Know Your Rights! Access to health care for uninsured and precarious status migrants in Toronto

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Know Your Rights! Access to health care for uninsured and precarious status migrants in Toronto
Access to health care for uninsured and
precarious status migrants in Toronto

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Know Your Rights! Access to health care for uninsured and precarious status migrants in Toronto
Know your rights! Accessing Primary Care
     WHAT IS PRIMARY CARE ANYWAYS? Primary care is a broad term used in Canada
     to describe health services provided in the community. This includes diagnosis,
     treatment and management of health problemsas well as disease prevention and
     health promotion services. Primary care is often provided at a Community Health
     Centre. Primary care providers are often an individual’s first point of contact with
     the healthcare system.

#1    Medically uninsured individuals have a right to access Community Health Centres
      free of charge and regardless of ability to provide a health card. Community Health
      Centres can see people without OHIP for doctors appointments, tests, and special-
      ist visits. To look up a community health centre near you, call 416 236-2539. Here
      is a list of some of the CHCs in Toronto an their eligibility criteria:

                   Access Alliance                     Central Toronto Community Health Centre
 Eligibility: Immigrants and refugees, including    *Queen West CHC (Queen & Bathurst):
 people without immigration status. No OHIP re-     168 Bathurst Street, Phone: (416) 703-8480
 quired. No catchment area.                         Eligibility: Live within the catchment area of Col-
                                                    lege Street to the north, University to the east,
 *Downtown Location (College & Bathurst):           Dovercourt to the west, and Lake Ontario to the
 340 College St., Ste. 500, Phone: 416-324-8677     south. No OHIP required.

 *AccessPoint on Jane (Jane & St. Clair):           *SHOUT Clinic (Queen & Bathurst):
 761 Jane St. 2nd Floor, Phone: 416-760-8677        168 Bathurst Street, Phone: (416) 703-8482
                                                    Eligibility: For homeless and street-involved youth
 *AccessPoint on Danforth (Danforth & Victoria      (Ages 16-24). No catchment area.
 Park): 3079 Danforth Ave. Phone: 416-693-8677      No OHIP required.

         East End Community Health Centre                         Anishnawbe Health Centre
                                                    Eligibility: For people who identify as indigenous
 Eligibility: Catchment area is Greenwood Avenue or aboriginal (including North and South America).
 (south of Danforth Ave) and Coxwell Avenue         No catchment area. No OHIP required.
 (north of Danforth Ave) to the West, Victoria Park
 Avenue to the East, O’Connor Drive to St. Clair    *Main office (Queen and Sherbourne)
 Ave to the North, and Lake Ontario to the South. 225 Queen Street East Phone: 416-360-0486
 OHIP not required.
                                                   *Gerrard Site: (Jarvis & Gerrard)
 *East End CHC (Queen & Coxwell)                   179 Gerrard St. E. Phone: 416-920-2605
 1619 Queen Street East Phone: 416-778-5858
Inner City Family Health Team
Eligibility: Current or former resident of Seaton
House Men’s Shelter (including O’Neill, Downs-
view Dells, Birchmount Residence).
                                                         Regent Park Community Health Centre
Inner City Family Health Team (Queen & Church)          
69 Queen Street East, 4th floor                     Eligibility: For those with OHIP: South of Gerrard,
Phone: 416 368 5666                                 north of King, west of the Don River, east of
                                                    Sherbourne. For those without OHIP: South of
        Parkdale Community Health Centre            Bloor, north of Lake Ontario, west of the Don
                            River, east of Yonge Street. Serve many immi-
Eligibility: Bloor to the north, Lakeshore to the   grants.
south, Parkside to the west and Dovercourt to the
east, unless homeless. No OHIP required.            *Regent Park CHC (Dundas and Parliament)
                                                    465 Dundas Street East
*Parkdale CHC (Queen and Dufferin)                  Phone: 416-364-2261
1229 Queen Street W. Phone: 416-537-2455              South Riverdale Community Health Centre
           Sherbourne Health Centre                 Eligibility: Don River to the west, Lakeshore to
                      the South, Coxwell to the east, O’Connor to the
Eligibility:                                        north. No OHIP required.
Newcomer Team: Yonge Street and the DonRiver
to the east, between Bloor Street and Lake On-      *South Riverdale CHC (Queen and Broadview)
tario to the south.                                 955 Queen Street East, Phone: 416-461-2494
LGBT Family Health Team: City of
Toronto. Urban (including homeless and                   Flemingdon Community Health Centre
Family Health Team: City of Toronto.                Eligibility: Laird Drive to the west, Lawrence
No OHIP required for all of the above.              Avenue to the north, Victoria Park to the East and
                                                    O’Connor Drive to the South. No OHIP required.
*Sherbourne Health Centre                           Serve a large immigrant population.
(Sherbourne and Carlton)
333 Sherbourne Street, Phone: 416-324-4180          *Flemingdon CHC (Don Mills & Eglinton)
                                                    10 Gateway Blvd, Phone: 416-429-4991

