Capital Plan Development Task Force Meeting # 27 MINUTES for Monday, - - PowerPoint PPT Presentation

CONFIDENTIAL | MAHC Capital Plan Development Task Force Minutes | Mar. 4, 2019 | Page 1 of 4

Capital Plan Development Task Force – Meeting # 27 MINUTES for Monday, March 4th, 2019

SMMH Conference Room at 0730 – 0930hrs Committee Members: “” = Present “R” = Regrets Chair Cameron Renwick  Scott Aitchison  Dr. Sheena Branigan R Natalie Bubela  Charlane Cluett R

• Dr. Caroline Correia (telecon)

 Dr. Keith Cross  Colin Miller (for John Curran)  Jan Davidson R Peter Deane  Donna Denny  Michael Duben R

• Dr. Graeme Gair (telecon)

R Harold Featherston  Dr. Biagio Iannantuono  Dr. David Mathies R

• Dr. Jennifer Macmillan

 Cathy McMurray  Esther Millar  Terry Shields R Graydon Smith  Eric Spinks  Cathy Still  Chair: Cameron Renwick Recorder: Paula Bildson = Attached Resources (non-voting members) Chuck Wertheimer (RPG)  Shannon Crowder (RPG) R Tim Eastwood (Stantec) telecon  Melissa Cao (Stantec) R Allyson Snelling (MAHC)  Paula Bildson (MAHC)  John Sisson (guest)  Phil Matthews (guest)  Katherine Craine (guest)  Agenda Topics Outcome of Discussion / Decision Points Follow Up Date / Person Responsible

• 1. Introductions & Agenda
• The Chair welcomed everyone to the meeting.
• 2. Confidentiality / Code of

Conduct Check-in

• Members were reminded to treat all discussions as well as any paper or electronic records

in a confidential manner.

• 3. Previous Minutes 
• It was moved, seconded and carried that the task force minutes of February 4, 2019 be

approved as circulated.

• 4. Business Arising/Continuing

4.1 Local Share

• The Task Force was advised that KCI will be delivering a report at a meeting taking place

following the Task Force meeting today and more will be reported on Local Share once the report is received. 4.2 Part B Schedule 

• Task Force members were provided with an updated Part B Schedule.

4.3 LHIN Update / Ministry Announcement

• It was reported that a funding letter was received late Friday that MAHC had been

granted a 1.6 million in additional funding to get the organization closer to a balanced

• budget. Thanks went out to municipal leaders for their support in discussions with

government officials.

• It was shared with the Task Force that the Ontario Government is looking to develop
• verarching super agency which will take over the healthcare file of ON and be

Key message for update

CONFIDENTIAL | MAHC Capital Plan Development Task Force Minutes | Mar. 4, 2019 | Page 2 of 4

responsible for centralized procurement. Elimination of LHINs, and other orgs such as E- Health Ontario and Cancer Care Ontario. There will be a fair amount of work around the legal side of HR as transition takes place. Call tomorrow with OHA that Natalie and Phil will be on tomorrow will help to learn more. The new initiative is not centered on hospital care but more healthcare delivery more at the primary care level.

• It was reported that a conversation took place between the Premier, Natalie, and Phil.

The Premier was very direct in that he said Muskoka needs two hospitals. Information was shared with him about the 6 community sessions taking place this week and that the Task Force has great cross representation including our municipal leaders. It seemed that the Premier is well aware of the healthcare planning in Muskoka and appears very supportive of the two hospitals model.

• N. Bubela
• 5. New Business

5.1 Community Engagement

• The agenda and format for the sessions were summarized and explained that the

pamphlet that was circulated at the meeting was created to provide attendees with information to take with them.

• There will be 4 main stations of poster boards (HDMH options, SMMH options, programs

and services, and deign guiding principles.

• It was requested that Task Force members advise of their availability if they had not

already for what sessions that would be able to attend to assist in fielding questions at the different poster board stations.

