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AHS Multi-Year Health Facility Infrastructure Capital Submission 2020

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AHS Multi-Year Health Facility Infrastructure Capital Submission 2020 AHS Multi-Year Health Facility Infrastructure Capital Submission 2020 July 2, 2020 Please Note: The following information is being provided to the Ministry of Health for the purpose of obtaining advice, proposals, recommendations, analyses or policy options for the Minister of Health, Treasury Board and Cabinet in relation to the Provinces’ Capital Plan0 . Executive Summary ………………………………………………………………………………………………………… ……………………………………… The Alberta Health Services 2020 Multi-Year Health Facility The report takes into account direction from the Government of Infrastructure Capital Submission describes priority major capital Alberta and the priorities outlined in the AHS 2017-2020 Health needs (for projects over $5 million). The following information is Plan and Business Plan supporting its key desired outcomes of: provided to the Ministry of Health to inform the capital funding • Improved health outcomes for all Albertans. process of the Government of Alberta. The submission: • The well-being of Albertans is supported through • is mandated in the Health Facilities Capital Program population health initiatives. Manual as a major step in the planning and project • Albertans receive care from highly skilled care providers approval process and is submitted to Alberta Health on or and teams working to their full scope of practice. st about May 31 of each year; • A high quality, stable, accountable and sustainable health • outlines the overall planning and management of health system. infrastructure; The Alberta Health Services (AHS) Capital Management Strategic • communicates the planning and capital investments Capital Planning team continues to work towards completing needed to effectively maintain the existing asset base and Major Capital Needs Assessments or Strategic Options Analysis modify it as needed to support service delivery strategies; for all high priority initiatives identified by Zones or Provincial • provides the Ministers of Health and Infrastructure with the Programs across the province. These investigations will better information needed to recommend appropriate future inform decision-making and prioritization activities in the future funding for health infrastructure; and help ensure the most important projects are identified and • provides a rational and compelling context to Alberta presented to Government. Health and in turn to Treasury Board and Finance, for annually assessing individual project recommendations relative to provincial capital proposals (including all the ministries' capital submissions) and priorities; and • when possible provides a preliminary estimate of operating costs for the proposed capital investments. 1 Overview of Infrastructure ………………………………………………………………………………….…………………..…… ……………………………… 1.0 Overview of Infrastructure approximately 500, ranging from the largest urban hospital to AHS is responsible for owning, operating, funding and leasing small rural service or maintenance buildings. facilities supporting the delivery of health care. Currently, AHS utilizes in excess of 1,000 owned buildings and leased spaces Acute care hospitals, which comprise the majority of the owned (including license agreements) for direct care delivery and support building area, are the most expensive facilities to build and services. AHS leased spaces are in both private and government operate within AHS’ complement of building assets. owned buildings. Across the province there are just over 300 continuing care Most services are directly delivered by AHS in either owned or facilities in operation, approximately one-third are owned and leased space. Services are also funded by AHS and provided by operated by AHS, the remaining facilities are owned and operated voluntary and private partners in AHS or non-AHS owned or by private and voluntary organizations. leased space. AHS also has key partnerships with universities and colleges 1.2. Shelled and Vacant Space acknowledging our shared responsibility to educate and train A number of acute sites have unfinished shelled and/or vacant health professionals of the future, and support ongoing biomedical space, which has been set aside for specific future development. research and innovations. Some of the spaces that have been shelled for future use have As would be anticipated with a large volume of owned and had preparatory work done in anticipation of fit-out (e.g., partial leases spaces, there is wide variability in the condition and age mechanical/plumbing system installs, floor coring etc.). Originally of facilities. proposed future uses were based on previously developed strategic facility master plans. Most of the vacant space listed in 1.1. AHS-Owned Space the