2016

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TOWARD A MORE EFFECTIVE COLLABORATIVE MODEL

REFLET SALVÉO2

TABLE OF CONTENTS 3 Our mandate, Our values, Our catchment area

4 Our population

6 Message from the Executive Director and Chair

Our team

8 The LHINs and us

Recommendation and follow-up

Our joint success

10 Understanding your needs: community surveys

11 Our methods in practice

12 Community engagement

13 Mental health campaign: taking stock

14 Peer Positive

15 Our impact: training services providers

16 The effects of stress on the human body

17 Our Board of Directors

18 Financial statements

REFLET SALVEO OFFICE202B – Bathurst Street Toronto, Ontario M5R 3H8 Tel: 647.345.5502 Fax: 447.345.5520 TTY: 1.800.855.0511

www.refletsalveo.ca

Find us on @refletsalveo Facebook

Reflet Salvéo is a positive space.

Local Health IntegrationNetworkRéseau local d’intégrationdes services de santé

FUNDED BY

2016-2017 ANNUAL REPORT 3

OUR MANDATEOur mandate is to advise the three LHINs (Local Health Integration Networks) in the Greater Toronto Area on ways to develop equit-able health services for the Francophone community. We identify Francophones’ needs and priorities and make recommendations to these LHINs.

OUR VALUES • Respect for people in all their diversity • Universal right to health • Integrity, Transparency and Accountability

OUR CATCHMENT AREAReflet Salvéo advises the Central-West, Mississauga Halton, and Toronto Central LHINs. Our area is very urban: it includes most of the City of Toronto as well as the municipalities of Mississauga and Brampton. It also has a strong rural component, covering the towns of Oakville, Milton, Halton Hills, and Dufferin County with its small villages.

Our area is home to a considerable number of health care institutions, including primary care facilities such as hospitals, treatment centres, and clinics.

Brampton

Mississauga

Toronto

Oakville

Guelph

Newmarket

Markham

MiltonErin Mills

Caledon

North York

Orangeville

Mono

Halton Hills

REFLET SALVÉO4

OUR POPULATIONMISSISSAUGA HALTONSOURCE: www.mississaugahaltonlhin.on.ca

HIGHLIGHTS

THIS AREA INCLUDES THE CITIES OF MISSISSAUGA, OAKVILLE, HALTON HILLS AND MILTON

A 46%GROWTH IN POPULATION IS EXPECTED BETWEEN2010 & 2030

IMMIGRANTS REPRESENT

43%OF THE POPULATION (VS. 28.5% IN THE REST OF ONTARIO)

VISIBLE MINORITIES REPRESENT

40.7%OF THE POPULATION(VS. 25.9% IN THE REST OF ONTARIO)

BY 2035, THE POPULATION WILL GROW TO

+ 1.8 MILLION

THE MISSISSAUGA HALTON LHIN SERVES

35,372FRANCOPHONES

TORONTO CENTRALSOURCE: Analyse du milieu et orientations futures www.torontocentrallhin.on.ca

HIGHLIGHTS

CLOSE TO

53,375 FRANCOPHONESLIVE IN THIS LHIN

IT IS THE

FATEST GROWINGFRANCOPHONE POPULATION IN ONTARIO

THE FRANCOPHONE POPULATIONIS SPREAD OUTOVER THIS URBAN AREA

NEARLY HALFOF THESE FRANCOPHONES WERE BORN

OUTSIDE CANADAAND 75%WERE BORN OUTSIDE ONTARIO

MANY OF TORONTO’S FRANCOPHONES ARE EXPATRIATES, AND HAVE LIVED IN TORONTO FOR JUST A FEW YEARS

Brampton

Mississauga

Toronto

Oakville

Guelph

Newmarket

Markham

MiltonErin Mills

Caledon

North York

Orangeville

Mono

Halton Hills

2016-2017 ANNUAL REPORT 5

CENTRAL-WESTSOURCE : www.centralwestlhin.on.ca

HIGHLIGHTS

AN AREA THAT IS BOTH URBAN (BRAMPTON) AND VERY RURAL (ORANGEVILLE, CALEDON, ETC.)

MORE THAN

800,000PEOPLE LIVE IN THIS AREA

THE POPULATION ISYOUNGERTHAN IN OTHER REGIONS

50%OF THE POPULATIONSELF-IDENTIFY AS

VISIBLE MINORITY.THIS IS THE HIGHEST PERCENTAGE IN ONTARIO.

