Impact Report 2022-23

Impact Report
2022-23

A Message from
the CEO and Board Chair

In a year marked by milestones, Casey House proudly celebrated its 35th anniversary, saw growth in client numbers and in our staff team. We released the second season of our podcast Positively Speaking, featuring incredible stories of lived experience from people not often given a chance to be heard. And, we opened Ontario’s first indoor supervised inhalation space for substance use as part of our robust harm reduction services.

As part of our work to dismantle systemic racism and build capacity to serve communities at highest risk for HIV, we focused on the Indigenous community. We formed a partnership with OAHAS (Ontario Aboriginal HIV and AIDS Strategy), launched an Indigenous client advisory group, and had staff participate in numerous capacity-building opportunities, such as San’yas Indigenous Cultural Safety training.

We also learned more about our clients’ needs to improve how we provide care. Resiliency assessments show how significantly mental health intersects with physical health and a quarter of all our clients have a self-reported mental health diagnosis. For incoming clients, the prevalence is even more striking: 42% of new clients in the first six months of the year expressed mental health challenges.

We also saw how income and housing, and food security relates to multiple dimensions of health. Many of our clients face multiple barriers to having their basic needs met, which has a profound impact on their health and wellness. This is why our broad view of health care encompasses physical, mental and social well-being.

Building relationships is key to establishing trust and willingness to accept help. In order for people to see what it’s like at Casey House we created a video tour for clients and for clinicians referring patients for an inpatient admission.

Thank you to donors, staff, peers and volunteers for staying committed to transforming lives and health care through compassion and social justice.

Joanne Simons
Chief Executive Officer

head shot of Stephen Brown in a plaid jacket and black shirt

Stephen Brown
Chair, Board of Directors

Heart.

Humanity.

Healing.

Heart.

Humanity.

Healing.

Heart

We work to achieve stability in the health and lives of clients by building resilience and there is a clear demonstration of the compounded impacts of the social determinants of health in our clients’ resiliency scores.
This winter, we provided cold-weather preparedness supplies and space each morning for underhoused outpatient clients to gather and stay warm.

I saw the nurse, who treated my hands for frostbite.

Jane Doe, Casey House Client

The pervasive housing crisis and insufficient shelter spaces affected our ability to safely discharge people experiencing homelessness from inpatient care. We developed a decision tree to ensure a safe environment for healing post-discharge and prioritized advocating for the crucial need for improved housing options.

Humanity

Our unique approach centres the person in care planning, and one client-directed care option is choosing medical assistance in dying (MAID) at end-of-life.

Knowing that MAID was available to me improved my quality of life, up to the end…it’s made me less anxious, less fearful, less full of dread…

Eric from season 2, episode 1
of our podcast Positively Speaking

Healing

Healing is at the core of all Casey House services, and this is often most visible in our inpatient care.

So I was in my 20s and I fall sick. But I was feeling myself healthy, younger with a lot of energies. Perfect life, you know. And when I got the result from the test, I never believe in that I was sick. And nothing happened. And I never took the decision to get medication. And last year, I got really sick. I got AIDS. And I was very, very sick. I was close to pass away. I know that here, they’re going to help me. And I came to Casey House for a long time to get help. And right now, I am born again. I’m very grateful with Casey House. Because if Casey House don’t exist, then otherwise, I don’t know what happened with me.

Miguel, Positively Speaking, S2.Ep2

Building community
through partnership

In Canada, it is well known that the Indigenous community is at higher risk for HIV: Indigenous people experience an incidence rate of HIV infection of 15.2 per 100,000 individuals, far greater than the general population rate of 4 per 100,000 individuals. Factors include the social and structural determinants of health, coupled with barriers to accessing respectful and culturally relevant health care.

Casey House is well-positioned to provide Indigenous healing practices when requested, but without a strong history of serving this population, and without programming specific to the community, we knew that it would be imperative to engage in a capacity building process to create a welcoming environment and specific services that meets the community’s needs.

This year, as a first step we convened an Indigenous client advisory group and established a partnership with Ontario Aboriginal HIV/AIDS Strategy (OAHAS) to educate and inform us about how to reduce barriers, increase staff and volunteer capacity, and to start thinking about programming.

