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The COVID-19 pandemic has further exposed deep social and health inequities experienced by many segments of our population across Canada.
Community Health Centres (CHCs) across Canada have risen to meet these challenges head on, remaining open during the earliest days of the COVID-19 pandemic when many doctors’ offices and other services were closing their doors, and continuing to adapt their operations to meet the emerging and evolving needs of local communities as the pandemic has evolved.
The full picture of this multi-faceted response by CHCs comes into clear view across the five core pillars of the CHC model.
COVID-19 Pandemic Response: 5 Pillars of CHCs
Breaking Down
Barriers To Health
Services and programs focused on shelter and housing, employment and income security, healthy foods, and other day-to-day needs to reduce social causes of illness.
1
- Food Security - Preparing, delivering and serving meals/groceries.
- Shelter Support - Collaborating with other agencies to set up additional shelter and COVID-19 isolation spaces.
- Digital Accessibility - Making devices and supports available to individuals facing barriers to virtual services.
- Financial Assistance - Assisting individuals in getting financial assistance through CERB and other programs.
The Alex Community Health Centre (Calgary, AB)
Quick Response: Social Dispatch Centre
The Alex CHC, a Community Vaccination Promotion National (CVP-National) Project participant, responded quickly to tackle new barriers and needs presented by COVID-19. Early in the first year of the pandemic, social dispatch centre was established which provided 539 client referrals to emergency benefits, 2,833 counselling and support sessions, and 2,555 check-ins with at-risk youth.
Curbside Meal Pick-ups for Food Insecure Individuals
The Alex CHC’s Community Food Centre welcomed 876 first-time visitors over this same period as pandemic-related food insecurity grew, providing 1,419 curbside meal pick-ups for food insecure individuals.
North End Community Health Centre (Halifax, NS)
"The CHC hosted mobile vaccine clinics, drop-in clinics, and made site visits to increase vaccine education, access and uptake among homeless and street involved residents of the city. The CHC's connection to people experiencing homelessness, and to shelter and rough sleeping communities enabled them to fill major gaps in the local public health agency's vaccine outreach and delivery efforts."
Responding to
Local Needs
People from the community play an active and ongoing role identifying priorities for services, programs, and community action.
2
- COVID-19 Hotlines - Activating telephone hotlines to address COVID-19 concerns in the community.
- Regular Check-ins - Making calls to check in on vulnerable and isolated individuals.
- Community Ambassadors - Deploying community ambassadors who represent the vulnerable population to inform and support people in their language.
CUPS Calgary and The Alex CHC (Calgary, AB)
Medically Supported Accomodations
Two Calgary CHCs and CVP-National Project participants, CUPS and The Alex CHC, cooperated with Alberta Health Services and the Calgary Homeless Foundation on establishment and operation of the city's Assisted Self-Isolation Site (ASIS). Through ASIS, they provided medically supported accommodations for those experiencing homelessness who needed to selfisolate as a result of COVID-19. By late 2021, they had provided warm shelter, hot meals, care and support to more than 1,200 of the city's most vulnerable people.
Black Creek CHC responds
Throughout the pandemic, Black Creek Community Health Centre (Toronto, ON) reduced barriers for African, Black, Caribbean communities, encouraging and supporting vaccine uptake. In late 2021, they described many of the
challenges they encountered and successes over the course of the first 18 months of the pandemic.
Carea Community Health Centre (Oshawa, ON)
“We mobilized very quickly and hired a team of community ambassadors to reach out to underserved communities in a high priority response manner. Once vaccinations were available, we created community-based & appointment-based pop up walk-in vaccination clinics, because one of the things that we knew is that the appointment-based clinics were a barrier for many individuals.”
Umbrella Multicultural Health Co-Op
(New Westminster, BC)
(New Westminster, BC)
Newcomer Vaccine Clinics & Medical Office Assistance
Umbrella Multicultural Health Co-Op, another CVP-National Project participant, hosted accessible, barrier free, and culturally connected on-site vaccine clinics for newcomers to Canada and individuals with precarious status. Their Cross Cultural Health Brokers and medical office assistants provided direct support, in multiple languages, to help clients register in British Columbia’s Get Vaccinated database, book vaccine appointments, get temporary PHN numbers, and provide information about local clinics and times. The CHC’s Mobile Clinic also supported Temporary Farm Workers across the province, providing language and cultural brokerage at vaccine clinics, information sessions, and through various outreach activities.
Championing
Health For All
Measures are taken to ensure that programs and connections in the community reduce social inequities faced by different groups.