47%OF THE POPULATION ARE

IMMIGRANTS

THE NUMBER OF

FRANCOPHONESIS ESTIMATED TO BE

16,135

In general, population is younger and more diverse and its numbers are increasing much faster than in other regions of Ontario.

Central-West LHIN

Mississauga Halton LHIN

Toronto Central LHIN

REFLET SALVÉO6

MESSAGE FROM THE EXECUTIVE DIRECTOR AND CHAIRThis past year went by in a flash, and it was a particularly im-portant year in Reflet Salvéo’s brief history.

Following last year’s general meeting, which saw a largely new slate of directors elected to the board along with a new chair (who took the reins from Marlène Thélusma-Rémy), we threw ourselves into our work with renewed vigour. This report shows the fruit of our labours.

We have the energy to tackle the issues of a changing health system, and we are optimistic these changes will improve the delivery of French language health services. The mandate letter sent by the Ministry of Health to the LHINs (dated May 1, 2017) explicitly mentions Francophones as a priority population and under-lines the importance of providing an active offer for all. These principles were already established in the Patients First ministerial document and Bill 41.

With this in mind, this year we decided to put forward a single recommendation in our Advisory Report: to deepen and improve our collaborative model. Of course, our annual Advisory Report is not our sole form of communication with our LHINs. We work together as partners throughout the year in a number of different ways. For example, this year we formulated a recommendation in support of a service providers’ proposal for a health line.

Reflet Salvéo works to improve French-language health services through effective plan-ning. We stay informed of our community’s needs by listening to your concerns, carrying out studies, and by organizing and participating in community outreach.

This year, we were proud to launch the very first English-language training session on active offer for health-service providers. We are also proud of our ongoing, productive relationship with our LHIN partners. We have worked to reduce wait times for mental health patients, helped implement a care pathway for people living with HIV, continued to promote peer integration, and successfully carried out our campaign to demystify mental health issues. All this was accomplished while ensuring that the community re-mains the focus of our activities at every step.

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2016-2017 ANNUAL REPORT 7

Community engagement is at the heart of our mandate. Without an engaged commun-ity, we would be an entity in the legal sense only. With your support, we have both legislative and community legitimacy.

You have demonstrated your support throughout the year. You helped us grow our mem-bership (313 as of March 31!); you followed us on social media, and signed up for our newsletter. Your support inspires and motivates us to do more and to do better, because ultimately, an engaged community is a healthy community.

Isabelle GirardChair of the Board of Directors

Gilles MarchildonExecutive Director

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OUR TEAM:Reflet Salvéo would like to extend special thanks to Cynthia Kuassi, Josée Roy, and Nancy Razanakoto, members of our team who left us this year, as well as our interns, Marius Simba Mutazihara, Pierre Calixte Alysée, and Daniel Wang, who worked with us throughout this fiscal year.

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THE LHINS AND USOur relationships extend well beyond an annual advisory report. We work together through on-going dialogues.

A REPORT WITH A SINGLE RECOMMENDATION, TO BUILD A MORE EFFECTIVE COLLABORATIVE MODEL EFFICACE

RECOMMENDATION AND FOLLOW-UPThis year, our recommendation is particular. It does not concern implementing or improv-ing services; rather, it addresses the way in which the three LHINs and the Entity work together to improve the delivery of French-language health services and make them more accessible to Francophones living in the GTA.

In a departure from convention, this recommendation is not only addressed to the three LHINs but also to our own organization. It consists of three components:

1. COMMITMENT TO CLOSER COLLABORATION. Staff turnover and the potential disruption of best practices, as well as recent structural changes to the health system, pose challenge that require us to strengthen our working relationship.

2. REMOVAL OF CALENDAR CONSTRAINTS. Up until last year, Reflet Salvéo was required to produce a report every November 30. This date did not take into account our community’s needs, our own work rhythm, or our health services providers’ calendars. Although we will continue to produce a report on November 30, we will issue recommendations throughout the year when appropriate/timely.

3. IMPROVED FOLLOW-UP ON RECOMMENDATIONS. The impact of our recommendations is not always clear to community members. Although we are confident our recommendations are integral to our LHIN’s strategic planning, and while we understand that results are often achieved in several steps over longer periods of time, it would be helpful to draw clearer lines between our recommendations and concrete outcomes.

