halton healthcare services

Halton Hills Town Council Seeks Public Input

Mike Cluett

On the same night as our last council meeting in Milton, Halton Hills Town Council was debating on a very similar situation for their community.  Halton Health Care Services had made a request of HH Council to provide funding of $4.546 million to go towards their hospital renovation and expansion, including a CT scanner.

That council had deffered their decision in order to provide the community with an opportunity to send in their comments and concerns for council members to review before making a decision.

Its this decision that impresses on me the fact that when items of importance like this come up suddenly, we need to ensure the public has an opportunity to speak and let their voice be heard.  When HH Council met two weeks ago, their chambers were filled with close to 200 people who took their time to speak their minds.  The item of course was on the agenda and published ahead of time to provide the community with time to attend the meeting.

Im not trying to re-hash the issue but I just wanted to provide some examples of other communities who take the initiative and seek the public input to help them in making their decision.  The decision they come up with might not be what some want, but at least they have had their say.

Here’s the article from their local paper on www.insidehalton.com  There is more background information found here and here.  You will find those articles below as well.

From the Georgetown Independent & Acton Free Press

Town extends deadline for public to comment on hospital funding

The Town of Halton Hills has extended its deadline for the public comment on a proposal that the municipality contribute $4.546 million for the Georgetown Hospital renovation and expansion.

The Town’s contribution will come from a dedicated levy on property owners— about $24/year for 10 years.

Comments will now be accepted until Friday, Feb. 25.

A hospital decision to proceed with the $12.1 million expansion without provincial funding is dependent on a favourable vote for the contribution by Town council. The project would accommodate a CT Scanner and improve the Emergency Department.

Residents can submit their comments via the Town website, www.haltonhills.caor write to Town Clerk, Town of Halton Hills, 1 Halton Hills Dr., Halton Hills, ON, L7G 5G2.

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Council seeks public’s opinion on funding hospital project

Halton Hills council will host a public meeting Monday, Jan. 24 to solicit public opinion on whether or not the Town should fund an expansion of Georgetown Hospital to the tune of $4.5 million.The meeting will begin at 6:30 p.m. in the council chambers at the Halton Hills Civic Centre, 1 Halton Hills Drive.

At the January 10 council meeting Halton Healthcare Services formally requested financial support from the Town in the amount of $4.546 million toward a an expansion and renovation to accommodate a CT scanner at the Georgetown Hospital and increase the area of the emergency department.

Georgetown Hospital first opened its doors in 1961. Since then there has been significant growth in the town and the hospital now faces daily challenges meeting the healthcare needs of the community, particularly emergency and diagnostic imaging services.

In 2009 Halton Healthcare Services received approval from the Ministry of Health and Long-Term Care to acquire and operate a CT scanner at the Georgetown Hospital. The existing building requires renovations to accommodate this new service.

HHS has proposed that this project be funded through funds generated by HHS as well as the community. The current projected cost of this project is $12.196 million. The Georgetown Hospital Foundation has committed $5 million, HHS $2.4 million and the Georgetown Volunteer Association $250,000.

Based on the current estimated costs, HHS has asked Town council to consider the contribution of $4.546 million. 

Halton Hills Mayor Bonnette  said, “We all recognize the importance of the Georgetown Hospital to our community. Making grants to hospitals while possible, is not a usual mandate of a Town.

“Other communities have given financial grants to their hospitals. Therefore in considering such a grant request, Town council wants to hear from the community because if council gives such a grant it will need to raise property taxes to do so. We hope the community will respond with comments on the Town website or in person at the council meeting on Jan. 24”.

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Hospital asks Town for $4.5M to fund reno

In what is called an “extraordinary request”, Halton Healthcare Services came to Halton Hills council Monday night asking for a $4.546 million contribution to the proposed expansion and renovation of the Georgetown Hospital.

The $12.196 million project is required now in order for the 50-year-old hospital to accommodate a new CT scanner, approved but not yet purchased, because they have nowhere to put it.