3
- Proactive Services - Proactively working with public health and other partners units to inform and create equitable solutions for vulnerable communities and groups.
- Health Equity Focus - Implementing appropriate services, programs and approaches specifically by and for groups within the community that face systemic exclusion, barriers to care, and other social inequities.
Women’s Health in Women’s Hands CHC
(Toronto, ON)
(Toronto, ON)
Accessible Clinics for Different Groups: Vaccination & Primary Care
To further address low uptake of COVID-19 vaccines among African, Black, Caribbean communities, Women’s Health in Women’s Hands CHC partnered with the Black Physicians Association of Ontario to run accessible clinics. Individuals were able to access vaccine information and receive both vaccination and primary care from staff operating from culturally relevant and trauma-informed perspectives.
Regina Community Clinic (Regina, SK)
Responsive, flexible services in Regina
Regina Community Clinic (Regina, SK), another CVP-National Project participant, adapted its services throughout the pandemic to provide more flexibility, to move quicker, and to become more responive.
South East Ottawa Community Health Centre (Ottawa, ON)
South-East Ottawa CHC partnered in a city-wide COVID-19 community collaborative that brought together several of Ottawa’s Community Health Centres with other community partners to achieve coordination, scale, and increased impact for residents of Ottawa.
“As a collective of 4 different CHCs, we used government funding to strategise our response to the city as a whole. We developed the solutions collaboratively and we rolled that out across the city through a community of practice.”
Providing
Customized Care
People can receive care for a range of issues from a team of diverse healthcare providers, all through one health organization.
4
- Team-based Care - Providing care and support through a team of diverse healthcare and service professionals who work collaboratively to ensure that a person receives the most appropriate type of care and support, from the most appropriate member of the team, at the right time and place.
- Wrap-around Approach - Placing the person at the centre of diverse services and programs in order to address not only primary care needs but particular socio-economic factors affecting their health.
Woolwich Community Health Centre (St. Jacobs, ON)
Adapting the Team-Based Care Model to Meet Emerging Needs
At the very outset of the pandemic, Woolwich CHC pivoted to ensure continuity of service, conducting 80% of primary care visits virtually while a technology library and support for clients facing digital inequities were also put in place. A hybrid staff model was adopted throughout the pandemic and a wide range of activities to encourage vaccine uptake across the entire community was rolled out.
Rexdale Community Health Centre (Etobicoke, ON)
2SLGBTQ+ Peer-Support at Rexdale CHC
In order to support personal privacy and safety, Rexdale CHC (Toronto, ON) used Discord as a means of communicating with teens in the CHC's 2SLGBTQ+ peer support program who have not disclosed their identities to family, and employed a variety of other strategies to improve accessibility and quality of care.
Continuity of Care to Prevent Future Illness -Throughout the first year of the pandemic, CHCs across Canada on average were able to maintain 76% of their typical volume of primary care services and 71% of their typical scope of primary care services. This commitment to continuity of services when many other primary care providers were closing services or drastically reducing scope and volume was critical to prevent new or worsening illness among vulnerable clients.
South-East Ottawa Community Health Centre (Ottawa, ON)
COVID-19 Tests & Vaccinations for the Homebound & Vulnerable
SEOCHC administered more than 1,800 COVID-19 tests to homebound and vulnerable residents throughout the region, through their Mobile COVID-19 Testing Team. The CHC’s nurses travelled across all corners of the region, including rural areas, offering this service in the home. As vaccine supply became more readily available in March 2021, SEOCHC partnered with other Ottawa CHCs, home care agencies and the local public health unit to provide in home vaccinations for homebound clients and other seniors throughout the region. Each week, 2-3 mobile teams comprised of nurses and community health workers delivered in home vaccinations for a variety of vulnerable and home bound clients throughout the region.
Central Interior Native Health Society
(Prince George, BC)
(Prince George, BC)
Support for Indigeneous Elders
Once the COVID-19 vaccine rollout began, CINHS redeployed their staff to make phone calls to senior and elder clients to have one-on-one culturally sensitive conversations, to understand their feelings around vaccine comfort and safety. The CHC ensured safer spaces for their clients to have these conversations, to express fears and concerns about the vaccine. CINHS, another CVP-National Project participant, also provided judgment free spaces to educate and build trust with clients about the COVID-19 vaccine. CINHS became the lowest barrier COVID-19 testing site and hosted 3 onsite vaccine clinics for their clients and community members of all ages.
Preventing
Future Illness
Programs led by qualified staff help people manage their illness and learn how to keep up their health and wellbeing.