• The addition of a session for Lake of Bays residents has been arranged to take place at the

Dwight Community Center at the request from a Task Force member.

• The slide presentation for the community engagement sessions was reviewed.
• A key message at the sessions will be further refinement occurs at every stage of

planning.

• Attendees at the sessions will be asked to provide their feedback on the different options

by either filling out hard copies of a survey at the venues, or by filling out the on-line

• survey. Once survey closes on March 24, the feedback will be reviewed by the Task Force.
• It was felt that the announcement last week by the Ford government with the future

Ontario Health Teams may cause some change in the planning process, but it is unclear at this time what that may be. Thoughts are that MAHC is well positioned at this time to adapt or adopt what may be required to better suit any significant changes that the government may impose on healthcare planning.

• A question was raised re Mammography. It was shared MAHC is currently trying to get a

designation as a center with Cancer Care Ontario which could impact the model which could be adjusted further into the process. Key message for update 5.2 Costing of Options

• A slide depicting the construction costs provided to MAHC by Hanscomb was displayed

for review and comment. It was explained to the group that the construction cost does not include furniture, fixtures, and equipment and other items such as land acquisition, or Key message for update

CONFIDENTIAL | MAHC Capital Plan Development Task Force Minutes | Mar. 4, 2019 | Page 3 of 4

servicing of land, parking lots, gift shops etc.

• It was shared that the one reason for higher cost for HDMH options is for additional

square footage for One Kids Place and the Family Health Team to be brought into the main building. This isn’t the case for SMMH. It was asked if the government is favouring

• ne concept over the other; FHT on campus or off campus. It was reported that their

preference is not known, but the Ministry is looking for innovative models for service delivery.

• Numbers are still to be refined. Reality is that what is submitted at stage 1 will go through

much refinement and modification. It is also possible that budgetary restraints could be imposed by the Ministry.

• A requirement may be to see how the options can be phased over time to make option
• affordable. But the current costing provided is the level of detail that the Ministry is

looking for at this stage. This costing will assist the Task Force in selecting a preferred

• ption for each site.
• It was asked how the additional costs not included in the 10% will be explained to the
• public. It will be shared that FFE and other costs can amount as much if not more than the

10%. There is a lot of variability in that unknown number and is somewhat dependent on the option chosen, what MAHC is investing in today that can support the future planning. There is much unknown at this stage, but this is the norm and not unique to MAHC. Planning and strategizing will continue. 5.3 Options Evaluation

• The options evaluation slide was reviewed. Criteria have been identified in two

categories, Qualitative and Quantitative.

• In each of the approaches, have a new tower, if want to do in a more scaled back way

from what is planned for the towers, may need some adjustments. Within all of the models, the new beds are located in new towers. Can the new tower be built and then connected to the current building. Yes this can be done.

• It was stated that construction will cause disruptions. Interruption in service and/or

construction will happen. For example, Emerg renos affect Ophthalmology surgery. Construction crews have to halt working during these scheduled surgeries. Key message for update

• 6. Communication

6.1

• The communication plan for the community sessions was included in agenda package.
• The online feedback survey for feedback will go live on Monday, March 4, along with all

documents associated with the community engagement (i.e.: poster boards of option drawings, brochure, presentation) posted on the MAHC website Planning for the Future section – Building Design Options (Part B) webpage. The survey will remain open for feedback until March 24.

• There has been great support from the municipalities to help get the word out about the

community sessions through tools shared around.

• Media uptake to promote the sessions has also been good, and the CEO has facilitated TV

Key message for update

CONFIDENTIAL | MAHC Capital Plan Development Task Force Minutes | Mar. 4, 2019 | Page 4 of 4

interviews, including Cogeco (YourTV) and CTV Barrie.

• Allyson will produce a series of short videos to explain each option. These will be

uploaded to MAHC’s YouTube channel and shared on the website and social media in an attempt to reach those who were unable to attend the information sessions.