“This is quite an extraordinary request of town council,” said HHS President and CEO John Oliver at Monday’s council meeting during a 30-minute presentation by hospital board of directors, staff, and doctors.

He told council that unless the hospital gets money from the Town, the project won’t happen.

“It’s your decision that is going to trigger this,” he said, recognizing that hospitals are usually reliant on provincial money to pay for construction.

But Oliver said this is an absolutely urgent project for HHS that must be done now— not in another decade.

He explained it would likely be a seven to eight year wait— and that’s not guaranteed— before the hospital would get funding from the Ministry of Health and Long Term Care on a project of this size. Oliver said theirs and MPP Ted Arnott’s lobbying over the past few years has made little dent in the 10-year waiting queue for money at the Ministry.

Compared to similar HHS requests made to other Halton municipal councils for contributions to their hospitals, Oliver called this is a “modest” request.

But he added, “This is not my hospital… this is your hospital. I would estimate 80 to 85 per cent of your residents would be in and out of the diagnostic imaging and emergency departments during the year. They’re heavily used. … We could have stayed quiet and continued to pursue the funding from the Ministry or we could make this special request of council.”

The proposal includes a 14,000 sq. ft. addition, housing a new emergency department and a renovated 4,000 sq. ft. section of the current hospital, allowing all diagnostic equipment to be in the same section.

“No longer will people will have to walk through the bowels of the hospital to have a bone density scan done,” said Dr. Jeff Sutherland, Associate Chief of Staff. “The redevelopment of the emergency department will enable us to deal with an ever-increasing volume of emergency patients. During my career this volume has doubled without significant change in the emergency department’s layout.”

To move quicker on this project, the hospital wants to go with a joint community and HHS-funded project:

• Town of Halton Hills contributes $4.546 million

• HHS revenue and capital— $2.4M

• Georgetown Hospital Foundation launches a $5M fundraising campaign

• Georgetown Hospital Volunteer Association— $250,000.

In order to get things moving in time for a 2012 construction season, Oliver requested a Town answer before March, but Mayor Rick Bonnette intimated the CEO would have his answer before then.

Council approved a motion to host a special public meeting in conjunction with the Monday, Jan. 24 council meeting to allow members of the public to hear the hospital presentation, and Town Treasurer Ed DeSousa’s suggestions on how the Town could chip in their share. The public would be asked to provide feedback, so council can make an informed decision, said Bonnette.

The Town’s website will also include the hospital presentation made this week, and possibly a vote button and comment form.

Bonnette said the public is also welcome to e-mail their comments to all members of the council. It’s important the public knows what impact on their taxes this could mean, the mayor said.

“I think all of us around this table are behind this but it would be helpful to have public feedback,” said Ward 3 Councillor Moya Johnson. “We really need a CT scanner in this community.”

The current diagnostic services are located throughout the Georgetown Hospital. In 2010, approximately 1,500 patients were transferred from Georgetown hospital to other hospitals for CT scans. Over 500 of those were emergency patients who required a scan for diagnosis. It does not include doctor referrals for their patients in the community, but Oliver said those are significant numbers.

The Emergency Department is designed to serve 14,000 visits a year, but it is now seeing 32,800.

“The Georgetown Emergency Department is an incredibly efficient operation, which sees more patients per ER bed than any hospital in Ontario,” said Dr. Justin Busse, Director of the Emergency Department, noting the five physicians are working flat-out. No more efficiencies can be wrung out of the building and its staff and he fears their current high provincial performance on wait times and admission times will begin to deteriorate.

“I implore you for your support,” said Dr. Wei Chu, co-chief of Family Medicine, “not because we trying a build a shiny new waiting room or to show off new technology but because the redevelopment before you tonight will help us provide the essential services that the doctors and nurses need to treat our most critical and most vulnerable patients.” 

