Advancing the Community Health Centre Solution
The Alberta Association of Community Health Centres (AACHC) and its member centres are committed to supporting Albertans in improving their health and their healthcare system.
As founding members of the AACHC, The Alex Community Health Centre, Boyle McCauley Health Centre, CUPS Calgary and ACFA / la Clinique francophone de Calgary provide team-based primary care and a range of other social services and programs to over 50,000 Albertans who have complex needs and face major barriers in accessing other primary care and support services.
AACHC’s members demonstrate that community-based primary health care, delivered through collaborative interprofessional teams, can successfully improve outcomes for Albertans and reduce costs. Alberta CHCs not only deliver high quality care, they also address the social determinants of health that affect people’s health.
Community Health Centres (CHCs) are frontline healthcare and social support centres. They provide high-quality patient care through teams of physicians, nurse practitioners and other nursing professionals, dietitians, therapists and other allied health providers. CHCs also integrate this team-based healthcare with health promotion and population health programs. Significant emphasis is placed on prevention and early detection of health problems, and reducing individual, family and community barriers to health.
CHCs are not-for-profit or co-operative organizations governed by volunteer boards of directors comprised of diverse members from the community. This helps build community relationships of trust and foster broader health and social service integration. The AACHC is pleased to see Alberta Health recognize these dynamics within the description of CHCs on its website.
Through their population-based response to health and social needs, CHCs have a demonstrated capacity to tackle high-priority challenges such as chronic illnesses, avoidable hospital emergency department use, and the impacts of poverty. Their work is integral to the success of Alberta’s primary health care and wellness strategies, and the mandates of multiple ministries including Health and Wellness, Human Services, Justice and others.
Alberta’s CHCs currently provide care and support to 1.2% of Albertans. However, approximately 20% of the population has complex health and social needs and would be most appropriately served by the integrated primary care, health promotion and social services provided by CHCs. This major gap in access to CHCs in Alberta contributes to poorer health outcomes in our province and avoidable costs to Alberta’s healthcare and social systems.
AACHC looks forward to working with the Government of Alberta and provincial partners to improve and increase access for Albertans to appropriate primary health care. AACHC is recommending the following core steps:
Implement an annualized operational funding model for existing CHCs in Alberta that encompasses the package of team-based primary care, health promotion and community health services they deliver.
Alberta’s existing CHCs continue to play a critical role in providing high-quality health and social services to a diverse and complex client population in Calgary and Edmonton. They do so, however, despite major gaps in policy and funding for these services, and a very heavy reliance on organizational fundraising to meet the needs of the communities they serve.
CHCs are proud to bring tens of millions of additional dollars into Alberta’s public health and social service systems. However, these resources could be better leveraged on behalf of Albertans if they were not filling gaps in essential services that should be covered through adequate, core operational funding for CHCs.
It is important to provide all CHCs in the province with adequate core operating budgets. These budgets would ideally be attached to mutual accountability agreements outlining service expectations and other terms of agreement. By addressing gaps in core funding for CHCs, the Government of Alberta would demonstrate commitment to equity among primary care models in the province. It would also enable the provincial government to harvest a “low-hanging fruit” by unleashing further capacity within these organizations.
This would immediately improve comprehensiveness of care; it would further reduce pressures on other more costly health and social services; and it would help catalyze local economic development.
Invest in 10 new Community Health Centres throughout Alberta by 2019, increasing the percentage of Albertans who have access to a CHC from 1.2% to 2.5%.
Research from Alberta shows that 5% of the population (approx. 210,000) alone – termed “high-users of health care” – account for approximately 66% of overall costs incurred in the healthcare system. Large segments of this population, such as Frail elderly (largely those older than age 75), Complex older adults (many with significant mental health and addictions issues), and High-needs youth (including mental health, addictions and injury profiles) are individuals that continue to access acute care and other services due to gaps in access to appropriate, integrated frontline services.
Alberta’s existing CHCs have already proven very successful at delivering integrated care and support to individuals from within this 5% population segment, reducing their continued dependence on more costly services. These same CHCs also continue to prevent Alberta’s population of “high users of health care” from growing and intensifying. This cost-saving impact is multiplied across other sectors such as justice, corrections, and social services.
One of the best ways to cut the cost curve in health care and to improve the health system for all Albertans is to reduce the cost impact of high-users of health care.
Alberta’s existing CHCs do not have the capacity or geographical reach to provide services and support to all individuals within this 5% who require access to a CHC. Therefore, by drawing on provincial data to identify communities with high concentrations of high-users of health care, the Government of Alberta should invest in 10 new CHCs over the next two years so that 50,000 more individuals can benefit from the integrated health and social services provided by CHCs.
Various implementation opportunities may be pursued, including support for existing community agencies that could be positively transformed into CHCs through targeted investment to add team-based primary care and to fill other important service gaps. In addition to improving care and reducing costs to health and other public services, implementation of this next wave of CHCs for Albertans will yield important insights into future planning and funding of health and social services throughout the province.
Collaborate with AACHC to develop a longer-term strategy and timelines to meet the needs of all 20% Albertans who require priority access to a Community Health Centre.
Commitment to a longer term planning strategy, with identifiable timelines, will enable the Government of Alberta and key stakeholders throughout the province, including AACHC, to build a primary health care system that meets the diverse needs of Albertans and their communities.
This collaborative approach to implementing a mixture of models and approaches to primary care throughout the province should include consideration of how best to increase access, over time, to CHCs for the 20% of Albertans who requite priority access to CHCs.