Health Profile – City of Thunder Bay Integrated District Network May 2012 North West LHIN RLISS du Nord-Ouest Health Profile for City of Thunder Bay Integrated District Network (IDN) Introduction This profile is one of a series of five profiles for each of the proposed Integrated District Networks (IDN)s. Three of the five IDN areas correspond to three of four current sub-LHIN planning areas – Rainy River District, City of Thunder Bay (and surrounding area) and Thunder Bay District (excluding City of Thunder Bay and surrounding area). The fourth and fifth proposed IDNs are formed from the current Kenora District sub-LHIN planning area. The Northern IDN is proposed to encompass Sioux Lookout and all First Nations communities north of Sioux Lookout. The remaining part of Kenora District (including Red Lake, Kenora and Dryden) will be referred to as Kenora District IDN. The map illustrates the North West LHIN’s current sub-LHIN planning areas showing communities that have acute care hospitals. Figure 1: Map of the North West LHIN The Thunder Bay City sub-LHIN planning area of the North West LHIN is comprised of the city of Thunder Bay and the surrounding census subdivisions - Neebing, Oliver Paipoonge, Conmee, Gillies, O’Connor, Shuniah and Fort William 52 Moving forward, it is proposed that the area will be referred to as the City of Thunder Bay Integrated District Network. Health Profile – City of Thunder Bay Integrated District Network (Draft) 2 North West LHIN RLISS du Nord-Ouest The following table presents some of the demographic characteristics of the IDN compared to the total North West LHIN population. Table 1: Population Characteristics, 2006 Census Indicator Total Population City of Thunder Bay IDN 122,905 North West LHIN 235,090 % Age 65+ 16.0% 14.1% % Age 75+ 8.1% 6.8% % Aboriginal Identity 8.3% 19.2% % Francophone 2.8% 3.5% % Immigrant Population 10.5% % Age 25+ completed post-secondary educ. 48.2% 8.7% 50.8% Data Source: Statistics Canada. 2006 Census. Population Estimates and Projections The following table lists the census subdivisions (municipalities/communities) contained within the City of Thunder Bay IDN and their respective population estimates for 2009. The list is in decreasing order of population size. Table 2: Population Estimates for Census Subdivisions (CSDs) in City of Thunder Bay IDN CSD/Community Thunder Bay 2009 Population Estimate 110,984 Oliver Paipoonge Shuniah Neebing Fort William 52 Conmee O’Connor 5,775 2,968 2,213 904 740 725 Gillies City of Thunder Bay IDN 548 124,857 Data Source: Population Estimates PHU County Municipality table, intellIHEALTH Ontario. There are no communities within this IDN that are designated under the French Language Services Act. The City of Thunder Bay IDN area accounts for 52 percent of the North West LHIN’s population and is expected to shrink by two percent over the next 10 years. Expected growth rates vary by age group. For example, the population aged 0 to 19 is expected to decrease by 16 percent over the next 10 years while the population of 65 to 79 year olds expected to increase by 42 percent. Health Profile – City of Thunder Bay Integrated District Network (Draft) 3 North West LHIN RLISS du Nord-Ouest Table 3: 10-Year Population Growth Forecast Age Group 00-19 20-44 2009 27,335 39,456 2019 22,847 36,891 10-year Growth -16% -7% 45-64 65-79 80+ City of Thunder Bay IDN Total NW LHIN Total 37,533 14,285 6,337 124,945 239,579 35,091 20,285 7,211 122,326 238,464 -7% 42% 14% -2% 0% Source: PwC. Draft North West LHIN Blueprint Project Report. Oct 2011. Health Status and Health Outcomes Data from the Canadian Community Health Survey (CCHS) is only available at the Public Health Unit (PHU) or Local Health Integration Network (LHIN) level in Ontario. The Thunder Bay District Health Unit (TBDHU) area is the health region that best represents the City of Thunder Bay IDN area. The TBDHU area corresponds to the Thunder Bay District Census Division. Table 4: Self-Reported Health Status, CCHS 2009/2010, age 12+ Indicator Perceived health as excellent or very good (%) Thunder Bay District Health Unit (TBDHU) 58.0 North West LHIN ON 57.4 61.0 Perceived mental health as excellent or very good (%) 67.7 68.2 74.3 Perceived life stress, quite a lot (age 15+) (%) 21.5 21.8 24.0 76.7 76.2 67.4 90.3 90.7 91.5 Sense of community belonging, somewhat strong or very strong (%) Life satisfaction – satisfied or very satisfied (%) Statistics Canada. 