Town Council Meeting June 28, 2010

Mike Cluett

Last night I attended the town council meeting in which there was to be a discussion on possible ways for the Town of Milton to set up and fund a hospital expansion reserve fund for consideration in next years budget.

The original motion can be found here for you to review.

Some of the highlited options for funding include:

  • Capital Related Items:  Redirection of Slot Revenues, GTA Pooling Funds, Debenture Financing
  • Developer Related Items:   Development Charges
  • External Revenue Generating Items:  Hydro / Hospital Generation Partnership (similar to Oakville Hydro), Parking Facility, Tax Levy.

There was a lot of discussion from a number of delegates last night talking about the pros and cons of each item.  The general consensus around the table and in the gallery was that we need to do something …now.  But aside from some passionate discussions from some councillors there really wasn’t a lot of direction from the table other than what was in the report.

According to the report, here are the next steps:

Next Steps

Continuation of Working Group and Community Consultation.  It is anticipated that the established working group would continue throughout the project to ensure:

– help develop a co-ordinated communications plan to enable the parties to consult widely with the community about the level of municipal contribution and the Local Share plan including but not limited to the various options as outlined in this report.

Reserve Fund

Staff is recommending that the establishment of a reserve fund dedicated to funding the redevelopment and expansion of Milton District Hospital be included as a recommendation in the 2011 budget for consideration.

Now when you look at the next steps, you might think not much has changed and it really hasn’t.  The goal of everyone in this town is to ensure that Milton gets what it needs from the provincial government to expand the health care services for the residents of Milton.  The very last option to be considered would be the special tax levy that would be brought on Milton taxpayers to fund the local portion of what is needed for hospital expansion.  The VERY last option.

 There were a few interesting and controversial ideas that came up including naming rights (which the town has no control over), and selling Milton Hydro.  As you will see from my presentation, I suggested we move this idea up to the regional level of government and quite possibly pool the tax base and solve everyone’s problems.  There are some risks in that as Mayor Krantz brought up “be careful what you wish for, you just might get it!” but Milton’s tax base isn’t big enough.

 I also had concerns, that I didnt address in my presentation (due to 10 minute time limits) about slot revenues being used as we get them, instead of the towns current procedure of placing them in a reserve account for a year and then applying it to the capital budget.

I’ve been at the doors over the past few months and many of you have brought up slot revenues and how they should be used for the hospital fund.  Slot revenues are a gift, for the lack of a better word.  The Town of Milton gets a portion of the slot revenues every year but those funds aren’t 100% guaranteed.  They can end at any time and we cant take these revenues for granted.  So I’m cautious about relying solely on those funds.

Needless to say this isnt an issue that will go away or be solved in one meeting.

I talked about the need of not just putting strongly worded resolutions and forwarding copies of reports to provincial ministers and everyone else under the sun, but to make a concerted effort to work with other municipalities as well to put pressure on the the provincial government to change the Development Charges Act 1997.

Back then, the government changed the rules for municipalities and they were no longer allowed to use development charges (DC’s) to fund capital projects including funding local portions of the hospital.

The current government is on the record saying they wont be making changes and from reports recently other leaders are in agreement that the act shouldn’t be changed.  If this can be changed, the ability of a municipality to fund the local portion of hospital expansions becomes much easier and there is less of an impact on the taxpayer.

We need to be leaders and contact every municipal leader, every Mayor, every Councillor and get them on board to put pressure on the province to make these changes and soon.  There is an election coming up in 2011.

For those of you who were not at the meeting and cant watch on TV COGECO, here is a copy of my submission to council regarding this issue.  Feel free to comment.

Until then, I’ll see you at the doors.

Dear Gord Krantz, Mayor; Members of Town Council, Staff & Members of the public.

The purpose of my writing today is to submit my opinions on the report CORS 058-10 regarding Halton Healthcare Notice of Motion.

