2013 COMMUNITY EXCELLENCE AWARDS

Category Worksheet

PARTNERSHIPS
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Name of Local Government: Powell River Regional District

Project/Program Title: Willingdon Creek Village Seniors
Complex Care Facility
Project Summary Paragraph
The Powell River Regional Hospital District (PRRHD), which is an operational mandate
of the Powell River Regional District, had a need to replace an antiquated 81-bed
seniors care facility in conjunction with its health care provider partner, Vancouver
Coastal Health (VCH). However, current provincial government policy restricted the
Province, and its health care agents, from carrying capital debt and thus VCH could not
commit to share capital construction costs for a new facility; as has been the tradition for
previous health care facility projects. Without an innovative and collaborative approach
to rectify this situation, VCH and the taxpayers of the Powell River region would have
been forced to continue to fund excessive maintenance and operational costs for an
aged facility that could no longer physically meet acceptable standards or the current
demands in health care. Or, the stakeholders would have been forced to look towards
outside private development and management of facilities and operations. The
resolution of this situation is that the PRRHD and VCH have entered into an agreement
where;
A new 102-bed seniors health care facility will replace the existing facility;
PRRHD will:
own the land as part of the existing Powell River General Hospital site;
finance the entire construction of the new facility through MFA borrowing;
own the new complex care facility; and
recover 50% of the construction costs from VCH through a lease arrangement.
VCH will:
manage the design and construction of the new facility; and
operate the new facility.
The resultant new seniors complex care facility is a 100% public-public partnership.

Project Analysis
1. OBJECTIVE
The current seniors care facility is quite aged and antiquated. It was established in the 1950s
and since that time care for seniors has drastically changed and so too has their demands for
living conditions. Many lifelong citizens in the Powell River region are finding it necessary to
leave the community to seek out their living and care needs in their autumn years. This puts

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additional stress on them and their health as well as undeserved stress and inconvenience on
their extended families. Rooms are also too small for todays seniors and the living space which
they want to enjoy. The facility also has shortfalls in types or levels of care that can be provided
and due to the age of the building, some care is manipulated to fit the physical limitations of the
building. The objective was to replace the existing facility with a new one specifically designed
with modern health care environments in mind, state of the art equipment, and the ability to
carry out current and trending health care practices.

2. CHALLENGES
The major challenge was how to go about bringing a new seniors health care facility to reality.
There were two options available; one was to turn to a private developer and manager of senior
health care facilities. The other was to build a publicly-owned facility. The downside of a private
care facility was that the public would have virtually no input into operations or care and elected
officials would have little influence and have no authority over decision making. This would
include both initial concept and design and eventually operations. The upside was that a private
developer would not be that difficult to locate and the capital costs would all be their
responsibility and on their shoulders. The upside to a public facility was that the citizens would
have a say in operations and care and the elected officials would have influence and authority
regarding decision making. This would entail the initial consulting phase of what the building
should look and feel like including future operations. The downside was that VCH typically was
a primary developer of public health care facilities. However, cutbacks and fiscal restraints
precluded them from even considering to construct a new facility.

3. BENEFITS
Citizens in the region feel like a part of the ownership; they are shareholders in a worthy
enterprise. This is evident from the support displayed at the public open houses and their
engagement in reviewing and commenting on architectural concepts and design. Local VCH
staff also feel like a part of the ownership. They too had considerable input into what they
believed an ideal facility should look like and what amenities would make a clients health and
well-being more satisfactory. The local staff currently working in the old facility also have some
solace in not losing their positions, seniority or benefits in their work environment. VCH will
transfer the employees to the new facility once it is ready for occupation. With a private
developer, there was a risk that employees would lose their jobs, seniority, benefits and ability
to continue contributing to their current pension plan. It was suspected that they would then
have to re-apply with the private developer to ensure ongoing employment. The site location for
the new facility was an astute choice. It will be in very close proximity to the hospital. Due to
this, synergies and efficiencies have been deliberately built into the design. A tunnel will link the
two and the kitchen in the hospital will provide all of the dietary needs for both the hospital and
the seniors' facility. As well, laundry will be handled in the same fashion. The new facility will
also be more efficient and effective than the existing facility. It will apply current nursing care
practices in a modern health care environment. For example, todays beds cannot be removed
from residential rooms without disassembly due to door frame sizes. Another example is that
living quarter units will be available where couples can continue to live together as a family unit.

