OVCN Health Care Case Study - Oct 2011


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OVCN Health Care Case Study - Oct 2011

  1. 1. Ontario Volunteer Centre NetworkThe Contributions of Volunteers inHealth Care OrganizationsCase StudiesOctober 7, 2011
  2. 2. 1 of 12IntroductionOntario’s health care system is massive, diverse and complex. Consider the following:154 public hospital corporationsi;440 children’s mental health agenciesii;330 community mental health agenciesiii;150 addiction agenciesiv;98 hospicesv;73 community health centresvi;10 Aboriginal Health Access Centres vii;… and that list is not exhaustive. A wide array of other agencies and groups make an equallysignificant contribution to the health of Ontarians. Given that, it’s not surprising that 450,000 ofthe 5 million Ontario residents (9%) who volunteered in 2007 dedicated their time to theprovince’s health care system.viiiWhat may be surprising is that volunteers in 21 hospitals alone provided more than one millionhours of unpaid labour in a single year – 205 hours each, on averageix. Their roles, and those oftheir colleagues, are as diverse as the system itself: some work with patients directly, othersserve in a leadership capacity, while others offer the type of specialized skills (resourcedevelopment, for example) for which the organization would otherwise have to hire staff or payfor services. In doing so, they benefit the organization, the individuals they serve, theircommunities, and the health care system as a whole.The following case studies were collected by the Ontario Volunteer Centre Network (OVCN) toillustrate benefits delivered to health care in Ontario from the collaborative efforts of VolunteerCentres, community benefit organizations, and individual volunteers. Established in 1995, andformalized with approved terms of reference in 2003, the OVCN serves as the provincialnetwork for all of Ontario’s 23 recognized Volunteer Centres, and as their collective voice.Through projects such as Change the World (the Ontario Youth Volunteer Challenge) andBuilding Stronger Foundations, the OVCN encourages and promotes volunteerism, providestools and resources for volunteer managers, and strengthens the individual and collectiveability of Volunteer Centres in Ontario.The OVCN and its members are indebted to the Ontario Trillium Foundation for funding thisstudy.
  3. 3. OVCN Case Study: The Contributions of Volunteers in Health Care Organizations2 of 12Case StudiesThis paper profiles four of the dedicated volunteers1whose contributions enrich lives, supportorganizations, and ensure the sustainability of our health care system – now and in the future.It also focuses on the agencies with which they are involved and the role of Ontario’s VolunteerCentres in facilitating and supporting that relationship. From each of those perspectives, thebenefits that accrue from their involvement are profound.AngelaTwenty years ago, having received help at a particularly difficult time in her life, Angela decidedto give back by helping others. Summoning up her courage after attending a publicpresentation on palliative care, she made a call to Warmhearts Palliative Caregivers – aSudbury-based agency that provides compassionate support for individuals and their familieswho are dealing with end-of-life issues.Angela found her calling at Warmhearts, and discovered that the work was satisfying, fulfillingand very rewarding. Two decades and 82 clients later, she still remembers her first: “There wasa reason he was put in my life. I was getting as much from the visits as he was, probably more. Ibecame his confidante, his family, and I helped him celebrate his life. He (and my other clients)helped me grow personally and spiritually.”She reflects on that growth: “The experience has completely changed my perspective about lifeand death. My life is enriched with unbelievable experiences, unforgettable memories and somany blessings that I will cherish forever.” Angela’s relationships with her clients are rich anddeeply personal: “The volunteer’s main role is to provide comfort to the client and the family - tolisten - but more importantly, to hear ‘what’s in their hearts’. Many times, when there is nothingelse one can do, the volunteers do the only thing that matters: we offer comfort by just beingpresent. No words are necessary.”Angela’s response to her clients’ needs is as varied as the individuals themselves, and oftencreative: “In one case, I was part of a team of volunteers. We all had different roles. Onevolunteer read to the client; she said that nobody could brush her hair like I could, so thatbecame my job. It’s the little things that make a difference.” In another: “I line danced in thehospital. I don’t know what made me do it, but some nurses joined in and the client loved it.”Another time: “I wrote a song, it showed my client that she mattered in life.”And clearly they matter in hers: “This journey has taught me not to sweat the small stuff – andcompared with dying, almost anything else is small stuff. I quickly learned to appreciate thelittle things we take for granted. Dying individuals teach you so much about living. Their storiesare remarkable. It’s truly been a learning experience about courage, strength and hope. Our1The names of some of the volunteers have been changed to protect their privacy and that of their clients
  4. 4. OVCN Case Study: The Contributions of Volunteers in Health Care Organizations3 of 12clients are the inspiration for me and my fellow volunteers to continue our work in hospicepalliative care.”Just as Angela supports her clients and their families, Warmhearts ensures that they supporttheir more than 170 volunteers by providing them with training and education, debriefing witheach volunteer when he or she loses a client, teaching them to set boundaries and to cope withthe emotions involved in working with people who are dying. On a regular basis, they celebratethe extraordinary contributions of volunteers like Angela with special recognition events.With just five staff and a mandate to cover Greater Sudbury, Sudbury East and ManitoulinIsland, Warmhearts provides a hospice volunteer visiting program, advocacy, bereavementsupport, and hospice palliative care education.“Warmhearts depends largely on volunteers to deliver effective and professional service to theclient,” says Madeleine Sauvé, Client Services Coordinator. “Volunteers also contribute to oursuccess by fulfilling other roles ranging from public awareness, advocacy, education andrevenue development to administration and governance – in short, every aspect of our agency’smandate.”Warmhearts is supported, in turn, by its membership in Volunteer Sudbury/Bénévolat Sudbury,which assists the agency by promoting volunteerism, educating on best practices and referringthe most appropriate volunteers to fulfill the organization’s mission.Volunteer Sudbury seeks volunteers from the community through a variety of methods:presentations to focus groups; kiosks at health, education and community fairs and events;postings on the website and requests through its contact list. The volunteer center keeps itsmembers informed of training opportunities, new information in the field and strategies forvolunteer appreciation, and co-hosts pertinent presentations and a networking group.According to Diane Charette-Lavoie, Manager of Volunteer Sudbury: “We help volunteers tounderstand the needs of organizations such as Warmhearts, so that they will be better preparedfor their commitment to the community.”Together, all three – Angela, Warmhearts and Volunteer Sudbury – form a powerful chain, onethat reflects Warmhearts’ slogan: “Holding hands, touching hearts, wherever they may be” andenables the organization to enhance the quality of life for people whose lives are ending, easestheir transition from life to death, and supports their families in coming to terms with the mostfinal of goodbyes.Without Warmhearts and volunteers like Angela, more people would die alone – at home, or inhospitals, hospices, retirement homes and nursing homes. More families would face thefinancial burden of hiring private care, and the health care system would experience evengreater demands on its already stretched resources.