As a resident who has lived in Milton for over 7 years now, I along with many others have seen the need to ensure that the healthcare services for our residents are placed at the top of our priority list by the provincial government.  Outlined in the detailed staff report are many of the potential pitfalls that Halton Healthcare Services faces in getting the project started.  Many of the options that we have at our disposal are hinged on the province of Ontario coming to the realization that Milton, Canada’s fastest growing municipality for the last few years, is recognized in their long range goals for expansion.

Expansion of Milton District Hospital is not a new phenomenon whatsoever.  Just recently over half the population of Milton at the time, 35000 plus residents signed a petition to be delivered to the provincial government letting them know Milton should be a priority.  The efforts of those involved with the Friends of Milton Hospital organization should be applauded as many hours, days and weeks went into this movement to let our elected officials at the provincial level know that we need more for the residents of Milton.

I have no qualm with the goal.  I don’t think we can find anyone in our town that would disagree with the notion we need to have a bigger and better healthcare facility for Milton.  Our town is now approaching the 100,000 level and what we have right now is not enough.  This isn’t to say that the individuals, doctors, nurses and other healthcare workers at the Milton Hospital are doing a poor job.  They are doing the best they can with the resources they have.

The problem is the provincial government.  They need to make our town’s healthcare facility a priority and fast.  As Mr. Oliver from Halton Healthcare Services stated in the meeting on May 17th, even if they got approval that day for expansion, they are many years away from shovels in the ground.  Our hope is that the provincial government, after their budget deliberations, comes to the same conclusion that Halton Healthcare Services, the Town of Milton and the residents of Milton already know.  Approve the hospital expansion now.

I’m glad that staff also realized we need to put added pressure on the provincial government to change the Development Charges Act of 1997 and allow municipalities to raise funds for the local share of the hospital funding through development charges.  I would add that the town of Milton should urge all municipalities in Ontario to put added pressure on the province to get these changes put through.  All towns and cities in Ontario are either facing the same problems we are or will in the near future and there has to be concerted effort on behalf of ALL municipalities in the province to get these changes made.

This leads me to some concerns about where the funding will come from for the local portion that will be required to get the projects moving.  The face of health care services has changed over the last 20 years.  No longer do local hospitals serve local residents.  Hospitals serve the population in general throughout the region.  Milton residents can take advantage of services at the Burlington, Oakville and even Mississauga area hospitals for different health care related items.  My concern is with burdening the Town of Milton with raising all the funds required for the local portion.  Our tax base isn’t big enough to raise that kind of money in a fixed amount of time.

If we include the “hospital fund” as a budgeted line item for 2010, we run the risk of other high priority projects falling by the wayside and much needed infrastructure such as roads, bridges, etc being delayed.

One of the options listed in the report is to divert Milton Community Funds that were allocated to the Arts Centre to the hospital fund for the next few years.  This would add approximately $500,000 to the fund if it’s done over the next 5 years, which is a fraction of what would be needed.  Milton can do some of the fundraising for the local portion, but it would impede any future long term budgeting that the town needs to do to accommodate other projects, Boyne Survey growth, and Intensification along Main Street.

As we all know, there is immense pressure from the provincial government to grow our population.  Some examples I’ve sighted are the Boyne Survey and the intensification plans faced along Main Street.  The Town doesn’t have any indication from any other level of government on who is going to help, if any, pay for these projects.  Our budgets for the foreseeable future are going to be stretched to the limit.  Adding the addition pressure of the hospital fund, solely on the backs of the taxpayers of Milton will add further problems in long term budgeting.

This proposal should be sent to the Region of Halton for review and have the local portion of the possible expansion handled at that level.  The Town of Milton doesn’t have the resources to raise the much needed funds and if applied at the Regional level and a much greater tax base, the costs can be spread out through the region of Halton as it will be the region of Halton that will benefit from any hospital expansion.

The resources available at the regional level are greater such as debt financing, development charges and at the very last resort tax increases.  The job can get done faster and more efficiently at that level of government without putting the strain on Milton’s long term budgeting issues that we will be facing as growth continues.