• 7. Next Steps:

7.1 Next Meeting Monday, April 8 HDMH Boardroom

1

Capital Plan Development Task Force

March 4th, 2019 Meeting

2

Code of Conduct Reminder

• Speak in a professional, respectful manner at all times
• Do not use condescending or raised voices, be aware of tone
• f voice and body language
• Be attentive and listen without judgment
• Respect the sensitivity of issues communicated
• Be mindful of the words and language we use and the

impact on others

• Use positive language
• Have a positive attitude
• Do not tolerate aggression and discrimination in any form

3

Part B Schedule

• Updated version of Stage 1 Part B Schedule

Highlights is in your agenda package.

Version: Feb 4 19 Schedule Highlights - Stage 1 Part B 2018-2019 September October November December January February March April May June July August Notes

20

4

Community Engagement

• March 2019 Schedule

5

Community Engagement

• Agenda/Format:

Agenda Item Time Allotted Person(s) Responsible Tool Sign-in & Backgrounder Allyson Snelling/Paula Bildson Sign-in sheet Brochure/Backgrounde r Opening Remarks 5 mins Cameron Renwick, Task Force Chair Speaking notes Formal Presentation  Where we are in the process  Reminder of Two Acute Sites model selected  Overview of programs & services/bed distribution  Design Guiding Principles  Description of the five building design options  Costing of the five building design options  Task Force evaluation process  Next steps 45 mins Natalie Bubela/Harold Featherston Natalie Bubela/Harold Featherston Natalie Bubela/Harold Featherston Tim Eastwood, Stantec Tim Eastwood, Stantec Tim Eastwood, Stantec Tim Eastwood, Stantec Cameron Renwick, Task Force Chair PowerPoint, speaking notes Brief Q&A (to clarify any information presented only) 15 mins Cameron Renwick, Task Force Chair Stations with Poster Boards  HDMH Options  SMMH Options  Design Guiding Principles  Programs & services/bed distribution 60 mins Task Force members Task Force members Task Force members Task Force members 2 Poster Boards 3 Poster Boards Poster Board Poster Board

6

Community Information Sessions

March 4 – 8, 2019

WELCOME!

7

Tonight’s Agenda

• MAHC’s future planning journey
• Two Acute Sites Future Service Delivery Model
• Building Design Options / Site Plans
• Design Guiding Principles
• Poster Boards / Options Stations
• Feedback survey – hard copy/online

8

Capital Planning Overview

• To ensure safe, quality, sustainable health care

for future generations

• Strategic Plan – Sustainable Future
• Ministry of Health requirement
• Our facilities don’t meet current standards
• Changing practices require new and different

space

• Lengthy process with approvals required
• Alignment with evolving health care directions

9

Pre-Capital Submission (Part A & B) Stage 1 Proposal (Part A & B) Stage 2 Functional Program (Part A & B) Stage 3 Preliminary Design or Output Specifications Stage 4 Working Drawings or Output Specifications Stage 5 Implementation

Review and support of Pre-Capital Submission Review and approval of Stage 1 Submission Review and approval of Stage 2 Functional Program Review and approval of blocks and sketch plans; approval to proceed to working drawings or blocks/output specifications Review and approval to tender & implement/ issue RFP or approval to award construction contract/ Project Agreement Requires Government approval to plan

Ministry Process

Requires Government approval to plan Requires Government approval to construct

2017-2019 2012-2015

10

Future Model & Services (Part A)

One Site Inpatient Site / Outpatient Site

Proposed with:

• Emergency, inpatient and

surgical services at each site;

• 61 more inpatient beds, with

new stroke rehabilitation unit;