       Women’s Health in Women’s Hands                Davenport Perth Community Health Centre
Eligibility: Women of Caribbean, Latin American,    Eligibility: Bathurst to east, railway tracks to west,
African, South Asian and Aboriginal descent only.   Rogers Rd. to north, Bloor street to South. No
No OHIP required. No catchment area.                OHIP required.
*Women’s Health in Women’s Hands                    *Davenport Perth CHC (Landsdowne & Daven-
(Yonge & Carlton) 2 Carlton Street, Suite 500       port)
Phone: 416 593 7655 ext 7                           1900 Davenport Rd., Phone: (416) 658-6812
     Don’t see a Community Health Centre in Your Area? For a full list of CHCs in Ontario,
     please see:
     Unfortunately, the CHC in your area may have a waiting list. You can ask to be placed on the
     list if there is one. You can also ask if there are other CHCs in the area that are accepting
     new patients. Always go to a hospital if you require emergency health services.

#2   Clinics for the uninsured. These clinics do not require you to be a patient in advance. You can show
     up for the drop-in clinics or make an appointment for those that require it. These clinics will do their
     best to help you get the tests you need but may not be able to pay for them.
       The Scarborough Clinic for the Uninsured                West End Non-Insured Walk-in Clinic

     What: A drop-in clinic that sees people who do notWhat: A walk in clinic for people with no-status/
     have health insurance on a first come, first servethe non-insured, people who are in the 3 month
     basis. In addition, a non-emergency children’s    OHIP wait period, people who do not have a pri-
     clinic is held once a month.                      mary care provider (ie. no doctor or nurse practi-
                                                       tioner), people who live west of Yonge Street and
     When: The clinic runs Tuesday and Thursday eve- in the City of Toronto. People who cannot use the
     nings only, from 5pm-8:30pm                       NIWIC include: Anyone who has status, anyone
                                                       who already has a regular doctor/nurse practitio-
     Where:1127 Markham Road, Scarborough, ON          ner, anyone who already has OHIP or IFH, any-
                                                       one who has private insurance, anyone who is a
                                                       visitor or a student.
                   Muslim Welfare Centre When: Monday from 4:00 p.m. until 7:30 p.m.
                         clinic.php                    (last client at 7:15 p.m.) and Wednesday from
     What: Free Health Clinic for those who are not    1:00 p.m. to 4:30 p.m. (last client at 4:15p.m.)
     covered by OHIP such as refugees, students, visi-
     tiors or new immigrants who are waiting for OHIP Where: AccessPoint on Jane, 761 Jane Street
     coverage.                                         (at Woolner) on the 2nd Floor
                                                                     Welcome Medical Clinic
     When: Every second Friday of the month            
     11:00 a.m. - 2:00 p.m.                               What: A volunteer clinic available only to patients
     Every second Wednesday of the month                  without OHIP.
     5:00 p.m. - 8:00 p.m.
     Every third Tuesday of the month                    Where: New Best Care Medical Centre
     6:00 p.m. - 9:00 p.m.                               Unit #4, 790 Burnhamthorpe West
     Every last Friday of the month                      Mississauga, ON, L5C 4G3
     5:00 p.m. - 8:00 p.m.                               (Park behind the Red Lobster or take the #26
     OR by appointment: (416) 754-8116                   Bus)
                                                         When: To book an appointment, call 647-200-
     Where: 100 McLevin Ave. Suite#4A & 4                3353. No Walk-ins. Please leave voicemails in
     Scarborough, Phone: +1 (416) 754-8116, +1-866- English or have someone do that for you.
     754-3111 (Toll Free)                                Contact us at:

#3    Some health centres have budgets set aside for professional translators. If you have an appoint-
      ment, call in advance to see whether translation services are available.