  5. 5. OVCN Case Study: The Contributions of Volunteers in Health Care Organizations4 of 12NicoleNicole, like many of her colleagues at the Canadian Institute of Chartered Accountants (CICA),believes that the corporate community has a responsibility to support the work of Ontario’shealth care system. Motivated by that belief, she joined with her colleagues to explorevolunteer opportunities; Volunteer Toronto put them in touch with the Centre for Addictionand Mental Health (CAMH). Together, CICA staff have reinvigorated and helped to maintainCAMH’s Garden of Remembrance for the last three years.The garden, created in memory of a client who died many years ago, was intended to be agreen space where current clients could seek respite. However, with few resources available atCAMH to maintain it, the garden had become unkempt and a less-than-uplifting sight for themany clients whose rooms overlook it. That is, until the CICA showed up.Twice yearly, 15 CICA staff arrive to plant and prune, water and weed, and ultimately, create aspace that, according to Jim Davey, Coordinator of Corporate Volunteers for CAMH VolunteerResources, “promotes recovery and wellness.” Working in partnership with the recreationtherapist and the Centre’s clients, the efforts of CICA staff pay off in more than just pansies andpetunias.“My colleagues have come to realize the value of volunteering – some of them have even soughtout volunteer activities on their own – a first, for many of them,” says Nicole. “They’re proud ofthe work they do, and have developed a sense of community and an attachment to CAMH.We’ve bonded as a team.”The experience has helped to demythologize mental illness, raised the awareness of CICA staffabout the issues surrounding mental health, and increased their understanding of the all-too-pervasive stigma experienced by those with psychiatric problems. It has also helped some ofthem to be more forthcoming about their own struggles with mental illness, or those of theirfamilies.The benefits are equally diverse for CAMH clients. According to Nicole: “Our presence in thegarden is felt – it tells clients that someone knows that they are there, and that they deserve anice place, too… We provide an important link with the community and the world outside theinstitution that would otherwise not be available.”Jim Davey elaborates: “CICA staff, like our other corporate volunteers, makes an effort toestablish a rapport with clients. They encourage them and, through their engagement, instillconfidence and self esteem. The main focus is on engaging the individual, not the illness – andit’s that connection that has a huge impact on our clients – they feel welcomed and accepted,part of the community.” Jim continues: “That relationship with the community helps to restoreand maintain their health which, in turn, reduces risk of relapse,” – a substantial return for sucha modest investment.
  6. 6. OVCN Case Study: The Contributions of Volunteers in Health Care Organizations5 of 12Volunteer Toronto helped to leverage that investment. For the CICA, like other potentialcorporate volunteers, the involvement of Volunteer Toronto provides a third partyendorsement of CAMH – a significant asset, given that mental health institutions oftenexperience the same stigma as the people they serve.Deborah Gardner, Executive Director, Volunteer Toronto notes that, since establishing theirconnection through the garden project, her centre has also been involved with CAMH in a widevariety of other activities - most recently as a partner in the national emergency planningproject initiated by Volunteer Canada. Volunteer Toronto shares CAMH’s commitment tocultural competency and has even become a corporate volunteer for CAMH in the interest ofreducing stigma among its own staff.MildredAfter a lifetime as a nurse, Mildred wasn’t quite prepared to retire. Instead, at 72, she became avolunteer for the Alzheimer’s Society of Kitchener-Waterloo (K-W). Six years later, she describesher role: “I provide care for the caregiver – it allows them to get away for a few hours, insteadof having to be ’on duty’ 24/7. I take people for walks – the exercise helps to keep themhealthy.” The stimulation she provides – sharing photos, reading to her clients – helps maintaintheir cognitive abilities. Her only wish: that there were more of her. “If there were morevolunteers (which would allow for more frequent visits and longer hours),” she says, “familieswould benefit even more.”She admits that there are challenges: “Sometimes, people (your clients) don’t recognize you.Families may be in crisis – not yet ready to place their loved one into long term care, but unableto cope.” And she imagines what would happen if volunteers were not available: “Families(many of whom can’t afford the $20 an hour it would cost) would have to pay for respite or relyon the limited resources available through the Community Care Access Centre. Clients wouldenter nursing homes much sooner.” And, perhaps most significantly from the perspective of thehealth care system, “calls to 911 and visits to the Emergency Department would increase.”Jill Mercier, Volunteer Companion Program Lead with the Alzheimer Society K-W recognizesMildred’s value to her organization, and that of the other 100 + ‘core’ volunteers: “Bycontributing their time and talent, volunteers serve as extra hands whose skills augment thoseof our staff and allow us to spend more time on direct service. They provide input from, andknowledge of diverse communities, and help to increase public awareness of the Society. Theyoften come to the position with skills and knowledge about Alzheimer’s disease and relateddementia that they have acquired through their work experiences.”She describes Mildred’s role: “She’s been matched with several families over the years, and hasbecome a friend and a strong advocate for the people she visits – both the person withdementia and their spouse, whom she ‘walks alongside’ as the disease progresses.”
