Prince Edward County Memorial Hospital New Hospital Planning

Prince Edward County Memorial Hospital New Hospital Planning Brad Harrington, Vice President & CFO November 18, 2016

Existing HospitalNew Hospital! • .

How do we get approval for a New Hospital? • 5 Stages: • Approvals at each stage are by MOHLTC (HCIB)/SELHIN and are considered in respect to: – Alignment to MOHLTC/SELHIN guiding principles and priorities. – Consistency with community needs and service need projections.

What is the Mo. HLTC Capital Priorities? • Mo. HLTC evaluates capital projects with primary consideration to the proposals alignment to health care system and regional priorities. Within this context, the proposal must also demonstrate: o Operational efficiency o Accessibility o Safety o Infection Prevention o Sustainability

MOHLTC – RURAL AND NORTHERN HEALTH CARE FRAMEWORK • In 2010, the MOHLTC developed guiding principles for rural health care planning: - Community Engagement - Flexible Local Planning and Delivery - Culturally and Linguistically Responsive - Value-Overall efficiency and cost effectiveness of regionalized care - Integration with community - Innovation - Connected and coordinated with LHIN, provincial initiatives and organizations - Evidence-based; Sustainable – maintain and improve access

What are our SE LHIN Priorities? • Three Key Priorities: - Developing a regional system of integrated health care across the care continuum, from primary care and public health through to community, acute and long-term care - Improving the patient experience with a focus on the transition points in care - Focusing on the unique health care needs of Aboriginal and Francophone populations

Community Engagement My local health care system should provide: 2. Local access to: 24 hour emergency services Inpatient beds Basic diagnostic services Home and community care services 1. Family care providers who: Provide system navigation and equitable access to services Help keep people healthy through health promotion and maintenance 3. Efficient access to specialist services • With adequate transportation options A sustainable, local system of care that can create healthy communities and is: Patient-centered High quality Timely 4. Effective coordination of services and communication between providers

How do we get a hospital approved? Key Terms: • What is a Pre-Capital Submission? – The Pre-Capital submission is essentially a 15 -page template that poses a number of questions we answer to paint a picture of PECM role as a health care provider in the local health system. • What is a Master Program? – A Master Program outlines the type and extent of health care services that QHC intends to deliver. In other words, the Master Program reflects a health care facility's present and future service role within the community. It outlines current and projected future programs and services, workload, staffing and departmental space requirements by site. • What is a Functional Program? – A functional program, typically developed by a functional programmer consultant, is a predesign document describing the functional requirements of a building or renovation in sufficient detail to initiate schematic design.

QHC Hospital System – Master Program Primary Care Hospitals QHC Prince Edward County Memorial Hospital QHC North Hastings Hospital QHC Trenton Memorial Hospital Each with “Protected” Core Services: • Emergency Room (24 hour) • Acute Inpatient beds Supported by: • Appropriate basic diagnostics for ER and inpatients • Ambulatory clinics appropriate for hospital-based delivery and based on local need Regional Secondary Hospital QHC Belleville General Hospital Core Primary Care Services: • Emergency Room (24 hour) • Acute Inpatient beds • Appropriate basic diagnostics and clinics Regional Services: • Obstetrics/Pediatrics • ICU • Surgery • Internal Medicine • Oncology Clinic • Mental Health – inpatient/outpatient • Inpatient Rehab and Rehab Day • Children’s Treatment Centre • Supported by advanced diagnostics: - MRI - CT - Cardiopulmonary - Bone mineral density - Nuclear medicine - Lab - Interventional radiology

QHC Prince Edward County Memorial Hospital: Today & Tomorrow Low risk regional endoscopy services • • Emergency room (24 hour) • Basic diagnostics: - X-ray, ultrasound - Point-of-care lab Ambulatory clinics (e. g. , mental health services) • Acute inpatient beds - General, acute care for elderly Efficient access to BGH specialist services 10

Presentation Title Presenter’s Name and Title Date of Presentation

Where are we with the Approval? • 2013: Agreement of PECM and PEFHT to proceed with colocated physical facility model, i. e. , hospital and FHT on same site but in separate buildings • Precap Submitted (January 2015) • Stage 1 Part A Completed (May 2016) • Corporate Master Program Submitted (October 2016) • Waiting on MOHLTC approval of the Pre-Capital submission before proceeding to complete the Stage 1 Part B (Master Plan)

Is this a Priority for QHC? • The Corporate Master Program/ and Pre-Capital submissions identify redevelopment of PECM as the #1 QHC redevelopment priority. • Services will include: – – – 24/7 Emergency Department Diagnostics Imaging and Cardio-diagnostic Services In-Patient Beds Ambulatory Services (Medical Day, Minor Surgery, Urology, Endo) Laboratory Services Dialysis Services

Where will the hospital be built? • The Due Diligence work to determine where the hospital will be sited is Stage 1 Part B. • This has not yet been completed! • Multiple Options exist: Mc. Farland Land; Existing Hospital Property • The Hospital will be sited based on the due diligence work that will be completed and that will inform everyone what is in the best interests of the community long term.

Future Role: Prince Edward County Memorial Hospital The new PECMH would continue to have an important role in health care delivery in PEC by providing acute hospital care, 24 hour emergency services, diagnostic services and efficient access to the other QHC hospitals in Belleville and Trenton and to other tertiary hospitals in Kingston for treatment of more severe conditions.

QHC Prince Edward County Memorial Hospital: Evolving to a Integrated Future Vision A range of integrated health care services “wrapped around the patient”… …co-located in a new health care campus 16

How much will a new Hospital Cost? • Project cost estimates are prepared and submitted for Ministry review at each stage of the development of the project. o Cost estimates are prepared by independent certified cost consultants and are expected to be accurate within +/- 5%. o Cost estimates are prepared in current $ and allowances are carried for changes in scope and inflation to the anticipated time of tender. o Following the tender, a final estimate of cost is prepared using the tendered cost of the work. o Planning estimates based on previous submission suggest the costs could be roughly $75 M-$80 M

How is a New Hospital Funded? • Ministry funding amounts are determined according to a cost share formula which provides; o 90% of the hard cost of construction, not including land or facilities for revenue generation (parking, gift shop etc. ). o Changes during construction are only funded where these are a result of unknowable site conditions of regulatory changes after tendering. o 100% of consultant fees, with upset limits derived as a % of construction costs. o 90% for ancillary costs directly related to construction, such as soil testing and air quality testing. o 100% of minor non depreciable equipment, with an upset limit of 2% of construction.

We need your HELP!! The community is required to provide all funds beyond the share provided by the Ministry. The local share includes: • 10% of hard construction costs, including construction related ancillaries. • 100% of land acquisition costs. • 100% of most changes. • 100% of depreciable equipment. • Any funded ancillary costs which are in excess of defined upset limits. • The requirement will be roughly $14 -$18 M

Does the Municipality have a Role? The Municipality does not have a formal role or responsibilities to the project. As the elected representatives of the residents, council may provide significant assistance: o Provide leadership support to the Foundation to promote and assist fundraising with the general population. o Provide a commitment for a direct funding contribution o Engage with local politicians and provincial bureaucrats to promote awareness and demonstrate public support for the project.

How long is this going to take? • Depends who you talk too…. • Typically 10 -12 Years • What’s really possible….

Next Steps • MOHLTC approval of Pre-Capital submission (anticipated in early 2017) • Completion of the Stage 1 Part B – Master Plan – Assessment of the current site – Investigation of other siting options (Greenfield Development) – Recommendation, cost estimate – Local Share Plan – Submission anticipated in mid 2017 • Future work for Stages 2 through 5

Questions?