     Telehealth Ontario is a free, confidential telephone service you can call to get health advice or
     general health information from a registered nurse. You do not need a health insurance number to
     call nor do you need to provide any personal contact information if you do not want to. It is available
     24 hours a day, 7 days a week and can offer translation support in multiple languages. Telehealth
     Ontario: 1-866-797-0000.
Know your rights! Sexual Health
    Regardless of your immigration status, you can       Crossways Clinic
    visit a Toronto Public Health sexual health clinic   2340 DUNDAS ST W
    for:                                                 Toronto, ON M6P 4A9
                                                         Phone: 416 392-0999
    -Birth control counselling
    -Low cost or free birth control                      Drop in: Mon: 9:30 - 12 noon, 2 - 6:30 pm;
    -Free condoms                                        Tue: 1 - 5:30 pm; Wed: 9:30 - 11:30 am, 1 -
    -Plan B (emergency contraceptive pill)               3:30 pm; Thu: 12 - 4 pm; Fri: 9:30 - 12 noon
    -STI testing and free treatment                      *Rapid HIV testing available
    -HIV testing
                                                         The Gate

    -Pregnancy testing, counselling and referral
    -Sexuality and relationship counselling              Flemingdon Health Centre
                                                         10 GATEWAY BLVD
    You do not need a referral or OHIP to attend         Toronto, ON M3C 3A1
    TPH sexual health clinics. They are:                 Phone: 416 429-4991

    Birth Control and Sexual Health Centre               Drop in: Mon, Thu: 3 - 5 pm
    Suite 403                                            Note: New clients arrive before 4:30 pm
    960 LAWRENCE AVE W, Toronto, ON M6A 3B5
    Phone: 416 789 4541                                  Hassle Free Clinic
                                                         66 GERRARD ST E
    By Appointment:                                      Toronto, ON M5B 1G3
    Mon: 2 - 5 pm; Tue: 4 - 7 pm; Wed: 12 - 5 pm;        Phone: 416 922-0566
    Thu: 5 - 8 pm; Fri: 12:30 - 4:30 pm
    *Anonymous HIV testing (including the rapid HIV      Men/Trans (Drop-in): Mon, Wed: 4 - 8 pm
    test)                                                Women/Trans (Drop-in): Mon, Wed, Fri: 10 -
                                                         12 noon
    Black Creek Community Health Centre (Sheri-          Women/Trans (By Appointment):
    dan Mall site)                                       Mon, Wed, Fri: 10 - 3 pm;
    North York Sheridan Mall, Unit 5                     Tue, Thu: 6 - 8 pm
    2202 JANE ST, Toronto, ON M3M 1A4                    *Anonymous HIV testing (including the rapid
    Phone: 416 789-4541                                  HIV test) available
                                                         All anonymous HIV tests are done by ap-
    Drop-in: Tue : 4 - 6 pm                              pointment.
    By Appointment: Tue: 3 - 4pm
                                                         Immigrant Women’s Health Centre
    Black Creek Community Health Centre (York-           489 COLLEGE ST #200
    gate Mall site)                                      Toronto, ON M6G 1A5
    1 YORK GATE BLVD                                     Phone: 416 323-9986
    Toronto, ON M3N 3A1
    Work: 416 246-2388                                   Drop-in:
                                                         Mon & Tue: 10 - 6 pm; Wed: 2 - 8 pm;
    Drop-in:                                             Thu: 10 - 2 pm
    Wed: 2 - 5:30 pm                                     Please arrive at least 1 hour before end of
    New clients arrive before 5 pm                       clinic time
The Jane Street Clinic                                  Taibu Community Health Centre
662 JANE ST                                             27 TAPSCOTT RD
Toronto, ON M6N 4A7                                     Toronto, ON M1B 4Y7
Work: 416 338-7272                                      Work: 416 644-3536

Drop-in:                                                By Appointment:
Tue: 1 - 5:30 pm; Wed: 2 - 6:30 pm; Thu: 9:30 -         Tue: 2:30 - 6:30 pm
11:30, 1 - 4 pm
*Rapid HIV testing available                            The Talk Shop
                                                        5110 YONGE ST
Rexdale Community Health Centre                         Toronto, ON M2N 6M1
8 TABER RD                                              Work: 416 338-7000
Toronto, ON M9W 3A4
Work: 416 744-0066                                      Drop-in:
                                                        Mon, Thu: 2 - 6:30 pm
By Appointment:                                         Wed: 9:30 - 11:30 am, 1 - 3:30 pm
Wed: 1:30 - 5:30 pm                                     Rapid HIV testing