5
- Group Programs - Health promotion and education programs designed to support and empower individuals for better health.
- Systems Navigation - Supports and services to help people stay connected to a wide range of healthcare and social support services key to achieving and maintaining health.
- Timely, Appropriate Services - Making screening, testing, and illness-prevention supports available in diverse lan- guages and other ways that reduce barriers to access and uptake.
REACH Community Health Centre (Vancouver, BC)
"We collaborated with over 40 organizations to engage a diverse cross section of our community to include numerous ages and cultural groups. These partnerships allowed us to come into these organizations' existing programs and groups to provide COVID-19 vaccine information. Our REACH CHC Cross Cultural Health Promoters supported this with materials translation and also gathering feedback from participants. Our outreach team also attended 3 large events, a seniors fair, Santa Breakfast for the community and youth volunteer fair in an effort to reach the broadest population possible."
Access to in-person Primary Care Visits
From March 2020 to March 2021, during the height of the pandemic, 88% of Community Health Centres across Canada were able to accommodate in- person primary care visits "always or almost always" for clients unable to use virtual services or who had very complex care needs.
Jasper Place Wellness Centre (Edmonton, AB)
Support for Indigenous Members of the Community
Jasper Place Wellness Centre reached over 500 vulnerable, Indigenous community members in Edmonton with COVID-19 vaccine information and support, made possible through CACHC’s CVP-National Project, funded by the Public Health Agency of Canada. The CHC’s team enlisted two Indigenous community members, who have survived residential schools and experienced homelessness, to connect and reduce barriers with Indigenous community members.
SWITCH Student-Run Health Centre (Saskatoon, SK)
Connecting Pet Care & COVID-19 Support
SWITCH Student-Run Health Centre hosted a Pet Fair and Pet Care Clinic as a means of incentivizing access to COVID-19 vaccine information and providing vaccination. The CHC partnered with Community Veterinary Outreach in promoting and hosting the events.
Click to visit CACHC's COVID-19 page and learn more.
Click to visit CACHC’s COVID-19 page and learn more.
COVID-19
Pandemic Response:
5 Pillars of CHCs
The COVID-19 pandemic has further exposed deep social and health inequities experienced by many segments of our population across Canada.
Community Health Centres (CHCs) across Canada have risen to meet these challenges head on, remaining open during the earliest days of the COVID-19 pandemic when many doctors’ offices and other services were closing their doors, and continuing to adapt their operations to meet the emerging and evolving needs of local communities as the pandemic has evolved.
The full picture of this multi-faceted response by CHCs comes into clear view across the five core pillars of the CHC model.
COVID-19 Pandemic Response: 5 Pillars of CHCs
Breaking Down
Barriers To Health
Services and programs focused on shelter and housing, employment and income security, healthy foods, and other day-to-day needs to reduce social causes of illness.
1
- Food Security - Preparing, delivering and serving meals/groceries.
- Shelter Support - Collaborating with other agencies to set up additional shelter and COVID-19 isolation spaces.
- Digital Accessibility - Making devices and supports available to individuals facing barriers to virtual services.
- Financial Assistance - Assisting individuals in getting financial assistance through CERB and other programs.
The Alex Community Health Centre (Calgary, AB)
CACHC
Quick Response: Social Dispatch Centre
The Alex CHC, a Community Vaccination Promotion National (CVP-National) Project participant, responded quickly to tackle new barriers and needs presented by COVID-19. Early in the first year of the pandemic, social dispatch centre was established which provided 539 client referrals to emergency benefits, 2,833 counselling and support sessions, and 2,555 check-ins with at-risk youth in the first year of the pandemic.
Curbside Meal Pick-ups for Food Insecure Individuals
The Alex CHC’s Community Food Centre welcomed 876 first-time visitors over this same period as pandemic-related food insecurity grew, providing 1,419 curbside meal pick-ups for food insecure individuals.
North End Community Health Centre (Halifax, NS)
CACHC
"The CHC hosted mobile vaccine clinics, drop-in clinics, and made site visits to increase vaccine education, access and uptake among homeless and street involved residents of the city. The CHC's connection to people experiencing homelessness, and to shelter and rough sleeping communities enabled them to fill major gaps in the local public health agency's vaccine outreach and delivery efforts."
Responding to
Local Needs
People from the community play an active and ongoing role identifying priorities for services, programs, and community action.
2
- COVID-19 Hotlines - Activating telephone hotlines to address COVID-19 concerns in the community.
- Regular Check-ins - Making calls to check in on vulnerable and isolated individuals.