With these recommendations, we hope to strengthen the relationship between the LHINs and Reflet Salvéo, backed by transparency, close collaboration, and effective communication.

2016-2017 ANNUAL REPORT 9

OUR JOINT SUCCESSAN ADDITIONAL POSITION AT THE CENTRE FRANCOPHONE DE TORONTOReflet Salvéo works with a number of partners as part of a regional committee on mental health services. Our joint efforts have led to the creation of several mental health case manager positions in a number of regions. We worked to create a position at the Centre Francophone de Toronto, funded by the Toronto Central LHIN, to reduce wait times for mental health services.

SENIORS’ HEALTH LINEEarlier this year, Reflet Salvéo recommended the Toronto Central LHIN to fund the French Seniors’ Health Line pilot project, spearheaded by Centres d’Acceuil Héritage (CAH). This project will help further integrate the Francophone lens into the changing health system.

CLOSER COLLABORATIONReflet Salvéo increased the frequency of its work meetings with the three LHINs’ French-language service co-ordinators, despite the latter’s high staff turnover rate.

ACTIVE OFFER PROGRESS AND TRAINING(see pages 14-15)

WHAT ARE LHINS?Local Health Integration Networks are government agencies that plan, integrate, and fund local health services.

REFLET SALVÉO10

UNDERSTANDING YOUR NEEDS:COMMUNITY SURVEYSThis year, Reflet Salvéo used a new survey method to gain a better understanding of Francophones’ needs.

COMMUNITY SURVEYSIDENTIFY COMMUNITIES IN NEEDA need may be raised through a conversation, a community member’s request, a local leader’s suggestion, an exchange with a LHIN, or a study or article on a particular neighbourhood. Once it is brought to our attention, we identify the community in need.

COLLABORATE WITH COMMUNITY-BASED ORGANIZATIONSWe seek out an organization with roots in the community to help us as-sess needs, while ensuring this organization has the volunteer capacity to conduct a survey.

COLLECT DATAWe assist this organization in collecting data, offering our support when required. Data are collected online, in person, or by phone. We work with the community organization to determine a relevant sample population.

ANALYZE THE RESULTSWe analyze the survey results in collaboration with the organization to define the most pressing needs and to set priorities. We then propose solutions to respond to these needs.

WORK WITH SUPPLIERS, LHINS, AND THE COMMUNITYBefore publishing results, we work with the local LHIN and members of the com-munity to identify a health services provider that can help find a solution. We then work with this health services provider (with community input) and the LHIN to de-velop adequate health services.

2016-2017 ANNUAL REPORT 11

OUR METHODS IN PRACTICETHE REXDALE EXAMPLEAt the start of 2015, members of the community contacted us regarding a lack of French-language services in Rexdale. We then contacted the Auberge Francophone, an organization with deep roots in Etobicoke North.

We engaged the Auberge to conduct a community survey, providing it with the neces-sary resources.

With our support, the Auberge hired a consultant and collected data.

We then analyzed these data in collaboration with the Central-West LHIN. The survey results showed a pressing need for primary care services and revealed the percep-tion among respondents of a moderate to heavy decline in the health condition of Francophones.

SIGNAL FROM

THE COMMUNITY

FINANCIAL AND

TECHNICAL

SUPPORT,

HIRING OF

A CONSULTANT

COLLECTION

OF DATA

ANALYSIS WITH

PARTNERS

PRESENTATION

OF RESULTS

TO LHINS

PUBLICATION

AND SEARCH

FOR SOLUTIONS

WITH HEALTH

SERVICE

PROVIDERS,

LHINS, AND

THE COMMUNITY

SOLUTION!

IMPROVED

FRENCH-

LANGUAGE

SERVICES!

WELL-DEFINED

NEEDS

CALLING UPON A

WELL-ESTABLISHED

ORGANIZATION

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COMMUNITY ENGAGEMENTReflet Salvéo serves as the link between the Francophone com-munities in our three LHINs and the health care system. Our health planning is influenced directly by community input.

We inform, consult, engage, and empower our Francophone community as we work to develop health services.