We began to offer traditional healing practices and sacred medicines into care, including a weekly drumming ceremony to honour Indigenous identity and culture. We were gifted a sacred drum by the Toronto Central Regional Indigenous Cancer Program, fostering a sense of community among Indigenous members, staff, peers, and volunteers who use it for ceremonies and spiritual practices. In September 2022, we had the privilege of hosting the first annual sacred bundle feast of the drums, which brought together sacred drums and their caretakers from eight local Toronto hospitals.

Building relationships takes time and trust. We have learned that trust is best earned through listening, to understand the health care Indigenous people are asking for and deserve.

Building community through partnership

an indigenous woman drumming and singing holding a red blanket

Building relationships takes time and trust. We have learned that trust is best earned through listening, to understand the health care Indigenous people are asking for and deserve.

Hospital-based supervised consumption
services continue to grow

Supervised consumption services can be an accessible entry point for people to engage with health care, and our hospital’s supervised consumption services (SCS) continued to grow this year: visits more than doubled from 200 last fiscal year to more than 440 visits this year (and 30 overdoses were reversed).

2022

200

VISITS

2023

440

VISITS

jan 2022

A substantial portion of that growth can be attributed to the expansion of services to include supervised inhalation. As of November 2022, Casey House clients can smoke substances on-site, making ours the first SCS in the province to offer indoor supervised inhalation.

Adding this option for clients makes safer drug use and overdose prevention more accessible. Smoking is an increasingly common method of drug consumption and smoking-related deaths are on the rise.

The demand is evident, as inhalation usage has become the most popular: within three months, 50% of SCS visits were for inhalation and by six months it was 75%. These numbers make us feel proud of listening to what our community wants and needs.

3 MONTHS

50%

OF VISITS FOR
INHALATION

6 MONTHS

75%

OF VISITS FOR
INHALATION

Adding supervised inhalation is also proving to be a valuable connection to health care for many individuals. More than 50% of all clients visiting the outpatient SCS were new to Casey House. Additionally, several newly registered clients initially coming for lunch started accessing the SCS, then transitioned to coming to the SCS every day, and then started visiting our nursing team for health checks. Some clients also transitioned from injecting their drugs to smoking them, which is a safer method of consumption.

As proud as we are of being able to offer a safe space to our clients for supervised inhalation, we look forward to other organizations being able to also offer this much-needed service.

CP 24 News article about our first supervised inhalation service.

Hospital-based supervised consumption
services continue to grow

2022

200

VISITS

jan 2022

2023

440

VISITS

Adding this option for clients makes safer drug use and overdose prevention more accessible. Smoking is an increasingly common method of drug consumption and smoking-related deaths are on the rise.

3 MONTHS

50%

OF VISITS FOR
INHALATION

6 MONTHS

75%

OF VISITS FOR
INHALATION

3 MONTHS

50%

OF VISITS FOR
INHALATION

6 MONTHS

75%

OF VISITS FOR
INHALATION

As proud as we are of being able to offer a safe space to our clients for supervised inhalation, we look forward to other organizations being able to also offer this much-needed service.

CP 24 News article about our first supervised inhalation service.

Advocating for systemic change

Casey House advocates for our model of compassionate and socially-just health care and seeks to address the structural barriers that prevent optimal health, and improve the well-being of all people living with and at risk of HIV. With the continuing drug poisoning crisis, housing crisis, and rising cost of living, the need to address the social factors that determine health and well-being is beyond urgent. This year, we advocated across all three levels of government for policies and programs to improve health care and outcomes for people in high need for housing, income, and substance use supports.

Advocating for harm reduction and progressive drug policy

People are going to use either way, this [harm reduction] helps save their lives. All of us need help sometimes.”

Casey House social worker

People are going to use either way, this [harm reduction] helps save their lives. All of us need help sometimes.”

Casey House social worker

Casey House believes that harm reduction is an essential health service, and that people who use drugs should not be criminalized. We contributed our insights on the current state of the City of Toronto’s drug policy and programming, including our clients’ perspectives on decriminalizing personal drug possession, which we highlighted during the 2022 municipal election. At the provincial level, we advocated for harm reduction to be further embedded in overall health care during the 2022 Ontario election, and the 2023 Ontario Budget. We were proud to showcase our unique harm reduction model to elected officials, including the Associate Minister of Mental Health and Addictions and our local MPP for Toronto Centre.

