Director’s Tool Kit 2015
North West Regional Hospital District
Building for Health Execu ve Director Yvonne Koerner Suite 300 ‐ 4545 Lazelle Avenue Terrace, BC V8G 4E1 Tel: 250‐615‐6100 Toll Free: 1‐800‐663‐3208 Fax: 250‐635‐9222 Email: [email protected]
TABLE OF CONTENTS
2015 NWRHD Addresses and contact information
Roster of Votes Directors and Alternates 2015
About the North West Regional Hospital District
Procedure Bylaw 82 - Replaced Bylaw 67
Confidentiality and In-Camera Protocol
Remuneration Bylaw 64
Director Remuneration/Expense Claim form
UBCM 2014 Information Package
Links to Medical Travel Assistance
New Queen Charlotte / Haida Gwaii Hospital History – news releases and letters
Memorandum of Understanding with Northern Health
NH Glossary of Acronyms and Terms
Hospital District Act
Directors and Alternates (*) January 2015
REGIONAL DISTRICT OF BULKLEY-NECHAKO DIRECTOR *ALTERNATE AGENDA INSTRUCTIONS Representing: Town of Smithers Taylor Bachrach *Frank Wray Mail agenda to: PO Box 879 PO Box 512 Taylor Bachrach Smithers, BC V0J 2N0 Smithers, BC V0J 2N0 PO Box 879 Work 250-847-9298 Home: 250-778-210-0311 Smithers, BC V0J 2N0 Work 250-847-1600 Work: 250-847-2622 Cell 778-210-0877 [email protected] [email protected] Representing: Village of Telkwa Brad Layton *Darcy Repen c/o Village of Telkwa c/o Village of Telkwa Box 220 Box 220 Telkwa, BC V0J 2X0 Telkwa, BC V0J 2X0 Cell: 250-877-1344 [email protected] Work: 250-846-5060 [email protected] Representing: District of Houston Shane Brienen *Tim Anderson c/o District of Houston [email protected] Box 370 Houston, BC V0J 1Z0 Cell 250-845-8542 [email protected] Representing: Electoral Area A – Smithers Rural Mark Fisher * Email the digital agenda to 10668 Hislop Road [email protected], larger Telkwa, BC V0J 2X1 agendas may not go through and Home: 250-846-9045 Director Fisher should be [email protected] contacted for alternate arrangements. Provide a hard copy of the agenda at the meeting. Representing: Electoral Area G – Houston Rural Rob Newell * Email the digital agenda to 16204 Baggerman Road [email protected] and Houston, BC V0J 1Z1 provide a hard copy of the agenda Home 250-845-4264 at the meeting. [email protected]
P:\My Documents\NWRHD Folder -Yvonne\2015 Tool Kit\NWRHD 2015 Directors and Alternates.doc Directors and Alternates (*) January 2015
REGIONAL DISTRICT OF KITIMAT-STIKINE DIRECTOR *ALTERNATE AGENDA INSTRUCTIONS Representing: City of Terrace Stacey Tyers *Michael Prevost Phone cell (250) 615-1186 for 5685 Oscar Rd. 1-4739 Walsh Ave agenda pick-up or mail to: Terrace, BC V8G 0C2 Terrace, BC V8G 1Y7 Stacey Tyers Home: 250-635-3876 Cell: 250-641-2724 c/o City of Terrace Cell: 250-615-1186 [email protected] 3215 Eby St. City/Fax: 250-638-4777 Terrace, BC V8G 2X8 [email protected] Representing: City of Terrace James Cordeiro *Lynne Christiansen Phone 250-615-5466 for agenda 5242 Mountain Vista Drive 5250 Skeena Dr pick-up and place agenda in Terrace, BC V8G 4X5 Terrace, BC V8G 0A6 Board Mailbox. 250-615-5466 250-631-2092 [email protected] [email protected] Representing: Village of Hazelton Alice Maitland *Shirley Muldon Email the digital agenda to PO Box 160 3915 River Road [email protected] and place Hazelton, BC V0J 1Y0 Hazelton, BC V0J 1Y0 a hard copy in her Board Mailbox. Home: 250-842-5427 250-842-5527 Work: 250-842-5291 [email protected] [email protected] Representing: District of New Hazelton Gail Lowry *Braunwyn Henwood Send agenda by courier (Loomis) PO Box 817 PO Box 357 to: New Hazelton, BC V0J 2J0 New Hazelton, BC V0J 2J0 Gail Lowry Home: 250-842-5501 Home: 250-842-0141 3026 Bowser St [email protected] [email protected] New Hazelton, BC V0J 2J0 250-842-5501 Representing: District of Kitimat Philip Germuth *Mary Murphy Mail agenda to: 51 Chinook Avenue 31 Sturgeon St Philip Germuth Kitimat, BC V8C 2K6 Kitimat, BC V8C 2K6 51 Chinook Ave. Home: 250-632-2464 Home: 250-632-5201 Kitimat, BC V8C 2K6 Cell: 250-632-1593 Cell 250-632-1932 D of K Fax: 250-632-4995 [email protected] [email protected] Representing: District of Stewart Galina Durant *Patricia Lynn Mail agenda to: PO Box 460 PO Box 132 Galina Durant 705 Brightwell St Stewart, BC V0T 1W0 Box 124 Stewart, BC V0T 1W0 Home: 250-636-2666 Stewart, BC V0T1W0 Work 250-636-2251 [email protected] [email protected]
P:\My Documents\NWRHD Folder -Yvonne\2015 Tool Kit\NWRHD 2015 Directors and Alternates.doc Directors and Alternates (*) January 2015
REGIONAL DISTRICT OF KITIMAT-STIKINE – continued DIRECTOR *ALTERNATE AGENDA INSTRUCTIONS Representing: Electoral Area A – Nass Valley, Meziadin Harry Nyce * Email the digital agenda to PO Box 26 [email protected] and place a Gitwinksihlkw, BC V0J 3T0 hard copy in his Board Mailbox. Home: 250-633-2486 Work: 250-633-2601 Cell: 250-615-7766 W/Fax: 250-633-2367 [email protected] Representing: Electoral Area B – Hazeltons Rural, Kispiox Valley, Moricetown through Cedarvale Linda Pierre * Send agenda by courier (Loomis) 2155 Aldous Street to: South Hazelton, BC V0J 2J1 Linda Pierre Home: 250-842-2192 2155 Aldous St [email protected] South Hazelton, BC V0J 2J1 250-842-2192 Representing: Electoral Area C – Rural Terrace, South Coast Jessica McCallum-Miller *Joe Murphy Mail Agenda to: 406-4204 Sparks St 4536 Johns Regional District Jessica McCallum-Miller Terrace, BC V8G 2W5 Terrace, BC V8G 0B3 406-4204 Sparks St 250-922-4055 250-638-8393 Terrace, BC V8G 2W5 [email protected] [email protected] Representing: Electoral Area D – Telegraph Creek, Iskut, Bob Quinn Dave Brocklebank *Adrian Carlick Email the digital agenda to PO Box 100 PO Box 8 [email protected] and place a Telegraph Creek, BC V0J 2W0 Iskut, BC V0J 1K0 hard copy in his Board Mailbox. Home: 250-235-3207 [email protected] Fax: 250-235-3499 Work: 250-235-3441 Cell: 250-615-6978 [email protected] Representing: Electoral Area E – Thornhill Ted Ramsey *Bruce Bidgood Phone cell (250) 641-1459 for 2660 Penner St. 4413 Maroney Ave agenda pick-up and keep the Thornhill, BC V8G 5A4 Terrace, BC V8G 5M7 agenda at the front office for him. Home: 250-635-6332 250-635-6044 home Cell: 250-641-1459 250-641-0732 cell [email protected] [email protected] Representing: Electoral Area F – Dease Lake Tina Etzerza * Email the digital agenda to PO Box 244 [email protected] and place a Lot 15 Commercial Dr hard copy in her Board Mailbox Dease Lake, BC V0C 1L0 250-771-3405 [email protected]
P:\My Documents\NWRHD Folder -Yvonne\2015 Tool Kit\NWRHD 2015 Directors and Alternates.doc Directors and Alternates (*) January 2015
SKEENA-QUEEN CHARLOTTE REGIONAL DISTRICT DIRECTOR *ALTERNATE AGENDA INSTRUCTIONS Representing: District of Port Edward Dave MacDonald *Dan Franzen Mail agenda to: 770 Pacific, PO Box 1100 Home: 250-628-3667 Dave MacDonald Port Edward, BC V0V 1G0 [email protected] PO Box 1100 Home: 250-628-3667 Port Edward, BC V0V 1G0 Cell: 250-627-9498 [email protected] Representing: Electoral Area A – Lax Kw’alaams Des Nobels * Mail agenda to: PO Box 807 Des Nobles Prince Rupert, BC V8J 3Y1 PO Box 807 Home: 250-627-1859 Prince Rupert, BC V8J 3Y1 [email protected] Representing: Electoral Area C – Dolphin Island, Kulkayu (Hartley Bay) Karl Bergman * Mail agenda to: 1521 Riverside Rd., P.O. Box 104 Karl Bergman Oona River, BC V0V 1E0 PO Box 104 Work: 250-628-6804 1521 Riverside Rd Fax: 250-628-6809 Oona River, BC V0V 1E0 Cell: 778-884-1234 [email protected] Representing: Electoral Area D – Masset, Skidegate Michael Racz * Email the digital agenda to PO Box 523 [email protected] and Queen Charlotte, BC V0T 1S0 provide a hard copy of the agenda Home: 250-559-7775 at the meeting. Cell: 250-637-1957 Fax: 250-559-4701 [email protected] Representing: Electoral Area E – Sandspit, Moresby Island (Haida Gwaii) Bill Beldessi * Email the digital agenda to Box 482 [email protected] and provide a Sandspit, BC V0T 1T0 hard copy of the agenda at the Home: 250-637-2226 meeting. Cell: 250-637-1196 [email protected]
P:\My Documents\NWRHD Folder -Yvonne\2015 Tool Kit\NWRHD 2015 Directors and Alternates.doc Directors and Alternates (*) January 2015
SKEENA-QUEEN CHARLOTTE REGIONAL DISTRICT – continued DIRECTOR *ALTERNATE AGENDA INSTRUCTIONS Representing: City of Prince Rupert Barry Cunningham *Lee Brain Barry Cunningham 424 3rd Ave W 141 Raven Crescent c/o City of Prince Rupert Prince Rupert, BC V8G 1L7 Prince Rupert, V8J 4C7 Home: 250-624-5100 Home: 250-627-0934 Cell: 250-600-5557 Cell: 250-600-4533 Work: 250-627-0347 [email protected] [email protected] [email protected] Representing: City of Prince Rupert Nelson Kinney *Blair Mirau Mail agenda to: 1426 - 2nd Avenue West Home: 250-627-0934 Nelson Kinney Prince Rupert, BC V8J 1J6 [email protected] 1426 2nd Ave W Home: 250-624-5602 Prince Rupert, BC V8J 1J6 [email protected] Representing: Village of Masset Barry Pages *Jason Thompson Email the digital agenda to PO Box 68 Home: 250-626-3995 [email protected] and provide a Masset, BC V0T 1M0 [email protected] hard copy of the agenda at the Home: 250-626-5503 meeting. Work: 250-626-3995 Fax: 250-626-3968 [email protected] Representing: Village of Port Clements Ian Gould *Doug Daugert Email the digital agenda to PO Box 495 Home: 250-557-4295 [email protected] and provide a Port Clements, BC V0T 1R0 [email protected] hard copy of the agenda at the Home: 250-557-4295 meeting. [email protected] Representing: Village of Queen Charlotte Greg Martin *Jo-Anne MacMullin Email the digital agenda to PO Box 808 PO Box 402 [email protected] and Queen Charlotte, BC V0T 1S0 Queen Charlotte, BC V0T 1S0 provide a hard copy of the 250-559-8193 250-559-8597 agenda at the meeting. [email protected] [email protected]
P:\My Documents\NWRHD Folder -Yvonne\2015 Tool Kit\NWRHD 2015 Directors and Alternates.doc NORTH WEST REGIONAL HOSPITAL DISTRICT ROSTER OF DIRECTORS AND ALTERNATES – 2015
Regional District of Bulkley-Nechako
Director/Home Ph Number Representing Alternate Votes Attending Mark Fisher 250-846-9045 Area A 2 Rob Newell 250-845-2464 Area G 1 Shane Brienen 250-845-8542 District of Houston Tim Anderson 2 Taylor Bachrach 250-847-4647 Town of Smithers Frank Wray 2 Brad Layton 250-877-1344 Village of Telkwa Darcy Repen 1
Regional District of Kitimat-Stikine
Director/Home Ph Number Representing Alternate Votes Attending Harry Nyce 250-633-2486 Electoral Area A 1 Linda Pierre 250-842-2192 Electoral Area B 2 Jessica McCallum-Miller 250- Electoral Area C Joe Murphy 2 922-4055 Dave Brocklebank 250-235-3207 Electoral Area D Adrian Carlick 1 Ted Ramsey 250-635-6332 Electoral Area E Bruce Bidgood 2 Tina Etzerza 250-771-3405 Electoral Area F 1 Alice Maitland 250-842-5427 Village of Hazelton Shirley Muldon 1 Gail Lowry 250-842-5501 Dist. of New Hazelton Braunwyn Henwood 1 Philip Germuth 250-632-2464 District of Kitimat Mary Murphy 2 Galina Durant 250-636-2251 District of Stewart Patricia Lynn 1 Stacey Tyers 250-631-2092 City of Terrace Michael Prevost 1 James Cordeiro 250-922-4055 City of Terrace Lynne Christiansen 2
Regional District of Skeena-Queen Charlotte
Director/Home Ph Number Representing Alternate Votes Attending Des Nobels 250-627-1859 Electoral Area A 1 Karl Bergman 250-628-6804 Electoral Area C 1 Michael Racz 250-559-7775 Electoral Area D 1 Bill Beldessi 250-624-2002 Electoral Area E 1 Greg Martin 250-557-4295 Village of QC Jo-Anne MacMullin 1 Nelson Kinney 250-624-5602 City of Prince Rupert Blair Mirau 2 Barry Cunningham 250-624-5100 City of Prince Rupert Lee Brain 2 Dave MacDonald 250-628-3667 Dist of Port Edward Dan Franzen 1 Barry Pages 250-626-5503 Village of Masset Jason Thompson 1 Ian Gould 250-557-4295 Village of Port Clements Doug Daugert 1
P:\My Documents\NWRHD Folder -Yvonne\2015 Tool Kit\Binder\1.1 Roster of votes - 2015 - NWRHD.doc About the North West Regional Hospital District
1.0 Introduction
Regional Hospital Districts are governed according to the Hospital District Act and the BC Government ministry responsible is the Ministry of Health Services. There are 23 active regional hospital districts (RHDs) throughout the province.
The RHDs operate under the authority of Section 20 the "Hospital District Act." They were created to provide funding for the establishment, acquisition, construction, reconstruction, enlargement operation and maintenance of hospitals and hospital facilities defined under the Hospital Act. As a result of hospital district reorganization between 1996 and 1998, there are 13 defunct regional hospital districts for which taxes continue to be levied. However, the taxes will be discontinued when all old debt is paid.