following table will require redevelopment. AHS owns the majority of the area/space from which services are offered or are required to support health service delivery. The total number of AHS-owned (standalone) buildings is 2 Unfinished Shelled / Vacant Spaces Unfinished Shelled / Vacant Spaces Shelled / Proposed Shelled / Proposed Facility Vacant Facility Vacant Space (m2) Future Use Space (m2) Future Use Chinook Regional 6,440 • Renal Dialysis Richmond Road 9,175 • Administration • Two Inpatient Units Hospital (New Addition) Shelled Diagnostic Treatment Vacant and • Support Services • Staff Support Centre Shelled • Ambulatory Services • Unassigned Level 4 and 5 • Chinook Regional 1,080 • ICU/CCU Expansion Rockyview General 5,800 Laboratory Services Hospital • Ambulatory Services Hospital Vacant • Unassigned Shelled • Facility Support Space Level 3 Red Deer Regional 198 • ICU Medicine Hat Regional 410 • Diagnostic Imaging Health Centre Shelled • Diagnostic Imaging Hospital Shelled Red Deer Regional 81 • Ambulatory Expansion Medicine Hat Regional 2,048 • Unassigned Health Centre – Hospital – Level 3 Vacant (potential for NAPRA Vacant Ambulatory Annex Compliance) Medicine Hat Regional 1,244 • Mental Health Inpatient Alberta Hospital 2,110 Addictions and Mental Health Hospital – Level 6 Vacant Edmonton (Building 12) Vacant Inpatient Units (1970s Foothills Medical Centre 2,410 • Operating Theatres (planned construction would require th McCaig Tower 5 Floor Shelled for ASI) significant renovation for reuse) Foothills Medical Centre 850 • Inpatient or Outpatient Clinical Edson Healthcare Centre 360 • Linen Services Main Building Vacant 11th Floor West Wing Shelled • Building Support Services Foothills Medical Centre 1,420 • Inpatient Clinical (Planning Strathcona Community 50 • Diagnostic Imaging (MRI) Main Building Vacant Underway for NICU Hospital Shelled 6th Floor West Wing Expansion) Fort Saskatchewan 215 • Administrative • Peter Lougheed Centre 1,785 Acute Inpatient Community Hospital Shelled • Off Site/Outpatient Community Shelled Programs Calgary South Health 10,500 • ICU Kaye Edmonton Clinic 13,745 • Brain Centre Campus Shelled • Emergency Department Shelled • Ambulatory Clinics • Diagnostic Imaging • AKC Transplant Clinics and • Outpatient Dental Common Areas • Cardiac ICU • Ped Medicine and Adult PAC • Day Cardiology • Stroke Clinics • Surgical Suites Mazankowski Alberta 3,574 • Brain Centre • Outpatient Clinics Heart Institute • Cardiac Services • Endoscopy/Bronchoscopy Shelled 3 1.3 Leased Space AHS may sell surplus properties subject to approval from the Minister of Health. AHS is required to obtain an independent AHS presently manages a portfolio of over 300 leases with an appraisal of fair market value of the property. Properties must be annual operating budget of approximately 90 million dollars. This sold for fair market value unless the property will be used for the value considers the rental of the space itself and related operating ongoing benefit of other government agencies. The AHS Real costs (i.e. systems maintenance, custodial and utilities). Estate land disposal process can create issues for timely, effective handling of land disposal projects. The process for The primary groups that occupy the leased spaces include: disposal includes: Senior Executive Sponsorship, Government of • Acute Care (including Cancer Care) Alberta approval, property condition assessment, appraisal, • Urgent Care marketing, sale documentation and closing. Subject to • Public Health and Community Care Government of Alberta approval, AHS can proceed with the • Corporate Services process. • Continuing Care • Addiction and Mental Health All transactions in land are subject to legislation (Regional Health • Emergency Medical Services (EMS) Authorities Regulation – AR 15/95) that requires AHS to: • Obtain the Minister of Health’s approval (Section 2.6). Strategic lease management is an essential asset strategy when • Receive fair value for the transaction (Section 2.71(1). flexibility is required regarding service location, the need to meet Less than fair market value can be received where “the increasing demand or where expediency is critical. property will be used for the ongoing benefit of residents of the health region.” Internal capital funds are required to complete leasehold improvements or alternatively AHS Real Estate negotiates an The proceeds from the sale of an interest in land can result in one allowance in the lease that provides the required capital; however of the three outcomes below: this can increase the lease operating budget as the capital is amortized over the lease term. Either scenario requires an • proceeds from the sale are deposited in the AHS account; additional funding source. • the funds are treated as ‘general revenue’ by AHS; or • land is transferred for a nominal sum and there are no
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