Message from the Chairman of

the Board & the Executive Director

Contributing to Ontario’s Health System Transformation

A wind of change has been blowing over Ontario ever since enactment of the Patients First Act. Throughout this past year, Entité 4 has remained closely involved with its partners, through various consultations, to ensure that the needs of Francophones within its catchment area are taken into consideration as this law is implemented. We were therefore pleased to see that the importance of equitable access to French language health services is stated in the Act. We will continue to work collaboratively with our three partner LHINs during the implementation phase.

Recently, the Minister of Health and Long-Term Care published mandate letters for each LHIN: these letters speak of collective priorities for all stakeholders and outline the Ministry’s expectations regarding new LHIN roles and responsibilities. Entité 4 appreciates the repeated mention of French language services in these documents.

2016 also marks the renewal of the French Language Health Planning Entities’ mandate for a further five years. This confirms the importance of our work and allows us to continue working for Francophone communities along with our partner LHINs, as well as support the Ministry of Health and Long-Term Care as it proceeds with its transformation of the health system.

With our partner LHINs, we developed a joint three-year strategy document (2016-2019) entitled "Toward Equitable Access to French Language Services". Four priority sectors are at the forefront of our strategy: mental health, primary care, home and community care, and palliative care. As well, one of the strategic actions at the heart of this strategy is accompanying and guiding health service providers in their active offer of French language services, so that this principle becomes embedded in their daily practices.

We are proud to present our achievements this year. We thank everyone involved for their hard work, the quality of their collaboration and their belief in our mandate. We could not have achieved this alone. We remain confident for the future of French language health services.

Yves Lévesque Yves Lévesque Yves Lévesque Chairman of the Board
Estelle Duchon Estelle Duchon Estelle Duchon Executive Director




In order to improve access to health services in French, Entité 4 facilitates community engagement and provides innovative advice to its partners on planning, organizing and integrating diverse, high quality health care services.



Entité 4 is known for its contribution to the development of an integrated health system which offers excellent quality of care and responds to the needs of Francophones.




Be creative and think outside the box in order to put forward efficient models for organizing health care services.


Maintain consistency of thought, action and speech and display integrity in the management of public funds.


Maintain an attitude of collaboration with Entité 4's partners: cooperating with the existing local health system will help improve the community's health and access to services in French.


Maintain high quality standards and rely on accurate data so that Entité 4's credibility remains indisputable.






A Diversified and Growing Francophone population

There are 611,500 Francophones in Ontario:1

A. Central LHIN
  • North York (City of Toronto)
  • York
  • Simcoe (South)
B. RLISS Centre-Est
  • Scarborough (City of Toronto)
  • Durham
  • Northumberland
  • Kawartha Lakes
  • Peterborough
  • Haliburton
C. North Simcoe Muskoka LHIN
  • Simcoe (North)
  • Muskoka

Francophone communities within our catchment area are very diverse. For example, the Greater Toronto Area is home to an ever increasing number of newly arrived Francophones from various ethnocultural backgrounds. On the other hand, North Simcoe Muskoka boasts one of the oldest French speaking communities in Ontario. This community celebrated 400 years of French presence in Ontario in 2015.2

This richness of diversity translates into complex and varied health needs within these communities.

  1. Data from 2011 Census according to the Inclusive Definition of Francophone (2014). Office of Francophone Affairs.
  2. 400 Years of French Presence in Ontario (2014) Office of Francophone Affairs.

Challenges for

Francophone populations

  • Linguistic barriers have severe consequences for Francophone patients and the health system;
    - increased risk of errors in diagnosis and inadequate treatment;
    - francophones feel helpless, stressed and ignored by health professionals;
    - increased length of medical consultations;
    - higher probability of using numerous diagnostics tests;
    - lesser use of health services for preventive purposes;
    - reduce adherence to treatment;
    - consent forms misunderstood.
  • Francophones do not know how or where to access French language health services in Ontario.
  • Francophones are not identified by health care professionals.

"I don’t speak English. I go see my family doctor but I can’t ask him any questions."