  7. 7. OVCN Case Study: The Contributions of Volunteers in Health Care Organizations6 of 12Like Mildred, Jill believes that her volunteers provide significant benefits. These benefits areillustrated in the ‘Rising Tide’ study, published by the Alzheimer Society of Canada, which foundthat volunteers help to increase physical activity, improve diet and enhance lifestyle, providecaregiver support, and assist families in navigating an often confusing health care system.None of that is a surprise to Jane Hennig, Executive Director of the Volunteer Action Centre ofKitchener Waterloo and Area. “In our role, we hear many stories of amazing volunteers likeMildred who contribute so much to our community. We also recognize the complexity ofvolunteer involvement and the related risk management strategies implemented for the well-being of the clients, the volunteers and the organizations.”What is clear from the Alzheimer’s Society story is that the need for highly skilled, dedicated,and long-term volunteers is paramount for service delivery. Jane emphasizes that: “It is vital forsupport resources like the Volunteer Action Centre to consult, collaborate, and provide guidanceto community benefit organizations on the best practices in volunteer management that willensure proper matching, training, supervision, and recognition of volunteers like Mildred. If weare to continue to retain these long-term volunteers, we must do a very good job in ensuringtheir experience is a positive one.”Jane notes that long-term volunteering is, however, not the strongest current trend involunteering: “The Volunteer Action Centre also works with all of its member organizations tofacilitate the motivations and interests of the evolving volunteer environment. Developingprogram directions that attract short-term, sporadic volunteers to meaningful and beneficialactivities is essential to sustaining community organizations. We support organizations’initiatives that foster creativity in program development and enhance short-term experiencesfor volunteers.”Both organizations are aware of the challenges inherent to the changing face of volunteering,but are optimistic about the positive effect that working in cooperation continues to have ontheir community. Jane is enthusiastic about the variety of collaborations between theVolunteer Action Centre and the Alzheimer’s Society. “As organizations like the Alzheimer’sSociety meet growing demands for service through their volunteers, the Volunteer Action Centreworks to find new connections that will expand the volunteer base for them. We have helped tobridge connections with local post-secondary education institutions to help inform and engagefuture generations and build their awareness of the value of volunteering. The Alzheimer’sSociety has been an active participant in working with new audiences in order to developvolunteers who might move into vital long-term roles like Mildred’s.” Jill agrees, noting: “Weappreciate the Volunteer Action Centre for being available and supportive as a bridging resourcefor us.”
  8. 8. OVCN Case Study: The Contributions of Volunteers in Health Care Organizations7 of 12MargaretIn her twenty-nine years as a volunteer with Brockville General Hospital (BGH) Margaret hasserved in many roles. From circulating among the wards with the auxiliary snack wagon, todelivering flowers, to feeding patients in the complex continuing care ward, Margaret’snurturing tendencies and sunny disposition have been put to good use.More than twenty times a month for the past 13 years, she’s fed people who are unable to feedthemselves. And it’s not just about dinner. For someone whose life is defined by the hospitalwalls and the unrelenting sameness of its schedule, the quality time and social interactionMargaret offers is as important as the meal itself. Although they may have troublecommunicating, her patients let her know how much they appreciate her contribution to theirlives: “One of my patients has a wonderful smile – her eyes brighten when I come in.”Despite that, and despite having received the highest honour available to a health carevolunteer (the Hospital Auxiliaries Association of Ontario Provincial Life Membership award)Margaret is convinced that she gets back as much as she gives: “I enjoy the work – especiallytalking to people.” And she understands the fragility of the human body: “I often think that it(immobility) could happen to me.” What she doesn’t say is how important it would be for her tohave another ‘Margaret’ available if it did.Christine Deault knows all too well the value of Margaret’s contribution. As Coordinator ofVolunteer Services at BGH, she’s proud of the Volunteer Association’s 121 years of continuousservice. She notes that, in 2010/11, BGH volunteers provided 26,563 hours of service – inaddition to those contributed by Palliative Care volunteers and members of the hospitalfoundation.She describes the work they do: “Volunteers provide service to patients on two nursing floors –they deliver ice water, take away breakfast trays, replenish supplies and chat with patients.” InDay Surgery: “Volunteers wheel patients to their car on discharge, help the person who’smeeting them, liaise with families in the waiting room.” Since January, they’ve also providedsupport in the Emergency Room: “… providing blankets, ice packs, coffee or juice.”They don’t, she emphasizes, replace professional staff. Instead, they allow nurses more time forpatient care by assisting with non-nursing tasks, which might otherwise be left undone (such ashair care) or done quickly (feeding, for example) without the added value that people likeMargaret are able to provide. In general, they help patients be more comfortable, and make aninherently challenging experience less difficult.Christine also notes the importance of volunteers as the hospital’s ambassadors in thecommunity: “They help us to stay engaged,” and they participate in consultations about thedesign of Brockville’s health system.