I would like to urge Mayor Krantz and members of council to rethink where this motion should be coming from and with the help of our regional councillors urge Halton to look at these plans as they have greater resources to work with at this level and Milton can continue to work out its long range budget issues with regards to growth.

Thank you for your time.

Best regards,

 

Mike Cluett

 

905-878-1327 Phone | 647-888-9032 Cell | mike@mikecluett.ca | www.mikecluett.ca

Council to Debate Hospital Tax Levy

Mike Cluett

From the Milton Canadian Champion May 20, 2010 By Tim Foran

Councillors to debate hospital tax levy

Milton council will debate whether to provide cash, perhaps through a dedicated tax levy, to assist Halton Healthcare Services Corporation’s as yet unapproved plans to expand Milton District Hospital.

At Monday’s council session, Ward 3 Councillor Cindy Lunau introduced a notice of motion, which Ward 4 Councillor Paul Scherer indicated he would second, stating the Town would “endeavour” to help HHS cover its share of the costs to redevelop the half-century-old hospital, which hasn’t undergone a major expansion since the mid-1980s.

The motion states the Town would research and identify potential funding mechanisms including the possibility of including a special property tax levy beginning next year.  Council will debate and vote on the motion at the June 28 council session. Lunau said she wanted the long lead time for the community to have an opportunity to provide feedback and plan to attend the session.

Under Provincial funding guidelines that began in June, 2006, Ontario pays for all of the planning costs and 90 per cent of the bricks and mortar for hospital capital projects. Previously, most capital cost share rates varied from 50 to 80 per cent depending on the project, the Province stated at the time.

However, the hospital corporation is still responsible for the remaining 10 per cent of construction costs along with covering the full cost of building revenue-generating facilities such as cafeterias, retail areas and parking lots as well as the medical equipment inside the hospital.

In total, depending on the equipment a hospital needs, that means the Province will cover around 70 per cent of the total project costs, with the hospital corporation paying the remaining portion, dubbed the local share.

The hospital has three ways to pay that local share: its own revenues from, for example, parking lot fees or stores; fundraising done by the Milton District Hospital Foundation; and through financial assistance from municipalities.

The problem Milton council tried to wrap its head around Monday is that HHS won’t provide the municipality with an estimate right now of how much money it would need.  “At the end of the day, if we put too much (money) away, that’s fine,” Scherer said to HHS President John Oliver during Monday’s council session.  “But we need a starting point.”

Oliver said he understood council’s frustration but he doesn’t want to float a dollar figure that would inevitably turn out to be wrong years later after more detailed planning has taken place.

The hospital provided a preliminary cost estimate when it presented its business case for the expansion to the Ministry of Health in September, 2008 but Oliver said after the council meeting that number is already out of date and he doesn’t wish to release it.

“It’s not just inflation, the original size and scope has evolved from the original business case,” he explained. He said he also doesn’t want to jeopardize a competitive bidding process by leaking expected total costs.

However, Oliver did provide council with a benchmark for comparison when he said the redevelopment planned for Milton’s hospital is at least as big as the one proposed for Burlington’s Joseph Brant Memorial Hospital. The first phase of the redevelopment of Jo Brant is projected to cost $312 million, with the local share pegged at $120 million. In December, Burlington’s city council committed to covering half of that cost, or $60 million, and has already started a dedicated property tax levy this year. The City of Vaughan last year committed $80 million to a proposed new hospital for its community. Both projects are also unapproved and are in competition with the Milton hospital expansion to get on the Province’s next 10-year list of infrastructure projects, to be released next year, likely as part of the 2011 budget.

However, the competition is not just among those three hospitals. The Ministry of Health is currently prioritizing at least 50 other proposed hospital projects before submitting its list of requests to the Ministry of Energy and Infrastructure, which will ultimately decide on the 10-year capital plan.