2011. Health Profile. Statistics Canada Catalogue no. 82-228-XWE. Ottawa. Released June 28 2011. http://www12.statcan.gc.ca/health-sante/82-228/index.cfm?Lang=E The perceived health status of TBDHU area residents is very similar to that of the North West LHIN residents as a whole. Health Profile – City of Thunder Bay Integrated District Network (Draft) 4 North West LHIN RLISS du Nord-Ouest Table 5: Self-Reported Health Behaviours/Practices, CCHS 2009/2010, age 12+ Thunder Bay District Health Unit (TBDHU) Indicator North West LHIN ON Overweight or obese (%) 60.2 61.7 52.0 Pain or discomfort that prevents activities (%) 18.8 19.0 13.5 Current smoker; daily or occasional (%) 24.6 23.9 18.9 Heavy drinking (%) 20.4 20.9 15.9 Leisure-time physical activity; moderately active or active (%) 57.3 58.0 50.5 Regular medical doctor (%) 84.4 83.5 91.1 Contact with a medical doctor in the past 12 months (%) 80.2 79.3 82.2 Source: Statistics Canada. 2011. Health Profile. Statistics Canada Catalogue no. 82-228-XWE. Ottawa. Released June 28 2011. http://www12.statcan.gc.ca/health-sante/82-228/index.cfm?Lang=E The rates of heavy drinking, smoking and being overweight are similar between the TDBHU area and the North West LHIN residents overall, but higher than provincial rates. The following table provides age-standardized rates of hospitalization and death for various diseases or conditions from the Statistics Canada Health Profiles. The hospitalization data is for fiscal year 2009/10 and the mortality data is for the calendar years 2005 to 2007 (average annual rate). Table 6: Hospitalization and Mortality Indicators – Health Profile, Statistics Canada Indicator (age-standardized rate per 100,000 population) Injury hospitalization Thunder Bay District Health Unit (TBDHU) 752.0 North West LHIN ON 861.0 406.0 Self-injury hospitalizations 139.0 156.0 58.0 Mental illness hospitalization rate 972.0 933.0 392.0 Ambulatory care sensitive conditions 521.0 538.0 280.0 Coronary artery bypass graft (CABG) 147.0 133.0 72.0 Percutaneous coronary intervention (PCI) 293.0 277.0 170.0 Total; all causes of death 594.1 629.1 521.8 All cancers; deaths 161.1 171.7 159.1 Circulatory diseases; deaths 181.7 182.4 155.6 Respiratory diseases; deaths 38.0 41.8 41.3 Unintentional injuries; deaths 33.3 39.4 23.4 Suicides and self-inflicted injuries; deaths 17.0 20.6 7.7 Source: Statistics Canada. 2011. Health Profile. Statistics Canada Catalogue no. 82-228-XWE. Ottawa. Released June 28 2011. http://www12.statcan.gc.ca/health-sante/82-228/index.cfm?Lang=E Hospitalization rates due to injury and mortality rates due to injuries and suicides are significantly higher in the TBDHU area compared to the province, but lower than in the North West LHIN as a whole. Health Profile – City of Thunder Bay Integrated District Network (Draft) 5 North West LHIN RLISS du Nord-Ouest Health Service Access and Utilization Thunder Bay Regional Health Sciences Centre (TBRHSC) is the only acute care hospital located in the City of Thunder Bay IDN and provides service to the entire North West LHIN. It is identified for French Language Services (FLS). The table below summarizes the 2009/10 admissions and inpatient days at TBRHSC. The table includes acute care admissions for mental health diagnoses, but excludes admissions to designated mental health beds. Table 7: Distribution of Acute Care Services in the City of Thunder Bay IDN Facility/Hospital Site Admissions Days Share of District’s Admissions Share of LHIN's Admissions 18,458 119,549 100% 63% Thunder Bay Regional Health Sciences Centre (TBRHSC) Source: PwC. Draft North West LHIN Blueprint Project Report. Oct 2011. All of the inpatient acute care service in this IDN is provided by TBRHSC. In addition, TBRHSC accounts