  9. 9. OVCN Case Study: The Contributions of Volunteers in Health Care Organizations8 of 12Frank Rockett supports the work of the BGH Volunteer Association. As the Executive Director ofthe Volunteer Bureau of Leeds-Grenville, Frank provides the type of training and informationabout best practices on which Christine relies. The Bureau’s volunteer-matching web portal alsolinks people looking for volunteer opportunities with agencies that need their service.Frank sees his job as “promoting volunteerism” – a role that he fulfills through participation inspecial events and community fairs, and by focusing the media’s (and, consequently, thepublic’s) attention on the worth and value of volunteers. He is committed to “keepingvolunteerism in the minds of politicians,” and works hard to do exactly that. His only regret isthat, with a very limited budget and a very large region to serve, he is unable to do more.Why It MattersThe cost of Ontario’s health care system is growing at what most consider an unsustainablepace. Consider the following:The 2011 provincial budget allocated $47 billion to health care.xBetween 1989 and 2009 the per capita cost of health services more than doubled - from$1,500 to $3,500 for every Ontarian.xiHealth care currently accounts for 42% of the Ontario government’s total programspending, and could rise to 50% in the near futurexii, causing at least one analyst to referto health care as the “Pac Man” of provincial budgets.xiiiThe percentage of people over 65 in the population will rise from 13.7% in 2007 to21.9% by 2030. xivEach of those 3.7 million seniors can be expected to place increaseddemands on the province’s already overburdened health care system – costing threetimes more, on average, than their younger counterparts.xvGiven those startling figures, it’s not surprising that all of us – taxpayers, politicians, policyanalysts and health care providers themselves – are looking for ways to relieve the pressure onthe system while, at the same time, ensuring that it continues to provide the high quality carethat Ontarians need and expect. Volunteers, and the agencies that support them, contributesignificantly to that effort.The time (61 hours per volunteer, according to Giving and Volunteering in Ontario) andexpertise that Ontario’s 450,000xvihealth care volunteers contribute to the province’s healthcare system has considerable monetary value. Even at the modest hourly rate ($16.50) used inVolunteer Canadas “Volunteer Management Audit, 2001,”xviithe total contribution of all healthcare volunteers in Ontario can be estimated at $452 million per year. The size of thatcontribution rises dramatically (to $555 million per year), if the more recent hourly rate($20.25) set by a major US organization in 2009 is appliedxviii.