• addition of MRI technology

Two Acute Sites

11

Programs and Services (Part A)*

Programs and Services Current State Future State Emergency Department Dual Sited Dual Sited Endoscopy Dual Sited Dual Sited Diagnostic Imaging Dual Sited Dual Sited Core Laboratory Dual Sited Dual Sited General Surgery Dual Sited Dual Sited Obstetrics Dual Sited Dual Sited Beds Dual Sited Dual Sited Intensive Care Dual Sited Dual Sited Specialty Surgery Single Sited Single Sited Specialty Programs Single Sited Single Sited New Stroke Rehabilitation Unit

• Single Sited

New MRI

• TBD (single or dual)

*Proposed to Ministry

12

Inpatient Bed Distribution*

INPATIENT BEDS

MAHC SMMH HDMH MAHC SMMH HDMH

Medicine/Surgical 67 37 30 103 47 56 Intensive Care 9 4 5 12 6 6 Obstetrics 4 2 2 4 2 2 CCC (Complex Continuing Care) 16 16

• 24

24

• Stroke Rehab
• 14
• 14

TOTAL 96 59 37 157 79 78

*Proposed to Ministry

2031-32 2016-17

13

Infrastructure Approach (Part B)

Physical and cost elements (bricks & mortar)

• Service Support Infrastructure Report
• Business Case / Option Analysis
• Facility Development Plan
• Spatial requirement
• Multi-year infrastructure plan
• Technical Building Assessment
• Master Site Plan
• Master Building Plan
• Options for Master Plan
• Proposed floor plans
• Proposed space summary
• Implementation / phasing plan
• Schedule
• Other operational issues
• Funding/financing plan
• Project estimates

14

Workshops with Clinicians

15

Design Guiding Principles

• Aligns with the goals of the MAHC organization
• Supports Patient- and Family-Centered Care
• Promotes Health and Wellness
• Facilitates Operational Excellence
• Enables Innovation and Environmental

Sustainability

• Promotes Community Connection and System

Integration

• Meets the ‘Quadruple Aim’: better health, better care,

better value, better experience

16

Options Under Consideration

South Muskoka Memorial Hospital Site (3 options)

• Renovation and expansion of current building
• New, replacement building on current land
• New build on new land

Huntsville District Memorial Hospital Site (2 options)

• Renovation and expansion of current building
• New, replacement building on current land

17

Ideal Development Location – SMMH

18

Ideal Development Location – HDMH

19

SMMH – Renovation/Expansion

20

SMMH – Replacement on Current Land

21

SMMH – New Build on New Land

22

HDMH – Renovation/Expansion

23

HDMH – Replacement on Current Land

24

Construction Cost of Options

HDMH OPTION CONSTRUCTION COST Renovation / Expansion $196,600,500 Replacement on Current Land $210,126,700 SMMH OPTION CONSTRUCTION COST Renovation / Expansion $186,914,300 Replacement on Current Land $198,131,300 New Site on New Land $181,996,300

*Additional costs: equipment, furnishings, land acquisition and land servicing, etc.

SMMH Options HDMH Options

25

Next Steps

• Stakeholder engagement on options / survey
• Feedback review by Task Force
• Task Force recommends preferred building

design option for each site to Board of Directors

• Submit Part A and B to Ministry branch
• Wait for review and decision

26

Take the Feedback Survey!

• Tell us in your opinion:

– Does each option address the needs of the community – why or why not? – What are the gaps and/or challenges? – Is there anything else you think is important to consider?

• Hard copy forms today
• Online: www.surveymonkey/r/MAHCfuture
• Feedback deadline: March 24, 2019

www.mahc.ca/planning-for-the-future @MAHCHospitals

27

Options Evaluation

Qualitative Criteria SMMH Reno SMMH Replace SMMH New Site HDMH Reno SMMH Replace MAHC Alignment Patient and Family Centered Care Health and Wellness Operational Excellence Innovation & Environmental Sustainability Community Connection & System Integration Quantitative Criteria SMMH Reno SMMH Replace SMMH New Site HDMH Reno SMMH Replace Cost Approvals Construction Duration & Phasing Community Feedback