for almost two-thirds (63%) of all admissions to North West LHIN acute care facilities. In addition to acute care beds, there are a number of other inpatient bed types located in the acute care facilities in the City of Thunder Bay IDN. Table 8: Bed Types (as of Sept. 30, 2010) Hospital Acute Thunder Bay Regional Health Sciences Centre Inpatient Rehab Mental Health Newborn Bassinets 50 18 327 Thunder Bay St Joseph's Care Group City of Thunder Bay IDN Total CCC 327 50 174 71 50 174 121 ELDCAP 18 Source: Web-Enabled Reporting System (WERS); extracted Jan. 2012. The majority of the designated Inpatient Mental Health beds in the North West LHIN are located in the city of Thunder Bay. The following table contains the location of these beds in the North West LHIN. Table 9: Designated (Adult) Mental Health Beds in North West LHIN Provider Name Sub-LHIN area Type Mental Health Beds 19 Lake Of The Woods District Hospital Kenora District Acute Psych Thunder Bay Regional Health Sciences Centre Thunder Bay City Acute Psych 30 Thunder Bay Regional Health Sciences Centre St Joseph's Care Group – Lakehead site North West LHIN Total Thunder Bay City Forensic 20 Thunder Bay City Long Term 71 Health Profile – City of Thunder Bay Integrated District Network (Draft) 140 6 North West LHIN RLISS du Nord-Ouest Of the 45,940 weighted days of inpatient mental health care for residents of the complete Thunder Bay District Census Division, 64% were at the Lakehead site of St. Joseph’s Care Group in Thunder Bay, and 34% at Thunder Bay Regional Health Sciences Centre. Inpatient (IP) Rehabilitation The residents of the North West LHIN received 16 percent less IP rehabilitation services than expected given their clinical and socio-demographic characteristics. Within the North West LHIN, residents of Rainy River District and Kenora District had particularly low access to IP rehabilitation; Rainy River had 70 percent less IP rehabilitation services than expected and Kenora had 30 percent less than expected. St. Joseph’s Care Group located in the City of Thunder Bay has 50 IP Rehabilitation beds which service all residents of the North West LHIN. Long-Term Care (LTC) There were nine Long Term Care (LTC) homes with a total of 1,137 beds in the City of Thunder Bay IDN area in 2009/10. The following table shows the distribution of LTC beds by home. Table 10: Long-Term Care Homes in the City of Thunder Bay IDN, Fiscal Year 2009/10 LTC Home # of LTC Beds Bethammi Nursing Home 110 Dawson Court Home for the Aged 150 Grandview Lodge Home for the Aged 150 Hogarth Riverview Manor 96 Pinewood Court 128 Pioneer Ridge Home for the Aged 150 Roseview Manor 157 Thunder Bay Interim Long-Term Care Centre 65 Versa Care Limited 131 City of Thunder Bay IDN Total 1,137 *Source: The North West LHIN Health Services Inventory Four of the nine LTC homes in this area are identified for French Language Services (FLS): Bethammi Nursing Home; Hogarth Riverview Manor; Roseview Manor; and Versa Care Limited. The North West Community Care Access Centre (CCAC) is also indentified for FLS. Health Profile – City of Thunder Bay Integrated District Network (Draft) 7 North West LHIN RLISS du Nord-Ouest Market Share of Acute Inpatient Days The following table shows where residents of the City of Thunder Bay IDN (sub-LHIN) went for acute care in Ontario in fiscal year 2009/10. Table 11: Market share of acute inpatient days in Ontario hospitals by sub-LHIN 2009/10 Sub-LHIN/LHIN of Hospital Kenora District Rainy River District City of Thunder Bay Thunder Bay District Other LHIN Kenora District 76% 0% 22% 0% 2% 45,312 Rainy River District 4% 71% 22% 0% 3% 14,255 Thunder Bay City 0% 0% 93% 0% 7% 94,928 Thunder Bay District 1% 0% 42% 50% 6% 23,732 35,407 10,531 111,248 12,057 8,984 178,227 Sub-LHIN of Patient Total Days Total Days Source: PwC. Draft North West LHIN Blueprint Project Report. Oct 2011. Almost all (93%) of the total inpatient days among the City of Thunder Bay IDN residents in Ontario hospitals were provided by Thunder Bay Regional Health Sciences Centre. Health Profile – City of Thunder Bay Integrated District