Tuesday, 29 May 2018

Make your vote count for acute care

MAHC Board Chair Evelyn Brown
Evelyn Brown,
Board Chair
This blog has been prepared by Evelyn Brown, Chair of the MAHC Board of Directors.

Throughout this election campaign, health care has been at the forefront, and it should be. A high-functioning public health care system should be important to each and every resident of Ontario. We count on the provincial government to fund and facilitate safe, high-quality care. We want to know that it will be there when we need it – whether it’s having access to a primary care provider like a family doctor or nurse practitioner, being able to obtain home care so seniors can stay safely in their own homes, ensuring there is capacity in facilities like nursing homes for those transitioning to long-term care, or being able to sustain acute and emergency care in the hospital.

The Ontario Hospital Association has summed it up well, saying Ontario’s hospitals are on the brink. Many hospitals are under enormous pressure to provide care to a growing and aging population. The provincial funding formula for hospitals poses significant and unique challenges for medium-size hospitals and needs substantial change now. The formula also fails to recognize, adapt to and support the unique challenges of rural multi-site hospitals like Muskoka Algonquin Healthcare that have additional infrastructure, staffing and other expenses to deliver core services where we have fewer community health resources. Where amalgamations have occurred to drive efficiency, like here in Muskoka, we have not been adequately supported to stay afloat and in the black.

We are fortunate to have amazing health care professionals supporting inpatient and outpatient care across two hospital sites. But we can’t do it without appropriate support from the province and a long-term solution to operating challenges. Significant investments in hospitals and across the continuum of care are required, as well as a plan to adequately prepare for patient needs – now and in the future. A deliberate and purposeful strategy must be identified to ensure that medium-size hospitals are able to provide and sustain the services that our community deserves.

We offered each of the candidates an opportunity to sit down for some open dialogue about funding and capacity challenges facing Ontario hospitals and how these challenges relate to MAHC. No matter which Party is elected in June, now is the time for urgent action on health care. Now is the time to increase funding, reduce wait times, and put an end to hallway medicine so that patients can continue to receive the highest quality of care in the environment that they deserve. When you cast your ballot on June 7, think of your hospital and who will meet the growing health care needs of Muskokans and our fellow Ontarians.

Evelyn Brown

Wednesday, 14 February 2018

Building a Case for a Reserve Fund for Health Care Capital Needs in Muskoka

This blog has been prepared by Evelyn Brown, Chair of the MAHC Board of Directors.

Board Chair Evelyn Brown
The Muskoka Algonquin Healthcare Board of Directors is drawing attention, through our political leaders, to the need for Muskoka ratepayers to start making investments now for future health care capital needs.
On January 19, Phil Matthews, Vice Chair of the Board, and I appeared before the District of Muskoka’s Corporate & Emergency Services Committee to encourage the creation of a reserve fund for health care capital needs. Phil referred to this reserve fund as “a major asset that we don’t have today”.
The timing of our presentation was based on the immediacy of 2018 budget deliberations by the District. The purpose of the presentation was to highlight the capital needs of the health care system and to demonstrate the importance of broad financial support, both today and in the future. Our presentation concentrated on MAHC’s current capital needs and also referenced an order of magnitude for future redevelopment costs.
Our presentation was not for a specific figure or sum of money, but rather was asking consideration be given to creating a health care capital reserve fund supported annually by taxation.
What we know today:
There are significant needs at MAHC today to safeguard and sustain the quality of care we provide. Our presentation indicated that our needs over the next three to five years are estimated at $39 million for equipment, technology and aging building infrastructure. Future redevelopment needs, regardless of the model selected, will be even more substantial (hundreds of millions of dollars over time) and will compound this challenge for our communities.

Currently, there are insufficient funds available to MAHC for replacing capital needs – MAHC relies on the community through donations to our Foundations and Auxiliaries to replace aging infrastructure, and buy new equipment to keep pace with technology. Unfortunately, today’s capital needs outpace community contributions, meaning there are insufficient funds available now to fix aging buildings, let alone to bank toward any future needs.

We also know today that the capital building cost (bricks and mortar) of hospital redevelopment is shared by the Ministry of Health and Long-Term Care, which contributes approximately 90%, and what the Ministry calls the community’s “local share”, which is the remaining 10%. Other infrastructure costs, such as parking lots, new equipment and furnishings, are also expected to be paid for by the community through donations, like they are today. These could add up to an additional 14% or more of the building costs of future redevelopment.

Our presentation referenced the potential order of magnitude of the community share of a future redevelopment. MAHC’s 2015 Pre-Capital Submission to the Ministry of Health and Long-Term Care included the cost surveyors’ estimate of the potential local share plus infrastructure costs of the three models that were previously developed for hospital redevelopment ranging from $84 million to $114 million (shown in the table below).
What we know about the future:
The Capital Plan Development Task Force has been struck by the MAHC Board of Directors to recommend the best model for future hospital care that ensures high-quality, safe and sustainable care for future generations. The task force is committed to a thorough and comprehensive process to look at potential models for the future, even if they are unpopular, to satisfy the requirements of the Ministry of Health and Long-Term Care.
The task force is researching three potential models and developing what programs and services could be provided through each of the models. This process continues and is a new chapter in MAHC’s future planning work and the ending to that chapter has yet to be written. The timeline for the Stage 1 submission is dependent upon doing it right and taking the time that is necessary to ensure appropriate engagement and thorough analysis.
No decisions have been made about the preferred model of delivering acute care in the future.
The task force is aiming to bring its recommendation of a preferred model to the MAHC Board of Directors this spring, and to submit the Stage 1 (Part A & B) to Capital Investment Branch of Ministry by the end of 2018.
Most importantly, we know that regardless of the model recommended by the task force and selected by the Board, it is prudent for Muskoka to begin investing in this multi-million-dollar fund now. Quite simply we can start to incrementally put aside funds now, or massively pay later. By asking our local leaders for prudence and forethought for the Muskoka ratepayers to support the needs of the health care system today and in the future, we do not believe we are undermining the Stage 1 future planning work that is underway. We are helping our local leaders to understand the role the community will need to play in building the future health care system.