Community information sessions to take place in March on two acute care hospital models being explored

The Capital Plan Development Task Force is narrowing in on a few options for two acute care hospital sites—one in Bracebridge and one in Huntsville.

Muskoka Algonquin Healthcare (MAHC) CEO Natalie Bubela and the Chair of the MAHC Board of Directors, Phil Matthews, were before Huntsville Council on February 25, 2019, with a quick update on hospital matters including its capital planning process.

They said the Task Force is looking at two options in Huntsville and three options in Bracebridge. In Huntsville, it is exploring both the renovation and expansion of the existing building at its current site, as well as the possibility of an entirely new building at its current location.

A new building or the expansion of the existing Huntsville District Memorial Hospital would take place to the north as the topography to the east and west is more challenging, according to a slide provided at Monday’s council meeting.

The area where the existing South Muskoka Memorial Hospital in Bracebridge would be rebuilt or expanded is delineated in a slide. The other option to be explored is whether to build a new hospital on a new site or greenfield.

While in Bracebridge, the Task Force is also considering the renovation and/or expansion of the existing building or an entirely new build on its current site. The Task Force is also considering a new building on an a new site, within the town core, due to existing land constraints, according to Bubela and Matthews’ presentation.

The Huntsville hospital, in its present form, was built 45 years ago in 1974, while the Bracebridge hospital was built in 1967, Matthews told council. Both sites are in need of updating, but the idea of building one mega-hospital to replace the two drew fierce opposition. Community members, including health care professionals, particularly in north Muskoka, expressed concerns with response times during acute emergencies, politicians talked about the economic impact on a community once a hospital is removed, and some donors—which the hospital relies on for its capital needs—threatened to pull future donations. In the end, the Task Force recommended maintaining two acute care hospital sites, which the majority of the board accepted. That stance was reiterated by Matthews on Monday.

“We really need to look at these two sites and get them up to speed. Technology is changing. The whole world of medicine is changing, but what we have agreed to is that the two acute care site model—with emergency and surgical services at each site—is the model that we will take to the government. We will put the best case forward to make sure the government realizes this is the answer for Muskoka and area. It’s going to be a fight, but we’re willing to take it on,” Matthews told councillors.

Bubela reminded councillors that any approvals would mean that the government would cover 90 per cent of building costs and the community would be expected to cover the remaining 10 per cent. She also noted that things like furniture, for example, would also not be covered by the Ministry.

“We’re really fortunate that Mayor Aitchison sits on and participates on our Task Force as well as the Mayor of Bracebridge and other municipal leaders,” said Bubela, who also noted that none of the work of MAHC would be possible without the support and advocacy of the community.

She said the Task Force has come up with guiding principles to help it review the different options for both hospital sites and come up with recommendations for the hospital board. Some of the principles include promoting community connection and system integration as well as supporting patient and family-centric care.

Six community engagement sessions are expected to take place in March, where each of the options will be further presented. One will be held in Huntsville on March 7, 2019, at the Active Living Centre at 7 p.m. “And our hopes are at that point that we’ll have a sense of high-level costing of what it would cost to build the various options that we’re looking at. From that point, the Taskforce would make a recommendation that would then go to the board. The board would approve a recommendation, then part A and part B would be put together, submitted to the North Simcoe Muskoka LHIN and Ministry sometime in the early fall,” said Bubela. She said the process could be expected to take anywhere from nine months to a year before the Ministry responds.

Huntsville Councillor Dan Armour asked whether the submission to the Ministry would be public. “That would be absolutely available,” said Bubela.

Councillor Jonathan Wiebe said, assuming that the Ministry accepts the recommendation for two hospitals, he asked whether the board would have an influence on the timing of the project in terms of which site gets developed first. Bubela said that is really not known at this point.

Matthews reminded councillors that there are five hospitals in the local LHIN and all of them have a capital plan in front of the Ministry right now.

We’re all competing for dollars. Will we all get them? That’s a big if, so it’s a very competitive marketplace we’re playing in. We’ve got to make sure our plan is the best plan that we can possibly put forward to get the Minister’s attention and commitment to making this thing work.MAHC Board Chair Phil MATTHEWS

Councillor Brian Thompson thanked them for going with the two-site model. He also asked if there was any indication on the Ministry’s stance.

“We’re in the middle of very uncertain times,” said Matthews, adding that they’ve heard nothing specific from either the LHIN or the Ministry.

MAHC has generally managed to balance its books but only thanks to one-time funding from the Province. Administrators maintain that the Province’s funding formula works against hospitals such as MAHC.

MAHC has managed to balance its budgets thanks to one-time cash infusions by the Ministry, except in 2015/2016. This year it is facing a $2.5 million shortfall.

Bubela said she and MAHC’s Chief Financial Officer had a chance to meet with the financial branch of the Ministry to remind them of the hospital’s financial situation and the support they’ve received from the municipalities. “They indicated to me that they could not make any promises, that they themselves were not entirely aware of the direction that the government was going to be taking,” said Bubela, adding that as a result of that they were not able to offer any insight into what might happen in future, but she said they were very receptive.

Aitchison reminded those present that not only has the Province agreed with a two-site hospital model for this area going forward, but they’ve also acknowledged that there’s a funding formula problem for hospitals, particularly when it comes to medium-sized hospitals like those found in Muskoka. He said the Minister has assured that the formula would be addressed and said Bracebridge Mayor Graydon Smith had reminded the Minister of that commitment at a recent conference.

Aitchison said Smith, who sits on the board of AMO (the Association of Municipalities of Ontario), as well as the hospital administration and others, would continue to lobby the Minister to remind her that she did make a commitment to “fix this problem, not just for us, there’s about 24 or so hospitals sort of in the same boat as us all over the province. They happen to be in more sort of rural ridings, which tend to be Tory ridings, which we hope will serve us well in our deliberations with them,” said Aitchison.

We’re getting close to the time where we should be expecting some sort of a solution from the Ministry and it’s important for us to keep their feet to the fire.Huntsville Mayor Scott Aitchison

There has been much speculation on changes coming to health care in Ontario. On February 26, 2019, a media release from the Province announced its intention to “break down barriers to better patient care” and reduce “hallway health care by focusing resources on patient needs.” It is still unclear how their plan would impact this area.

The release also states that Ontario’s new plan would improve access to services and patient experience by:

• “Organizing health care providers to work as one coordinated team, focused on patients and specific local needs. Patients would experience easy transitions from one health provider to another (for example, between hospitals and home care providers, with one patient story, one patient record and one care plan).
• Providing patients, families and caregivers help in navigating the public health care system, 24/7.
• Integrating multiple provincial agencies and specialized provincial programs into a single agency to provide a central point of accountability and oversight for the health care system. This would improve clinical guidance and support for providers and enable better quality care for patients.
• Improving access to secure digital tools, including online health records and virtual care options for patients—a 21st-century approach to health care.”

You can find the full release here.

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