Network (Draft) 8 North West LHIN RLISS du Nord-Ouest The table below shows the percentage of admissions by residents the Thunder Bay District Census Division (CD) of North West LHIN that occurred at Manitoba hospitals. For fiscal year 2009/10 there were 18,775 admissions of Thunder Bay District Census Division residents to Ontario facilities and 190 to Manitoba facilities for a total of 18,965 admissions in both Ontario and Manitoba facilities. Table 12: Percentage of Patients Hospitalized in Manitoba by Clinical Program (ICD-10 Chapter), 2009/10 Clinical Program 01 Infectious/Parasitic Diseases 02 Neoplasm’s 03 Blood and Immune 04 Endocrine, Nutrition, Metabolic 05 Mental and Behavioural 06 Nervous System Total Admissions – Ontario and Manitoba Thunder Bay North District CD West LHIN 203 376 1,028 1,578 210 330 784 1,199 513 998 311 543 % Admitted to MB hospitals Thunder Bay North West District CD LHIN 0% 8% 1% 10% 1% 2% 1% 5% 1% 1% 0% 7% 07 Eye and Adnexa 08 Ear and Mastoid 09 Circulatory 10 Respiratory 11 Digestive 12 Skin and Subcutaneous Tissue 40 115 3,119 1,774 2,260 219 90 184 4,851 2,877 3,559 384 50% 0% 2% 0% 0% 1% 62% 1% 7% 3% 4% 4% 13 Musculoskeletal & Connective 14 Genitourinary 15 Pregnancy and Childbirth 16 Perinatal Period 17 Congenital and Chromosomal 19 Injury and Poisoning 913 1,056 2,474 618 125 1,709 1,465 1,666 4,932 1,019 186 2,904 0% 1% 0% 0% 2% 1% 6% 8% 7% 11% 18% 7% 20 External Causes Total 1,494 18,965 2,818 31,964 1% 1% 6% 6% Source: PwC. Draft North West LHIN Blueprint Project Report. Oct 2011. Overall, one percent of all acute care admissions among Thunder Bay District’s population in fiscal year 2009/10 were to hospitals in Manitoba. This percentage varied by clinical program. Of note is the fact that 50% of admissions (20 admissions) to area residents for most responsible diagnoses in the Eye and Adnexa chapter were to Manitoba facilities. Health Profile – City of Thunder Bay Integrated District Network (Draft) 9 North West LHIN RLISS du Nord-Ouest The table below shows the number of hospital admissions for ambulatory care sensitive conditions (ACSC) that would have been avoided if the City of Thunder Bay IDN had the provincial average standardized admission rate. Table 13: Potentially Avoidable 2009/10 Hospital Admissions at Provincial Average Standardized Admission Rate (Top 10 for City of Thunder Bay IDN) Ambulatory Care Sensitive Condition Influenza / pneumonia Chronic Obstructive Pulmonary Disease (COPD) Kidney / Urinary Congestive Heart Failure (CHF) Atrial fibrillation Cellulitis Angina Diabetes with complications Perforated ulcer Alcohol related Top 10 ACSC City of Thunder Bay IDN Total All ACSC City of Thunder Bay IDN 394 North West LHIN Total 729 266 159 141 98 411 208 216 178 87 84 79 63 45 155 192 203 73 246 1,417 1,439 2,610 2,867 Source: PwC. Draft North West LHIN Blueprint Project Report. Oct 2011. Emergency (ED) Visits North West LHIN residents have high rates of ED visits use, particularly for less-urgent and non-urgent visits (CTAS levels IV and V). The standardized rate of ED visits per capita among North West LHIN residents was 2.1 times the provincial average in 2009/10. Across the sub-LHINs this ranged from a low of 1.8 times the provincial average in the City of Thunder Bay IDN to 3.1 in Thunder Bay District IDN. Table 14 shows the volume 2009/10 volume of unscheduled emergency department visits by residents of the City of Thunder Bay IDN by CTAS level and hospital of visit. Health Profile – City of Thunder Bay Integrated District Network (Draft) 10 North West LHIN RLISS du Nord-Ouest Table 14: Emergency Visits by North West LHIN Hospital and CTAS Level for City of Thunder Bay IDN Residents, 2009/10 I - Resuscitation II Emergent III Urgent IV- Lessurgent V - Nonurgent Thunder Bay CMA Total Atikokan General Hospital <5 <5 17 63 54 138 Dryden Regional Health Centre 0 <5 51 80 22 157 Geraldton District Hospital Lake of the Woods District Hospital 0 8 19 73 50 150 0 <5 19 62 18 100 Manitouwadge General Hospital 0 0 6 6 11 23 The McCausland Hospital Nipigon District Memorial Hospital Red