2.0 NWRHD Geography & People
The North West Regional Hospital District (NWRHD) was established in December 1995 by Letters Patent. It shares the same boundaries as the entire Regional District of Kitimat-Stikine (RDKS) and Skeena-Queen Charlotte Regional District (SQCRD), and the western portion of the Regional District of Bulkley-Nechako (RDBN). The NWRHD is the largest hospital district geographically in the province of BC.
A 27-member elected Board of Directors represents 25 municipalities and electoral areas, located in the three North West British Columbia regional districts. The Chair and Vice-Chairs hold a one year term each (January-December).
Regional District Community Director Name/Position (as at January 7, 2015) District of Houston Director, Shane Brienen (Mayor, District of Houston) Village of Telkwa Director, Brad Layton (Councillor, Village of Telkwa) Regional District Town of Smithers Director, Taylor Bachrach (Mayor, Town of Smithers) Bulkley-Nechako Electoral Area A-Smithers Rural Director, Mark Fisher Electoral Area G-Houston Rural Director, Rob Newell
District of Hazelton Director, Gail Lowry (Mayor, District of New Hazelton) Village of Hazelton Director, Alice Maitland (Mayor, Village of Hazelton) City of Terrace Director, Stacey Tyers (Councillor, City of Terrace) City of Terrace Director, James Cordeiro (Councillor, City of Terrace) District of Kitimat Director, Philip Germuth (Mayor, District of Kitimat) District of Stewart Director, Galina Durant (Mayor, District of Stewart) Electoral Area A – Nass Valley, Regional District Director, Harry Nyce Meziadin of Kitimat-Stikine Electoral Area B – Hazeltons rural, Director, Linda Pierre Kispiox, Moricetown through Cedarvale Electoral Area C – Terrace Rural Director, Jessica-McCallum-Miller Electoral Area D – Telegraph Creek, Director, Dave Brocklebank Iskut, Bob Quinn Electoral Area E - Thornhill Director, Ted Ramsey Electoral Area F – Dease Lake Director, Tina Etzera
City of Prince Rupert Director, Barry Cunningham (Councillor, City of Prince Rupert) City of Prince Rupert Director, Nelson Kinney (Councillor, City of Prince Rupert) Village of Masset Director, Barry Pages (Councillor, Village of Masset) Village of Queen Charlotte Vice-Chair, Greg Martin (Mayor, Village of Queen Charlotte) Village of Port Clements Director, Ian Gould (Mayor, Village of Port Clements) Skeena-Queen District of Port Edward Director, Dave MacDonald (Mayor, District of Port Edward) Charlotte Electoral Area A – Lax Kw’alaams, Director, Des Nobels Regional District Metlakatla, Crippen Cove, Dodge Cove Electoral Area C – Oona River, Dolphin Director, Karl Bergman Island, Kulkayu (Hartley Bay) Electoral Area D – Graham Island Rural Director, Michael Racz Electoral Area E – Sandspit, Moresby Director, Bill Beldessi Island
About NWRHD Page 1 of 5 3.0 Acute Care and Chronic Care Facilities in the NW Regional Hospital District
There are 16 principal health facilities operated by the Northern Health Authority (NHA) within the NWRHD boundaries. The NWRHD pays for as much as 40% of the cost of capital funding for health facilities and medical equipment within its boundaries, while the remaining 60% share is funded by the Provincial Government or through donations provided by local Hospital or Community Foundations, and individual patrons.
Table 1: Facilities that the NW Regional Hospital District contributes capital funding towards for major capital construction (and related) and major equipment purchases. Regional District Community Major Acute and Chronic Care Facility Houston Houston Health Centre Regional District Bulkley- Smithers Bulkley Valley District Hospital Nechako Smithers Bulkley Lodge
Hazeltons Wrinch Memorial Hospital Kitimat Kitimat General Hospital Terrace Mills Memorial Hospital Regional District of Terrace Terrace Community Mental Health Services Kitimat-Stikine Terrace Terraceview Lodge Terrace Seven Sisters Residence Stewart Stewart Health Centre Dease Lake Stikine Health Centre
Prince Rupert Prince Rupert Regional Hospital Prince Rupert Acropolis Manor Skeena-Queen Charlotte Masset Northern Haida Gwaii Hospital & Health Centre Regional District Village of Queen Charlotte Queen Charlotte City Health Centre Village of Queen Charlotte Queen Charlotte Islands General Hospital
Other Facilities in the NW Regional Hospital District
The NW Regional Hospital District does not contribute public funds towards many other facilities that are located with its boundaries. Nor does the NWRHD contribute toward operations, programs and services or the administration of health facilities.
The Ministry of Health works together with BC’s health authorities to provide quality, appropriate and timely health services to British Columbians. The ministry sets province-wide goals, standards and performance agreements for health service delivery by the health authorities. The full spectrum of health services in our region are the responsibility of the Northern Health Authority and/or the Provincial Health Services Authority (PHSA).
PHSA is one of six health authorities – the other five health authorities serve geographic regions of BC. PHSA's primary role is to ensure that BC residents have access to a coordinated network of high-quality specialized health care services. PHSA operates eight agencies that provide province-wide health care services, including:
• BC Cancer Agency • BC Centre for Disease Control • BC Children's Hospital and Sunny Hill Health Centre for Children • BC Mental Health and Addiction Services • BC Provincial Renal Agency • BC Transplant Society • BC Women's Hospital & Health Centre • Cardiac Services BC.
Most recently, the BC Ambulance Service is transitioning from the Ministry of Health Services to the PHSA. To read more about this process go to the BC Ambulance Service website.
About NWRHD Page 2 of 5 The other health care facilities in our region include a variety of assisted living, health units, public and mental health centres, home and community care program spaces that are listed below in Table 2. These facilities are funded by the Northern Health Authority and their partners in health care services.
Table 2: Facilities within the NW Regional Hospital District geography supported by Northern Health & their partners Regional District Community Major Acute and Chronic Care Facility Houston Cottonwood Manor Regional District Bulkley- Smithers Smithers Community Health Nechako Smithers Smithers Home and Community Health
Hazeltons Hazelton Community Health Hazeltons Hazelton Mental Health & Addictions Hazeltons Hazelton Street Residence Regional District of Hazeltons Skeena Place Kitimat-Stikine Terrace Birchwood Place Terrace Terrace Adult Sunshine Centre Terrace Terrace Health Unit
Prince Rupert Prince Rupert Community Health Skidegate Skidegate Seniors’ Centre Skeena-Queen Charlotte Masset Old Masset Adult Day Program Regional District Masset Masset Community Health Village of Queen Charlotte Queen Charlotte Islands Community Health Village of Queen Charlotte Martin Manor
4.0 NWRHD Major Capital and Equipment Projects and the Setting of Capital Planning Priorities/Budgets
The NWRHD Board has a Memorandum of Understanding with the Northern Health Authority that sets out the approval process for capital project decisions. Once the Board has approved a project funding, a capital expenditure bylaw is adopted. The bylaw states whether the project is funded from current budget monies or long term debt.
During construction the NWRHD receives expenditure claims that are funded by temporary borrowing. According to the bylaw, the temporary borrowing is rolled into long term debt. The debt from hospital capital construction is borrowed from the Municipal Finance Authority (MFA), exclusively available to municipalities in Canada, at the most competitive rates in the marketplace due its AAA credit rating.
The Annual Budgeting process therefore may contact all or some of the following elements: • Revenue from the tax levy and other sources • Costs for administration and board expenses • Costs for planning, business cases studies • Annual grants for minor capital equipment and global grants (change from year to year but can include items such as building renovations, technology upgrades, univeral services and projects identified by the health authority • Temporary borrowing costs for capital projects in progress • Principal and interest payments in support of long term debt.
Projects and priorities are proposed each year by the Northern Health Authority; the final approved list is developed in consultation between the health authority and the regional hospital district. The Northern Health Authority invites the RHDs to twice annual planning meetings.
4.1 Current and Future Capital Projects – Hospital Renovations or Replacements in NW British Columbia
All major projects are controlled by Min Of Transportation and Infrastructure. A major project is defined as a project exceeding $10M. A Project Board is formed and is made up of various Ministries representatives, Cathy Ulrich from NH, Michael Hoefer as her alternative, and the project manager. NWRHD has asked for representation on the next project, ie. Mills Memorial Replacement. If this occurs it will be a staff person that would be a member. Projects that exceed $50M may be considered as a public-private partnership (P3).
About NWRHD Page 3 of 5 The planning process beings with a master plan which includes master programing and costing. From this work a concept plan is prepared and submitted to MOH. Once the concept plan is approved then the business plan is prepared. The business plan is submitted to MOH and the Treasury board for final approval and a funding announcement.
Currently a replacement for Queen Charlotte Islands General Hospital and Health Centre (Village of Queen Charlotte) is under construction. The new hospital will be called the Queen Charlotte/Haida Gwaii Hospital. This hospital is expected to cost $50.7M, with an estimated $18.9M contribution coming from the NWRHD. Completion is expected in the spring of 2016.
The NWRHD communities have a fleet of aging buildings not well suited to the new standards and requirements of a modern health care system. Of the utmost concern is the provision of quality primary, acute and chronic care for the residents of our communities, while being fiscally responsible. Construction of hospitals is expensive and at least three of our facilities are near the end of their life.
The following facilities have been identified as the top priorities for the NWRH 1. Mills Memorial Hospital Replacement (Terrace) 2. Bulkley Valley District Hospital 3. Wrinch Memorial Hospital
Replacement of Mills Memorial Hospital is currently listed as Northern Health’s top priority. The master plan and concept plan are complete and are currently, as of Jan 2015, with MOH for review.
5.0 North West Regional Hospital District Meeting Schedule 2015: • Five regular board meetings per year • Dates are confirmed in January 2015 • Next advertised meeting will be held on January 23, 2015
6.0 For more information about the North West Regional Hospital District
Lead Staff: Executive Director Yvonne Koerner
Executive Committee of the Board: A new executive committee will be elected in January 2015. One member from each RD. 1. Stoney Stoltenberg (Chair / Director Electoral Area A , RDBN elected Jan 2014 2. Carol Kulesha (Vice-Chair / Mayor, Village of Queen Charlotte, SQCRD) elected Jan 2014 3. Bruce Bidgood (Vice-Chair / Councilor, City of Terrace, RDKS) elected Jan 2014
How to Contact Us: Suite 300-4545 Lazelle Avenue Terrace, BC V8G 4E1 Tel: 250-615-6100 Fax: 250-635-9222 Toll Free: 1-800-663-3208 Email: [email protected]
Links
Hospital District Act link: http://www.bclaws.ca/EPLibraries/bclaws_new/document/ID/freeside/00_96200_01
Ministry of Health Services link: http://www.gov.bc.ca/health/
RDKS link: http://www.rdks.bc.ca
SQCRD link: http://www.sqcrd.bc.ca
RDBN link: http://www.rdbn.bc.ca
About NWRHD Page 4 of 5
Northern Health Authority link http://www.northernhealth.ca
Northern Health Webcam for the New Queen Charlotte/ Haida Gwaii Hospital Project http://www.northernhealth.ca/AboutUs/CapitalProjects/QueenCharlotteHospitalProject.aspx#322479-webcam
Provincial Health Services Authority link http://www.phsa.ca
BC Ambulance Service link http://www.bcas.ca
Partnerships BC link http://www.partnershipsbc.ca
About NWRHD Page 5 of 5 NORTH WEST REGIONAL HOSPITAL DISTRICT BYLAW NO. 82, 2013
A Procedure bylaw to Regulate the Meetings and Conduct of the Regional Hospital District Board
The Board of the North West Regional Hospital District, in open meeting assembled, enacts as follows:
1. ELECTION OF OFFICERS
1.1 Annually, at the inaugural meeting, being the first meeting after January 1, the North West Regional Hospital District Board (hereinafter referred to as the RHD Board) shall hold an election of officers. The Executive Director shall call the meeting to order and conduct the election.
1.2 From among its Directors a Chair shall be elected. Following the election of the Chair, and at the same meeting, the RHD Board shall elect two (2) Vice-Chairs from among its Directors, one from each regional district not represented by the Chair, and on the same basis as the election of the Chair.
1.3 If a vote is required, the candidate with the overall majority of votes cast shall be declared elected by simple majority. In the event of a tie a decision will be made by drawing of lots. When there are three (3) or more candidates for the position of Chair or Vice-Chair, the candidate with the lease number of votes shall be dropped from the ballot with each successive vote until one (1) candidate receives a majority of votes cats. Voting will occur by secret ballot, and the ballots shall be destroyed by the Executive Director following the election.
1.4 During the absence or illness or other disability of the Chair, a Vice-Chair has all the authority and is subject to the same rules as the Chair.
1.5 If the office of Chair or a Vice-Chair becomes vacant, the RHD Board shall elect another Chair or Vice-Chair from among its Directors at the first possible regular meeting of the Board.
2. MEETINGS OF THE RHD BOARD
2.1 At the inaugural meeting, the RHD Board shall set the day, time and place of the regular meetings of the Board.
3. OPENING PROCEDURES
3.1 At Board meetings, as soon as a quorum is present following the stated time of the meeting, the Chair shall take the chair and call the Directors to order.
1 3.2 Quorum shall be defined as the minimum number of members required to conduct business. Quorum for RHD board meetings shall be 50% of the directors having 50% of the votes. Quorum shall include members physically present and those attending electronically. Quorum is needed for the meeting to begin.
3.3 If the Chair does not attend the meeting within fifteen (15) minutes after the appointed time, a Vice-Chair shall take the chair and call the Directors to order. If the both Vice- Chairs are absent, the Executive Director shall take the chair and call the Directors to order. If a quorum is present, the Directors shall elect an Interim Chair who shall preside during the meeting until the arrival of the Chair or a Vice-Chair. The person appointed as Interim Chair has all the authority and is subject to the same rules as the Chair.
3.4 Electronic participants shall t be counted towards quorum, and are considered present at the meeting and will be recorded as attending electronically.
3.5 If no quorum is present within thirty (30) minutes after the appointed time of the meeting, the Secretary shall record in the minute book the names of the Directors present and the meeting shall be adjourned.
3.6 Immediately after the Chair has taken his seat and has called the meeting to order, the minutes of the preceding meeting shall be read by the Secretary in order to correct mistakes. However, the reading of the minutes shall be dispensed with if each member has been sent a copy of the minutes at least 5 days before the meeting at which they are to be considered.
4. ELECTRONIC MEETINGS
4.1 Members of the RHD Board may attend meetings electronically in accordance with the following guidelines and requirements. This includes regular, special, and committee meetings. Electronic participation in in-camera meetings will be left to the discretion of the RHD Board depending on the sensitivity of the topic and level of confidentiality required for the subject matter.
4.2 Any board member who is unable to be physically present at the RHD Board meeting location for reasons pertaining to extenuating circumstances such as health or poor travel conditions may attend the RHD Board meeting electronically. The Chair shall have the right to determine what constitutes valid extenuating circumstances.
4.3 A Board member attending electronically may participate in the meeting by either audio only or a combination of both audio and visual means. Each member participating in the meeting must be able to communicate with all of the other members concurrently.
4.4 A Board member attending electronically has the right to vote on resolutions and bylaws as though physically present.
4.5 Although the district will make every effort to accommodate electronic participation in meetings as required, nothing in this bylaw shall be construed to guarantee any member electronic access to a RHD Board meeting.
2
4.6 Electronic participation in meetings may be restricted by equipment capacity.
4.7 Participating in meetings closed to the public (in-camera) will not be undertaken by wireless means such as cell phones.
