Proposed Model for
Integrated Community Health Hubs
June 2015
INTRODUCTION
The desire for a “one-stop-shop” has been clearly articulated and voiced by the residents of Mississauga
Halton LHIN, and therefore was identified as a key goal within our 2013-2016 Integrated Health Service
Plan. The concept of an Integrated Community Health Hub however is not new. In fact, there are
various models that exist throughout the province of Ontario, as well as other jurisdictions. A number of
these “hub” models have been established by the United Way, to meet the social service needs in areas
of vulnerability or marginalized communities.
Our efforts to establish Integrated Community Health Hubs within Mississauga Halton is timely, as this
model of care delivery was clearly articulated by Premiere Kathleen Wynne in her 2014 – 2015 mandate
letters to her Ministers. In particular, a focus on Community Hubs was emphasized in the mandate
letters to the Ministers of Health and Long-Term Care, Education, Community and Social Services,
Seniors, Associate Minister of Health and Long-Term Care, and Municipal Affairs and Housing. Further,
the proposed Mississauga Halton LHIN Integrated Community Health Hub model particularly aligns well
with the Minister of Health’s key goals (as articulated in the Mandate Letter):
1. People receiving care at the right time and the right place
2. An accountable, transparent system, and;
3. The promotion of healthier lifestyles
Providing high-quality, accessible and efficient community services is part of the government's plan for
Ontario. As such, in April 2015 Premier Kathleen Wynne announced the establishment of the Premiere’s
Community Hub Framework Advisory Group, stating "Community hubs are an important part of our
efforts to make public services more accessible and efficient for the people of our province…foster social
cohesion and make communities more liveable."
Ontario’s Comprehensive Mental Health Strategy also recommended creating community hubs for
services and activities, by incorporating mental health and addictions supports throughout the
communities in which people live, in locations that can be easily accessed - particularly disadvantaged
neighbourhoods. Ontario’s Poverty Reduction Strategy, 2013 Annual Report also highlighted the hub
model as a way of moving towards an integrated child and family services system that provide clear
access points to services for local children and families.
As the Mississauga Halton LHIN embarked on developing a proposed model for Integrated Community
Health Hubs within the LHIN, we wanted to ensure we kept to our commitment to focus on health
equity. Therefore, it was imperative that the social determinants of health were incorporated into the
model such that services addressed the needs of individuals from a holistic perspective, along with a
wellness perspective. In developing our model, we partnered with the United Way of Peel to explore
the establishment of models that put “People First”, and foster establishing an inter-generational
community centre that minimizes stigma, creates a supportive network, and becomes a place that
people want to go to – for any number of reasons.
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WHAT IS A MISSISSAUGA HALTON INTEGRATED COMMUNITY HEALTH HUB?
A Mississauga Halton Integrated Community Health Hub (referred to as “Community Hubs” for the
balance of this paper) is an inter-generational centre that integrates health and wellness (recreational
facilities), health needs (primary care, seniors services, addictions and mental health, allied health
services, clinics) and social services (employment, youth, settlement services), to meet the local needs of
the community that it serves. A true “hub” or centre for the community to congregate, the inclusion of
a continuum of services enables patients, their families and the community at large to access services in
one convenient location, maximizing access to information and services. It also decreases stigma
associated with going to a specific place for a type of service (i.e. mental health) and most importantly,
fosters and builds a positive sense of community.
