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To: Chair and Members Community Services Committee

From: Rick Williams Commissioner, Community Services

Cheryl Faber Director, Programs

Date: March 21, 2018

Subject: Update: Application for New Long-Term Care Home Beds

Report: CS-3-2018-3 ______

Recommendation

This report is provided for information.

Origin

Further to Report 3(2018)-8 that was brought before Council at its February 20, 2018 meeting with a recommendation of support, the following report provides an update on the status of the Long- Term Care Home (LTCH) bed application(s) submitted to the Ministry of Health and Long-Term Care (MOHTLC) by the March 2, 2018 deadline.

Analysis

Following the Council meeting, staff proceeded to research and develop two separate applications for submission to the MOHLTC in consultation with the North Simcoe Muskoka Local Health Integration Network (NSM LHIN), the Senior Team at The Pines, the Chair and members of Fairvern Nursing Home’s Board, Extendicare, Muskoka Algonquin Healthcare, LHIN Home and Community Care and other health partners.

Two applications for new LTCH beds were submitted by The District Municipality of Muskoka, including:  A new LTCH with five resident housing areas of 32 beds each, totalling 160 LTCH beds; and  A Phase 2 expansion of 64 beds for Fairvern LTCH, to provide the home with a total of 160 LTCH beds with five resident housing areas of 32 beds (76 beds currently + 20 Phase 1 beds + 64 Phase 2 beds).

Managing Our Legacy Together Page 1 Evidence and analytics shaped the final applications proving the substantive growing demand for increased capacity for LTCH beds for the population 65 years and older, of which is 25.5% (15,435 individuals) of the total population of Muskoka (Statistics , 2016). Of this population, further demand was explored based on sub-sets of the population, including:  the current number of individuals on the wait list for LTC placement;  the number of days 9 out of 10 people wait for LTC placement;  the percentage of individuals on the LTC wait list from Muskoka and outside of Muskoka;  the annual percentage of demographic pressure on LTC in Muskoka for the next five to twenty years;  the number of individuals with complex needs living in Muskoka (the top 5% of users whom account for 65% of the health care costs);  the number of individuals including their length of stay at Muskoka Algonquin Healthcare who are finished their acute stay and are waiting placement into LTC, or an alternate level of care in the community;  the number of Indigenous people, especially those 65 years or older living in Muskoka;  the number of individuals with a disability and the potential estimation of individuals with a developmental disability interspersed in our communities who were once residents of Muskoka Regional Centre or Huronia Regional Centre;  the incidence rate of vulnerability of residents in Muskoka based on age;  the number of residents living in the northern part of and in the southern part of ; and  the impact to East Parry Sound residents based on the 2017 closure of Lady Isabelle LTCH which had 66 beds available for occupancy.

Today, residents of Muskoka and those that wish to bring loved ones to age here have the option of four LTCHs with the availability of 510 beds, currently operating at full capacity. Projecting the demand and increased utilization of LTC into the future, demonstrates the point that more beds are required and to be located accordingly.

Currently underway through the Ministry’s Enhanced LTCH Renewal Strategy (launched in 2014); Fairvern LTCH’s phase one expansion of 20 new beds has just received approval from the MOHLTC and the NSM LHIN. It has been confirmed by both parties that this a separate process from the new call for LTC beds. Hence the opportunity to build on the resounding support and need for more than 20 beds from the community at the Ministry’s public consultation on December 12, 2017. A phase two expansion of 64 more beds was submitted for Fairvern to complement the future acute care capital planning, establish campus of care models in Muskoka and to supplement the needs of our population.

The deadline for submission was Friday, March 2, 2018. The MOHLTC is evaluating all applications received, along with corroborating local intelligence and planning inputs from the LHINs across the province. Applicants have only received confirmation of submissions at this time and no further information has been provided based on the timeline moving forward. The LHIN has advised that upon receipt of 17 submissions received for North Simcoe Muskoka during this cycle that the District was the only LTCH operator that applied for the expansion of LTCH beds in the Muskoka sub-region.

Financial Considerations

Pending evaluation and review by the MOHLTC and the NSM LHIN, the financial considerations remain consistent with what was outlined in the previous Report 3(2018)-8 supported by Council.

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Communications

As stated, the Ministry was informed in advance of the District’s support and intention of application for two submissions. Conversations simultaneously occurred during the application timeframe with the NSM LHIN and local health partners to support the case and need for LTCH bed development in Muskoka.

As noted in the previous Report 3(2018)-8 pending decision, the District will explore further the opportunity for private-public partnerships and arrangements will be defined in detail within project plans for LTCH roll-out.

Depending on the outcome of the application process, a communication strategy will be developed.

Strategic Priorities

Click on icons below to view strategies under each priority area:

s2.3, 2.4, s5.1, 5.2, s3.1, 3.5 5.5, 2.8, 2.9 5.3, 5.4,5.6

Respectfully submitted,

Original signed by Original signed by

Cheryl Faber Rick Williams Director, Programs Commissioner, Community Services

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