4.8 A board member participating in a meeting electronically is deemed to be present in the meeting and is entitled to receive remuneration for attending the meeting. Travel costs may be reimbursed if incurred while attempting to attend the meeting in person.
4.9 The person presiding the meeting must be physically present at the meeting. In the absence of the Chair or if the Chair is attending electronically, a Vice-Chair shall preside over the meeting. In the absence of both Vice-Chairs the members present shall elect from among themselves a presiding member for that meeting.
4.10 If the meeting is open to the public, the facilities must enable the public to hear, or see and hear, the participation of the member or members participating electronically.
4.11 Members of the public are not entitled to request electronic meetings of the Board or to monitor or participate in Board meetings from remote locations.
4.12 Interruption in the communication link to a member or members participating electronically may result in a short recess until it is determined whether or not the link can be re-established.
AGENDA
5.1 The Executive Director shall prepare an agenda before every regular and in-camera meeting of the RHD Board and shall circulate a copy to each Director at least five (5) days before the meeting.
5.2 With the approval of the Chair or a Vice-Chair, the Executive Director shall prepare supplementary agendas for urgent or pressing business for circulation on the day of the meeting.
5.3 The agenda, at a meeting other than a regular meeting, shall be governed by the specific purpose or purposes under consideration. Where possible, the agenda will be circulated at least seventy-two (72) hours in advance.
5.4 When any order, resolution or question is lost by reason of the RHD Board or any Committee thereof breaking up for want of a quorum, the order, resolution or question so lost shall be the first item of business to be proceeded with and disposed of at the next meeting of the RHD Board or Committee.
6. RULES OF CONDUCT AND DEBATE
6.1 Every Director shall address himself to the Chair before speaking to any question or motion.
3 6.2 Directors shall address the Chair as “Mr. Chair” or “Madam Chair” and shall refer to each other as “Director ______”.
6.3 No member shall speak disrespectfully of Her Majesty the Queen or any member of the Royal Family, or of the Governor General, Lieutenant Governor or persons administrating the Government of Canada or of this Province, nor shall he use offensive words in or against the RHD Board or against any member thereof, nor shall he speak beside the question in debate. No member shall reflect upon any vote of the RHD Board except for the purpose of moving that such vote be rescinded; nor shall he resist the rules of the RHD Board on questions of order or practice, or upon the interpretation of the rules of the RHD Board. In case any member shall so resist or disobey, he may be ordered by the RHD Board to leave his seat for that meeting. In case of his refusing to do so he may on the order of the Chairperson be removed therefrom by the police. But in case of an apology being made by the offender he may, by vote of the RHD Board, be immediately permitted to take his seat again.
6.4 No member may speak more than once to the same question without leave of the Chair, except in explanation of a material part of his speech that may have been misconceived and in doing so, he may not introduce a new matter. A reply shall be allowed to a member who has made a substantial motion to the RHD Board, but not to a member who had moved an amendment.
6.5 After a question is finally put by the Chair, no member shall speak to the question, nor shall any other motion be made until after the result of the vote has been declared. The decision of the Chair as to whether the question has been finally put shall be conclusive.
7. POINTS OF ORDER
7.1 The Chair, the Vice-Chair or the Director presiding at the meeting of the RHD Board, shall preserve order and decide all points of order which may arise, subject to an appeal to the other Directors of the RHD Board then present.
7.2 If an appeal is made by a Director of the RHD Board of a decision of the Chair, the question “Shall the chair be sustained?” shall be immediately put by the Chair and decided without debate. The Chair shall be governed by the majority of the Directors of the RHD Board then present (exclusive of himself). In the event of the votes being equal, the question shall pass in the affirmative.
7.3 If the Chair refuses to put the question “Shall the chair be sustained?”, the RHD Board shall forthwith appoint a Vice-Chair, or if both Vice-Chairs are absent, one of the Directors to preside temporarily in lieu of such Chair, as the case may be, and the Vice- Chair or Director of the RHD Board so temporarily appointed shall proceed in accordance with Subsection 7.2. In the event of the votes being equal, the question shall pass in the affirmative.
7.4 Any resolution or motion carried under the circumstances mentioned in Subsection 7.3 is as effectual and binding as if carried under the presidency of the Chair.
4 8 VOTING OF QUESTIONS
8.1 Weighted votes and majority votes shall be applicable to committee meetings as they are to Board meetings.
8.2 Electronically participating members have the right to vote as though physically present.
8.3 If a member considers that he is not entitled to participate in the discussion of a matter or to vote on a question in respect of the matter, the member shall declare this and state the general nature of why the member considers this to be the case.
8.4 A declaration of “non-entitlement” requires the following procedure be carried out:
a) The member is not considered as part of the quorum for the vote on which the member declared “non-entitlement.”
b) The member shall not take part in the discussion of the matter and is not entitled to vote on any question in respect of the matter; shall immediately leave the meeting or that part of the meeting during which the matter is under consideration; and, shall not attempt in any way, whether before, during, or after the meeting, to influence the voting on any question in respect of the matter.
c) The member is entitled to return to the meeting, but only after all discussion and voting on the matter is complete.
8.5 Any Director who is present at the meeting but who declines to vote on a question for any reason other than that outlined in Section 8.3, shall be regarded as having voted in the affirmative and his vote or votes shall be counted accordingly.
8.6 In all cases where the votes of the Directors then present, including the vote of the Chair or other person presiding, are tied, the question shall be defeated and it shall be the duty of the presiding Director to so declare.
8.7 As soon as the Chair has announced the results of the vote on a question, any Director who voted in opposition may request the Chair to have his name so recorded in the minutes.
8.8 When a question under consideration contains distinct propositions, the vote upon each proposition shall be taken separately only upon the request of any member to do so. Unless otherwise requested, all recommendations may be removed on a consent basis.
8.9 A resolution of the Board passed at a previous meeting shall only be rescinded by a 2/3 vote of the Directors present.
9. PETITIONS AND DELEGATIONS
9.1 Individuals or groups wishing to appear before a Regional Hospital District Board meeting may do so only if they have first notified the Chair or Executive Director in writing before the agenda has been prepared and circulated to the RHD Board, except on extraordinary occasions declared as such by the Chair, or by a 2/3 majority of the members present.
5 9.2 Every delegation shall be allowed a reasonable time at the discretion of the Chair to present its petition or submission, after which the RHD Board may dispose of the petition or submission at the meeting, refer the subject matter to a Committee, a subsequent meeting of the RHD Board, or take such other action as is deemed expedient.
10. REPORTS
10.1 A Standing or Select Committee of the RHD Board may report to the RHD Board at any regular meeting or shall report as required by the RHD Board.
11. MOTIONS
11.1 Motions other than routine motions shall be put in writing and seconded before being debated or put from the chair.
11.2 A motion that has been seconded may be read by the Chair or Executive Director before debate at the request of any Director.
11.3 Amendments shall be in writing and shall be decided upon before the main question is put to a vote. Only one amendment shall be allowed to an amendment.
11.4 A motion to commit the subject matter to a Committee, until it is decided, shall preclude all amendment of the main question.
11.5 A motion to adjourn the RHD Board or to adjourn the debate shall always be in order, but if such motion is defeated, no second motion to the same effect shall be made until some intermediate business or matter has been disposed of.
12. BYLAWS
12.1 Except where the Letters Patent require otherwise, every bylaw shall be read a first time upon the motion “...that Bylaw No. , be introduced and given first reading.” The title and intended object of the bylaw shall be given and the question shall be decided without amendment or debate.
12.2 The bylaw may then be read a second time upon the motion “...that Bylaw No. , be given second reading.”
12.3 First and second readings on any bylaw may, at the Board’s discretion, be done concurrently, on the motion "... that Bylaw No. be introduced and given first and second reading.”
12.4 When the bylaw has been read a second time, it may be referred to a committee.
12.5 Whether or not the bylaw has been referred to a committee, it may then be read a third time and passed upon the motion “...that Bylaw No. , be given third reading.”
12.6 A bylaw may be adopted upon the motion “...that Bylaw No. , be adopted.”
6 13. SPECIAL MEETINGS
13.1 A special meeting, being a meeting other than a statutory, regular or adjourned meeting may be called by the Board at a meeting of the RHD Board or any time by the Chair or upon request in writing, of a majority of the Directors.
13.2 The RHD Board shall meet for a special meeting on the day and at the place and hour specified in the notice except if a quorum is not present within 30 minutes after the time appointed for commencement of the meeting.
14. POLLS
14.1 Polls and/or votes by electronic communication may be undertaken when a RHD Board decision is urgently required prior to a regular meeting.
15. SPECIAL CLOSED MEETING IN-CAMERA
15.1 Unless and otherwise owing to extenuating circumstances and as otherwise may be determined by resolution of the RHD Board, the following matters shall be the only items to be dealt with by the RHD Board at Special Meetings in closed session (In-Camera): personnel matters; matters concerning litigation; and the purchase, sale or lease of property.
15.2 The Executive Director shall, with the approval of the Chair or Vice-Chair in the Chair’s absence, issue notice of a Special Meeting to be called for after or preceding any regularly scheduled meeting.
15.3 A Special Closed Meeting during a regular RHD Board meeting shall commence by resolution “That this Board now proceed to resolve itself into a special closed meeting” and upon adjournment of the Special Closed Meeting, the Board may resume its regular meeting.
15.4 All RHD Board Directors shall adhere to the Confidentiality and In-Camera Protocol guidelines.
16. PUBLIC ATTENDANCE
16.1 Regular and special meetings of the RHD Board shall be open to the public and no person shall be excluded, except for improper conduct.
16.2 If, in the opinion of the RHD Board, the public interest so requires, the RHD Board may by resolution exclude from any special closed meeting persons other than its Directors.
17. STANDING AND SELECT COMMITTEES
17.1 Directors of the RHD Board may attend the meetings of any of its Committees. They shall not be allowed to vote but may be allowed to take part in any discussion or debate by permission of a majority of the votes of the Committee.
7 17.2 The general duty of all Committees of the RHD Board shall be to consider and report to the RHD Board from time to time, or whenever desired by the RHD Board and as often as the interest of the Regional Hospital District may require, on all matters referred to them by the Chair or the RHD Board coming within their purview, and to recommend such action by the RHD Board in relation thereto as they deem necessary or expedient.
17.3 A majority of the Directors appointed to compose any Standing or Select Committee shall form a quorum.
17.4 In the transaction of business, all Standing and Select Committees shall adhere as far as possible to the rules governing proceedings in meetings of the RHD Board.
17.5 On completion if its assignment and submission of its report to the RHD Board, a Select Committee shall be automatically dissolved.
18. RULES OF ORDER
18.1 In all unprovided cases in the proceeding of the RHD Board or in Committee, Roberts Rules of Order shall be followed.
19. REPEAL BYLAW NO. 67
19.1 The North West Regional Hospital District “Procedure Bylaw 67, 2011” is hereby repealed.
20. CITATION
This bylaw may be cited for all intents and purposes as the “North West Regional Hospital District Procedure Bylaw No. 82, 2013.”
READ a first time this 22nd day of November , 2013.
READ a second time this 22nd day of November , 2013.
READ a third time this 22nd day of November , 2013.
ADOPTED this 22nd day of November , 2013.
Chair Executive Director
Certified a true copy of Bylaw No. 82, 2013 as adopted.
Formatted: No underline Yvonne Koerner Executive Director
8 NORTH WEST REGIONAL HOSPITAL DISTRICT
Confidentiality and In- Camera Protocol
The following protocol outlines the responsibilities and obligations of all persons with access to confidential materials and those who attend in-camera proceedings of the North West Regional Hospital District Board (hereinafter referred to as the RHD Board).
1. CONFIDENTIALITY PROCEDURES
1.1 All documents submitted for the RHD Board and/or Committee meeting agendas, or for any other purpose, that are deemed confidential must be clearly marked confidential before being delivered to the Executive Director for distribution.
1.2 The Recording Secretary will print confidential material on coloured paper for easy identification.
1.3 Confidential reports may be included with the in-camera agenda. Directors that receive confidential reports have an obligation to ensure that they are filed in a secure location before and after a meeting.
1.4 The proceedings and reports from in-camera sessions do not form part of the public minutes. Only the actions taken by the RHD Board or committee and a reference to supporting materials may be included in the published document. The record of the in-camera session will be kept separately on file as confidential in the Office of the Executive Director and may not be circulated.
1.5 All material marked confidential will remain in-camera unless officially declared to be public information by the RHD Board.
1.6 In order for meetings to run efficiently, when possible, in-camera items may be discussed together in one session during a meeting at either at the beginning or at end of a meeting agenda. A separate in-camera agenda may be prepared. The regular agenda may indicate only that an in-camera session is being held.
2. IN-CAMERA PROTOCOL
2.1 During a meeting, the Chair will ask for a motion to move in-camera to consider a confidential report. Once the vote passes anyone who is not a member of the Board or approved staff must leave the room, unless specifically invited to remain by the Chair.
2.2 It is important to ensure that in-camera documents are not visible to others during an open session of a Board or committee meeting.
2.3 When the in-camera session concludes, the Chair will ask for a motion to move to open session. After the motion has passed, those who left the room will be invited to return to the meeting.
2.4 No discussion from an in-camera meeting should be disclosed at anytime unless officially declared to be made public information by the RHD Board.
2.5 Directors of the RHD Board and approved others in attendance, will observe the strictly confidential nature of the documents and the business discussed and subsequent report dealt with during an in- camera session. It is their responsibility to ensure that such information is not divulged to unauthorized persons. The contents of a confidential document or discussion can only be shared among those persons who were entitled to be in attendance at the meeting.
2.6 Electronic participants in an in-camera meeting are responsible to use discretion to ensure the integrity and confidentiality of the meeting.
NORTH WEST REGIONAL HOSPITAL DISTRICT BYLAW NO. 64
A Bylaw to Provide Director Remuneration
WHEREAS the North West Regional Hospital District Board may, by bylaw, provide for payment of remuneration of Directors and Alternate Directors, and for reasonable expenses incurred by the Director or Alternate Director in connection with Regional Hospital District business, pursuant to Section 15 of the Hospital District Act;
AND WHERAS the North West Regional Hospital District Board deems it desirable to replace Director Remuneration Bylaw No. 51;
NOW THEREFORE the North West Regional Hospital District, in open meeting, enacts as follows:
A. Definitions:
“Regional Hospital District” means the “North West Regional Hospital District”.
“Director” means a member of the North West Regional Hospital District Board unless the text states otherwise.
“Executive Committee” means a committee comprised of the Chair and two Vice Chairs.
“Meal Allowance” means, where the travel does not include an overnight stay, an allowance will be paid which equals $50 a day, or for less than a day:
Breakfast $10.00 Lunch $15.00 Dinner $25.00
“Other Travel Expense” includes mileage, taxi, air, or other transportation method and accommodation. Other travel expenses, other than mileage, must be supported by receipts.
“Overnight Per Diem” means, for each night away from home, an allowance will be paid which includes expenses for meals, and other incurred incidentals such as use of fax, telephone, photocopying or laundering services, and gratuities. The Overnight Per Diem is $65.
“Travel Expense” means, all items included under “Meal Allowance”, “Other Travel Expense”, and “Overnight Per Diem”.
B. Regional Hospital District Board Remuneration and Expenses
1. The Chairperson’s remuneration for attendance at all regularly scheduled Board and Committee meetings will be $450.
2. The Vice Chairs’ remuneration for attendance at the regularly scheduled Board Meetings will be $350.
3 Directors’ remuneration for attendance at all regularly scheduled Board and Committee meetings will be $250.
4. The Chair and Vice Chairs’ remuneration to compensate for preparation work and obligations in regards to their positions in the amount of $100 per meeting.