Lake Margaret Cochenour Memorial Hospital Riverside Health Care Facility – Emo Riverside Health Care Facility La Verendrye Hospital Riverside Health Care Facility – Rainy River Sioux Lookout Meno Ya Win Health Centre Thunder Bay Regional Health Sciences Centre Wilson Memorial General Hospital 0 0 11 23 38 72 <5 5 58 222 343 630 <5 <5 10 18 22 53 0 0 0 0 <5 <5 0 5 30 89 74 198 0 0 <5 <5 8 16 0 <5 23 138 76 238 824 18,160 47,263 23,586 2,073 91,906 0 13 19 35 21 88 829 18,201 47,530 24,399 2,812 93,771 CTAS Level City of Thunder Bay IDN Total Source: PwC. Draft North West LHIN Blueprint Project Report. Oct 2011. Only 2% of unscheduled emergency visits by the City of Thunder Bay IDN residents were to hospitals other than Thunder Bay Regional Health Sciences Centre (TBRHSC); i.e. outside of the IDN area. Only 29% of unscheduled ED visits by City of Thunder Bay IDN residents were CTAS level IV and V (low acuity). TBRHSC saw 94% of the these visits and almost all (99.5%) of the high acuity cases (CTAS I to III). Health Profile – City of Thunder Bay Integrated District Network (Draft) 11 North West LHIN RLISS du Nord-Ouest The following table shows the distribution of all ED visits by City of Thunder Bay IDN residents to any Ontario hospital by main reason for the visit. Table 15: Emergency Visits for City of Thunder Bay IDN Residents by ICD-10 Chapter of Main Problem Diagnosis, 2009/10 ICD10 Chapter Visits % ER Visits Avg. Visits per Person * 19 Injury and Poisoning 22,322 24.0 1.8 10 Respiratory 13,031 14.0 2 20 External Causes 10,363 11.1 2.3 09 Circulatory 7,467 8.0 2.1 13 Musculoskeletal and Connective 6,697 7.2 2.1 11 Digestive 6,607 7.1 2.1 12 Skin and Subcutaneous Tissue 5,596 6.0 2.8 14 Genitourinary 5,462 5.9 2.2 08 Ear and Mastoid 3,412 3.7 1.9 05 Mental and Behavioural 3,351 3.6 2.8 06 Nervous System 2,269 2.4 2.1 01 Infectious/Parasitic Diseases 2,061 2.2 1.8 07 Eye and Adnexa 1,629 1.8 1.8 04 Endocrine, Nutrition, Metabolic 1,152 1.2 2.2 15 Pregnancy and Childbirth 770 0.8 2.2 02 Neoplasm’s 352 0.4 3 03 Blood and Immune 310 0.3 2.7 16 Perinatal Period 123 0.1 3 18 0.0 1.6 92,992 100.0 2.1 17 Congenital and Chromosomal Total Source: PwC. Draft North West LHIN Blueprint Project Report. Oct 2011. Note:* Average is based on those people with at least one emergency visit. Health Profile – City of Thunder Bay Integrated District Network (Draft) 12 North West LHIN RLISS du Nord-Ouest Non-Acute Care LHIN Funded Services The table below lists the health service providers (HSP) in other sectors that provide service to City of Thunder Bay IDN residents and receive some or all of their funding from the North West LHIN. Table 16: North West LHIN Funded Health Service Providers for City of Thunder Bay IDN Residents, fiscal year 2010/11 Community Social Services (CSS) Sector Organization Name Alzheimer Society Thunder Bay Brain Injury Services of Northern Ontario (BISNO) Canadian Hearing Society (The) Canadian Red Cross Society – Thunder Bay Canadian National Institute for the Blind (The) Corporation of the City of Thunder Bay Head Office Location Thunder Bay Thunder Bay Area Served 1 %Total Revenue funded by 2 NW LHIN City of Thunder Bay and surrounding area and Thunder Bay District Northern Ontario with services primarily in City of Thunder Bay 39.6% 62.8% Thunder Bay North West LHIN 0.7% Thunder Bay City of Thunder Bay and surrounding area, Thunder Bay District and Dryden area 77.2% Thunder Bay North West LHIN 27.5% Thunder Bay City of Thunder Bay 3.7% Dilico Anishinabek Family Care Thunder Bay Fort William First Nation Thunder Bay HAGI - Community Services for Independence Thunder Bay Hospice North West Thunder Bay St. Joseph’s Care Group Victorian Order of Nurses – Thunder Bay Thunder Bay Wesway Inc. Thunder Bay Thunder Bay City of Thunder Bay and surrounding area and Thunder Bay District including Armstrong, Longlac, Nipigon, Pic River, Pic Mobert City of Thunder Bay (Fort William First Nation members) City of Thunder Bay and surrounding area and Thunder Bay District City of Thunder Bay and surrounding area and Thunder Bay District North West LHIN