The following list reflects the types of services that could be considered within a Community Hub:
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Primary Care Team (including physicians, nurse practitioners, dieticians, physiotherapy, social
work services)
Lab & Diagnostic Imaging Services
Pharmacy services
Seniors Services
 Adult Day Programs
 Bathing Programs
 Specialized Dementia Programs
 Falls Prevention Programs
 Medication Management
 Socialization/Recreation Programs (including education workshops)
 Seniors Community Outreach Services/Seniors Information Centre
Chronic Disease Prevention & Promotion Programs
 Diabetic Education
 Foot Care Clinics
 Wound Care Clinics
 Healthy Eating Workshops & Kitchen
Social Services
 Employment Services
 Settlement Services
 Food Bank/Food Security
 Parenting Supports
 Housing Supports
Addictions & Mental Health Services
 Counseling, Treatment & Drop-in Services
 Peer Support Groups
 Crisis intervention services
Youth Programming
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 Youth Counseling & Employment supports
 Mentoring Programs
Recreation
 Wellness programs for all ages
 Therapeutic Pool programs
 Arts programs
Police Services
 Community Programs & Education
Childcare services
 Day-Care
 Early Years Centre/Programs
In support of establishing an “integrated” community hub, services would be supported by shared front
and back office operations. A common reception and way-finding would welcome consumers/visitors,
supporting a person-centred, friendly experience, guiding people to their desired services. A warm
hand-over between services would be facilitated and all partners would be aware of other
programs/services available within the community hub (or beyond) to ensure individuals in need get
access to the services that they require.
The size of the facility would vary, dependent on the needs of the local area and land, infrastructure
availability and costs.
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KEY PRINCIPLES FOR DEVELOPMENT
Integration of Services (not simply co-location) – while respecting individual’s privacy, services would be
connected to support the community and become a centre where partners are aware of what they offer
the individuals entering the facility, creating a warm and inviting atmosphere
A Partnership Model – services/programs developed with partners: health, social services, municipal
and regional services, newcomers (i.e. Region, Town/City recreation services etc., United Way, YMCA,
Health Service Providers, etc.).
Unique to the Needs of the Local Community – the service model for each hub would vary depending
on the needs and demographic profile of the community in which it is situated. That is, services would
be reflective of the characteristics of the community, the specific needs of its residents in relation to
existing gaps in health and social services for that neighbourhood.
Situated in Areas of Vulnerability – community hubs will be developed in areas that have been
identified as “hot spots” – neighbourhoods with marginalized communities
Flexibility – recognizing that communities do change, and people are transient, the flexibility of space
and services is paramount, such that the Community Hub can accommodate the varying needs that may
occur within its community over time, and ensure it remains responsive to these changing needs. The
ability to utilize community space for flexible purposes also supports a range of programming and the
introduction of new and innovative programs as they are developed.
Leveraging Technology – capacity to utilize telemedicine to increase access, build capacity and support
education is key
Collective Impact – looking at alignment of focus for various stakeholder partners supports a joint
concerted effort (as well as funding) towards common areas of focus
Health Equity – application of the Health Equity Impact Assessment tool (HEIA) in planning
Culturally Competent And Responsive Service Delivery Model – the delivery of services within the
Community Hub must be respectful of and sensitive to the cultures of the community that it serves
An Engaged Community – developing a community hub that meets the needs of local residents requires
that the community be engaged in its development. This also allows the community to provide input
into informal programs that support the unique social, cultural and artistic elements that can strengthen
community life
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MISSISSAUGA HALTON LHIN COMMUNITY HUB DEVELOPMENT APPROACH
The ability to establish Community Hubs across the geography of the Mississauga Halton region will be
challenged on a number of fronts, largely the availability of land, infrastructure (building capital – new or
redevelopment) and service capacity (funding to support enhanced programs and services). That said,
while a number of factors may expedite exploration of a Community Hub within a specific
neighbourhood (as noted below: Potential Community Hub Locations), a thoughtful approach to
planning allows us to identify key neighbourhoods to focus on.
Key elements that will be considered in the development approach include:
A. Site Location – locally situated in areas of high need
B. Capital Infrastructure – ability to re-purpose existing infrastructure (efficient use of public
assets) or partner with key stakeholders to share multi-use space or lease at affordable rates
C. Model for Programs and Services – will be designed based on the needs of the local community,
present and into the future, and leverage existing community programs
D. Community Engagement – input from the local community and key stakeholders to shape the
planning and development of the Community Hub
E. Cost – to support capital and service enhancements/programming
F. Development & Implementation Plan – key stages to move from conception to implementation
A. Mississauga Halton LHIN Potential Site Locations
Community Neighbourhood Profiles were developed for our region, whereby a variety of data sources
were reviewed and cross-referenced to establish common areas of concern between various sectors.