A Francophone Patient



Towards Equitable Access to French Language Health Services

PLANNING the Offer of French Language Health Services. A Francophone perspective is included when planning and integrating health services.

ENGAGING the Francophone community. Francophones are involved in defining their needs and in planning health services in French.

BUILDING health service providers’ capacity. Health service providers have the proper support to develop their capacity to offer health services in French.

SUSTAINING the offer of services by identifying and designating health service providers to offer French language services.

Representants of Entité 4, Colibri and YMCA at ÉSC Nouvelle-Alliance



Entité 4 actively raises awareness among health service providers about the importance of language as a factor of quality and safety of care. It also promotes the identification and designation processes as indispensable tools for ensuring the sustainability of French language health services.

This concerted approach fosters a clear and targeted coordination of actions taken by main stakeholders: our three partner LHINs, health service providers, Entité 4 and Francophone communities.

LHINPlanning &
Entité 4Community
Service ProvidersHealthcare Services
in French

"As a partner of Toronto North Support Services, Entité 4 provided us with great support and encouraged us in our community engagement and our organizational capacity, which fostered the active offer of French language services in York and North York. Entité 4 also contributed by playing a major role in informing decision-makers about the significant progress we achieved and the impact our services had in the community, which led to the renewal of this project. [...] We are open to your advice and value this partnership."

Papy Yakabue

Community Outreach Worker, Toronto North Support Services

An open dialogue with Francophones and community partners is very important to Entité 4. Our community engagement activities are designed to inform members of the community on health services available in French and encourage them to get involved in the planning process for these services. The goal of community engagement is to understand Francophones' needs and develop services adapted to the community.

Apart from school and community events, Entité 4 participated in the Festival du Loup in La Fontaine, attended the Foire de la francophonie organized by AFRY, had a booth at the Official Languages Open House in CFB Borden and spoke to the Francophone community in Scarborough at Kay Créole’s Family Day event.

Entité 4's booth at the Festival du Loup in La Fontaine.

Entité 4 has been active on Twitter this past year. Entité 4 posted 209 tweets that were engaged close to 600 times.

205 members. Being a member of Entité 4 means being Francophone, living or working within Entité 4’s catchment area, and supporting our mission to improve access to quality health services in French within our three partner LHIN territories.

1,216 subscribers to Cap s@nté, Entité 4’s electronic newsletter.

Entité 4’s sixth Annual General Meeting took place at Black Creek CHC in front of approximately 80 guests and attendees. This event was a perfect opportunity to thank our partners who contributed in developing access to French language health services during 2015-2016, and to talk about the imminent transformation of Ontario’s health system.

Yves Lévesque, Entité 4's Board Chair

Entité 4 sits on committees and participates in working groups or tables to advise stakeholders on the needs of Francophone communities, particularly in the planning of health services which address these needs. Entité 4 also uses these meetings to promote existing services and encourages its partners to share this information.

6 working tables throughout Entité 4’s catchment area:

  • Coalition for Healthy Francophone Communities in Scarborough (Scarborough)
  • York Francophone Advisory Committee on Health (North York West)
  • Francophone Community Table on Health – Durham Region (Durham Region)
  • Francophone Community Partners with Schools (COMPASS) (North Simcoe Muskoka Region)
  • Bendale Acres Steering Committee (Scarborough)
  • Toronto North Support Services Partnership Committee on Mental Health (North York)

"It is rare to have an opportunity, in life but even more so at work, to work with a partner such as Entité 4 who provides this level of support to the community. My role as Navigator through the health system represents only a portion of activities taking place within the community which are aimed at improving access to health services in French and well-being in the North Simcoe Muskoka Region. [...] I am sure that support, cultural and linguistic awareness, as well as self-identification of individuals who speak French in the workplace, at school or at home will raise hopes that Francophones can live in French in Ontario, in a healthy way, and that it is not a matter of one or the other."

Céleste Lalonde

Francophone Health System Navigator, CHIGAMIK Community Health Centre

Entité 4 works in close collaboration with Central, Central East and North Simcoe Muskoka LHINs, who are responsible for planning, coordinating and funding the local health system. We advise them on the health needs expressed by Francophone communities in our territory by making recommendations to our partner LHINs to improve quality of services for Francophones.