*Anonymous HIV testing
                                                        You can also call the AIDS and Sexual Health
Rexdale Youth Resource Centre                           Infoline. Toll free: 1-800-668-2437 They are a
1530 ALBION RD                                          province-wide free anonymous service staffed
Toronto, ON M9V 1B4                                     by professional, multidisciplinary, and multi-
Work: 416 741-8714                                      cultural counsellors who offer assistance in
                                                        different languages. They offer information
By Appointment: Thu: 2:45 - 5:30 pm                     on:
Anonymous HIV testing (including the rapid HIV
test)                                                   -HIV/AIDS (Pre-test and post-test options; Infor-
*Must be 28 years old or under                          mation and referral to point of care HIV Rapid
                                                        Test sites province-wide)
Scarborough Sexual Health Clinic                        -Safer sex activities
Scarborough Civic Centre                                -Risk assessment
160 BOROUGH DR                                          -STIs
Toronto, ON M1P 4N8                                     -Birth control options
Work: 416 338-7438                                      -Emergency contraception
Drop-in: Mon: 9:30 - 12 noon, 2 - 6:30 pm; Tue:         -Relationship concerns
1 - 3:30 pm; Wed: 9:30 - 12 noon, 3:30 - 6:30 pm;       -Pregnancy and options
Thu: 1 - 3:30 pm; Fri: 9:30 - 12 noon                   -Sexual orientation
By Appointment: Wed: 2 - 3:30 pm; Thu: 9:30 -           -Issues related to harm reduction, including injec-
11:30 am                                                tion drug use and needle exchange programs
*Rapid HIV testing available                            -Referral to appropriate clinics and community
Special Treatment Clinic                                -Crisis intervention
8th Floor                                               -Assistance in problem solving and decision mak-
790 BAY ST                                              ing
Toronto, ON M5G 1N8                                     -Individualized time to address each client’s
Work: 416 351-3800 ext.2207                             needs
                                                        -Complementary service to existing public health
Drop-in: Tue, Wed, Thu: 5 - 7 pm                        and community programs
#5    All residents of Toronto, regardless of immigration status are entitled to access to Toronto Public
      Health Services. Many programs, services and materials are available in multiple languages.
     Prenatal and Post-Partum services                   Tuberculosis Prevention and Control Program
     Public Health Nurses and/or registered Dietitians   Talk to your healthcare provider about TB preven-
     offer:                                              tion, testing, and treatment, and a referral to To-
     -Preconception, prenatal and postpartum educa-      ronto TB clinics (including coverage for patients
     tion and support                                    with no health insurance).
     -Telephone assessments and counselling
     -Home visits                                        Dental Services
     -Healthy Babies, Healthy Children Program           Children under 18 years of age or seniors 65 years
     -Prenatal programs                                  and older, live in the City of Toronto, lack private
     -Breastfeeding support                              dental insurance, and are unable to afford a pri-
     -Information and referrals to appropriate commu-    vate dentist can access free TPH dental clinics.
     nity resources                                      For a list of Toronto Public Health dental clinics,
                                                         see: locations.
     Patients can refer themselves by calling            htm
     Toronto Health Connection
     416-338-7600                                        If you do not meet the criteria above, you can still
     Monday to Friday                                    access low-cost dental services here:
     8:30 a.m. - 4:30 p.m.                     
     Healthy Babies Healthy Children
     Provides long term home visiting to families who Harm Reduction Programs
     meet eligibility requirements                    A needle exchange program is offered for drug
                                                      users through “The Works.” Services include
     HBHC is delivered by a team of:                  distribution of injection and other safer drug us-
     Public health nurses (PHNs), and                 eequipment and condoms, education, counselling,
     Family home visitors (FHVs) who are skilled peer lab testing, and vaccination. The Works also offers
     parents who speak the same language as the       a low threshold methadone clinic for opiate users:
     family                                           416-392-0521.

