Task Force seeks community input on options for two acute care hospital sites



Muskoka Algonquin Healthcare (MAHC) and the Capital Plan Development Task Force want your input.

They’ve been holding public meetings to explain the hospital models currently being explored. One of those meetings was held at the Active Living Centre in Huntsville on Thursday, March 7, which drew an estimated 70 people.

Up for consideration is whether to renovate and expand the existing hospital buildings in Huntsville and Bracebridge or whether to replace the buildings and construct new ones on the existing sites. There is also a third option, a new hospital on a new site, being considered for the Bracebridge hospital, which borders a ravine on one side and a residential neighbourhood on the other and sits on 11 acres of land rather than the ideal 30 to 40 acres, according to Tim Eastwood with Stantec Architecture, the consultant working on the project.

Regardless of the model chosen, those who attended the meeting were assured that both acute care sites would continue to have emergency rooms and provide inpatient as well as surgical services.

Below are the models being proposed:

In Huntsville

Renovation/expansion of the existing Huntsville hospital building would mean using a part of the existing hospital and adding an expansion to the east and south towards Muskoka Road 3.  About 30 per cent of the existing building would be used and approximately 70 per cent would be an addition. It would be a three-storey building with a total area of about 260,000 square feet and an estimated construction cost of about $197 million. It could be built in phases, which would take many years but give the community more time to come up with its share of the cost.

Replacing the existing hospital building with a new build to the east of the existing building would cost an estimated $210 million. Once the new building is completed, staff and patients would move to the new building, the old one would be completely removed, and parking would be built in its place. The new building would also be three storeys with an area of approximately 287,000 square feet.

In Bracebridge

Renovation/expansion of the existing building would mean using about 25 per cent of the existing building with 75 per cent of the building being newly constructed north of the existing hospital and towards Liddard Street. The building would be four storeys and about 242,000 square feet at an estimated construction cost of about $187 million.

Replacing the existing hospital building in Bracebridge would mean constructing a new building on the northwest corner of the property towards Liddard Street. It would also be a four-storey building with an area of about 251,000 square feet and a construction cost of approximately $198 million

A third option for Bracebridge would be to build a new two-storey building on an entirely new and serviced 30 to 40 acre site, which would have to be accessed from two roads and be located in close proximity to Highway 11. Choosing a site would entail a separate process if this option is chosen. The building would have an area of about 234,000 square feet and construction costs are estimated at $182 million, not including the cost of the land.

Both the Huntsville and Bracebridge sites would be built or renovated to accommodate additional beds in the future, based on projections associated with the age and growth of the population. Below is a breakdown of how services and beds would be distributed between the two sites:

While Huntsville, a designated stroke centre for the area, would get 14 stroke rehabilitation beds, Bracebridge would get additional complex continuing care beds.

Beds and service distribution among the two sites, as presented at the meeting held March 7, 2019, in Huntsville.

MAHC CEO Natalie Bubela explained that some services could be offered in the community, rather than in the hospital, which could result in a smaller hospital footprint and savings in construction costs.

Harold Featherston, Chief Executive Diagnostics, Ambulatory and Planning for MAHC, explained that if the plan is approved, the Province would fund 90 per cent of construction costs, which means the community would be responsible for raising the other 10 per cent as well as other costs such as furniture, equipment, land acquisition (if needed) and servicing that land, as well as revenue generating spaces such as gift shops and parking areas.

Bubela spoke to significant changes to health care delivery announced by the Ford government, which would dissolve the Local Health Integration Networks (LHINs) and create a super agency called Ontario Health. Health agencies such as eHealth and Cancer Care Ontario will be overseen by Ontario Health.

“It’s difficult to anticipate how these changes, since we’re in early days, may impact our capital planning and for that matter any capital planning that’s occurring in Ontario. But it is important to remember that decision-making does rest with the Ministry of Health and Long-Term Care and based on our intelligence up until now, we do not see that changing and that capital projects are continuing to proceed as they have in the past,” said Bubela. “We will continue to work toward making the strongest possible case for hospital redevelopment in Muskoka and area and continue to ensure that as we’re doing this planning that we’re planning in a way that can adapt to any future and/or local health integrated care systems that may be developed.”

She noted that other changes include calling for the creation of health teams across the province. The teams must be able to deliver a minimum of three services such as, for example, hospital, primary, long-term and mental health and addiction services in an integrated manner.

“We here in Muskoka look forward to working collaboratively with all of our partners, building on the work of MAHST and together being one of the first Health Teams in Ontario,” said Bubela. MAHST, the Muskoka and Area Health System Transformation Council,was an earlier advisory body tasked with developing an integrated health care model and implementation plan.

Cameron Renwick, Vice Chair of the Board of Directors for MAHC and Chair of the task force, asked that people provide input about the options being explored. He said the feedback would be collated and used by the task force to formulate its recommendation to the hospital board sometime in the spring. He said that once the preferred options have been determined there’ll be a more detailed analysis of the potential costs as well as the possibility of phasing-in the project and seeing how that would impact the cost.

Ministry stages in the capital plan development process. MAHC is currently on Stage 1.

For more information about the capital planning process and the options being proposed, access MAHC’s website here. You can also provide feedback until March 24 on the models being proposed here.

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  1. A cursory examination of the 15-year projection should have eliminated the new-build alternative in Bracebridge at the outset. They are projected to gain 11 beds in this time-frame; while Huntsville is projected to gain 40 beds (including 14 stroke-rehab beds). And although this option is shown as the least expensive of all 5; it also represents the least usable area : With the cost of acquiring and servicing (water, sewer, hydro, roads, high-speed internet) approximately 40 acres of prime commercial/industrial land omitted, the eventual cost is far higher.
    With respect to the 4 remaining options, I feel that replacement is the better option in both locations. Increased parking (even though that would be part of the municipal 10%, as a funding source) and less disruption are just 2 benefits. The costs shouldn’t be an issue for 50-year facilities. The cost/sq.ft. is $0,79 for SMMH (vs. $0.77 for 70% replacement): The respective costing for NMMH is $0.73 (vs. $0.76 for 75% replacement). I quite realize that these are high-level estimates; subject to change with more detailed financials (but the order of comparative magnitude should still be valid).
    Just consider the problems in connecting existing wiring and plumbing (based on outdated codes). You can’t: everything has to be replaced and brought up to code (thereby destroying major portions of ceilings and walls). Why even contemplate it, to save about one-quarter of an ancient facility?
    Ms. Bubela’s suggestions about moving several services into the community are well-taken. I believe that the existing Fairvern building is destined for reconstruction as townhomes. If not, however, this would be an excellent location for most/all of these services.
    I’m certain that Tim Horton’s will move into both locations; under a profit-sharing basis. And if we could find an appropriate restaurateur (with dietician-regulated offerings) to run both cafeterias on a similar benefit basis; we could recoup some of the 10%.
    This is our one kick at the can for at least the next 50 years. Let’s do both communities proud by building brand-new facilities on our own, readily-serviced land .

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