To coordinate work and increase equitable access to French Language services, Entité 4 and its partner LHINs decided to synchronize their respective planning cycles. A joint three-year strategy (2016-2019) was developed to align with LHIN Integrated Health Service Plans (IHSP), with an annual update which coincides with LHIN Annual Business Plans. This joint strategy was also aligned with the transformation of Ontario’s health care system under "Patients First: Action Plan for Health Care".

Our three-year strategy is based on two types of actions:

  • Systemic actions which create the right conditions for developing equitable access to French language health services.
  • Sectoral initiatives to continue improving access to, navigation and coordination of health services for Francophones.

Number of recommendations being implemented in collaboration with LHINs, which were made over the past few years:


Recommendations to Central LHIN


Recommendations to Central East LHIN


Recommendations to North Simcoe Muskoka LHIN

Recognition Awards recipients at the 2016 AGM

21 health service providers participated in active offer workshops offered by Entité 4 this year.

1 community of practice in North Simcoe Muskoka where health service providers collaborate in developing capacity to offer services to Francophones.

On a provincial level, Entité 4 is actively involved with the Regroupement des entités de planfication des services de santé en français de l’Ontario. Together, they sent a response to two Ministry Discussion Papers: Developing Ontario’s Dementia Strategy and Levels of Care Framework.

"Entité 4 promotes the needs of Francophones in central Ontario in order to plan services adapted to the realities of our communities. Thanks to the efforts and sustained commitment of its members, Ontario’s health service providers have valuable support to continue developing innovative models for French language service delivery."

L’Honorable Marie-France Lalonde,
Minister Responsible for Francophone Affairs

Primary Care

In North Simcoe Muskoka LHIN

Thanks to a successful pilot project and following a recommendation from Entité 4, North Simcoe Muskoka LHIN funded a French Language System Navigator position at CHIGAMIK CHC to help Francophones navigate the system. Since this project began, more than 40 Francophone patients were helped with accessing health services in French in Simcoe and Muskoka.

In Central LHIN

Following a needs assessment project coupled with an outreach program and several community engagement sessions, Central LHIN funded a Bilingual Health Navigator position at BLACK CREEK CHC. The main objective is to implement referral and navigation processes. The Navigator also promotes a healthy lifestyle in communities largely constituted of newcomers who encounter many challenges. There have been close to 150 participants in workshops offered in French and 53 patients used the navigation services.

In Central East LHIN

TAIBU CHC continues to be successful in engaging the Francophone community, offering health promotion and outreach activities. Over 355 Francophones participated in these activities this year. Central East LHIN also offered funding to TAIBU CHC to hire a Bilingual Nurse Practitioner who now serves 148 Francophone patients.

"As a newcomer to Toronto about one year ago, it was very good news when I met with the TAIBU CHC health promoter and to find out that I could be served in French for my health issues because I had difficulty communicating in English. Ever since my wife, my two children and myself have become clients, we have participated in many activities, such as Christmas celebrations. This was our first Christmas away from home. As well, we received invaluable support from the nurse practitioner during my wife’s pregnancy and after our daughter was born."

A Francophone Resident of Scarborough

Liben Gebremikael, Executive Director at TAIBU CHC and Marie-France Lalonde, Minister Responsible for Francophone Affairs


Central LHIN provided funding for a pilot project led by Toronto North Support Services: Mental Health and Addictions Outreach aimed at Francophones, with a focus on French-speaking immigrants and newcomers. There were close to 300 Francophone participants in outreach activities, which generated referrals to mental health case management through the Access Point.

Mental Health First Aid training was offered in French throughout our territory by some of our partners such as CHIGAMIK CHC, Canadian Mental Health Association - Durham, TAIBU CHC and Toronto North Support Services, with the support of Réseau Franco-santé du Sud de l'Ontario. A total of 103 participants received their certification this year.

"I think that all adults should take this workshop, particularly Francophones living in Toronto. Because it is offered in French, it allows those who are not comfortable in English to learn on the subject and benefit from this valuable training. Truly, it if had not been offered in French, I would never have participated and I would have remained ignorant, consequently there would have been one less person able to intervene if needed and even perhaps save a life."