     Who is it for during the pre-natal period:          Immunization
                                                         To receive vaccine information and to report chil-
     -Pregnant women who are homeless or have            dren’s immunizations, the public may call: 416-
     transient housing                                   392-1250.
     -Pregnant teens/young adults 21 years of age
     and under
     -Pregnant women of any age who are cognitively
     -Pregnant women with a history of, symptoms
     of, or a diagnosis of a mental health nature that
     increases their risk for ineffective parenting
     -Pregnant women who are newcomers to
     Canada, i.e. here less than 3 years, isolated
     and having their first baby in Canada

     Call 416-338-7600 for more information.
Know your rights! Uninsured in Pregnancy
* Midwifery care is free (no cost) for any woman who is a resident of Ontario. It does not matter what
your legal immigration status is, as long as you are a resident of Ontario.

*Find a midwife near you:

* In addition to midwives, clients can go to community health centres to get care while they are preg-
nant. See above under Primary Care.

* Midwives can care for women and order all the tests in a healthy, normal pregnancy – but pregnant
women need to pay for these tests.

* Midwives in Ontario offer both home and hospital birth to their clients – if you have your baby in
hospital, you need to pay the hospital fee. Different hospitals in the city charge different rates for unin-
sured patients. You might want to call a few hospitals to find out which ones have cheaper rates.

*Research has shown that homebirth with a midwife is a very safe option for low-risk women (women
with no health problems, or pregnancy related concerns). There are NO costs to having your baby at
home with a midwife and research shows that women and babies who have a normal pregnancy are
just as healthy with home birth with a midwife in Canada as they are if they give birth in the hospital.

* When you are actually in labour or have another medical emergency, the hospital or doctor cannot
refuse to care for you, even if you do not have any money. The hospital and doctor will bill you for the
care they provide, but they will still provide you with the care you need in an emergency.

* As above, the hospital may take you to a collection agency to collect the fees you owe them for any
amount of time you stayed in the hospital. If they take you to a collection agency, this can affect your
credit rating and ability to get a loan in the future

* Most hospitals will let you pay them in small amounts (even $50 a month) instead of taking you to a
collection agency – sometimes it is better to try to work this out with the hospital finance department
instead of waiting until they go to a collection agency.

* Many hospitals will not end up making you pay the full fee if they see that you can even pay part of it
(e.g. half the fee). Doctors are unlikely to take you to a collection agency to collect their fee.

*Canadian-born children to uninsured mothers have full access to OHIP and are eligible to receive a
health insurance card.

* Even if your baby needs to stay in the hospital because it is sick, you might not have to stay in the
hospital as a patient if you are healthy - this can save you costs of having to stay in the hospital.

* Many hospitals have ‘sleeping rooms’ where parents can stay for one or two days if their baby is in
the nursery. These sleeping rooms mean you are not a patient, but you can stay to help care for your
baby (e.g. breastfeed). If you stay in a sleeping room, you do not need to pay. You can only stay in
the sleeping room for 1 or 2 days if it is free. If your baby needs to stay in the hospital you might not
be able to stay.

KYR for uninsured pregnant women courtesy of: Manavi Handa, Registered Midwife, Assistant Pro-
fessor Ryerson University
Know your rights! Emergency Medical Care
    #1 You cannot be refused emergency medical care based on your ability to provide a healthcard. You
    will however be billed by the hospital. Rates vary at different hospitals for uninsured clients.
    #2 All hospitals in Ontario should have access to translation services via telephone although not all
    healthcare providers will be knowledgeable about how to access such services. If you require transla-
    tion services, ask your healthcare provider about telephone translation services.

    #3 Even if you don’t receive a bill at the time of your discharge from hospital, you may be sent a bill in
    the mail. Many hospitals have an equity/diversity office. Ask to speak with them as they may be able
    to help you negotiate payment in installments with the hospital’s finance department. Ask them to bill
    you as a medically uninsured “ontario resident” as opposed to a medically uninsured traveller. Hospi-
    tals are not required to do this, but they may oblige if you ask.

    #4 Hospitals may take you to a collection agency if you are unable to pay for your hospital fees. In
    many cases, it is better to try to negotiate payment of some portion of the fees than to wait for a bill to
    be sent to you that will go unpaid and subsequently will be followed up by a collection agency. Again,
    if they take you to a collection agency it may affect your credit rating and your ability to apply for
    loans, a credit card, a cellular phone etc. in the future.

    * Every effort has been made to verify the content in this handbook however service provision is dy-
    namic and the content in this book may not always be up-to-date. Call ahead! If you notice an error,
    please send an e-mail to
    *Last updated November 2013
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