  10. 10. OVCN Case Study: The Contributions of Volunteers in Health Care Organizations9 of 12Whichever figure is used, it’s clear that volunteers contribute enormously to the sustainabilityof Ontario’s health care system from a financial perspective. For a system in which funding isincreasingly tight, that’s a contribution that must not be undervalued.Estimating the monetary value of volunteer time and expertise is only the beginning. Assessingthe contribution of volunteers in the health care system must also consider the types of non-monetary advantages demonstrated in just these four case studies:As demonstrated in Angela’s story, volunteers can help to reduce the number ofemergency department visits and hospitalizations by helping people who have chronicillnesses or those who require palliative care to remain longer in their homes.Margaret shows us that, volunteers can help to deliver essential services such as feedingin acute care environments, which helps to relieve the pressure on professional staffand enhances the quality of life for the patient.Mildred’s experience makes it clear that, volunteers can help to reduce early admissionto long-term care facilities by helping seniors to maintain brain health, and remain asindependent as possible for as long as possible.Nicole and her colleagues demonstrate the power of volunteers to help reduce thestigma and isolation associated with mental illness by helping people to connect withthe community, and focusing on the individual, not the illness.Angela, Margaret, Mildred, Nicole and the almost half a million other health care volunteerslike them are providing an invaluable service – one that we cannot do without. The Ontariogovernment has demonstrated a strong commitment to controlling health care costs while alsomaintaining and enhancing the care that Ontarians receive. In light of that commitment, thecorps of volunteers that contribute so generously to that system must be recognized andstrongly supported.As Jane Hennig has observed, volunteer involvement is a complex process. Matching volunteerswith organizations and roles, providing them with the tools and resources they need to besuccessful, recognizing their contributions, and ensuring risk management and due diligencerequire the skillful management of volunteer resources.The organizations that support Ontario’s volunteers, and the Volunteer Centres that, in turn,support those organizations each play a pivotal role in ensuring the sustainability of Ontario’shealth care system. It is critical then that we, as a province, support them.
  11. 11. OVCN Case Study: The Contributions of Volunteers in Health Care Organizations10 of 12Appendix: Project MethodologyIn January 2011, the OVCN received funds from the Ontario Trillium Foundation to develop aCase Study document focused on the contributions of volunteers and Volunteer Centres inOntario’s health care sector. An external consulting firm was engaged through a competitiveselection process, and the project was completed under the direction of a steering committeecomprised of OVCN member representatives. The Volunteer Action Centre in Kitchener-Waterloo acted as the lead for the project.To obtain case examples that could be included in the research, a questionnaire for health careorganizations and a package of explanatory material were developed by the consultants inconsultation with the project steering committee. Those documents were forwarded to allmembers of the OVCN on April 8thwith a request that they forward the materials to up to fivehealth care organizations to which they provide services. Health care organizations were askedto:describe the involvement of volunteers in their organizations;comment on the benefits accrued from the contribution of volunteers;provide a detailed description of one volunteer’s role and contributions; andidentify the ways in which the services provided by Volunteer Centres have supportedthe organization’s engagement, retention, and management of its volunteer corps.Completed submissions were requested by May 6th; fourteen organizations responded. Theirsubmissions described a broad range of volunteer roles and contributions in a variety of healthcare settings – ranging from hospitals and community health centres to palliative care andchronic illness support programs. It was noted that the number of cases submitted wassomewhat less than anticipated because volunteers may be reluctant to ‘tell their stories’ –many may not understand what’s unique or ‘special’ about the work they do, and may feeluncomfortable being singled out for their contribution.Four submissions were selected to be featured in the case study document, using criteriadeveloped in consultation with the project steering committee. It should be noted that,although all four of the case examples described in the study involve female volunteers, thirtyfive percent of the individual volunteers described in detailed case examples were male.For each of the examples selected, telephone interviews were utilized to build an in-depthpicture from the points of view of the volunteer, the health care organization, and theVolunteer Centre. Findings from the interviews were documented as ‘stories’ which wereintended to convey the highly individualized nature of volunteer involvement and to highlightthe many benefits of those contributions to patients and clients, health care organizations, thecommunity, and the volunteers themselves. Each ‘story’ was reviewed by those whoseexperience it described prior to being finalized for inclusion in the Case Study document.The consultants wish to extend special thanks to the volunteers and the staff of health careorganizations and Volunteer Centres for contributing their stories to this document.
