Our
Pre-Capital Submission was submitted to the North Simcoe Muskoka Local Health
Integration Network for review on August 7, 2015. Through the month of
September we worked collaboratively with staff at the LHIN to revise the Part A
to incorporate their input and feedback based on their analysis of the
projected demand on two North Simcoe Muskoka regional programs: Complex
Continuing Care and Acute Integrated Stroke Rehab. Part A of the Pre-Capital
Submission is our future plan for programs and services that MAHC will provide
in the next 5, 10 and 20 years planning horizons. The Part A was revised to
incorporate changes to the bed projections for the future and is posted on
MAHC’s website.
On
October 26, the LHIN Board of Directors endorsed Part A and directed the LHIN
to facilitate further engagement between MAHC and the local municipalities to
support enhanced awareness and endorsement for the proposed health service
delivery model (one hospital) in the future. This engagement will be facilitated
by LHIN Board Chair Robert Morton in the next two months and will involve
representatives from MAHC and the local mayors and the District of Muskoka. We
know that community support for the proposed future model is important to moving
any potential capital redevelopment project through the Ministry of Health and
Long-Term Care’s process. We are optimistic that these sessions with our
elected officials will help them better understand the rationale for the
Board-approved future direction to pursue one hospital and garner their support
and the support of our communities at large.
At
the same time, some of the area municipalities have raised concerns about the
approach we used for our Community Information Sessions, as well as access to
service in the future, the evaluation criteria utilized, and land use planning legislation and policies. I felt the need to address these concerns in my blog and explain our position.
Community Engagement
MAHC
wanted an engagement approach with our community that would facilitate
meaningful conversations, feedback and interaction with those directly involved
in the planning such as the consultants, architects, Board members, physicians,
committee members and administration. To that end, directly following the
formal presentation, community attendees were encouraged to move through a variety of information posters and to stations set up for each of the models under consideration where they could engage one-on-one with
the planning team members. Having directly participated at one of the
stations and by observing the activity in the room, there was clearly a
richness and depth to the conversations that wouldn’t have been possible using the
standard microphone in the centre of the room approach where people line up to
pose their questions or make their observations. This approach was validated by
the very positive feedback we received from many community members with respect
to the information shared, the format in which it was presented, and their
access to those directly involved in the project. We were able to directly
involve more people through this approach.
Access
The
Board has acknowledged that access to services was one of the most common concerns
raised within the 350 pieces of written feedback and other feedback that was
received. The Board has made a strong commitment to being an active partner in
local transportation initiatives and health integration efforts like the
Muskoka Health Link and the Health Hubs to help improve access to care. In
addition, there are several initiatives occurring municipally that will help
improve access to all areas of Muskoka. Both the Towns of Bracebridge and
Huntsville are working on their own transit strategies and the District of
Muskoka has identified transit and the Highway 11 Corridor Bus system
as a strategic priority. With these important initiatives underway and by
working together as partners, MAHC is confident that transportation access can
be improved not only for access to health care but for access to all services
that Muskoka has to offer.
Travel Times
Access
to health care is more than just travel times. One of the primary
considerations in MAHC’s planning work was to ensure the preferred model was
one that would be sustainable for future generations, thus preserving current
services. Sustainability and access to services was a risk to some of the
models considered because those models did not allow for critical mass and
efficiencies. Not achieving critical mass and efficiencies of some services
currently available at one, or both sites, risks the availability of these
services locally in the future, which could reduce access to care.
Evaluation Criteria
The
criteria developed to assess the various models under consideration were based
on several factors including Ministry criteria, advice from planning
consultants, feedback from the working groups and an analysis by the Ad-Hoc
Steering Committee that guided this work. The intent of the criteria was
to provide decision-makers with an objective tool to compare and contrast the
various options. It included several different categories, one of which was
community support and perspective. The criteria helped eliminate some of the
unfavourable redevelopment options early in the process that had the least
support, such as the Ambulatory/Acute model initially considered. True to our
commitment to a transparent and open process, the criteria that would be used to evaluate the models was broadly shared throughout the planning process
and public information sessions.
Land Use Planning
Our
knowledge and expertise is in health care service planning, not in land use
planning and as a result we understood the importance of working closely with
our Municipal and District partners. To that end, MAHC met with representatives
of the District of Muskoka on several occasions. These meetings included
the District Chair, the Commissioner of Engineering and Public Works, the Commissioner of
Community Services, the Commissioner of Planning and Economic Development, the Commissioner
of Finance and Corporate Services, the Chief Administrative Officer, and other
District planning staff and engineers. The District of Muskoka and Emergency Medical
Services team assisted with mapping and modeling and was consulted regarding
the potential impact of one hospital. Generally, it was acknowledged that a single
site model located somewhere between the two existing sites would pose
challenges, but no initial deal breakers were identified in our meetings. It
would be preferable that any services required for one hospital could build
upon existing investments in infrastructure, such as water and sewer services.
Preliminary costing by the District in their September 2015 report supports the fact
that there is capacity in the system to do so. I would be remiss if I didn’t remind my blog readers that there are many steps and years in the process before redevelopment approval is granted by the Ministry of Health and Long-Term Care. We need to be united in our attempt to build an accessible, innovative, and technologically advanced hospital that will provide safe, high-quality health care that our communities deserve and need in this highly competitive environment where limited capital dollars are available. We are committed to working with our municipal leaders and our communities to move this plan forward for Muskoka. The opportunity for us to come together to build the very best in hospital care is not only exciting, but a guarantee of health care locally for generations to come.