That is, looking at the social determinants of health, areas of concern (high incidence of usage) identified
by the United Way (Peel), Multi-Cultural Councils, City planners, Regional planners, key health service
provider informants, police, food banks, social services (poverty index), Strengthening Neighbourhoods
Mississauga, Community Development Halton and newcomer groups were then overlaid to identify key
neighbourhoods in which a Community Hub may best serve the local residents. As we progress, health
(usage, service availability and epidemiological data) will be overlaid to allow for a comprehensive
picture of the health needs and service gaps in a specific neighbourhood. This methodology then allows
us to identify key health and social services to expand or establish in each respective Community Hub.
Through our collective research, “hot spot” areas are being identified, noted within the various Health
Link geographies.
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At this time, further work is being conducted in Peel (with United Way Peel, the Region of Peel, City of
Mississauga, Peel Newcomers Strategy, Peel Police and Peel Board of Education ) and Halton (Town of
Oakville, Halton Regional Police and Halton Newcomers Strategy) to further refine the neighbourhoods
identified as potential high risk and support a collective approach between sectors to address the needs
of residents from a holistic perspective.
B. Capital Infrastructure
Premiere Wynne identified within her mandate letters to her Ministers that they must utilize public
assets efficiently and build stronger ties among community. At a local level, working in partnership with
key town, city, regional, education and government officials enables us to look at our local assets and
the potential of repurposing or redesigning existing infrastructure for more effective use to meet
community needs. Working in partnership alongside the community, the ability to share multi-use
space or lease at affordable rates presents an efficient model of resource use. Ministry support and
that of local government will need to be in place to support this model.
C. Model for Programs and Services
The types of programs and services within each Community Hub will vary depending on the location of
the Community Hub. The model will support a 0-99 age spectrum, incorporating services for all ages
from childhood to the older adult, with flexible and shared space that supports health and wellness,
treatment and supports/ongoing maintenance. This includes (but is not limited to) recreational facilities
(gym space, pool), kitchen (healthy cooking tips/educational sessions), primary care (physicians,
physiotherapy, social work, dietician), child and seniors services (day care, treatment), mental health
and addictions, social services.
Effective development of Community Hubs must draw on programs and services currently established in
local communities and neighbourhoods. This will provide the opportunity to co-locate and integrate
well established providers and their existing client base. Select services addressing the needs of specific
ethnic communities reflective of the diverse population in the LHIN, including the Francophone and
Aboriginal communities will also be considered.
D. Community Engagement
Input from the local community will be imperative in the planning process and development of the
Community Hub; if the facility is to be designed to meet the needs of the local community, then local
stakeholders must be involved in providing input. Stakeholder input from key partners such as Primary
Care, community and social services and other key stakeholders who may wish to provide services
within the Community Hub should also be involved in the planning and development process.
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E. Cost
From a health perspective, costs will be based on the Ministry’s support, along with that of other key
stakeholders for capital needs (new or redevelopment); expansion of programs and services is also
dependent on community funding enhancements through the Ministry. Other services located within
the hub will be dependent on funding from other Ministries as well as availability from the various
stakeholder partners and community fundraising.
F. Development & Implementation Plan
The City of Ryde, Australia (www.ryde.nsw.gov.au/communityhubs) has identified 7 key stages in the
development of a Community Hub that will need to be considered and progressed through:
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Identifying Needs and Planning
Building Relationships
Establishing Commonality
Progressing Coordination
Creating Collaboration
Transforming into a Hub
ANTICIPATED OUTCOMES FOR COMMUNITY HUBS
The Community Hub model offers a large number of benefits to the local community. Collectively, it will
be important to establish some measures that help establish if indeed the Community Hub has an
impact on population health. It is anticipated however that the model of integrated community services
for the local community will result in:
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Improved communication and coordination of care
Effective early identification and intervention
Fewer repeat emergency department visits and unplanned hospital readmissions
Shorter wait times for community and hospital based services
Lower prevalence of mental health and addictions problems
Lower per person cost for mental health and addictions services
Fewer attempted and completed suicides
Increased community supports for people with lived experience (enhanced peer networks);
building community to support community
Decreased stigma and discrimination in communities and workplaces
Improved graduation rates from high school
Reduced violence and crime rate
Improved supports and access to supports for racialized populations
Better overall health outcomes and better quality of life for people and their families
Improved patient experience with the health care system
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NEXT STEPS
The Mississauga Halton LHIN proposed model for Integrated Community Health Hubs aligns directly with
the LHIN’s vision of a seamless health system for our community – promoting optimal health and
delivering high quality care when are where needed. As such, we are following the basis of our
Integrated Health Service Plan, and “Partnering for a Healthier Tomorrow”. We look forward to working
with our partners to collectively meet the health needs of the residents that we serve.