  12. 12. OVCN Case Study: The Contributions of Volunteers in Health Care Organizations11 of 12EndnotesiOntario Hospital Association www.oha.com/ABOUTUS/WELCOME/Pages/Default.aspx .iiNavigating the Journey to Wellness: The Comprehensive Mental Health and Addictions Action Plan forOntarians (2010). Final Report of the Select Committee on Mental Health and Addictions. Available at:www.ontla.on.ca/committee-proceedings/committee-reports/files_pdf/Select%20Report%20ENG.pdf .iiiNavigating the Journey to Wellness: The Comprehensive Mental Health and Addictions Action Plan forOntarians (2010). Final Report of the Select Committee on Mental Health and Addictions. Available at:www.ontla.on.ca/committee-proceedings/committee-reports/files_pdf/Select%20Report%20ENG.pdf .ivNavigating the Journey to Wellness: The Comprehensive Mental Health and Addictions Action Plan forOntarians (2010). Final Report of the Select Committee on Mental Health and Addictions. Available at:www.ontla.on.ca/committee-proceedings/committee-reports/files_pdf/Select%20Report%20ENG.pdf .vHospice Association of Ontario. Available at: www.hospice.on.ca/faq.php#where.viAssociation of Ontario Health Centres. Available at: www.ontariochc.ca/index.php?ci_id=2341&la_id=1viiAssociation of Ontario Health Centres. Available at:www.ontariochc.ca/index.php?ci_id=2341&la_id=1viiiLindsey Vodarek, David Lasby and Brynn Clarke. Giving and Volunteering in Ontario: Findings from theCanada Survey of Giving, Volunteering and Participating (2007) pp. 18-21. Imagine Canada. Available at:www.givingandvolunteering.ca/files/giving/en/reports/ontario_report_en_2007_21122010.pdfixD. Kew, L. McGrattan and M. L. Tinmouth. Volunteer Resources: Healthcare Benchmarking 2009/10Results. Professional Administrators of Volunteer Resources – Ontario (p. 5-7)x2011 Ontario Budget: Chapter II: Ontarios Economic Outlook and Fiscal Plan- Section H: Details ofOntario’s Finances. Available at: www.fin.gov.on.ca/en/budget/ontariobudgets/2011/ch2h.htmlxiIdeas and Opportunities for Bending the Health Care Cost Curve: Advice for the Government of Ontario(2010). Ontario Association of Community Health Centres, Ontario Federation of Community MentalHealth and Addiction Programs, and Ontario Hospital Association. Available at:www.oha.com/News/MediaCentre/Documents/Bending%20the%20Health%20Care%20Cost%20Curve%20(Final%20Report%20-%20April%2013%202010).pdfxiiOntarios Long-Term Report on the Economy, Chapter 3: Long-Term Sustainability of Ontario PublicServices (2010). Ontario Ministry of Finance. Available at:www.fin.gov.on.ca/en/economy/ltr/2010/ch3.html#ch3_2xiiiDon Drummond, Charting a Path to Sustainable Health Care in Ontario: Special Report (May 27, 2010).TD Bank Financial Group. Available at: www.td.com/economics/special/db0510_health_care.pdf
  13. 13. OVCN Case Study: The Contributions of Volunteers in Health Care Organizations12 of 12xivOntarios Long-Term Report on the Economy, Chapter 3: Long-Term Sustainability of Ontario PublicServices (2010). Ontario Ministry of Finance. Available at:www.fin.gov.on.ca/en/economy/ltr/2010/ch3.html#ch3_2xvOntarios Long-Term Report on the Economy, Chapter 3: Long-Term Sustainability of Ontario PublicServices (2010). Ontario Ministry of Finance (2010). Available at:www.fin.gov.on.ca/en/economy/ltr/2010/ltr2010.pdfxviVodarek, Lindsey, David Lasby and Brynn Clarke. Giving and Volunteering in Ontario: Findings from theCanada Survey of Giving, Volunteering and Participation (2007), pp. 18-21. Imagine Canada. Available at:www.givingandvolunteering.ca/files/giving/en/reports/ontario_report_en_2007_21122010.pdfxviiVolunteer Management Audit: The Canadian Code for Volunteer Involvement (2001), VolunteerCanada. Available at:http://www.volunteerguelphwellington.on.ca/useredits/File/ManagementAuditEng.pdfxviiiThe Value of Volunteer Time (2010) The Independent Sector. Available at:http://independentsector.org/volunteer_time