5. Where an Alternate Director attends as a Director, he/she will be paid at the Director’s remuneration and travel expense rates.
6. Directors are entitled to receive a mileage allowance equal to 50 cents per km on paved roads and 65 cents per km on gravel roads. If travel is by air, Directors are entitled to economy class airfare. Generally, Directors shall travel by the most convenient and economical method.
7. Directors are entitled to reimbursement of meals and other travel expenses.
8. Obtaining prior authorization and claiming expenses are the sole responsibility of the Director. The Regional Hospital District will not reimburse expense claims made in excess of three months after the date of return.
9. Spousal, family, and other personal expenses are the personal responsibility of the Director, including expenses incurred for extra time or extra travel for personal business.
C. Special Director Allowance
1. Remuneration and travel expenses to be paid to Directors for attendance at Committee meetings other than Regional Hospital District Committees on behalf of the Regional Hospital District and authorized by the Board as follows:
a) $250 for attendance of more than four hours b) $125 for attendance of less than four hours c) travel expense.
The meetings must be on a day other than a regular Board meeting and may include travel time to and from the meeting.
D. Time spent by a Director at conventions, conferences, and seminars will not be counted as time worked for the purposes of remuneration but will, when authorized by the Board, entitle the Director to travel expenses.
E. This bylaw may be cited as the "Director Remuneration Bylaw No. 64, 2010".
READ a first time this 28th day of May , 2010.
READ a second time this 28th day of May , 2010.
READ a third time this 28th day of May , 2010.
ADOPTED this 28th day of May , 2010.
Chairperson Administrator
Certified a true copy of Bylaw No. 64, 2010 as adopted.
Tanalee Hesse Administrator
UBCM 2014
Confidential Property of: North West Regional Hospital District Building for Health Suite 300 - 4545 Lazelle Avenue, Terrace, BC V8G 4E1 Tel: 250-615-6100 Toll Free: 1-800-663-3208 Fax: 250-635-9222 Email: [email protected]
Table of Contents North West Regional Hospital District - Our Area...... 2 Major Concerns: ...... 2 Our Facilities ...... 3 Current Project – Queen Charlotte/Haida Gwaii General Hospital ...... 4 Top Priority Project: Replacement of Mills Memorial Hospital/ New Level 3 Trauma Center ...... 5 Reasons for a Trauma Center in the North West Region...... 6 Future Infrastructure Investment Funding Formula ...... 9 Reductions to NH’s Routine Capital Investment Budget ...... 11 Medical Travel Assistance for the North ...... 12 BCAS Resolution ...... 13 Air Quality in Northwestern BC ...... 14 Kitimat Airshed Emissions Effects Assessment Project, July 18, 2014 ...... 14 RTA SO2 Permit Amendment ...... 16 LNG Impact on the Airshed ...... 16 About Terrace, BC...... 18 Socio-Economic Profile For Local Health Area 88 – Terrace BC ...... 19
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North West Regional Hospital District - Our Area
The North West Regional Hospital District (NWRHD) is the largest regional hospital district geographically in the province of BC. It shares the same boundaries as the entire Regional District of Kitimat-Stikine (RDKS) and Skeena- Queen Charlotte Regional District (SQCRD), and the western portion of the Regional District of Bulkley-Nechako (RDBN).
A 27-member elected Board of Directors represents the 25 municipalities and electoral areas, of the three North West British Columbia regional districts.
Our region is experiencing a period of economic renewal. With several major projects starting or expected to begin in the very near future, our communities need to be prepared. Adequate health services and the infrastructure that supports it are essential to safe and secure resource development. Competition for health workers, their recruitment and retention are dependent on adequate infrastructure. Our health care providers will be faced with a varied population of children, workers, seniors as well as a large transient workforce. North West Regional Hospital District is looking for assistance in ensuring our communities are prepared to embrace these new opportunities. Our hospitals must be ready for anticipated increases both from local families and the pressures of temporary camp workers.
As a Regional Hospital District we wish to work with and support Northern Health in their endeavors to provide the best possible health care to the North.
This information package contains information on the needs and concerns of our region.
Major Concerns:
Replacement of Mills Memorial Hospital Establishment of a Trauma Center in the North Funding Formula for Future Investment in Hospital Infrastructure Reduction in Operating Capital for NH BC Ambulance Service in Rural Communities Air Quality in North West BC
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Our Facilities
The NWRHD is responsible for contributing to Facilities Support per Regional Hospital District 18 the capital requirements of 16 principle health 16 facilities, more facilities than any other hospital 16 district in the Northern Health Authority. 14 12 10 NWRHD is faced with the burden of several 10 9 very old facilities which are in need of 8 6 replacement or major renovations in the near 4 future. Four of these facilities have been 3 3 2 identified by the NWRHD as needing to be 0 replaced. Northern Health has our top three North West Cariboo-Chilcotin Fraser-Fort George Peace River Northern Health Corporate Facilities facilities on their Prioritized Projects List, Mills Memorial, Bulkley Valley District and Wrinch NWRHD Ages of Oldest Facilities Memorial. Northern Health’s estimated 70 66 replacement cost for these hospitals is currently 61 60 at $650 Million dollars. 49 50 43 Currently the construction of the New Queen 40 Charlotte/Haida Gwaii General Hospital is 30 underway. This is an exciting first step in the 20 process, but much more needs to be done as we 10 have other seriously aging hospitals. 0 Bulkley Valley Mills Memorial Prince Rupert Wrinch Memorial District Regional Mills Memorial is the hospital in our region that the board has identified as a top priority and NWRHD Aging Facilities immediate need. Northern Health is in agreement and 2014 Approximate Replacement Costs ($M) has also identified Mills Wrinch Memorial as their number Memorial, one priority project. $50.0 Prince NWRHD’s Priorities Rupert Bulkley Valley Regional, District, $175.0 1. Mills Memorial Hospital $175.0 2. Bulkley Valley District Hospital 3. Wrinch Memorial Hospital Mills Memorial, 4. Prince Rupert Hospital $250.0
Total Estimated Replacement Cost $650 M
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Current Project – Queen Charlotte/Haida Gwaii General Hospital
The New Queen Charlotte/ Haida Gwaii General Hospital will be a model for primary health care in a rural setting: providing care for patients from birth through end of life. The North West Regional Hospital District board is looking forward to the construction process. The selected contractor Bouygues Building Canada broke ground July 30, 2013 and completion is anticipated for November 2015.
This is $50 million build and the NWRHD district is contributing forty percent to its construction, $18.9 Million. We have been in full support of this project since its conception, and in doing so committed to establishing significant long term debt. Prior to this project the NWRHD Net Residential Tax Rate was at $.39. We raised our tax levy in 2011 to $.63 and again in 2012 to $.71 in order to create a project reserve and ensure the capital debt would be managed. These tax increases have resulted in the NWRHD having one of the highest hospital tax levies in the province.
Below is an architect’s sketch of the planned hospital.
Construction is currently underway by Bourgue Building Canada. The estimated completion date is November 2015. A webcam is at the site for viewing the current status.
There is a webcam on site. To see the update progress of the project click on the link below. http://www.northernhealth.ca/AboutUs/CapitalProjects/QueenCharlotteHospitalProject.aspx#322 479-webcam
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Top Priority Project: Replacement of Mills Memorial Hospital/ New Level 3 Trauma Center
Northwestern BC is in a period of economic growth. The Modernization of the Rio Tinto Aluminum Smelter, building of the Northwest Transmission Line, several proposed LNG terminals and pipelines, and numerous mining ventures have already begun to impact our communities.
Northwest BC needs to prepare for this new and exciting future. Quality health care is a key variable for industry and its employees. Accessible health care, along with quality education and quality recreation is of major importance to those companies looking to relocate to our region.
The major health care issue in the Northwest is the lack of both an essential Level 3 Trauma Center and a dedicated air ambulance. To investors and prospective new residents, perception of the health care system is as important as reality. There is a high level of concern over the number of individuals that die before they reach the level of care required to stabilize them. Pre- hospital deaths are reported at 82% compared to more urban jurisdictions of BC which range from 67 to 73% for all classes of deaths.* The north has been under criticism in the news for having an absolutely third class ambulance system. (Vancouver Sun April 7, 2013).
The future needs to include a Level 3 Trauma Center. Despite the best safety program, increases in industrialization equates to increased risk for industrial type accidents. Hospitals in the region need to prepare for these associated risks. The formation of a Level 3 Trauma Center will not occur in Terrace without a new Mills Memorial. The existing hospital is not capable of preforming the procedures required to be a full Level 3 Trauma Center. The old building has structural barriers which make renovations as costly as building a new hospital. A new Mills Memorial Hospital would provide the needed infrastructure to have a level 3 Trauma Center with its expanded services.
The BC Ambulance services only stations air ambulances in communities with a trauma center, as it requires its staff to start and end each shift at a base that provides specialized health services. A Level 3 Trauma Center in the north would open the door for the establishment of an air ambulance base.
Increased economic activity in the region increases the demand for health infrastructure and its highly trained health care professionals. Mills Memorial is currently a partner and training hospital for UNBC’s medical program. A new updated hospital would benefit the education and training of UNBC students and benefit the communities as these students are exposed to the north and be more likely to embrace the northern lifestyle.
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Reasons for a Trauma Center in the North West Region
Northwest BC is a vast area with a population of approximately 80,000 people, the population Trauma Center Levels density is less that 1 person/square mile. For Level One - Vancouver General Hospital most communities the nearest designated is the only Level 1 Trauma center in BC. trauma center is 4 to 10 hour drive away in Level one centers can handle all trauma Prince George, (Level 3 Center). Pre-hospital cases. care is provided by BC Ambulance Service with ground transportation and basic life support Level Three - UNBC in Prince George is capabilities only. Many smaller communities the only level 3 center currently in the lack basic ambulance service and response is north. They have the ability to receive from the nearest community, one to two plus patients, stabilize them and ship them to a hours away. This is another issue that needs to higher level of care if required. Level three be addressed that affects quality health care in centers perform surgeries, fix fractures, Northern BC and will be discussed in another internal injuries and urology procedures. section of this report. They have a 24/7 ICU for patients after surgery and can care for patients on A Population-Based Analysis of Injury-Related ventilators. They do not deal with thoracic Deaths and Access to Trauma Care in Rural- trauma or head injuries. This Trauma center Remote Northwest British Columbia Study in serves the whole northern half of the 2010, lead by Dr. Richard Simons, Medical province. Only a few of the NW Director Trauma Services at Vancouver Coastal communities are within a 4 hours drive of Heath, resulted in the following conclusions: this trauma center and most of the Injury rates and injury mortality rates are population is at 6 to 8 hours of driving or generally higher than the urban centers, yet flying time. access to trauma centers is often compromised by: Incident discovery, limited phone service Level Five - Mills Memorial is now (land lines/cell), incomplete 911, EMS system accredited as a level 5 center. Major access, geographical and climactic challenges Trauma victims receive resuscitative compounded by limited transportation options, care, are stabilized and are transferred to a airport capabilities and paramedic training level, higher level trauma center. dysfunctional hospital no-refusal policies, lack of hospital destination polices and lack of system leadership and co-ordination.*
The study looked at data from 2001 to 2006 from the Discharge Abstract Database, BC Coroner reports from 2003 to 2006, along with hospital charts of 127 trauma patients admitted to five NW BC hospitals. The analysis included place and timing of death following injury in NW BC, access to and quality of local trauma services, and the opportunities to improve trauma outcomes. The class of death in the NW was determined by the BC Coroner’s Office, so it is comparable to other BC jurisdictions.
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The BC Coroners Service 2010 Annual Report shows Northern BC as having the highest death rate per 2,000 30 100,000 population. (p. 65) 1,800 22.9 The report included two 1,600 25 suggested causal factors: 1,400 11.7 28.5 20 1,200 Large proportion of 23.2 1,000 highway travel, which 15 800 increases both speed and 600 14.5 10 public interface with 400 5 heavy commercial 200 vehicles 0 0 Longer emergency Fraser Interior Island Metro Northern response times and greater distance to Number of Deaths medical facilities Death rate per 10,000 population by region, 2010 Northern Region Classifications of Deaths, 2010 For total deaths investigated by the BC
Homicide Undetermined Coroner Service there were 22.9 deaths 2% 5% per 10,000 population. This does not included individuals injured in the Suicide north that died after reaching 8% Vancouver. These deaths are recorded under the Metro region. Accidental 24% Natural In 2010 24% of all deaths in the North 61% were the result of accidents. Suicide was the second leading cause of death at 8%, with 2% classified as homicide and 5% undetermined.
MVI Deaths and Death Rate by Region 2006-2010 A breakdown of the types of accidents shows that falls are the leading cause of death, adults 70 and over account for 120 30 75.8% of deaths due to falls. Deaths 23.9 100 25 due to Motor Vehicle Incidents in BC 80 15.4 20 were highest in the North, 23.9 deaths 60 15 per 100,000 population. (page 65). 6.4 7.8 2.8 40 10 20 5 0 0 Fraser Interior Island Metro Northern Deaths Rate per 100,000 Pop.
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The Simons study brought out several important pieces of information regarding the status of the North West.* Pre-hospital deaths are significantly more frequent in NW BC, 82% compared to more urban jurisdictions of BC (67-73%) 77% of deaths occur at the scene in the NW compared to 48% in the more urban jurisdiction of VCHA with its advanced pre-hospital capabilities and four designated trauma centers. Pre-hospital times could be determined in 61 of 127 charts reviewed with a mean time of 85 minutes. These times underestimate the problem as the first documented time is the dispatch time, which does not account for the often-prolonged incident discover and system access times. Secondary Transfers to definitive care was common. (31%) The mean time delay from admission to transfer for secondary or tertiary referrals, based on hospital chart review, was 42 hours. Conclusions show: 1. NW BC does have a higher injury hospitalization and injury death rate than most other parts of the province with motor vehicle-related trauma being a significant contributing factor. 2. The majority of trauma death in NW BC occurs before hospital admission. 3. In-hospital mortality contributes minimally to excess deaths after injury. 4. Although pre-hospital delays were the primary responsibility of excess mortality, hospital staff were far from reticent about identifying their limitations and the need for more organized trauma services in the region.
Consideration needs to be given to the fact that this report included data only up to 2006. Since 2006 NW BC has seen a period of economic growth and pressures have increase. The need for more organized trauma services for the region has only increased.
Some suggestions to improve trauma services given by hospital staff include: Need for functional no-refusal policies Centralized and coordinated trauma capabilities in region Need for hospital bypass protocols
The NWRHD is pleased to hear from NH that a NW Medical Lead is in place for NH’s Critical Care Council which will lead out the next trauma accreditation in 2016 and that a NW part-time Trauma Coordinator role has also been filled. This is a step in the right direction.
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Future Infrastructure Investment Funding Formula
There is a definite need to improve the health infrastructure in the NWRHD. The current economic growth is exasperating the issue by increasing pressure on existing services. Mills Memorial Hospital and Bulkley Valley District Hospital are both over sixty years old and are substandard facilities that compromise the staffs’ ability to provide adequate support for quality health care. These hospitals are at the point where they may be a hindrance to economic development. Wrinch Memorial and the Prince Rupert Hospital are also both aging and will need to be replaced after Mills Memorial and Bulkley Valley District Hospital. The estimated costs to replace the four aging hospitals are currently totaling $650 million dollars.
