Community Health Centres

BC Rural Health Network

Position Paper

COMMUNITY HEALTH CENTRES

February 9, 2021

Definitions
A Community Health Centre shall adhere to the following five criteria as laid out by the BC Association of Community Health Centres, which operates as a provincial chapter of the Canadian Association of Community Health Centres:   
1). Provides inter-professional primary care
2). Integrates services/programs in primary care, health promoti and community
wellbeing
3). Is community-governed and community-centred
4). Actively addresses the social determinants of health
5). Demonstrates commitment to health equity and social justice

These five criteria should be applied to everyone providing primary care since failure to meet the five criteria means that the healthcare within a community will potentially fall short of meeting community health needs.

Background and Moving Forward

The BCRHN has come to the conclusion that currently there are four different models in BC addressing the shortage of primary healthcare services:
1. Primary Care Networks (PCNs)
2. Urgent and Primary Care Centres (UPCCs)
3. Community Health Centres (CHCs)
4. Patient Medical Homes (PMHs) (physician and nurse practitioner offices)

The BC Ministry of Health (MoH) has been promoting each of these models as it works to meet the primary healthcare crisis in BC.  BCRHN recognizes that all four approaches will be used. PCNs are created to bring together all primary health care groups in a geographic area.  As the social determinants of health are critical to the wellbeing of any community, organizations working in specific social determinant arenas should be a part of these collaborative efforts.

The MoH has designed and opened UPCCs primarily in urban and suburban settings.  This paper advocates for the MoH to create CHCs in British Columbia rural communities. 

Each PCN should include all existing CHCs and CHC formation committees in community collaboration. PCNs that have no CHCs in their area should give priority to providing organizational and financial support for communities that have expressed an interest in establishing one.

Community members should be included as equal decision makers from the planning stages of a PCN. If a Division of Family Practice has already set up a PCN without significant community membership, action should immediately be taken to include community members as collaborative partners in present and future decisions.

In the case where there is a primary healthcare centre operated by a Health Authority, if a community group wishes to adopt the governing responsibility, the Health Authority should work collaboratively to make the transition. During the transition the Community Board would be advisory to the Health Authority health centre.

CHC Needs – Political Advocacy Campaigns

The BCRHN promotes the following campaigns in support of recognized CHC needs:

1. MoH funding for more than one CHC per Health Authority per year. The BCRHN joins the BCACHC in asking for funds for least three CHCs per Health Authority each year from 2021 to 2025. A focus on rural primary care needs will be part of the siting criteria, meaning one or more of the CHCs per Health Authority should be in rural communities .

2. CHCs need a broader definition explicitly including the social determinants of health (i.e. poverty, housing, food security, access to care, etc.) in order to do the upstream (and cost-saving) work of wellness promotion and preventive healthcare. This requires a multi-Ministry approach.

3. New funding models, to include planning support, development and implementation of new CHCs, as well as improving established CHCs.

Position:  

The following outlines the BCRHN position on Community Health Centres:

1. Government funding for organizational and financial support shall be made available for rural BC communities that would like to establish a Community Health Centre (CHC).

2. Every BC Primary Care Network (PCN) shall include each Community Health Centre and Community Health Society/Group in that PCN.

3. In rural communities where Urgent and Primary Care Centres presently exist, consideration shall be given to replace them with a CHC. If they cannot be replaced, effort should be made to incorporate as many of the five domains of a CHC as possible.

4. Every Primary Care Network shall include significant representation from community health societies and groups with assurances that the community is meaningfully engaged in the PCN planning process.

Note: The BCRHN recognizes that there is potential conflict in areas where UPCC and CHC jurisdictions overlap. Any issues or concerns that arise in this regard will be addressed as they unfold.