A Francophone Resident of Scarborough

Participants and facilitators of Mental Health First Aid Program in French at TAIBU CHC (Photo: TAIBU CHC)



The Adult Day Program, operated by Centres d’Accueil Héritage, has seen an increase in participation this year. This group of seniors also had the opportunity to attend a Fall Prevention Program offered through a partnership between Oshawa Senior Citizens Centre and Centres d’Accueil Héritage.

A Steering Committee at Bendale Acres Long Term Care Home has been working to build French language services capacity and to promote services offered to increase bed occupancy. As of March 31st, there were 22 Francophone residents at Pavillon Omer Deslauriers of Bendale Acres Long-Term Care Home where services are offered in French.

"The support provided by Entité 4, whether technical, political, or practical when implementing activities, greatly contributed to the success of our Francophone Navigation Service at Black Creek which benefits Francophones throughout North York. We wish to thank Entité 4 with whom we hope to continue our collaboration as long as possible."

Stanislas Etiegne
Francophone Health System Navigator, BLACK CREEK CHC

Francophone clients of Centres d'Accueil Héritage at the Toronto Challenge


Entité 4 hired a consultant to better understand palliative care capacity in French within its catchment area. Recommendations ensued for each of our partner LHINs on ways to improve palliative care for Francophones. The main issues raised touched on reliability of information, difficulty to navigate through services for patients, support for caregivers and lack of end-of-life discussions with health professionals.

This year, Entité 4 joined palliative care planning tables at each partner LHIN to ensure Francophone needs are identified during the planning phase.


To maximize utilization of services available in French, Entité 4 participates in the development of promotional materials for health service providers (Black Creek CHC, Centres d’Accueil Héritage, TAIBU CHC).


Entité 4 staff continues to develop strategic ties with partners, as well as improve performance and increase knowledge about planning and developing health services.


Professional development


& forums


Training session
for Board Members



Estelle Duchon
Executive Director

Ameth Lo
Director of Planning
(since January 2017)

Nancy Steben
Planning Officer
(since May 2016)

Simon Houle
Planning Officer
(since August 2016)

Sophie Sakillarides
Communications and Community 
Liaison Officer

Lynda Rooke
AExecutive Assistant, Management, 

Finance and Human Resources

Sonia Lapointe
Administrative Assistant
(until June 2016)



Central LHIN

Yves Lévesque, Chairman
Narjiss Lazrak, Vice-President
Dominique Janssens, Treasurer

Central East LHIN

Laura Lutoto, Board Secretary
Jules Nkamtchou
Jean Bouchard

North Simcoe Muskoka LHIN

Annick Brown, [until 2016]
Marie-France Heikens
Nina Lavoie [until October 2016]



The Statement of Operations on the right is an excerpt from Entité 4’s 2016-2017 audited Financial Statements. A copy of these financial statements in their entirety, as well as the opinion letter prepared by Marcil Lavallée for fiscal year 2016-2017, are available upon demand.

ÉStatement of Operations
For the year ended March 31, 2017
2017 2016


LHIN contributions 654 064$ 654 064$
Deferred contribution related to capital assets - (3 868)
Amortization of deferred contributions related to capital assets 8 131 14 105
Gain on disposal of capital assets 300 -

TOTAL 668 169 662 329


Salaries and benefits 408 929 384 781
Consultants and professional fees 102 953 128 348
Rent 32 738 32 542
Travel expenses 26 465 23 148
Conferences and training 16 605 16 690
Computer services 12 905 19 955
Telecommunications 12 081 11 993
Advertising and promotion 10 182 9 630
Office supplies 8 992 8 907
Office expenses 7 911 4 106
HST non refundable on expenses 6 427 8 582
Insurance 3 764 3 623
Interest and service charges 544 759
Amortization of capital assets 8 131 14 105

TOTAL 658 627 668 169

Excess of revenues over expenses -$ -$

Yves Lévesque
Chairman of the Board

Dominique Janssens