2014 Estimated Replacement Cost (Millions) Mills Memorial $250 Bulkley Valley District $175 Wrinch Memorial $50 Prince Rupert Regional $175 $650
This needed infrastructure cannot be funded using the current cost sharing formula where resident tax payers contribute 40 percent. Future revenues need to be invested into this area now in order to meet the health care demands coming from economic growth. Our area expects a period of economic growth but we have no assurance that our revenues will increase proportionately with the increased demands on services.
The type of economic growth that is expected is not anticipated to have a reciprocal effect on the assessment tax base. Mines do not increase the assessment tax base in the same way as pipelines have in the Northeast. Mines typically have low assessment values attached to the property, and the equipment used for mining is not included in the assessment. A significant amount of the Rio Tinto Alcan modernization is equipment related.
The major projects in the area will increase the need for health care services. This is already being felt in Kitimat as the emergency rooms are filling up with transient camp workers needing primary health care, but do not have a family doctor. Mega projects are planning to house workers in camps. Workers will not own homes in the area nor pay property taxes. The dollars earned will not necessarily stay in our region. During this construction phase communities will be under intense pressure without the required tax base.
The Province, through the Ministry of Health and Health Authorities, has a responsibility to provide quality health care to all BC residents. In order to improve the health care infrastructure the funding model needs to change. According to the Ministry of Health Cost-Sharing review 2003, the health authorities must be unfettered by cost sharing requirements in their ability to provide health care services regardless of the fiscal capacity of the region. The NWRHD will
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not be capable of continuing to fund major projects at 40%. The New Queen Charlotte/ Haida Gwaii Hospital will be the last hospital that the NWRHD can fund at 40%. As we look at the updated replacement costs from Northern Health it is hard to imagine being capable of funding even 20%.
Northwest Regional Hospital District Forecast Impact of Replacing Four Hospitals at 20% Contibution 2010 - 2031
12,000,000 $2.25 New Prince Rupert 2028-2031 $2.00 New Wrinch 10,000,000 2025-2027 New Bulkley Valley $1.75 2021-2024 New Mills Memorial Net Residential Tax rate 2017-2020 8,000,000 New QC/HG Hospital 40% contributed $1.50 Complete 2015 20% 40% Contribution $1.25 6,000,000 $1.00
4,000,000 $0.75
$0.50 2,000,000 $0.25 Actuals Budget
0 $- 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 Tax Levy 20% Capital Debt 20%
Net Residential Tax Rate 20% Net Residential Tax Rate 40%
The NWRHD residential tax levy was $39 per $100,000 of assessed value in 2010. The tax levy increased to $63 in 2011 and then to $71 in 2012 in anticipation of the construction of the Queen Charlotte /Haida Gwaii General Hospital. Tax payers saw an increase of 82% in two years as the NWRHD took proactive steps to ensure it would be able to meet the financial obligations.
North West tax payers already pay some of the highest tax rates per $100,000 of assessed value in the province. A new Mills Memorial Hospital, with a 20% contribution, to a $250M facility, would cause property taxes to increase to $97 per $100,000, a 148% increase from 2010. This will have a very negative effect on our communities, especially for those on fixed incomes.
The cost sharing formula between the NWRHD and the province must be changed. Forecasting has been done using a 20% contribution as our fiscal capacity to fund new hospitals is reaching a maximum.
The annual cash flows required for servicing debenture debt will be over $2.4 million when the
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New Queen Charlotte/Haida Forecasted Future Cash Flows Required to Gwaii hospital is complete. Service MFA Debenture Debt for Hospitals Contributing 20% to a New 20 Percent 40 Percent Mills Memorial will increase $14 the needed cash flow to close Prince Rupert to $4.2 million, a 70% $12 increase. A 40% contribution Bulkey Valley $10 would bring cash flow Mills Memorial Wrinch requirement to $6.2 million or $8 a 153% increase. Based on Queen Charlotte City current estimates, the $6 replacement of these four hospitals will result in a $4 required cash flow of over $6 $2 million annually at a 20% contribution and cash flows of $- a staggering $11.7 million 2010 2015 2020 2025 2030 annually with a 40% contribution.
Reductions to NH’s Routine Capital Investment Budget
The NWRHD would like to express its deep concern for the continued cuts to Northern Health’s routine capital investment budget. As a region with aging facilities and aging equipment paired with increased demand on health care services, this is not the time to cut preventative and routine maintenance programs.
The $3 million received by Northern Health this past year does not allow for anything outside of crisis management. Crisis management does not equate with good health care. Facilities are already at the end of their lives; more and more failures will occur. Reliability of equipment must be a top priority.
Northern Health has approached its Regional Hospital Districts and requested that we consider funding projects at 100%. The NWRHD board feels that this puts an unfair burden on our tax payers and is unwilling to cover the government’s share of projects.
Proper Maintenance programs need to be funded; the choice to not do maintenance will result in increased need for full capital replacements. Northern Health has assured us that they have a plan to divert internal fund to cover short falls for the current year, but this should not be the solution. The NWRHD asks the BC Government to return NH to its original routine capital investment funding levels to ensure reliability of the health care infrastructure in the north.
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Medical Travel Assistance for the North
The NWRHD requests the provincial government revamp its existing Travel Assistance Program to include accommodations and subsidize air travel to offset the cuts to BC Ferries.
Living in the north means that a person with a serious medical problem or medical emergency must travel to Prince George or the lower mainland. This travel is often on short notice and is very costly. Illness and disabilities require scheduled multiple appointments. Consultation is frequently a separate trip then the actual procedure and often there is another follow-up appointment.
Reductions in sailings by BC Ferries has intensified this problem as patients are now required to spend more days away from home or they have to fly due to incompatible ferry sailings. Accommodations are not covered under the current Travel Assistance Program where only ferry travel is subsidized. In remote areas such as Haida Gwaii, with ferries leaving only twice per week in the fall, winter and spring, patients may have to spend 6 days in Prince Rupert for a one doctor’s appointment. A patient with a Tuesday appointment would have to take a Thursday night ferry and then would not be able to return home till the following Thursday morning. This results in 6 nights of accommodations.
Currently there are airlines and hotels that do offer medical discounts as a goodwill gesture and though these discounts are appreciated more needs to be done.
The NWRHD recommends that a new TAP BC program is established which will provide subsidized air fare to patients and assist with accommodations for those northern residents required to travel for specialized health care not available in their community.
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BCAS Resolution
The Regional District Kitimat-Stikine has submitted a resolution to UBCM regarding the current service levels provided by BCAS to small rural communities in BC. This is not just a northern BC problem but it affects all rural small communities in BC. Provision of quality health care for all BC residents must be made a priority. We believe that the levels of service to small rural communities can and must be improved. We have identified what we believe are the two main issues and have recommendations to improve service.
Main Issues:
1. Frequent out-of-service shifts
Inability to staff an ambulance 24/7 with a call-out attendant. Being an ambulance attendant in a small community is essentially a volunteer service position. There is very little financial compensation ($2/hour) for the time that an individual is on-call. This low wage makes it difficult to find people willing and/or able to commit to daytime shifts. Very few employers can allow their personnel to respond to an ambulance call at a moment’s notice. The new resource economy needs its own First responders and these employees of industry are compensated for their training and expertise removing them from the BCAS pool of volunteers. The current BC Ambulance policy and wage structure for the southern region cannot simply be mimicked in the north.
Worksafe BC has issued reports on the welfare of BC Ambulance workers. Factors including stress, injuries including back strain, and continuously conducting physically demanding tasks are often compounded in rural remote areas, where a lack of support during emergency situations is evident. Those individuals that do agree to take on this responsibility suffer burn out regularly. In a small community the odds of knowing your patient is substantially higher which adds to an attendants stress level. We have small rural communities with zero coverage for 40 to 50% of their shifts. The hiring fairs and local hires have only provided short term relief, but it is only a matter of time before the individuals find full time employment or burn out from being on call 24/7.
Recommendations:
1. Creation of a full time position which combines the paramedic position with other community service work.
2. In a small rural community, have a full time unit chief with two part time attendants that rotate to provide continuous coverage.
3. Increase the on-call wage. Make it financially viable for someone to be an attendant in a small community and provide incentive for more individuals to step forward and be willing to be trained.
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4. Create new full time positions, recognizing the need for ambulance services in more sparsely populated areas.
2. The Emergency Health Services Act does not include a minimally acceptable level of service.
The Emergency Health Services Act and the 2013 amendment (Bill 7) does not define the minimum level of service required. The Act contains throughout it the phrase, “ the corporation considers advisable”. This phrase has allowed BCAS to say that covering large portions of northern BC out of one station is “advisable”. For example the entire Nass Valley is covered out of Terrace with minimum response times exceeding 90 minutes. Other examples include Haida Gwaii, having one island cover a second island when a ferry is required to get the ambulance to the other island, or Stewart BC being covered by Hazelton BC.
Recommendation:
Establish minimally acceptable levels of service which includes maximum levels for response times. Current response times of one hour or more are not viewed as acceptable.
Air Quality in Northwestern BC
The NWRHD understands the benefits of new economic growth in the region but needs assurances that the health of our residents will not be the price that is to be paid for this industrialization. We do not want to see costs that should be borne by a corporation downloaded onto the health care system.
Kitimat Airshed Emissions Effects Assessment Project, July 18, 2014 The Kitimat Airshed study included numerous scenarios looking at the different proposed projects for the Northwest. The summary powerpoint prepared by the MOE selected three emissions scenarios to focus on.
1. Lowest emissions scenario A, which includes RTA fully treating emissions and all electric LNG terminals.
2. Scenario B requires partial treatment of SO2 and appears to show RTA being capable of operating under the old SO2 permit of 27 tonnes/day.
3. Scenario H/I, a highest emissions case scenario, with RTA operating under the amended 42 tonnes/ day of SO2.
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Kitimat Airshed Emissions Effects Assessment Final Report page 7. Scenarios A, B and H/I used in MOE powerpoint summary presentation
The Kitimat Environmental Effects Project report (KEEP) shows that with full treatment (Scenario A) RTA would have the lowest impact on the health of local residents and the environment. There is an option to incur emissions of 6.5 tpd instead of 42 tpd. NWRHD has been informed by the Ministry of the Environment that the new smelter is being built in a manner that scrubbers can be easily added if required. We ask that the scrubbers be implemented.
The cost of adding scrubbers to the new smelter has been estimated anywhere from $100M to $300M. The project is now expected to cost $4.8B1. Using $300M for the cost of the scrubbers, this is a .6% project cost increase, to avoid an increase in respiratory incidents from .5% to the predicted 2% according to the KEEP report.
At a meeting March 8, 2013 the Kitimat Daily reports that Kerry Moran, KMP Director of Operations and Director of Operations for the new Smelter, stated about 12% of the population of Kitimat and Terrace has a challenge in their lungs, COPD or Asthma.” These individuals may see a very slight increase in
1 http://investnorthwestbc.ca/major-projects-and-investment-opportunities/map-view/kitimat/rio-tinto-alcan- kitimat-works-modernization
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restricted airways events, of the order of a 1% increase.2 Statistics Canada reports in 2013 7.2% of BC residents having asthma and 4.4% having COPD. It appears that we in the Terrace Kitimat region are already above the provincial average for lung conditions.
It concerns the NWRHD that RTA is telling residents what is an acceptable impact on our health. We see the choice to not install scrubbers as downloading onto our health system.
The Kitimat Airshed Study makes the comment in numerous places that “acceptability of impacts depends on one’s values, and is ultimately a policy decision that will be informed by this assessment.” The values of the NWRHD are to ensure that the health of its residents is protected and that every effort be made by industry to mitigate emissions by whatever means necessary, including the quality of raw material inputs sourced, timing of industrial processes and use of treatment technology.
NWRHD is additionally concerned that our airshed is being given to one industry and that this will make it more restrictive for additional industry to enter our region.
The NWRHD recommends that Scenario A be used as a template for going forward. This includes full treatment of SO2 by RTA and the use of world class pollution reducing technology for the LNG industry.
RTA SO2 Permit Amendment The NWRHD is concerned about, and not in favor of the Amended RTA SO2 permit. There is a need to be proactive when it comes to the health of our residents and allowing such a large permit increase could result in action not being taken until a serious situation is already occurring. NWRHD is disturbed that our Health Authority does not have the ability to veto such a permit. We appreciate the work done by the Northern Health Authority, and their success in having the overall health impacts move from a low rating to a moderate rating.
NWRHD supports Northern Health’s recommendations:
The permit contains a “trigger” to cut emissions through the reduction in production or by other measures should the technical assessment of the emissions plan be found to have underestimated the risk to the population. RTA installs scrubbers to minimize the emissions of SO2 into the air as part of the RTA Kitimat smelter modernization.
LNG Impact on the Airshed The residents of the Northwest have listened to the announcement that the proposed LNG industry will be “the cleanest in the world”. Recently conflicting information has been coming to the media and accusations have been made that these off-the-shelf BC LNG plants would produce fuel with a carbon
2 Kitimat Daily, March 16, 2013, RTA Seeks Public Consultation on SO2 Emissions, Walter McFarlane
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footprint three times greater than the world’s current lowest carbon LNG plants. (Glave/Moorhouse, 2013.)
The Kitimat Airshed study final report looks at four proposed LNG terminals using various technologies and estimates the emissions. (page 6)
1. Scenario A assumes LNG will use all electric drive technology. Result: SO2 9.6 t/d NOx 3.2 t/d 2. Scenario B assumes LNG will uses base case, direct-drive technology, burns natural gas, and performs NOx treatment. Result: SO2 10.8 t/d NOx 4.4 t/d 3. Scenario H/I assumes LNG uses base case, direct-drive technology, burns natural gas and does not perform NOx treatment Result: SO2 10.8 t/d NOx 14.5t/d
Environment Canada provides the following statement. “NO2 can have adverse effects on human health or the environment. NO2 itself can cause adverse effects on respiratory systems of humans and animals, and damage to vegetation. When dissolved by water vapour, the acids formed can have adverse effects on the respiratory systems of humans and animals. Nitric acid (HNO3) can cause damage to vegetation, buildings and materials, and contribute to acidification of aquatic and terrestrial ecosystems”.3
NWRHD is alarmed at the predicted elevation in air contaminants resulting from LNG projects. The sheer quantity of fuel burned would resulting in moderate to high risk categorization on human health and ambient to critical risk categorization for environmental receptors according to the Kitimat Airshed Final Report (p 198).
The NWRHD recommends that the Ministry of Environment require the LNG proponents to install dual drive facilities to ensure they are able to operate using renewable greenhouse gas friendly options and that all new operations conform to world class standards with zero emissions.
3 https://www.ec.gc.ca/air/default.asp?lang=En&n=489FEE7D-1
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About Terrace, BC.
The NWRHD’s number one priority 60% project is the replacement of Mills Memorial Hospital which is located in 50% Terrace, BC. The local health area of 40% Terrace covers 13,162.8 square kilometers and has a population of 30% BC 19,726 (2006 cens us). Terrace 20% Terrace’s population is over half 25- 10% 64 year olds, with slightly more children and slightly less seniors than 0% the provincial average. % under 18 % 18-24 % 25-64 % Aboriginal % Visible years Minority Terrace has a significantly higher percentage of First Nations, 24%, compared to the province at 5%. Aboriginal people continue to be challenged by longstanding inequalities in health when compared to other British Columbians. BC has committed to closing gaps in aboriginal health under the Transformative Change Accord.