• 213 new members since last year!INFORMWe inform the public in person or via email of changes to the health system and educate it about new and evolving services in local areas. • 12 newsletters • 7 press released • Monthly meetings with Francophones in Oakville, Brampton,

Orangeville, Etobicoke, etc. • Extensive media coverage • 573 Twitter followers • 316 Facebook likes, 535 Facebook friends

CONSULT • 1 in-depth study on the needs of

Rexdale Francophones • 11 survey on Francophones in

Moss Park/Regent Park (results to be issued in next year’s annual report)

• 1 survey of Francophones living with HIV • 1 consultation with agencies offering services

to people living with HIV • 13 community tables to solicit feedback in schools,

festivals, community centres, and health forums

ENGAGE • $6,000 provided to PoM – A World of Cultures through

the “Ma communauté s’engage” call for projects, to promote French-language services for young people in Mississauga and Brampton

2016-2017 ANNUAL REPORT 13

• 8 sponsored events • An increase in the number of Francophones on the boards of directors of decision-

making bodies • Participation of Francophones during Mount Sinai Hospital’s consultations on the

experience of black patients

EMPOWERServices to promote more accessible services, we invited the community to take part in:

• 2 educational sessions on mental health primary care • 1 educational session on governance • 1 educational session on resilience in the face of losses related to HIV

We also supported a feasibility study for Peel-Halton seniors, funded by the Ontario Trillium Foundation, to help our community partners gain independence in implementing adapted services.

MEMNTAL HEALTH CAMPAIGN:

TAKING STOCK • Campaign period: February 2016 to March 2017 • Distribution area: our three LHINs + Scarborough • More than 30 community meetings (organizations, groups, businesses) • Over 400 workshop participants • Number of tools distributed: 3,000 booklets and 3,000 paper ‘’cootie catchers’’ • Dozens of productive exchanges on mental health, particularly as it relates to

immigrants, which inform our planning work. • Assessment (based on an evaluation survey):

– 90% of respondents found our tools easy to use – 98% of respondents found the tools to be effective in promoting

mental wellness

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PEER POSITIVEADAPTING THE PROJECT FOR THE FRANCOPHONE COMMUNITY.

The Peer Positive project, led by CAMH and various community organizations, seeks to promote lived experience as a form of expertise, empower service users and engage them at all levels in the planning, delivery, and evaluation of services.

We are now developing the Francophone version of this program in partnership with CAMH.

• Reflet Salvéo has created a half-time position dedicated to this project, currently staffed by Thomas Labrune.

• 14 consultations have been carried out with Francophone peers and organizations. • A joint planning committee (made up of community members and organizations) is

overseeing this project’s development. • Africans in Partnership Against AIDS (APAA) has been chosen as the pilot

organization for this initiative.

In the fall of 2017, a peer-led support group will be created and trained, according to a capacity-building holistic approach. Participants will acquire the necessary skills and confidence to lead their own support groups in the future.

2016-2017 ANNUAL REPORT 15

The active offer of French-language health services is the regular and permanent of-fer of high-quality, culturally appropriate, and equitable services to the Francophone population.

Program participants included managers and decision-makers who have the abil-ity to influence the practices of various health service providers through the hiring of Francophone and bilingual staff and the implementation of innovative strategies and policies.

Studies have shown that Francophones (and others) enjoy better health when they are cared for in their own language.

Courses took place at Collège Boréal and the participants all expressed their satisfaction with the program. Reflet Salvéo will provide follow-up support to ensure that active offer becomes a reality.

WHAT IS IT? Training on active offer, in two cohorts, with three training sessions eachWHO IS IT FOR? Anglophone or bilingual health service providersWHEN WAS IT? February and March 2017

Launch of the training program at the Collège Boréal in February 2017, attended by the Minister Responsible for Francophone Affairs, the Honourable Marie-France Lalonde.

OUR IMPACT:EDUCATING HEALTH SERVICE PROVIDERS

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THE EFFECTS OF STRESS ON THE HUMAN BODYBY SOAFY RAMAMONJISOA

Chronic stress has a negative impact on both physical and mental health.

Stress triggers a chemical chain reaction in the body, a primitive “fight-or-flight” response. At one point, this reaction helped protect us from predators and other dangers.