Advocating for shelter and adequate housing

We call Central Intake [for emergency shelter space], and no beds are available…I’ve never seen it worse.

Casey House social worker

We call Central Intake [for emergency shelter space], and no beds are available…I’ve never seen it worse.

Casey House social worker

Housing is a human right, and stable housing and safe living conditions are essential to health and well-being. This year, we started advocating for more shelter and housing, particularly for people with complex health and psycho-social needs. Through our recommendations for the 2023 City Budget, we encouraged the City of Toronto to increase access to emergency shelter spaces and wrap-around homelessness services that help people manage their health and apply for long-term housing. At the provincial level, we advocated for the 2023 Ontario Budget to increase access to supportive housing for people coping with mental health and substance use challenges.

Advocating for income security

Casey House serves clients with disabilities living in poverty, particularly those with chronic conditions and diseases such as HIV, mental illness, and substance use disorder. We called for the swift passage of federal Bill C-22 – Canada Disability Benefit Act, so that this new disability benefit can be designed and delivered as quickly as possible. It should support people with episodic disabilities, reach people who face barriers to filing income tax returns, and ensure coordination with provincial disability support programs so that people have continued, uninterrupted access to current health benefits.

Casey House is anchored on a foundation of activism, advocacy and trailblazing. Today, our hospital continues to dismantle barriers to care, and constantly looks for ways to help more people overcome barriers that perpetuate health inequities and access care.

Meet Bernard

Bernard is one of our amazing peers. He’s been familiar with Casey House since his husband, Jeff, was cared for as an inpatient before passing away in December 2001.

A few years ago, after retiring from a successful career as a social worker, Bernard applied to be a volunteer and ended up becoming a peer. Making use of his lived experience of HIV was exactly the sort of opportunity Bernard was looking for. He says,

“There’s something very powerful about the peer program. We talk about everything. Share everything.”

black and white image of Bernard standing in front of the heart sculpture at Casey House.

“There’s something very powerful about the peer program. We talk about everything. Share everything.”

Bernard’s experience with his very first client illustrates how important peer support is.

He had a stroke, and was unable to move. He was brought in for palliative care. That was in 2020. And yet he’s still alive today!

This year, when another client was admitted to an acute care hospital and was coping with some medically induced psychosis, he didn’t trust anyone and said he felt as though everyone was trying to kill him. He was losing weight, not eating and becoming extremely weak, but was refusing the recommendation of a feeding tube.

During one of Bernard’s weekly visits, the hospital social worker shared a concern that the client was not getting enough calories. Through conversation and exploring the clash between his words and his feelings, Bernard was able to coach the client to make an informed decision about his care, and he did try the feeding tube. It made a huge difference, and months later, while still in hospital the client expressed how thankful he was for Bernard’s support and patience.

In addition to his one-on-one work with clients Bernard co-leads a group for long-term survivors and seniors living with HIV called Vintage+. He continues to contribute his skills and his experience to support others on their journeys towards health and wellness.

Alex finds connection and
community at Casey House

Alex has been a Casey House client since 2003. He’s accessed multiple services over the years, including the lunch program, massage therapy, and support from a social worker. He loves knowing that Casey House is here, offering specialized services to people who are living with HIV.

“Casey House is sort of like an oasis for all of us where we can feel safe.”

A black and white head and shoulders image of Alex wearing a plaid shirt

“Casey House is sort of like an oasis for all of us where we can feel safe.”

When asked about the massage therapy treatments he received at Casey House, Alex notes that while it was about gaining relief from pain, addressing muscle soreness, tension and anxiety was only one part. It was also about receiving physical touch and genuine acceptance.

“One of the things that happens to people living with HIV is that you get rejected, you get discriminated against… when you have the therapist giving you a massage, they are touching you and… you don’t feel that rejection anymore. They treat you like a regular person and that’s super important.”

One of the things that happens to people living with HIV is that you get rejected, you get discriminated against… when you have the therapist giving you a massage, they are touching you and… you don’t feel that rejection anymore. They treat you like a regular person and that’s super important.

The support Alex felt from massage therapy extended to conversation as well. They discussed substance use, and he was impressed with their knowledge of mental health and addictions, in addition to their expertise in massage and HIV. When Alex mentioned that he was having trouble finding housing, the massage therapist immediately connected him with a social worker, who helped with housing assistance.