City of Thunder Bay and surrounding area City of Thunder Bay and surrounding area, Thunder Bay District, Kenora District and Rainy River District 5.8% † 55.8% 60.9% 81.9% 2.6% 42.9% † Do not report on all programs 1 Source: Schedule A1 and A2 of SAAs from each health service provider 2 Source: Web Enabled Reporting System (WERS) 2010/11 Health Profile – City of Thunder Bay Integrated District Network (Draft) 13 North West LHIN RLISS du Nord-Ouest Community Health Centre (CHC) Sector Organization Name Head Office Location Area Served 1 City of Thunder Bay and surrounding area and Thunder Bay District Home Care Sector – Community Care Access Centre (CCAC) NorWest Community Health Centres Thunder Bay Organization Name Head Office Location Area Served 1 North West Community Care Thunder Bay North West LHIN Access Centre Community Mental Health and Addictions (CMHA) Sector Substance Abuse Programs Organization Name Alpha Court Non-Profit Housing Corporation Children’s Centre Thunder Bay Crossroads Centre Inc. Head Office Location Thunder Bay Thunder Bay Thunder Bay Dilico Anishinabek Family Care Thunder Bay St. Joseph’s Care Group Thunder Bay 3 C’s Reintroduction Centre (The) Thunder Bay Thunder Bay Counselling Centre Thunder Bay Thunder Bay Seaway NonProfit Apartments Thunder Bay Area Served %Total Revenue funded by NW 2 LHIN 88.0% %Total Revenue funded by NW 2 LHIN 98.7% 1 City of Thunder Bay and surrounding area City of Thunder Bay and surrounding area North West LHIN City of Thunder Bay and surrounding area and Thunder Bay District including Armstrong, Longlac, Nipigon, Pic River, Pic Mobert North West LHIN City of Thunder Bay and surrounding area, Thunder Bay District and Northern Communities Predominantly City of Thunder Bay and surrounding area with some referrals from Thunder Bay District City of Thunder Bay and surrounding area, Thunder Bay District and Ontario %Total Revenue funded by NW 2 LHIN 64.3% 1.7% 96.5% 5.8% 81.9% 88.9% 71.7% 15.3% Mental Health (MH) Sector Organization Name Alpha Court Non-Profit Housing Corporation Brain Injury Services of Northern Ontario (BISNO) Head Office Location Area Served 1 %Total Revenue funded by NW 2 LHIN Thunder Bay City of Thunder Bay and surrounding area 64.3% Thunder Bay Northern Ontario 62.8% 1 Source: Schedule A1 and A2 of SAAs from each health service provider 2 Source: Web Enabled Reporting System (WERS) 2010/11. Health Profile – City of Thunder Bay Integrated District Network (Draft) 14 North West LHIN RLISS du Nord-Ouest Mental Health (MH) Sector (Cont’d) Organization Name Head Office Location Centre for Education and Research on Aging and Health (CERAH) Thunder Bay Canadian Mental Health Association, Thunder Bay Thunder Bay Dilico Anishinabek Family Care Thunder Bay People Advocating Change Through Empowerment Inc. Thunder Bay St. Joseph’s Care Group Thunder Bay Thunder Bay Counselling Centre Thunder Bay Thunder Bay Regional Health Sciences Centre Thunder Bay Sexual Assault/Sexual Abuse Counseling and Crisis Centre Wesway Inc. Thunder Bay Thunder Bay Thunder Bay Area Served 1 %Total Revenue funded by NW 2 LHIN North West LHIN All programs in City of Thunder Bay and surrounding area. In addition Crisis Response in Thunder Bay District. Early Psychosis Intervention in City of Thunder Bay and surrounding area, Thunder Bay District, Kenora District and Rainy River District City of Thunder Bay and surrounding area and Thunder Bay District including Armstrong, Longlac, Nipigon, Pic River, Pic Mobert City of Thunder Bay and surrounding area and Thunder Bay District North West LHIN Predominantly City of Thunder Bay and surrounding area with some referrals from Thunder Bay District 29.5% 84.0% 5.8% 100.0% North West LHIN City of Thunder Bay and surrounding area, Thunder Bay District and Northern Communities City of Thunder Bay and surrounding area and Thunder Bay District 81.9% 21.1% 71.7% 13.0% 42.9% 1 Source: Schedule A1 and A2 of SAAs from each health service provider 2 Source: Web Enabled Reporting System (WERS) 2010/11. Health Profile – City of Thunder Bay Integrated District Network (Draft) 15