and make our organ-

ization function more efficiently and effectively.

In Newcomer Health, we will increase our community programming to create better access

to healthy living and nutrition information to residents of St. Jamestown.

In some instances names have been changes to protect individual’s privacy. Photos by Jason Stead Photography. Images are used for

illustrative purposes only.

Many Hands Make Light Work, 2011. The Sherbourne Health Centre Mosaic is a community-engaged public artwork project that was led by Red Dress Productions.

6

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Sherbourne Leadership Volunteers 2014/15

Board of Directors

Amanda Cato

Robert Champagne

Ken Chan

Kenneth Chung

Jeanette Cournoyer

Shannon Dent

Jonathan Fetros

Doug Kerr

Sudha Kutty

Lovisa McCallum

Neil Shah

Marianne Smith

Reena Tandon

Mark Warren

Richard Willett

Lily Yang

Board Committees

Community

Members

Lori Bailey

Lauren Bell

Michael Herrera

Stephen Yi

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Rainbow Health Ontario