Alex feels comforted, knowing that Casey House is here for him today – and will continue to be there for him in the future. He appreciates knowing there is a local hospital that specializes in HIV.

Others

As a hospital that strives to create an inclusive environment where everyone feels safe, we’re also tackling the deeply ingrained stigma associated with HIV. Knowing that fear fuels HIV stigma, and to raise awareness on the issue, we created a short film from the perspective of someone who experiences the fear and anxiety it causes. The intention was to shed light on the irrational fears held by the public that stem from misinformation and a lack of education about HIV and those living with it.

Others, directed by renowned filmmaker and screenwriter Paul Shkordoff, sets out to highlight the impact of judgement and what it can feel like to be haunted by stigma by employing a tense atmosphere and the emotional edginess of a thriller. While the film is a work of fiction, for people living with HIV, stigma is a series of terrible experiences that impact health and well-being. And it happens every day.

The story ends on a cliff hanger and cuts immediately to interview clips of six people speaking honestly about their life with HIV and the stigma they have faced. A professional actor living with HIV was intentionally cast to play the HIV+ protagonist, and learning this from Peter McPherson’s first words makes the transition from film to documentary particularly poignant. The six real stories from people who faced HIV stigma in their own lives and overcame it are featured alongside Others at smashstigma.ca

To create buzz around the film and a narrative around fear, an integrated plan engaged the public, which included an immersive experience world film-premiere, and an international media relations outreach for traditional and social media. The reception was extremely positive, with earned media in outlets such as Toronto Star, CTV’s Your Morning, and Pride.com.

People in a movie theatre watching a movie. The back of a man's head is on the screen.

Others movie poster at premiere. Lit up with warm yellow lights on large wall on the side of a building.

With bold ideas and brave partners, we make the humanity of each client the heart of everything we do.

Celebrating Black women in the HIV sector

Colourful Hibiscus flowers with green leaves

There was a new look and feel for our World AIDS Day event this year. Hosted alongside community partner Women’s Health in Women’s Hands, Voices for World AIDS Day: An evening of storytelling was a beautiful occasion of community and storytelling as we honoured Black female activists and artists who use their voices to inspire change in the HIV sector.

One by one, eight women, including Casey House staff member Racquel Bremmer, engaged the audience with personal accounts of their journeys, and the big and small ways they have responded to the HIV crisis. The stories were heartfelt, honest, and deeply courageous. It was an incredibly powerful evening and had a big impact on guests. As one audience member said:

It’s not every day you get to sing with Jully Black.

d'bi anitafrika and Jully Black embrace each other warmly

Jully Black and d’bi.young.anitafrika

Host Emily Mills with the speakers

d'bi anitafrika speaking to audience at a podium

d’bi.young.anitafrika

Jully Black, back to the camera, arms outstretched. Crowd is reacting with laughs and smiles.

Jully Black engaging the audience

We are grateful to corporate and in-kind sponsors, audience members, volunteers, and most importantly, the featured storytellers and their tremendous contributions to our communities: d’bi.young anitafrika, Sane Dube, Lena Soje, Jully Black, Racquel Bremmer, Muluba Habanyama, Molly Johnson, and Marvelous Muchenje.

In addition to helping us honour the voices, experiences and lives of Black women, the community’s financial support on World AIDS Day helps Casey House continue to be a hospital unlike any other.

Brightly coloured hibiscus flowers and green leaves

Additional Accomplishments

PROVIDED
OUTPATIENT CARE FOR

~500

CLIENTS

each quarter who came for 29,400 visits, an increase from 17,416 the year prior

Casey House Foundation

Casey House
Foundation

FIRST CHARITY

to receive a
AAA rating from
The Veritas Foundation,
who calculated a $3.34 value on every dollar committed compared with an average return rate of $2 – $2.25 for other charities.

12 peers

leveraged their lived experience with just over 1100 hours of peer support visits, almost the equivalent of a full-time staff member

Granted Accreditation
Canada’s primer status

A first step to assuring that our services are at the highest standard of quality care

Art With Heart

back in-person raised over $1 million

Assembled and Distributed

84,045

free safer drug use kits and 235 naloxone kits to clients and members of the public

LAUNCHED THE

the Harm Reduction Capacity Building Training Series : four educational videos originally developed for internal staff learning repurposed to reflect the community care landscape in Toronto. Eash episode features guest speakers from our network.