When we perceive danger, our brain sets off an alarm, releasing hormones such as adrenaline and cortisol. Adrenaline increases our heart rate and raises our blood pressure, while cortisol increas-es blood sugar levels. Cortisol also affects bodily functions that are not necessary in a fight-or-flight scenario, including the digestive and reproductive systems. Prolonged exposure to stress can therefore result in serious physical consequences, a phenomenon known as “chronic stress.”

The nervous system serves as the control centre for other systems in our body. Stress induces muscle tension, which only diminishes once the stress is removed. More and more people now suffer from chronic muscle tension caused by ongoing, persistent stress. Muscular tension further exacerbates stress-related issues, and a vicious circle is created.

Chronic stress can also have long-term effects on our reproductive systems. In men, stress can affect testosterone and sperm production, while women’s periods can become irregular or disappear altogether.

However, it is possible to reduce stress and promote better health. The first step is to identify the source of stress, whether that be work, school, a personal relationship, or another issue. Second, it is important to find a solution that can gradually ease these problems. A number of resources are available to help you manage stress, including local community mental health services. It is always a good idea to find someone to talk to, no matter who that person is, as long as they are willing to help you with your problems.

To elevate your mood, take time each day to exercise, meditate, take care of your physical health, or engage in an activity you are passionate about.

Stress is pretty much unavoidable and can often be difficult to manage. But we all should take steps to manage stress to avoid the negative physical and emotional consequences.

2016-2017 ANNUAL REPORT 17

OUR BOARD OF DIRECTORS Isabelle GirardChair of the Board of Directors

Lise Marie BaudryRepresentative of the Centre Francophone de Toronto and Vice-Chair

Sylvie LavoieTreasurer

Patrick PadjaCSSPH representative

Pascale AndriamamonjySecretary

Nicholas NgCommunity member

Solange BelluzCommunity member

Dave ChampagneCommunity member

Joyce IrvineRepresentative of Centres d’Accueil Héritage

Marc LavigneYouth representative, non-elected

STRUCTURE OF OUR BODReflet Salvéo’s board of directors is made up of nine members. Three seats are reserved for representatives from organizations that provide French-language services: Centres d’Accueil Héritage, Centre Francophone, and the CSSPH (Centres des Services en Santé de Peel Halton).

In addition to these three organizations, we endeavour to include other relevant stakeholders.

We also reserve at least three seats for community members, service users, and repre-sentatives from Francophone ethno-cultural groups.

We make an effort to recruit members who are representative of the cultural and geo-graphic diversity of our catchment area, as well as representatives from vulnerable popu-lations such as newcomers, visible minorities, LGBTQIA, women, seniors, and young people.

THANK YOU TO OUR VOLUNTEERSReflet Salvéo would like to thank our incredible team of volunteers, who allow us to effectively carry out our activities.

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FINANCIAL STATEMENTSTATEMENT OF OPERATIONS AND CHANGES IN NET ASSETS FOR THE FISCAL YEAR ENDING MARCH 31, 2017

2017 2016

REVENUELHIN fundingOperations (Appendix A) $568,713 $568,713

– Special projects (Appendix B) 36,542 4,752 Other funding

– Ontario Trillium Foundation 21,800 — – Centre for Addiction and Mental Health 21,662 — – Assemblée de la francophonie de l’Ontario 20,000 — – Young Canada Works 4,198 2,540

French Health Network of Central Southwestern Ontario 2,080 — Amortization of deferred contributions related to capital assets 2,080 4,514

676,245 589,519

COSTSWages and benefits 451,215 359,081 Professional fees 53,575 72,352 Special projects 36,544 18,156 Office expenses 34,433 18,156Rent 33,092 32,014 Telecommunications 20,961 17,490 Community engagement 16,787 24,730 Advertising and publicity 10,413 23,610 Computer maintenance 7,234 7,297 Costs of meetings and sector support 2,892 6,447 Travel costs 2,466 3,648 Insurance 2,244 2,360 Associations and subscriptions 715 698 Special projects — reimbursement of allowances — 8,967 Interest and service fees 1,594 1,457 Amortization of capital assets 2,080 4,514

676,245 587,573

DEFICIENCY OF REVENUE OVER EXPENSES — (7,054)

NET ASSETS, BEGINNING OF PERIOD 1,913 8,967

NET ASSETS, END OF PERIOD $1,913 1,913 $

ON BEHALF OF THE BOARD OF DIRECTORS

, director , director