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APPENDIX A: SAMPLE REVIEW OF COMMUNITY HUB MODELS
www.langs.org
1145 Concession Road,
Cambridge, ON, N3H 4L5
Phone: (519) 653-1470
Fax: (519) 653-1285
Email: info@langs.org
HISTORY OF THE ORGANIZATION
Langs (formerly Langs Farm Village Association) was established as a community development project in
1978 by a group of citizens and service providers concerned about vandalism and the lack of accessible
services in the community. These individuals believed that the establishment of a community-based
organization would play a positive and preventative role in the neighbourhood.
Langs is a neighbourhood based organization, but has become so much more! Langs has grown to
become a dynamic, respected community development organization providing comprehensive
health and social support services that are responsive to the changing needs of our region.
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WHO WE SERVE
The Langs Community Health Centre provides service to the residents of the Preston community of
Cambridge (21,000 people) Ontario Community Health Centres are funded to serve priority populations
who experience barriers to access, and priority populations such as seniors, youth and individuals with
mental health challenges. Langs also provides outreach services to the homeless population, to local
shelters for youth, clients of the Association of Community Living.
OUR FACILITY
Langs built and moved into a 58,000 sq ft facility on Concession Rd in Cambridge, ON in 2011. The
building is complete with a living wall, gymnasium, indoor walking track, multiple group/meeting rooms
and 2 types of green roofs. It’s beautiful and spacious Grand Atrium/Green Lounge features floor to
ceiling windows with a view of our private outdoor courtyard.
COMMUNITY PARTNERS AT LANGS
Langs has a proven track record of being a community hub model. The organization is co-located with
20+ community partners to provide social, health, recreational, educational and vocational services on
site. Locating all these services under one roof ensures that residents have access to a wide spectrum of
programs and services in their local community.
http://www.langs.org/wp-content/uploads/2012/12/A-Quick-Guide-to-Langs-Partners-Dec-31-2014.pdf
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TORONTO DORSET PARK COMMUNITY HUB
http://www.dorsetpark.com/dorset-park-community-hub/
The Dorset Park Community Hub is a one stop shop where community members of Dorset Park can
access essential services and programs, as well as community space. The Hub is a key element in United
Way Toronto’s Building Strong Neighbourhoods Strategy — an initiative that creates accessible
community space and brings together community health and social services in priority neighbourhoods
across Toronto.
Established in 2008, consultation with the community helped to identify community partners that
aligned with community need as well as space design. The total space of this Community Hub is
approximately 10,000 square feet and houses a variety of programs and services. These include, but are
not limited to, a food bank, youth services, senior’s services, child and family services and programming,
a Newcomer Centre, Early Years supports and resources for parents, employment services, a low vision
clinic, community mental health supports for youth and families and a computer lab accessible to the
public.
The Community Hub houses many partners including the lead agency Agincourt Community Services
Association, CNIB, ACCES Employment, VHA Home Health Care, Youth L.E.A.P.S, John Howard Society of
Toronto, Family Association for Mental Health Everywhere (FAME), Tropicana Community Services, Extra
Mile Ministries, as well as Action for Neighbourhood Change.
The partners have a number of shared processes. These include a centralized data base, shared intake
process, mutual referrals between agencies, hand off approach amongst staff from all partner agencies,
collaborative efforts at data collection for United Way reporting, and collaborative efforts to fundraise
(grant proposals, joint efforts).
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