- Community Ambassadors -
Deploying community ambassadors who represent the vulnerable population to inform and support people in their language.
CUPS Calgary and The Alex CHC (Calgary, AB)
CACHC
Medically Supported Accomodations
Two Calgary CHCs and CVP-National Project participants, CUPS and The Alex CHC, cooperated with Alberta Health Services and the Calgary Homeless Foundation on establishment and operation of the city's Assisted Self-Isolation Site (ASIS). Through ASIS, they provided medically supported accommodations for those experiencing homelessness who needed to selfisolate as a result of COVID-19. By late 2021, they had provided warm shelter, hot meals, care and support to more than 1,200 of the city's most vulnerable people.
Black Creek CHC responds
Throughout the pandemic, Black Creek Community Health Centre (Toronto, ON) reduced barriers for African, Black, Caribbean communities, encouraging and supporting vaccine uptake. In late 2021, they described many of the challenges they encountered and successes over the course of the first 18 months of the pandemic.
Carea Community Health Centre (Oshawa, ON)
CACHC
“We mobilized very quickly and hired a team of community ambassadors to reach out to underserved communities in a high priority response manner. Once vaccinations were available, we created community-based & appointment-based pop up walk-in vaccination clinics, because one of the things that we knew is that the appointment-based clinics were a barrier for many individuals.”
Umbrella Multicultural Health Co-Op (New Westminster, BC)
CACHC
Newcomer Vaccine Clinics & Medical Office Assistance
Umbrella Multicultural Health Co-Op, another CVP-National Project participant, hosted accessible, barrier free, and culturally connected on-site vaccine clinics for newcomers to Canada and individuals with precarious status. Their Cross Cultural Health Brokers and medical office assistants provided direct support, in multiple languages, to help clients register in British Columbia’s Get Vaccinated database, book vaccine appointments, get temporary PHN numbers, and provide information about local clinics and times. The CHC’s Mobile Clinic also supported Temporary Farm Workers across the province, providing language and cultural brokerage at vaccine clinics, information sessions, and through various outreach activities.
Championing
Health For All
Measures are taken to ensure that programs and connections in the community reduce social inequities faced by different groups.
3
- Proactive Services - Proactively working with public health and other partners units to inform and create equitable solutions for vulnerable communities and groups.
- Health Equity Focus - Implementing appropriate services, programs and approaches specifically by and for groups within the community that face systemic exclusion, barriers to care, and other social inequities.
Women’s Health in Women’s Hands CHC (Toronto, ON)
CACHC
Accessible Clinics for Different Groups: Vaccination & Primary Care
To further address low uptake of COVID-19 vaccines among African, Black, Caribbean communities, Women’s Health in Women’s Hands CHC partnered with the Black Physicians Association of Ontario to run accessible clinics. Individuals were able to access vaccine information and receive both vaccination and primary care from staff operating from culturally relevant and trauma-informed perspectives.
Regina Community Clinic (Regina, SK)
CACHC
Responsive, flexible services in Regina
Regina Community Clinic (Regina, SK), another CVP-National Project participant, adapted its services throughout the pandemic to provide more flexibility, to move quicker, and to become more responive.
South East Ottawa Community Health Centre (Ottawa, ON)
CACHC
South-East Ottawa CHC partnered in a city-wide COVID-19 community collaborative that brought together several of Ottawa’s Community Health Centres with other community partners to achieve coordination, scale, and increased impact for residents of Ottawa.
“As a collective of 4 different CHCs, we used government funding to strategise our response to the city as a whole. We developed the solutions collaboratively and we rolled that out across the city through a community of practice.”
Providing
Customized Care
People can receive care for a range of issues from a team of diverse healthcare providers, all through one health organization.
4
- Team-based Care - Providing care and support through a team of diverse healthcare and service professionals who work collaboratively to ensure that a person receives the most appropriate type of care and support, from the most appropriate member of the team, at the right time and place.
- Wrap-around Approach - Placing the person at the centre of diverse services and programs in order to address not only primary care needs but particular socio-economic factors affecting their health.
Woolwich Community Health Centre (St. Jacobs, ON)
CACHC
Adapting the Team-Based Care Model to Meet Emerging Needs
At the very outset of the pandemic, Woolwich CHC pivoted to ensure continuity of service, conducting 80% of primary care visits virtually while a technology library and support for clients facing digital inequities were also put in place. A hybrid staff model was adopted throughout the pandemic and a wide range of activities to encourage vaccine uptake across the entire community was rolled out.