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Socio-Economic Profile For Local Health Area 88 – Terrace BC
Several indicators are linked to the health of community. These factors add to the demands on its health care facility. The Terrace area stats predict that Mills Memorial will have greater demands placed on it than the provincial average as research shows that peoples’ health is linked their income levels, education and amount of crime in the community. (BC Stats.http://www.bcstats.gov.bc.ca/StatisticsBySubject/SocialStatistics/SocioEconomicProfilesIn dices/Profiles.aspx) Below shows the data for the Terrace area. These demands are becoming increasingly difficult to meet with a deteriorating facility.
90000
In Terrace the average family income is just under 80000 $69,000 per year, 15% lower than the provincial 70000 average. The lone female parent income is less 60000 than $32,000, 27% lower than the provincial 50000 BC average for a lone female parent. 40000 Terrace 30000 20000 5% 10000 5% 0 4% Average Family Income Average lone female parent 4%
3% The rate for percentages of individuals on BC 3% Income Assistance and Employment 2% Terrace Insurance in 2012 are both higher than the 2% provincial averages. Three percent are on 1% Income Assistance compared to two percent 1% for the province while another five percent 0% are on Employment Insurance compared to % on Income Assistance % on Employment Insuance two percent for the rest of the province. 50% 45% 40% Educational rates for Terrace are also lower that 35% provincial averages. The percentage of 18 year 30% olds who did not graduate between 2008-09— 25% BC 2011/12 was 33% compared to 26% for BC. For 20% Terrace the population age 25-54 47% in Terrace were 15% with post-secondary credentials in 2006 compared 10% 5% to 37.2% for the province. 0% % of 18yr olds not graduating % of pop w/o post-secondary credentials Page | 19
10% Serious violent crime in Terrace between 2009-2011 was 3.6 offences per 1000 8% population, 16% higher than the province. 6% Serious property crime was 11% higher that BC the province with 7.8 offenses per 1000 4% Terrace population compared to 7.0 for the province. 2%
0% Serious Violent Crime Serious Property Crime Every indicator of health problems tracked below shows the Terrace Area is higher 90 than the provincial average. 80 The average life expectancy at birth, 70 60 between 2008 – 2012, is 77.8 years 50 compared to the provincial average of 82.3 BC 40 years. Terrace 30 20 Hospitalization rates in 2011-2012 are 94% 10 higher than provincial rates for respiratory 0 issues, 17.5 per 1000 population vs. 9 for Life Expectancy Hospitalization Rates Hospitalization Rates BC. - Respiratory - Injury & Posioning
Hospitalization rates in 2011-2012 for 60 injury and poisoning are 86% higher. 7.6 per 1000 population vs. 4.4 for BC. 50 40 The Terrace teen pregnancy rates was 117% 30 higher, 50.5 per 1000 women 15-19 BC between 2008 and 2010, more than double 20 Terrace the BC at 23.3. 10 Children in Care in December 2012 was 0 107% higher than the provincial rate at 18.9 Teen Children in Infant Life loss due Suicide rate per 1000 population Age 0 -18, compared Pregnancies Care Mortality to accidental (15-19yrs) causes to 9.1 for BC.
Infant mortality rates are 57% higher, 5.8 per 1000 live births compared to 3.7 for BC.
Life lost due to accidental causes 121% higher, 15.5 per 1000 population compared to 7.0 for BC.
Suicide rates are 113% higher, 8.5 per 1000 population compared to 4 for BC.
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Links for Medical Travel Assistance
Transportation Hope Air – Provides free airfare for those with lower incomes (Not part of TAP BC) BC Travel Assistance Program (TAP BC) Transportation only Requires a TAP for to be filled out by the physician in advance of booking travel. This program will cover an escort if the physician states one is required. 100% subsidized travel on BC Ferries Airlines offering discounts to those with TAP forms. (Not subsidised, this is goodwill) Angel Flight - provides free air transport for cancer patients whose medical conditions make it difficult or impossible for them to travel by conventional means, to and from hospitals, clinics, doctor's offices and other medical facilities on the lower mainland and points on Vancouver Island. For more information, call 250 818-0288. Central Mountain Air Ltd. - Regular fare discounted and some flight restrictions waived. CMA serves the following communities: Campbell River, Comox, Dawson Creek, Fort St. John, Fort Nelson, Kamloops, Kelowna, Prince George, Quesnel, Smithers, Terrace, Vancouver and Williams Lake. For more information, call 1 888 865-8585. Harbour Air Seaplanes - 30 per cent discount on regular economy fares on any scheduled services. For more information, call 1 800 665-0212. Hawkair - special fares that do not require advance booking, allow change of travel dates without a change fee, are refundable, and can be booked for an open return. HawkAir flies from Smithers, Prince Rupert and Terrace-Kitimat to Vancouver. For more information, call 1 800 487-1216. North Pacific Seaplanes - 30 per cent discount on air travel in Prince Rupert/Haida Gwaii area. For more information, call 1 800 689-4234. Pacific Coastal Airlines - Special medical fares (approx. 30 per cent discount off regular full fare) can be purchased any time before scheduled flight departure with immediate credit card payment. Fares are fully refundable with no change or cancellation fees. Point- to-point flights to/from Vancouver and Anahim Lake, Bella Bella, Bella Coola, Campbell River, Comox, Cranbrook, Klemtu, Masset, Port Hardy, Port McNeill, Powell River, Trail, Victoria, Williams Lake. For more information, call 1 800 663-2872. WestCoast Air - 30 per cent discount on scheduled flights. Daily scheduled service to Vancouver, Victoria, Nanaimo, Comox, and the Sunshine Coast. For more information, call 1 800 665-0212. Helijet - 30 per cent discount on economy fare for flights on scheduled service between Victoria Harbour and Vancouver Harbour or Vancouver Airport. For more information, call 1 800 665-4354.
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Accommodations BC Family Residence Program Connecting Children and Families with Medical Care Accommodations The BC Family Residence Program (BCFRP) is administered by Variety - The Children's Charity of British Columbia, and provides subsidized accommodation for families whose child, including premature babies and newborns with other health concerns, is receiving care at BC Children's Hospital or Sunny Hill Health Centre for Children in Vancouver. Accommodation assistance is available for one room for up to 30 days per stay. Arrangements are made through Variety for accommodation in a subsidized family residence, such as Ronald McDonald House, Easter Seal House or other locations approved by the program. To apply for accommodation assistance call toll free: 1 866-496-6946
Hotels with Medical Discounts There is a website listing hotels by community in BC that offer discounts for medical visits. Rates vary by date so ensure you are looking at the rate for the month you plan to travel in. This can save you calling hotels individually as medical rates are not typically posted on websites and do not show up on discount hotel booking sites. http://csa.pss.gov.bc.ca/medicaltravel/
First Nations or Inuit If you are First Nations or Inuit travelling for non-emergency medical specialist services, you may be eligible for benefits under the First Nations and Inuit health programs offered by Health Canada. Contact your band office for more information or check Health Canada - First Nations, Inuit and Aboriginal Health.
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Memorandum of Understanding
THIS UNDERSTANDING made as of the as the of 201
BETWEEN:
NORTHERN HEALTH
(hereinafter called "NH")
OF THE FIRST PART AND:
CARIBOO-CHILCOTIN REGIONAL HOSPITAL DISTRICT FRASER-FORT GEORGE REGIONAL HOSPITAL DISTRICT NORTH WEST REGIONAL HOSPITAL DISTRICT NORTHERN ROCKIES REGIONAL HOSPITAL DISTRICT PEACE RIVER REGIONAL HOSPITAL DISTRICT STUART-NECHAKO REGIONAL HOSPITAL DISTRICT
(hereinafter called "RHOs")
OF THE SECOND PART
WHEREAS:
A) NH is responsible for all health care services within the Northern British Columbia region comprising of Northwest, Northeast and Northern Interior Health Service Delivery Areas, and
1 Page2
and to being presented to
Capital Projects requiring debt servicing or other forms of funding by NH, not included above and which historically would RHO funding, will be presented to a meeting of the Chairs/Staff of all RHOs within the region to seek feedback and identify funding requirements prior to being presented to the NH Board for approvaL
5. NH will provide three-year capital plans including construction, clinical information technology and equipment outlining funding requirements to the respective RHOs by November 181 of each year, recognizing that it will take time for NH to develop suitable plans integrated with service plans.
6. RHOs may examine widening the scope of projects that will be cost-shared under legislation, subject to RHO taxation limits.
7. NH will submit a summary of projects and/or equipment costing under $1 OOK to the RHOs for their review, annually. NH will submit a summary of the projects and/or equipment costing over $100K to the RHOs for reimbursement. RHOs reserve the right to request further detailed invoice copies.
8. For any project with an estimated cost greater than $1 million, including professional services, construction and equipment, the RHO may require the use of a Project Implementation and Accountability process (see Appendix 1.)
9. disposal of NH capital and disposition of proceeds will follow the out in
b) Each RHO maintains the flexibility to negotiate independently with NH w~o~ fur ~
adopted October 2003; formally renewed October 21. NH-RHD Memorandum of Understanding Psge3
1
mutual concern to Capital Plan, reeao<:tCK and input.
14. RHOs will have opportunity to meet with NH's Board Chair and Chief Executive Officer during the course of the North Central Local Government Association {NCLGA) and Union of B.C. Municipalities (UBCM) events held each year to discuss the Capital Plan and related issues.
15. NH's Chief Operating Officers (COOs) from each HSOA will attend RHO meetings upon request for discussion of ad-hoc items to ensure timely communication of issues.
16. This agreement will be reviewed every three years by NH and RHOs to ensure the process is accountable and effective. Any party can terminate its participation by giving 90 days' notice in writing to all parties of its intent to do so.
IN WITNESS WHEREOF the parties have executed this Memorandum of Understanding as of the da~ month an year first above written. NH-RHD Memorandum of Unt:JFers:tsmiina Page4
APPENDIX 1
NORTHERN HEALTH I REGIONAL HOSPITAL DISTRICT PROJECT IMPLEMENTATION AND ACCOUNTABILITY PROCESS
POLICY
Northern Health is rocnnr~"' are to the lCIJ\IUCl'"'' Authorities. NH has the to •mr11orno ..... r amount of funding contribution to the nrn,H::>r'TC:
NH and RHDs the
PROJECTS OVER $1 MILLION
Preliminary Planning
Projects over $1 million should be included in the five-year prioritized major capital project plan, and be consistent with the facility role and service plan.
Scope of Project
Northern Health will develop the scope of the project with consultation from their stakeholders and user groups. A Project Brief will be presented to the RHD for approval in-principle. The RHD may wish to consider approval of planning funds at this stage.
Project Brief includes: • Needs Assessment • Project description (including scope) • Location • Preliminary cost estimate
Planning
NH's formal request to the RHD will include the same project planning documentation as presented to NH's Board for their approval. It is anticipated this documentation will include: • •
adopted NH-RHD Memorandum of Understanding PageS
Project Management
NH may the RHD
scope RHD consent In the event that cost NH will contact the RHD and
the amount and nrr\\lii"'IC an
PROJECTS BETWEEN $100,000 AND $1 MILLION
Northern Health to provide:
• A Scope of Work for the project. This project brief will include an understanding of the priority, schematic design {if required). and order of magnitude budget.
• NH will provide the RHD with an annual list of all proposed projects for the current fiscal year for their budget consideration and feedback. A five-year plan will also be provided at this time.
• NH will, to the best of its abilities, complete all projects on time, on budget and within scope.
• NH will attend the RHD Board meetings to provide updates on any or all projects, if requested.
Reports to be provided by Northern Health:
• Quarterly update to the RHD. This update includes a schedule describing the progress for each approved project from schematic design through to final completion of the project It also provides the estimated construction timeframe and proposed completion date. This information is to be used in the planning of any opening ceremonies . • NH-RHD Memorandum Page6
Completion NH-RHD Memorandum of Understanding Pagel
APPENDIX 2
DISPOSAl OF NORTHERN HEAlTH CAPITAl ASSETS AND DISPOSITION OF PROCEEDS
POLICY
Northern Health 1"1'"\r'ln nil-:> F'IF'6 with the assets and the atSIPOSiltt
1. Disposal of Health Authority Capital Assets
NH will consult with an RHD of including equipment, land and buildings, with an initial capital cost over $500,000 that have been cost-shared by that RHD. The sale or of the asset will be in accordance with Ministry of Health policy.
In the event that an outstanding RHD debt remains on the property, NH will negotiate repayment through agreement with the RHD and/or the Ministry.
Any "trade in allowance" or "proceeds of sale" of assets which the RHD has cost shared shall be applied to the purchase of the replacement asset or, if the asset is not to be replaced, NH will negotiate the use of the proceeds of the sale or disposal towards an item on the NH Capital Plan within the RHD.
2. Transferring Assets within AHD Boundaries
When a major capital asset that a RHD has cost-shared is moved to another facility within the RHD boundaries, NH will consult with the RHD prior to transferring the asset from one facility to another.
3. Transferring Assets outside AHD Boundaries
When a major capital asset that a RHD has cost-shared is moved to another facility outside the RHD, the RHD Board will be asked for their consent prior to transferring the asset.
