There are a number of reasons why a Community Health Centre might make sense for your community.

Whether you are in a small town, a First Nation, a neighbourhood within a larger urban setting, or are part of an ethno-cultural group, language group or other community that wants access to more comprehensive care and support services, a CHC might make sense for you. For example:

• Community members want to be more engaged in making decisions about local primary health care services and programs. Community Health Centre boards of directors and other volunteer opportunities provide an excellent way for community members to get involved and to ensure that services are continually responsive to local needs and priorities.
• Your community not only needs increased access to physician care. You need access to the right care, at the right time, by the right provider(s) via a collaborative care team that includes physicians, nurse practitioners, nurses, dietitians, therapists and other providers.
• Your community also needs more that just health “care”. You need programs and services designed to address social issues that are having a negative impact on health. Community Health Centres excel at addressing what are called the social determinants of health – the wide variety of social economic, environmental and cultural factors that affect our well being.
• There is little to no coordination of health and social services in your community. Community Health Centres are integrated and coordinate closely with other service providers and groups to give their clients access to the wide variety of services and supports they may need.

• Your community includes many individuals who need services that are culturally and linguistically appropriate such as Francophones, Aboriginal Peoples, racialized groups and/or newcomers to Canada. Community Health Centres deliver culturally-appropriate primary health care services and programs that best meets the needs of their clients, including many services in languages other than English.
• In your rural community you may have difficulty attracting nurse practitioners and family physicians because there are few other nearby health professionals and they are hesitant to work without this support. By bringing together interprofessional teams with many types of health providers all under one roof, family physicians and nurse practitioners feel supported in their practices  and the health centre assumes ongoing responsibility for ensuring succession planning for health providers and continuity of care for members of the community.

Whatever the reason for your interest in a Community Health Centre, the Nova Scotia and Canadian associations of Community Health Centres can provide support and peer guidance through all the different components of developing a new centre. There are three essential steps to creating a Community Health Centre and these typically evolve with some overlap.

Emerging Community Health Centres develop in a way that involves community members as much as possible. A good process promotes individual and community health by encouraging people to identify their own needs, set priorities, plan for their future, and take responsibility for their own well-being. Typically, a sponsoring organization or steering group of three to five people spearheads the early phases of development to: assess the community’s needs and abilities; to analyze the options for change; and to begin mobilizing resources from inside and outside the community to get the new centre started.

Steering groups are made up of interested community residents, local service providers and representatives of other community interest groups and organizations. Typically, this steering group either evolves into the founding Board of Directors for a new CHC or helps to sponsor and recruit members for the Board of Directors. The steering group also plays a key role in determining the preferred governance and operational model for the proposed Community Health Centre — typically either a not-for-profit corporation or a cooperative.

Once the steering group has formed it invites other community members to explore community health needs in the community and how a community health centre can contribute positively to the health of the community. For more information on how to organize and mobilize the community, we recommend downloading and sharing the following resource from Ontario: Getting Started – Organizing the Community and From the Ground Up: An Organizing Handbook for Healthy Communities.

Following initial input from community members, a steering group should document the stated needs in the community and how a Community Health Centre can help to meet those needs. NSFCHC and CACHC can work collaboratively with steering groups to connect groups with other communities that have gone through this process. We can also provide input around how best to present community needs to stakeholders including the Nova Scotia Department of Health and Wellness, district health authorities and your local town/city councillors, MLAs and MPs.

It is critical to begin early in building relationships with a range of stakeholders including the Department of Health and Wellness and district health authorities, but especially with your local town/city councillors, MLA(s) and MP(s). It is important for your elected representatives to clear understand your community’s strong desire for a Community Health Centre and your activities as a local sponsoring/steering group.

Decisions around planning and funding of health services occur within a very complex decision-making environment and NSFCHC and CACHC can provide guidance and support around navigating this environment. It is important for these relationship to be built and maintained for the long-term. Since elected officials are incredibly busy and often have never seen anything beside the old fee-for-service physician care model, if will be important to support thier education around the health and economic benefits of the innovative Community Health Centre model of primary health care.

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