Other ministries are also prioritizing their own lists of proposed capital projects, one of which includes the proposed Wilfrid Laurier University campus in Milton. That prioritization is expected to take place over the next three months, said Jason Grier, a professional lobbyist from Hill and Knowlton working on behalf of HHS.

One of the things the Ministry of Health will be looking for during this time when prioritizing projects is whether the hospital corporation has a firm plan to meet its local share commitments, Grier said after council Monday.

“They don’t want to move forward on projects that aren’t going to have that local share commitment because then the project isn’t going to happen,” explained Grier, who served as executive assistant to George Smitherman when he was health minister in the provincial government.

Oliver told council it would help the hospital if the Town made a firm commitment of financial support. “I don’t know if you need to put a dollar figure behind it right now.”

Well That Was Interesting

Mike Cluett

Last nights council meeting had it all.  Expectations were running high by some members of council that it could either be a very short meeting or a very long meeting.

I had reported before that council salaries would be discussed at this meeting but apparently it went through on consent items and didn’t even make a blip on the radar.

Ward 3 councillor Cindy Lunau had a notice of motion to include a quick presentation by Halton Healthcare Services to Milton Town Council to give them an update on Milton District Hospital and its possible expansion.

John Oliver from Halton Healthcare made a presentation outlining the fact that expansion of the Milton DH is essential and must happen.  The provincial government has put a freeze on capital projects and will be reviewing them for the 2011 budget.  He made it very clear that Milton needs to be on the radar and get approval fast.  Even if they were given the green light today, it would be at least 2-5 years before anything will happen.

Regional Councillor Colin Best was frustrated with the process, as all councillors are, and with the fact the provincial government KNOWS Milton is growing but is doing nothing to help out.  We are being mandated to grow our population and size but yet have a hospital that is well under the required size for our community.  Mayor Krantz also shared in that frustration as well.

Mr. Oliver also outlined his pleasure with the community as a whole that came out as a result of the Friends of Milton Hospital campaign when over 35,000 people signed a petition to raise awareness with the provincial government that we need something done and soon.

He said that more work is needed and the community and council need to get behind this full force.

Councillor Lunau also put forward a notice of motion for staff to review possible ways for Milton Town Council to fund expansion, as if it were to happen, the local level of government would be required to put money forward.  Council’s idea is to start saving soon for that eventuality.

The problem council faces is where do you start?  And how much do we save for?  John Oliver couldn’t give us a number, although pressed by Councillor Paul Scherer a few times, as legally he could not give a number.  Council was advised to review other area municipalities and what their costs were as a starting point.

These possible funding options include, but are not limited to:

Increase of Development Charges; Special Tax Levy on Milton taxpayers to go to a dedicated hospital expansion fund only to be used for that purpose; Combination of the two.  Another possibility is using the GTA funding poll that has been collected from Milton taxpayers to support Toronto (don’t get us started on that) and now is no longer needed as another source of funding.

Needless to say, this will be something that will require community support like we havent seen before.  Last year, 35,000 people came to the table and to go forward we will need more!

There were some other discussions last night about parking on Queen Street, which is not allowed.  Councillor Greg Nelson failed in his attempt to put forward a motion to reopen the discussion to allow parking on either one side or both.  But after a very convincing presentation by the Milton Fire Chief, which included pictures of the street with one emergency vehicle and how it would impede traffic and cause a safety issue, it was voted down and parking on Queen Street will not be allowed.

And of course, the highly anticipated motion from Ward One Councillor Rick Day was ruled out of order.  Im not going to get into it here, but if you wanted to read what he was going to talk about, here is a link to his proposed notice of motion.

I also experimented with live Tweets from the council meeting last night.  Judging from some of your emails and comments to those posts, it was pretty successful.  I will try for future meetings to post updates via Twitter, which of course you can keep track by going to www.twitter.com/mike_cluettor follow here on the home of the Mike Cluett.

As always I welcome your emails and comments so keep them coming.  Until then, I’ll see you at the doors.