4. Change to Function
1. that the RHD will be notified as soon as om:>stote and 2. that consultation and consent will be discussed after the
October
Glossary of Acronyms and Terms
prepared by
Northern Health Communications
Revised: April 2014
3P ...... Performance, Planning & Priorities Committee (Board) AA ...... Advanced Access ABLS...... Advanced Burn Life Support ABF ...... Activity-Based Funding AC ...... Accreditation Canada ADHD ...... Attention Deficit Hyperactive Disorder ACLS ...... Advanced Cardiac Life Support ACSC ...... Ambulatory Care Sensitive Conditions ADHD ...... Attention Deficit Hyperactive Disorder ADL ...... Activities of Daily Living (dressing, bathing, etc.) Also see IADL. ADM ...... Assistant Deputy Minister ADT ...... Admission Discharge and Transfer AED ...... Automated External Defibrillator AFA ...... Advanced First Aid AFC ...... Audit & Finance Committee Agfa ...... Not an acronym – Agfa is a manufacturer of health care equipment (e.g., for medical imaging) AH ...... Aboriginal Health AHIC ...... Aboriginal Health Improvement Committee AHIP ...... Aboriginal Health Initiatives Program AIDS ...... Acquired Immune Deficiency Syndrome AIPCC ...... Accelerated Integrated Primary and Community Care AL ...... Assisted Living. A program of housing, hospitality services and personal assistance for adults who can live independently, but need help with daily activities. ALC ...... Alternate Level of Care: Patients in acute care beds who have completed the acute care portion of their treatments. Many of these patients are awaiting transfer to another level of care. ALOS ...... Average Length of Stay: The average number of days a patient stays in a facility. ALS ...... Advanced Life Support AMCARE ...... Aggregated Metrics for Clinical Analysis Research and Evaluation – AMCARE is a partnership between NH and UNBC to create a database of northern patients collected from participating family practitioner offices used for advancing best practices within primary care and for analysing population level data. AP ...... Accounts Payable APAU ...... Adolescent Psychiatric Assessment Unit
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APLW...... Aboriginal Patient Liaison Worker (also APL) APP ...... Alternate Payments Program: A payment model for physicians that more closely follows a salary model, as compared to FFS (fee for service). (Also see FFS) AR ...... Accounts Receivable ARC...... Alternate Resource Charges ARCHIE ...... Automated Resource for Chemical Hazard Incident Evaluation ASMR ...... Age Standardized Mortality Ratio: The ratio of a region’s mortality rate compared with the provincial mortality rate, adjusted for age group differences. ATLS ...... Advanced Trauma Life Support BASIC...... Bleeding, Airway, Shock, Immobilization after Classification BC ...... British Columbia BCAS ...... BC Ambulance Service BCCA ...... British Columbia Cancer Agency BCCDC ...... BC Centre for Disease Control BCERMS ...... BC Emergency Response Management System BCG ...... Bacillus Calmette-Guérin: A vaccine against tuberculosis; also used in cancer therapy to stimulate an immune response BCGEU ...... BC Government and Service Employees Union BCH, BCHMC ...... BC Housing / BC Housing Management Commission (same thing) BCIMC ...... BC Investment Management Corporation BCLS ...... Basic Cardiac Life Support BCMA ...... British Columbia Medical Association: the association of BC physicians responsible for setting medical service fee schedules, negotiating the schedule of benefits paid by MSP, and otherwise representing physicians. In 2013 the BCMA changed its name to Doctors of BC: British Columbia Medical Association BCNU ...... BC Nurses’ Union BCPHLN ...... British Columbia Public Health Laboratory Network BCPSQC ...... BC Patient Safety and Quality Council BCRC ...... BC Rural Collaborative. Formerly the Collaborative Rural Business Initiative (CRBI). A partnership between Northern Health and Interior Health to explore and implement collaboration on specific corporate support functions, including a shared Meditech infrastructure and platform. BD ...... Bone Density scan BI ...... Business Intelligence
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BIS ...... Business Integration Services. The team within ITS that provides second-tier application support plus application and interface development for NH’s enterprise applications. BLEVE ...... Boiling Liquid Expanding Vapour Explosion BLH ...... Burns Lake Hospital BLS ...... Basic Life Support BMP ...... Budget Management Plan BN ...... Briefing Note BNA ...... British North America Act BRD### ...... Board policies have the prefix BRD followed by the policy number BSE ...... Bovine Spongiform Encephalopathy (“mad cow disease”) BTLS...... Basic Trauma Life Support BUE ...... Bargaining Unit Equivalent BVDH ...... Bulkley Valley District Hospital (located in Smithers) CAD ...... Computer-Aided Dispatch OR Computer-Aided Design CAE ...... Chief Audit Executive. A person in a senior position responsible for effectively managing the internal audit activity in accordance with the internal audit charter and the Definition of Internal Auditing, the Code of Ethics, and the Standards. CASA ...... Clinical Applications Specialist Analyst. A computer specialist with specific expertise CBA ...... Community Bargaining Association CBS ...... Canadian Blood Services CBT ...... Cognitive Behavioural Therapy CCA ...... Critical Care Assistant CCB...... Critical Care Bypass CCHSA ...... Canadian Council on Health Services Accreditation (now known as Accreditation Canada) CCIMS ...... Continuing Care Information Management System. The provincial system for the collection and storage of Home & Community Care (HCC) client information. CCMOH ...... Council of Chief Medical Officers of Health CCO ...... Completed change order. The document used by a contractor or consultant to submit detail on specific recommended changes to capital projects that may result in increased project costs. CCU ...... Cardiac Care Unit OR Critical Care Unit (two different clinical departments) CCWG ...... Corporate Capital Working Group
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CDC ...... Child Development Centre OR Centre for Disease Control OR Communicable Disease Control (three different meanings) CDM ...... Chronic Disease Management CDMR ...... Care Delivery Model Redesign CDP...... Central Deposit Program CDPM ...... Chronic Disease Prevention and Management CDRP ...... Chemical Dependency Resource Program CEO ...... Chief Executive Officer Cerner ...... The integrated clinical information system implemented across Northern Health from 2006 to 2010. CFIA ...... Canadian Food Inspection Agency CFO ...... Chief Financial Officer CFOC ...... Chief Financial Officer Council CHA ...... Canada Health Act (1984) CHF ...... Congestive Heart Failure CHSPR ...... Centre for Health Services & Policy Research (UBC) CHT ...... Canada Health Transfer CIA ...... Certified Internal Auditor CIBC ...... Canadian Imperial Bank of Commerce CIH ...... Certified Industrial Hygienist CIHI ...... Canadian Institute of Health Information (pronounced “Kye-high”) CIHR ...... Canadian Institutes of Health Research CIO ...... Chief Information Officer CIS ...... Clinical Information Systems OR Critical Incident Stress CISD ...... Critical Incident Stress Debriefing CKD ...... Chronic kidney disease CMA ...... Canadian Medical Association CME ...... Continuing Medical Education CMG ...... Case Mix Group CMHO ...... Chief Medical Health Officer CNC ...... College of New Caledonia CNSC ...... Canadian Nuclear Safety Commission CO ...... Change Order OR Conservation Officer COA ...... Certificate of Approval
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COO ...... Chief Operating Officer – the lead position for each of Northern Health’s three HSDAs (pronounced “Coo”) COP ...... Community of Practice COPD ...... Chronic obstructive pulmonary disease Core Tech ...... Core Technologies. The team within ITS that supports and maintains our network infrastructure. COS ...... Chain of Signature form CPAF ...... Capital Projects Approval Form CPBC ...... College of Pharmacists of BC CPHA ...... Canadian Public Health Association CPWG ...... Capital Projects Working Group CQI ...... Continuous Quality Improvement CRA...... Canada Revenue Agency CRBI ...... Collaborative Rural Business Initiative. A partnership between NH and IH to explore and implement collaboration on specific corporate support functions, including a shared Meditech infrastructure and platform. Renamed BCRC (BC Rural Collaborative.) Crescendo ...... Dictation software developed and licensed by Crescendo Systems Corporation. CRN ...... Community Response Network CSAP ...... Canadian Society of Ambulance Personnel CSC ...... Clinical Service Contract CT or CAT scan ...... Computed (Axial) Tomography. A technique using a combination of x-ray equipment and computers to produce multiple cross-sectional images of an area of the body. CTAS ...... Canadian Triage Acuity Scale CTC ...... Critical Trauma Care CV ...... Curriculum Vitae (a resume) CWF ...... Clinical Work Force CWG ...... Capital Working Group OR Canada Winter Games DAI ...... Disability Advocates, Inc. DAP ...... Diagnostic Accreditation Program DART ...... Disaster Assistance Response Team DBA...... Database Administrator DC ...... Dawson Creek DCDH ...... Dawson Creek and District Hospital DES ...... District Energy System DI ...... Diagnostic Imaging
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DoFP ...... Division of Family Practice DIGMA ...... Drop-in group medical appointment DM ...... Deputy Minister DND ...... Department of National Defence Docushare ...... Internal website allowing control over access to shared documents. DPIC ...... Drug and Poison Information Centre DST ...... Decision Support Tool (refers to NH policies, protocols, guidelines, and procedures) DTF ...... Difficult to Fill E911 ...... Enhanced 911 (system that displays calling number and address) EA ...... Executive Assistant EARL ...... Employee Absence Reporting Line ECC ...... Emergency Coordination Centre ECD ...... Early Childhood Development ED ...... Executive Director OR Emergency Department EDI ...... Electronic Data Interchange. The system used to transmit payments from Northern Health’s bank account to deposit directly in vendor or employee bank accounts. EDIS ...... Emergency Department Information System EDMP ...... Enhanced Disability Management Program EFT ...... Equivalent Full Time (see also FTE) EH ...... Environmental Health eHealth ...... The provincial initiative to implement secure electronic health record systems to enhance healthcare through appropriate access to complete patient records. EHO ...... Environmental Health Officer EHR...... Electronic Health Record EHS ...... Emergency Health Services OR Extremely Hazardous Substance (Hazmat) EHSC ...... Emergency Health Services Commission ELOS ...... Expected Length of Stay ELT ...... Emergency Locator Transmitter eMAR ...... Electronic Medication Administration Record EMCA ...... Emergency Medical Care Assistant emPath ...... The payroll system used by NH to calculate pay, calculate costs to be passed to the financial reporting system and generate paycheques, replaced by Meditech in August 2011. EMPI ...... Enterprise Master Person Index
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EMR ...... Electronic Medical Record EMT ...... Emergency Medical Technician ENT ...... Ear, Nose and Throat physician (otolaryngologist) EOC ...... Emergency Operations Committee (or Centre) EOL ...... End of Life ER ...... Emergency Room eRex ...... Electronic purchase requisitioning developed by IH as a companion application to the Meditech procurement module. ERT ...... Emergency Response Team ERU...... Emergency Response Unit ESC ...... Executive Steering Committee ESP ...... Environment for Scheduling Personnel. The human resources information system used by NH to schedule and record time worked or absent for most employees. ESP is proprietary software owned and maintained by Kronos Incorporated. Exception ...... Variations to pre-scheduled data, such as unanticipated absences or overtime. FAB ...... First Available Bed FAES ...... FortisBC Alternate Energy Systems FASD ...... Fetal Alcohol Spectrum Disorder FBA ...... Facilities Bargaining Association FEMA ...... Federal Emergency Management Agency FFGRHD ...... Fraser-Fort George Regional Hospital District FFS ...... Fee-for-service: A payment model for physicians that reimburses the physician for each service they provide - e.g., for each office visit by a patient. Also see APP. FHA...... Fraser Health Authority FIPPA...... Freedom of Information & Protection of Privacy Act (sometimes also called FOIPPA) FIT ...... Fecal Immunoassay Test (colorectal cancer screening) Flow Sheet ...... Source document. Daily hard copy listing of employees, displaying scheduled hours of work or absence and providing room for manual record of time exceptions. FMU ...... Family Medicine Unit FN ...... First Nations OR Fort Nelson FNGH ...... Fort Nelson General Hospital FNHA ...... First Nations Health Authority FNHC ...... First Nations Health Council
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FNIHB ...... First Nations and Inuit Health Branch (a department of the Government of Canada) (Pronounced “Fuh-nib”) FSJ ...... Fort St. John OR Fort St. James FSJH...... Fort St. John Hospital FTE ...... Full Time Equivalent GAAP ...... Generally Accepted Accounting Principles GATU ...... Geriatric Assessment and Treatment Unit (now Geriatric Day Hospital) GCPE ...... Government Communications and Public Engagement (BC government communications department) GCS ...... Glasgow Coma Scale GDH ...... Geriatric Day Hospital GFR ...... Glomerular Filtration Rate GFT ...... Governance Functioning Tool GL ...... General Ledger GM ...... General Manager OR Genetically Modified OR General Motors GMA ...... Group Medical Appointment (see also DIGMA) GMR ...... Government and Management Relations Committee GMV ...... Group Medical Visit GP ...... General Practitioner GPA ...... General Practitioner Anesthetist GPO ...... General Practice Oncologist GRB ...... G.R. Baker Hospital (located in Quesnel) GSA ...... Governance Self-Assessment GST ...... Goods and Services Tax HA ...... Health Authority H&CC or HCC ...... Home and Community Care HAMIS ...... Health Authority Management Information System HAPI ...... Health Authority Physician Information Systems. The software suite recently implemented by Northern Health to facilitate development and management of service contracts. Implementation is currently being extended from physician contracts to encompass all service contracts managed by NH, including those of construction projects. HAZMAT ...... Hazardous Materials HBT ...... Healthcare Benefit Trust HCC, H&CC ...... Home and Community Care HCPP ...... Health Care Protection Program. The Provincial insurance program providing liability, property and crime coverage for the health authorities.