4. INNOVATION
Our project is innovative in that we believe a little known or used strategy has been deployed.
Traditionally, Regional Hospital Districts have engulfed themselves and focused on hospitals
and establishing, acquiring, constructing, reconstructing, enlarging, operating and maintaining
them. What we have accomplished is to fund the seniors facility as part of the PRRHDs
mandate. We are in effect aiding in the establishment and acquisition of a hospital facility. The

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project has received provincial consent. The devil is in the details of the Hospital District Act.
Hospital is defined as meaning a hospital by any provision of the Hospital Act and includes an
institution or facility in the health field designated by the minister under Section 49 as a health
facility for the purposes of the Act. Hospital facilities includes laboratories, laundries and things,
services and premises used or supplied in conjunction with a hospital. And Section 49 clearly
states that the minister may designate an institution or facility in the health field as a health
facility for the purposes of the Act. In Powell River the timing for this project could not be any
better. We are about to burn the mortgage for the borrowing on the current hospital initiated
approximately 20 years ago. This opens up tax room and it is expected that this new tax levy
will be approximately 50% of what the hospital levy was. So, a very timely win-win situation.
This project innovatively developed a project model that demonstrates that public funding,
ownership and operation of a care facility is a viable and sustainable alternative for replacing
aging health care facilities.

5. GOALS
The implementation of this project will provide an expanded residential care facility to replace a
facility that fails to meet acceptable service levels for seniors in our community. Residents in
the area will be able to continue living out their lives in the region. The facility will be state of the
art and will promote new ideology such as living in place. These are current trends in seniors
health care that are receiving welcomed approval by clients as well as family members.
Research has proven that the moving into an institutional setting is shocking enough let alone
being moved from one level of care facility to another as the clients needs and level of care
increases. These all have adverse effects on the cumulative health of the clients and constant
moving has been evidenced to deteriorate a clients health at a rapid rate. The facility will also
provide a community-type atmosphere to promote warmth, friendliness and a quiet
neighborhood appeal. Likewise, new residents will be attracted to the region in light of the
availability of enhanced health care facilities.

6. SUSTAINABILITY
The new seniors facility will continue in sustainable operation because the facility will remain
publicly owned by the local government and publicly operated by the Province, as agreed to in
the underlying Memorandum of Understanding between PRRHD and VCH. VCH will continue
to operate the facility and familiar staff will pick up where they left off at the former facility.
Operational budgets will continue to flow through the Province keeping day-to-day business on
an even keel and the PRRHD will look after annual funding of the borrowing through taxation,
along with a lease back funding arrangement from VCH.

7. TRANSFERABILITY
This project, and its innovative financing model, can be done in every part of British Columbia
by every Regional Hospital District. In a time when health care facilities and operations are
being privatized, with a resultant loss of public accountability, this project is a shining light of
how the extraordinary borrowing power of BC local governments can be used to provide a
public service. Previously, the advantage of Municipal Finance Authority borrowing was not fully
utilized in health care projects and thus clients and taxpayers were being inadequately served.
This project is simple and straightforward in its implementation and yet provides a previously
untapped solution to the challenge of providing care to a rapidly aging population.

8. KNOWLEDGE SHARING
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VCH and PRRHD stand ready to share our collective knowledge of this project with every health
authority and regional hospital district in British Columbia. Given an appropriate presentation
forum or medium, we will gladly share this effective and simple concept. The PRRHD will assist
in steering interested parties down the right path and what pitfalls to avoid and what avenues to
pursue. Those interested can also source information directly from the Hospital District Act.

9. TELL US MORE
This project is a story of dedicated elected officials, health authority personnel and local
government staff who simply worked on a challenging situation until an acceptable resolution
was found. Health care needs are a community priority and our community came together to
find a bright future. This is a story of a resilient community and the caring people within it. This
project has improved upon accountability to the community's citizens through retaining public
ownership (PRRHD) and public operation (VCH) of a new, expanded seniors health care
facility. The venture has not gone the route of privatization and corporate institutional settings
where the general public has no say and the local government has no influence or authority.

10. PARTNERS
a) Powell River Regional Hospital District
Vancouver Coastal Health
BC Ministry of Health
b) These partners were the most obvious choice and experts in their field. They also held
considerable authoritative jurisdiction and were able to give sound advice and direction.