Looking to develop or expand a Community Health Centre?
This blog serves as a guide for groups wondering how they can develop a Community Health Centre (CHC) for their community in BC. It is intended for groups that would like to open a new CHC or expand a current CHC that is not already part of a Primary Care Network.
CHCs have been around BC for over 50 years, but recently interest in the model has grown as people have learned the value of integrating team-based primary health care with support for the social determinants of health (SDOH) in a community based, culturally safe setting. In response to this growing demand, the Ministry of Health, in partnership with the BC Association of CHCs (BCACHC) has developed a “Roadmap to a CHC”. This guide is based on current processes and will likely evolve over time as BC undergoes the most significant primary care renewal in decades.
CHCs Eligible for Support
The Ministry of Health has developed a comprehensive policy describing the attributes of a CHC and how CHCs fit in the primary health care landscape. The policy was developed in collaboration with BCACHC as well as diverse community and government representatives, and reflects the commonly accepted definition of what it means to be a CHC in BC. It is important to familiarize yourself with the policy to ensure that your proposed CHC is aligned with the policy.
Community Health Centres and Primary Care Networks
CHCs are community governed entities that integrate primary health and social services. According to the Ministry of Health, CHCs, like all primary care resources, are to be integrated with other primary care and community resources as part of the Primary Care Networks (PCNs).
PCNs are population and geographically based entities meant to link primary care services together to provide coordination and integration of primary care at the community level. PCNs are led by the local Division of Family Practice (DOFP) and the Health Authority (HA) who work together in what are termed Collaborative Service Committees (CSCs). PCN planning should involve not only the CSC, but also diverse indigenous, community and patient representatives.
These groups come together to develop a service plan for their PCN which includes services to address gaps in attachment and related primary care programs for their community. The PCN service plan includes a request for human resources (doctors, nurses, nurse practitioners, physiotherapists, pharmacists and so forth) to increase access to primary care as well as a plan for coordinating services within the PCN.
The amount of resources available to a PCN is based on how many people in that area are unattached (do not have a primary care provider) as well as other factors that reflect the needs of the community. A CHC is included as part of the PCN service plan to meet the overall needs of the PCN community and resources for the CHC come from the pool of PCN resources.
We're here to help!
Reach out to BCACHC at any point in your journey for support with taking the next step. We aim to support and advance the CHC model and engage, advocate for, and support CHCs as an integral part of health and social services in BC communities. Our team is here to help.
Step 1: Develop Governance
CHCs are community governed entities, meaning they are governed by an elected board of directors from the community and who operate under the Societies Act. CHCs are not owned by the providers or the HAs. There are not strict criteria for determining who makes up a board, but it should be inclusive and representative of the community the CHC intends to serve – which can include CHC patients. CHCs can be not-for-profit societies or co-ops. In order to receive government support, the CHC must be registered as a Society.
Step 2: Develop the Model
Before approaching the PCN, it is critical to develop a comprehensive understanding of what your CHC will look like and what gaps in care it is meant to address. While you are not required to develop a full proposal at this point, it is important that you have a fulsome understanding of your CHC that will inform the full proposal. Some questions below can help guide your thinking:
Why do you need a CHC in your community? Is there a need and can you demonstrate that need with evidence? Why is the CHC the best model to do this?
What gaps will it address? Are you replicating other services?
Who will your CHC serve? What are the populations, based on local data, that would benefit from your services?
How will the CHC offer its services? How will programs be structured and roughly how many team members do you need?
How much will it cost to open, to operate?
When you can get your CHC up and running?
Where will your CHC be located? Do you have a location? Is it cost effective?
Once you have answered these questions, produce an executive summary that you can share with others to give an overview of your proposed CHC. This document should only be a few pages long but should give a good sense of what you are proposing in a format that can be shared with stakeholders and community.
Step 3: Approach the PCN
PCNs development only began a few years ago and consequently, the implementation of PCNs varies across the province. Some PCNs have been planned and implemented, some are in the process of planning, and other communities will plan their PCN in the future. Regardless of the stage of PCN planning and implantation in your area, any discussions around either the development of a new CHC or expansion of a current CHC, need to begin at the community level with the DOFP and the HA. The particular individuals to contact vary across the province but in general, you should reach out to the Executive Director of the local DOFP and the HA Director for Primary Care in your region. These first conversations will be focused on learning what stage PCN planning is at in your area, and how a CHC could fit into the PCN.
Step 4: Develop Full Proposal
If it is determined that a CHC (either new or expanded) is a fit for the local PCN, the group that wants to develop the CHC will be invited to submit a full proposal for their CHC. The full proposal is a detailed description of your model including a needs assessment, community consultations, program descriptions, capital requirements, budgets, and timelines for implementation. The PCN planning group works with you to refine the proposal to make sure it fits with the PCN service plan and then submits it to the Ministry of Health for approval. In order for the CHC proposal to be submitted, it must first be approved and endorsed by the local CSC/PCN planning committee.
Step 5: Approval
The Ministry of Health may request some revisions to the proposal and subsequently the proposal will likely be approved. You will receive a formal letter from the Ministry of Health indicating what resources have been approved and requirements for reporting, administration and so forth.
Step 6: Implementation
At this point, responsibility for the CHC implementation moves to the HA who will support you to get your CHC up and running. The CHC will become part of the PCN and CHC services will be offered in coordination with other members of your local PCN.
This process can be overwhelming but you're not in this alone.
Let us know if you have any questions.