Rexdale Community Health Centre (Etobicoke, ON)
CACHC
2SLGBTQ+ Peer-Support at Rexdale CHC
In order to support personal privacy and safety, Rexdale CHC (Toronto, ON) used Discord as a means of communicating with teens in the CHC's 2SLGBTQ+ peer support program who have not disclosed their identities to family, and employed a variety of other strategies to improve accessibility and quality of care.
Continuity of Care to Prevent Future Illness -Throughout the first year of the pandemic, CHCs across Canada on average were able to maintain 76% of their typical volume of primary care services and 71% of their typical scope of primary care services. This commitment to continuity of services when many other primary care providers were closing services or drastically reducing scope and volume was critical to prevent new or worsening illness among vulnerable clients.
South-East Ottawa Community Health Centre (Ottawa, ON)
CACHC
COVID-19 Tests & Vaccinations for the Homebound & Vulnerable
SEOCHC administered more than 1,800 COVID-19 tests to homebound and vulnerable residents throughout the region, through their Mobile COVID-19 Testing Team. The CHC’s nurses travelled across all corners of the region, including rural areas, offering this service in the home. As vaccine supply became more readily available in March 2021, SEOCHC partnered with other Ottawa CHCs, home care agencies and the local public health unit to provide in home vaccinations for homebound clients and other seniors throughout the region. Each week, 2-3 mobile teams comprised of nurses and community health workers delivered in home vaccinations for a variety of vulnerable and home bound clients throughout the region.
Central Interior Native Health Society (Prince George, BC)
CACHC
Support for Indigeneous Elders
Once the COVID-19 vaccine rollout began, CINHS redeployed their staff to make phone calls to senior and elder clients to have one-on-one culturally sensitive conversations, to understand their feelings around vaccine comfort and safety. The CHC ensured safer spaces for their clients to have these conversations, to express fears and concerns about the vaccine. CINHS, another CVP-National Project participant, also provided judgment free spaces to educate and build trust with clients about the COVID-19 vaccine. CINHS became the lowest barrier COVID-19 testing site and hosted 3 onsite vaccine clinics for their clients and community members of all ages.
Preventing
Future Illness
Programs led by qualified staff help people manage their illness and learn how to keep up their health and wellbeing.
5
- Group Programs - Health promotion and education programs designed to support and empower individuals for better health.
- Systems Navigation - Supports and services to help people stay connected to a wide range of healthcare and social support services key to achieving and maintaining health.
- Timely, Appropriate Services - Making screening, testing, and illness-prevention supports available in diverse lan- guages and other ways that reduce barriers to access and uptake.
REACH Community Health Centre (Vancouver, BC)
CACHC
"We collaborated with over 40 organizations to engage a diverse cross section of our community to include numerous ages and cultural groups. These partnerships allowed us to come into these organizations' existing programs and groups to provide COVID-19 vaccine information. Our REACH CHC Cross Cultural Health Promoters supported this with materials translation and also gathering feedback from participants. Our outreach team also attended 3 large events, a seniors fair, Santa Breakfast for the community and youth volunteer fair in an effort to reach the broadest population possible."
Access to in-person Primary Care Visits
From March 2020 to March 2021, during the height of the pandemic, 88% of Community Health Centres across Canada were able to accommodate in- person primary care visits "always or almost always" for clients unable to use virtual services or who had very complex care needs.
Jasper Place Wellness Centre (Edmonton, AB)
CACHC
Support for Indigenous Members of the Community
Jasper Place Wellness Centre reached over 500 vulnerable, Indigenous community members in Edmonton with COVID-19 vaccine information and support, made possible through CACHC’s CVP-National Project, funded by the Public Health Agency of Canada. The CHC’s team enlisted two Indigenous community members, who have survived residential schools and experienced homelessness, to connect and reduce barriers with Indigenous community members.
SWITCH Student-Run Health Centre (Saskatoon, SK)
CACHC
Connecting Pet Care & COVID-19 Support
SWITCH Student-Run Health Centre hosted a Pet Fair and Pet Care Clinic as a means of incentivizing access to COVID-19 vaccine information and providing vaccination. The CHC partnered with Community Veterinary Outreach in promoting and hosting the events.
Click to visit CACHC's COVID-19 page and learn more.
Click to visit CACHC’s COVID-19 page and learn more.
Moving Forward
The pandemic has underscored the need for increased access to Community Health Centres (CHCs) across the country so that people have timely access to integrated primary care and social services, particularly for complex health and social needs.
As we build back from the pandemic, we call on the federal government and all provincial governments to commit to health equity and investment in CHCs so that we “build back better”.