DELIVERED

2 sessions

of a training program in partnership with UHN and Uof T’s Centre for Advancing Collaborative Healthcare & Education (CACHE) for an interdisciplinary group of students from various health and social service fields. Students take two modules of CATIE’s HIV Basics course, then have a live session to review issues facing our clients; hear from someone with lived experience of HIV; components of effective communication with clients who may be LGBTQ+, may use drugs, or be experiencing homelessness. Students also worked in small groups to review a case study and present back to the group.

125

Admissions to the inpatient unit, clients had an average length of stay of 27 days (due to nursing shortage there were 14 beds open Apr – Dec 2022 and only 10 beds Jan – Mar)

Opened an
outpatient tax clinic

in April 2022 to help clients file taxes and get a notice of assessment, a necessity to apply for supportive housing. Saw 26 clients in the first 8 sessions with positive results, including notices of assessment, refunds, and online CRA accounts

Partnered with
LCBO for
Love Pairs with Everything campaign during Pride.

Photo of campaign image on the bay bloor store

RELEASED
Season 2
of our Podcast
Positively Speaking

Recognized
five outstanding people

with the Casey Award

Muluba Habanyama; Laurie Edmiston; Notisha Massaquoi; Rick Skimmings; and the Shevlen family

participants attended a Casey House Mental Health Series session on mental health implications of physical and emotional isolation in context of monkeypox, HIV and the overarching COVID-19 pandemic, including exploring the impact of HIV stigma in the 1980s and 90s. Speaker Yezarni Wynn and a panel of community workers discussed implications on service delivery and impact they are witnessing in clients.

COMPLETION

of CPSO Quality Improvement Partnership in partnership and with feedback from our nursing team the physicians group focussed on two areas to improve prescribing and communication. The CPSO asked to feature our work as an example.

Served Almost

16,000

hot midday meals

Added monthly
DENTAL CARE CLINIC

many dentists will not provide care to HIV+ individuals and dental health it is an important part of basic health

ADVOCATED FOR CHANGES TO PUBLIC POLICIES:

Engaged 15 clients in municipal policy consultations
Hosted 4 elected officials at the hospital
Co-signed/endorsed 4 policy actions in collaboration with aligned organizations
Contributed insights & recommendations to 3 public policy consultations
Submitted recommendations for 2 government budgets
Shared policy insights & recommendations during 2 election cycles

Engaged 15 clients in municipal policy consultations
Hosted 4 elected officials at the hospital
Co-signed/endorsed 4 policy actions in collaboration with aligned organizations
Contributed insights & recommendations to 3 public policy consultations
Submitted recommendations for 2 government budgets
Shared policy insights & recommendations during 2 election cycles

Nursing clinic
offered interim primary care to clients that came in crisis without a provider and moved them from crisis to stable in a short time

Held a full capacity education session

trauma-informed
care for

new paramedics-in-training

CEO
Joanne Simons
named in

Most influential Canadian Women in Healthcare issue of InsightsCare magazine

Helped inoculate clients
against COVID-19 by offering vaccinations on-site and booking appointments

Shared excess PPE (N95s, face shields) with three local community organizations: Michael Garron family practice, Parkdale Queen West CHC, Street Haven

Financial Highlights

FOUNDATION
Revenue Sources

Fundraising Events

Corporations and Foundations

Individual Donations

Investments & Other income

In-kind donations

Bequests

HOSPITAL
Revenue Sources

Ministry of Health funding

Annual recognition of capital funding

Foundation Grants

Other income

FOUNDATION
Revenue Sources

fundraising events

corporations and foundations

investments & other income

individual donations

bequests

HOSPITAL
Revenue Sources

Ministry of Health funding

Annual recognition of capital funding

Foundation Grants

Other income

Hospital spending of grants from Casey House Foundation

Hospital spending

For full financial statements, visit the ‘Accountability, accessibility and freedom of information’ page at caseyhouse.com https://caseyhouse.ca/about-us/accountability/financial-statements/

We provide clients with innovative comprehensive health care:

Inpatient
Care