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HCW ...... Health Care Worker HEABC ...... Health Employers’ Association of BC HEAL ...... Healthy Eating, Active Living HEU ...... Health Employees’ Union HH ...... Hudson’s Hope HIF ...... Health Innovation Fund HIMS ...... Health Information Management System HIRT ...... Hazardous Materials Incident Response Team HIV ...... Human Immunodeficiency Virus HLBC ...... Health Link British Columbia HLN ...... Health Link North. Northern Health’s clinical information system. HLSCHS ...... Houston Lions Senior Citizens Home Society. The society operating Cottonwood Manor until November 30, 2009. hospitality services .... Those services, other than shelter, offered to residents of Assisted Living facilities: meals, cleaning, laundry, social/recreational activities, and emergency response. HPC ...... Hospice Palliative Care HPV ...... Human Papilloma Virus HR ...... Human Resources OR Health Records HRIS ...... Human Resources Information Systems: ESP and emPath. Also used to refer to the team that maintains both systems. HSA ...... Health Service Administrator OR Health Sciences Association HSBC ...... Location of NH Regional offices in Prince George (the HSBC bank building) HSDA ...... Health Service Delivery Area. Northern Health is divided into three HSDAs: Northwest, Northern Interior, and Northeast. Each is led by a COO (Chief Operating Officer – pronounced “Coo”). HSDACWG ...... Health Service Delivery Area Capital Working Group HSP ...... Health Service Plan HSPBA ...... Health Science Professionals Bargaining Association HSRP ...... Hazardous Substance Response Program HSSBC ...... Health Shared Services British Columbia HST ...... Harmonized Sales Tax HSW ...... Home Support Worker HVAC ...... Heating, Ventilation, Air Conditioning OR High Voltage Alternating Current IA ...... Internal Audit
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IAAS ...... Internal Audit and Assurance Services. A division of the Office of the Comptroller General providing internal audit services to the ministries of the provincial government. IABC ...... International Association of Business Communicators IA-CM ...... Internal Audit Capability Model for the Public Sector. A framework developed by the IIA Research Foundation identifying the fundamentals needed for effective internal auditing in the public sector. IADL ...... Instrumental Activities of Daily Living -- (activities that don’t relate to personal care). Also see ADL. IARS ...... Income Assessment and Rate Setting. The process by which the Ministry of Health, using client demographics and taxpayer information, reviews and updates the HCC home support, assisted living, or residential rates. IBM ...... International Business Machines ICBC ...... Insurance Corporation of BC ICCIS ...... Integrated Community Clinical Information System ICoFR ...... Internal Controls over Financial Reporting ICU ...... Intensive Care Unit IDC ...... Innovation and Development Commons IHA, IH ...... Interior Health Authority IHS ...... Integrated Health Services. Integrated health services, or team-based care, is a new approach to health care in which primary care homes work in conjunction with teams of community health care professionals to provide seamless, coordinated and accessible health care services to patients. (Also see “Primary Care Home”) IIA ...... Institute of Internal Auditors. The international professional association providing the internal audit profession’s global voice, authority, leadership, advocate and principal educator. ILBC ...... Independent Living BC IM ...... Information Management IMS ...... Incident Management System IPCC ...... Integrated Primary and Community Care iPortal ...... Northern Health’s internal web site (see OurNH) IR ...... Interventional Radiography. Medical imaging in which minimally invasive procedures are performed using image guidance. IRM ...... Integrated Risk Management ITS, IT ...... Information Technology Services IUOE...... International Union of Operating Engineers JAC ...... Joint Advisory Committee JOHSC...... Joint Occupational Health & Safety Committee
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JSC ...... Joint Service Committee JV ...... Journal Voucher KED ...... Kendrick Extrication Device KGH ...... Kitimat General Hospital KHAG ...... Kitimat Health Advocacy Group KIT ...... Kitimat KPA ...... Key Process Area. The main building blocks that determine the capability of an IA activity, identifying what must be in place and sustained at each capability level before the IA activity can advance to the next level. KPI ...... Key Performance Indicator KPMG ...... Northern Health’s auditor Kronos ...... The vendor of ESP KTD...... Kendrick Traction Device LC ...... Leadership Council LDC ...... Learning & Development Centre (Commons) LDH ...... Lakes District Hospital (located in Burns Lake) LDRP ...... Labour Delivery Recovery Postpartum room Lean ...... Not an acronym, should not be written in all upper-case. A systematic approach to identifying and eliminating waste or non-value-added activities in a process through continuous improvement. LEMC ...... Local Emergency Management Committee LHA ...... Local Health Area LNG ...... Liquid Natural Gas LOS ...... Length of Stay LPN ...... Licensed Practical Nurse LR ...... Labour Relations LRB ...... Labour Relations Board LS ...... Learning Session LTC ...... Long Term Care LTCF ...... Long Term Care Facility LTD ...... Long Term Disability MAC ...... Medical Advisory Committee Mammography ...... Imaging of the breast MAR ...... Medication Administration Record MCAP ...... Managed Care Appropriateness Protocol MCB ...... McBride
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MCFD ...... Ministry of Children and Family Development MCI ...... Mass Casualty Incident MCK ...... Mackenzie MCM ...... Medical Counter Measures Meditech ...... Health care information systems software developed and licensed by Medical Information Technology, Inc. Med/Surg ...... Medical/Surgical MERV ...... Medical Emergency Response Vehicle MH ...... Mental Health MH&A ...... Mental Health and Addictions. Also known as MHAS (Mental Health and Addictions Services) MHECCU ...... Mental Health Evaluation and Community Consultation Unit MHO ...... Medical Health Officer MIS Standards ...... Standards for Management Information Systems in Health Service Organizations. National standards for financial and statistical data maintained by CIHI. MLA ...... Member of the Legislative Assembly MM ...... Materiel Management (note correct spelling of materiel – with an “e”) MMH ...... Mills Memorial Hospital (located in Terrace) MMU ...... Mobile Medical Unit MNRH ...... May Not Require Hospitalization (CIHI designation) MOA ...... Medical Office Assistant MOCAP ...... Medical On-Call Availability Program. Payment program in which physicians are contracted for on-call services. MOE ...... Ministry of Environment MOF ...... Ministry of Finance MOH (MOHS) ...... Ministry of Health (formerly referred to as Ministry of Health Services – ‘Services’ dropped in 2011) MOIS...... Medical Office Information System - a software program used in physician offices Pronounced “Moe-iss.” MOREOB ...... MOREOB (Managing Obstetrical Risk Efficiently) is a comprehensive three-year program of patient safety, professional development, and performance improvement for caregivers and administrators in hospital obstetrics units. MOS ...... Management and Operational Support. An MIS Standards labour category used to capture data on management and support activity. MOU ...... Memorandum of Understanding MPI ...... Multi-Patient Incident
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MRD ...... Most Responsible Diagnosis: The primary diagnosis responsible for the length of stay in hospital. Groups of MRDs make up CMGs (case mix groups). MRI ...... Magnetic Resonance Imagining MRR ...... Minimum Reporting Requirements MRSA ...... Methicillin-Resistant Staphylococcus Aureus MRT ...... Medical Response Technician OR Mountain Rescue Team MSB ...... Medical Staff Bylaws MSP ...... Medical Services Plan of British Columbia MVA ...... Motor Vehicle Accident MVC ...... Motor Vehicle Collision or Crash MVL ...... Mountainview Lodge (located in Kitimat) N/A ...... not applicable NASAR...... National Association for Search and Rescue NBA ...... Nurses’ Bargaining Association NCCS ...... Northern Cancer Control Strategy NCLGA ...... North Central Local Government Association NCME ...... Northern Continuing Medical Education NCSC ...... Northern Clinical Simulation Centre NDMS ...... National Disaster Medical System NE ...... Northeast NEHSDA ...... Northeast Health Service Delivery Area (see HSDA) NEMS ...... National Emergency Management System NFPA ...... National Fire Protection Association NGO ...... Non-Governmental Organization NH ...... Northern Health NHA ...... Northern Health Authority (this is our legal name, but “Northern Health” is preferred for most purposes) NHMAC ...... Northern Health Medical Advisory Committee NI ...... Northern Interior NICC ...... Nicotine Intervention Counselling Centre NICS ...... National Incident Command System NICU ...... Neonatal Intensive Care Unit NIHSDA...... Northern Interior Health Service Delivery Area (see HSDA) NIMAC ...... Northern Interior Medical Advisory Committee
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NIRHB ...... Northern Interior Regional Health Board (a predecessor organization to NH, centred in Prince George) NMP ...... Northern Medical Program NMS ...... Northern Medical Society NP ...... Nurse Practitioner NPCC ...... North Peace Care Centre (located in Fort St. John) NRC ...... National Research Council (US Canada) NRT ...... Nicotine Replacement Therapy NSQIP ...... National Surgical Quality Improvement Program. A risk-adjusted, outcomes- based program to measure and improve the quality of patient care. NUC ...... Nursing Unit Clerk NUC MED ...... Nuclear Medicine - The creation of diagnostic images using small amounts of radioactive materials detected by specialized cameras. NVCI ...... Non-Violent Crisis Intervention NW ...... Northwest NWHSDA ...... Northwest Health Service Delivery Area (see HSDA) NWRHD ...... Northwest Regional Hospital District OAG ...... Office of the Auditor General OALR ...... Office of the Assisted Living Registrar OCAP ...... Ownership, Control, Access, Privacy OCG ...... Office of the Comptroller General of British Columbia OCS ...... On Call Scheduling. Web-based application used to administer MOCAP payments. OD ...... Organization Development OE ...... Operational Effectiveness OEM ...... Office of Emergency Management OEMS ...... Office of Emergency Medical Services OIC ...... Order in Council OPIC ...... Office of the Privacy and Information Commissioner of BC OR ...... Operating Room Ormed ...... Ormed Financial Management Suite. Software used by NH for financial transactions and reporting, replaced by Meditech in August 2011. OSC ...... On-Scene Coordinator OR On-Site Commander OSHA ...... Occupational Safety and Health Act OR Occupational Safety and Health Administration OTOC ...... Overtime and On Call Record. Source document: daily hard copy listing of overtime worked and employees on call.
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OurNH ...... Northern Health’s internal web site (see iPortal) P&P Health ...... Public and Preventive Health P3 ...... Public-Private Partnership P4P ...... Pay for Performance PA ...... Performance Agreement PAB ...... Public Affairs Bureau - former name of Government Communications and Public Engagement (GCPE) PACS ...... Picture Archiving and Communications System, developed and licensed by the Agfa-Gevaert Group (Agfa). PALS ...... Pediatric Advanced Life Support Panorama ...... Public Health information system PAR ...... Personnel Accountability Report OR Powered Air Purifying Respirator OR Post- Anesthetic Recovery PARTY...... Prevent Alcohol and Risk-Related Trauma in Youth PASG ...... Personnel Accountability System PAT ...... Performance Agreement Target PATA ...... Pneumatic Anti-Shock Garment PBC ...... Partnerships BC OR Project Building Committee PBMA ...... Program Budgeting and Marginal Analysis PBMA ...... Program Budgeting and Marginal Analysis. A priority setting and resource allocation methodology that is based on opportunity cost and the margin. P-card ...... Purchasing Card. Corporate Visa card used by individuals for departmental purchasing and by Accounts Payable for invoice payment. PCCU ...... Pediatric Cardiac Care Unit PCQO...... Patient Care Quality Office PCQRB ...... Patient Care Quality Review Board PDR ...... Physician Database Repository. Web-based application used to gather and maintain physician privileging and credentialing information. PDSA ...... Plan-Do-Study-Act; iterative model of process improvement. PEOPLE # ...... Population projection done by BC Stats. The # indicates the version of the projection. PEP ...... Provincial Emergency Program PESP ...... Provincial Emergency Services Program PF ...... Pulmonary Function PFF ...... Patient-Focused Funding PG ...... Prince George PGRH ...... Prince George Regional Hospital – former name of UHNBC
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PH ...... Public Health PHAC ...... Public Health Agency of Canada PHC ...... Primary Health Care PHE ...... Public Health Engineer PHN ...... Public Health Nurse PHO ...... Provincial Health Officer PHP...... Public Health Protection PHQ9 ...... Patient Health Questionnaire - A depression screening tool PHSA ...... Provincial Health Services Authority PHTLS ...... Pre-Hospital Trauma Life Support PIA ...... Privacy Impact Assessment PICU ...... Pediatric Intensive Care Unit PIO ...... Public Information Officer PITO ...... Physicians’ Information Technology Office PLS ...... Paediatric Life Support PMA ...... Physician Master Agreement PMDP ...... Performance Management and Development Plan PMO ...... Project Management Office PNBF ...... Population Needs Based Funding PND ...... Perinatal Depression PO ...... Purchase Order PPE ...... Personal Protective Equipment PPH...... Public and Preventive Health PR ...... Public Relations OR Purchase Requisition PRH ...... Peace River Haven (located in Fort St. John) Primary Care ...... Care provided at the first level of contact with the health system. (See also: Primary Health Care; Primary Care Home: Secondary Care; Tertiary Care) Primary Care Home .... A place where patients have a personal family practitioner; care is holistic and patient-centred; care is accessible, continuous, coordinated and comprehensive, with patients having access to the broader interdisciplinary team; the practice uses well-supported information technology, including an electronic medical record; and quality improvement and patient safety are key areas of focus (also see Primary Health Care) Primary Health Care ... Basic, everyday health care. Primary health care providers are the first people you see when you access the health care system. Procura ...... Application used to schedule client visits and schedule and record time worked or absent for community home support staff.
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PRRHD ...... Peace River Regional Hospital District PRS ...... Professional Responsibility System PSA ...... Public Service Announcements PSAB ...... Public Sector Accounting Board PSEC ...... Public Service Employers Commission PSLS ...... Patient Safety Learning System. A provincial web-based tool for reporting safety events. PSO ...... Public Safety Officer PSP ...... Practice Support Program PSSAC ...... Physician Strategic Services Advisory Committee PSSP ...... Provincial Surgical Services Program PTN ...... Patient Transfer Network Pyxis® ...... Refers to both automated drug distribution cabinets and the related computerized medication access tracking system provided by Pyxis® Technologies. Q1 ...... First Quarter; Q2 is second quarter, Q3, and Q4 QA ...... Quality Assurance QAIP ...... Quality Assessment and Improvement Program QCC ...... Queen Charlotte, the largest community on Haida Gwaii (former name: Queen Charlotte City) QCI ...... Queen Charlotte Islands (former name of Haida Gwaii) QHS ...... Every night at bedtime – as in a prescription. From the Latin quaque hora somni, “each bedtime” QI ...... Quality Improvement Qmentum ...... Accreditation Canada’s program for the evaluation of health system performance, risk prevention planning, client safety, performance measurement and governance. QRT ...... Quick Response Team RAAR ...... Random Act of Acknowledgment and Recognition - a way for NH staff members to recognize each other RadNet ...... The diagnostic imaging module of Cerner. RAI ...... Resident Assessment Instrument. Also see InterRAI RBC ...... Royal Bank of Canada RCMP ...... Royal Canadian Mounted Police RD ...... Regional Director OR Regional District RCC ...... Regional Coordination Centre RESIO ...... Regional Evaluation of Surgical Indications and Outcomes
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RFC ...... Request for Change RFP ...... Request for Proposal RHD ...... Regional Hospital District RIS ...... Radiology Information System RITW ...... Respect in the Workplace RIW ...... Resource Intensity Weight: An average cost per case weight for each CMG in the CIHI database RMAC ...... Regional Medical Advisory Committee RN ...... Registered Nurse ROI ...... Return on Investment RPG ...... Resource Planning Group - a private capital/facilities planning firm RPN ...... Registered Psychiatric Nurse RPP ...... Rural Practice Subsidiary Agreement Rural Practice Programs RQ ...... Reportable Quantity (Hazmat) RRU ...... Riverview Replacement Units RTA ...... Rio Tinto Alcan SAR ...... Search and Rescue SARS...... Severe Acute Respiratory Syndrome SC ...... Service Contract SCSA ...... Smithers Community Services Association SD ...... School District Secondary Care ...... A specialty or subspecialty service (e.g., orthopaedic surgery) usually provided on referral from a primary care provider. (See also: Primary Care) SEO ...... Search Engine Optimization Sessions ...... Web-based application used to administer APP sessional fees. SFA ...... Standard First Aid SHAPE ...... Staffing, Human Resource and Payroll Entry SITREP ...... Situation Report SLA ...... Service Level Agreement SLH ...... Stuart Lake Hospital (located in Fort St. James) SMR...... Standardized Mortality Rate SNRHD ...... Stuart-Nechako Regional Hospital District SOFI ...... Statement of Financial Information SOP ...... Standing Operating Procedure SPR ...... Surgical Patient Registry
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SQL ...... Structured Query Language. A computer language used for the retrieval and maintenance of data in relational databases. STAR ...... Special Trauma and Rescue Team START ...... Simple Triage and Rapid Triage STD ...... Sexually Transmitted Disease Super Stat ...... Statutory holidays for which time worked is paid at a higher rate than the normal overtime rates under all but the Health Services & Support Community Subsector Association collective agreement. TA ...... Technical Advisor TB ...... Tuberculosis TBD ...... To be determined T-Bills ...... Treasury Bills TDCSS ...... Terrace & District Community Services Society TDG ...... Transport of Dangerous Goods (HAZMAT) TEDA ...... Terrace Economic Development Agency Telepharmacy ...... The use of audio and video telecommunications to facilitate provision of pharmacy services through allowing a centrally located pharmacist to provide supervision, dispensing and consultative services to a remote site. Tertiary Care ...... Services that cannot be effectively or efficiently provided in all health regions or facilities because they require a large population base to produce the cases required to maintain provider competence, and to sustain the sophisticated resources and support services necessary (e.g., organ transplantation). (See also: Primary Care) Time Card ...... ESP (Environment for Scheduling Personnel) -- an electronic record into which the employee’s time is generated and exceptions are manually entered. TKCC ...... Terrace Kitimat Chamber of Commerce TO ...... Training Officer TRC ...... Tobacco Reduction Co-ordinator TV ...... Television UBC ...... University of British Columbia UBCM ...... Union of BC Municipalities UCHSS ...... United Church Health Services Society (operates Wrinch Memorial Hospital in Hazelton) UHNBC ...... University Hospital of Northern British Columbia (formerly known as Prince George Regional Hospital) UNBC ...... University of Northern British Columbia UPP...... Unit-Producing Personnel. An MIS Standards labour category used to capture data on direct operations activity.
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US ...... Ultrasound VCHA ...... Vancouver Coastal Health Authority VIHA ...... Vancouver Island Health Authority - now known as Island Health VP ...... Vice President VRE ...... Vancomycin-Resistant Enterococci VTE ...... Venous Thromboembolism WCB ...... WorkSafe BC – the Workers’ Compensation Board of British Columbia WH&S ...... Workplace Health & Safety WHMIS ...... Workplace Hazardous Materials Information System (HAZMAT) WHO ...... World Health Organization WIGs ...... Wildly Important Goals WMH ...... Wrinch Memorial Hospital (located in Hazelton – operated by UCHSS) WNV ...... West Nile Virus WSBC ...... WorkSafe BC YMCA ...... Young Men’s Christian Association YTD...... Year to Date
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