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					       HEALTH SERVICES RESTRUCTURING COMMISSION




News Release

     Commission Calls for Renewed Hospital System in North Bay
  “All hospital services under one roof will improve care,” Commissioner says

October 29, 1998, North Bay — The Health Services Restructuring Commission (HSRC)
today released its preliminary decisions regarding the restructuring of health services in
North Bay.

“This community has already moved forward to restructure with the merger of the two
acute care hospitals in North Bay in 1994. The hospitals have shown commitment to
provide excellent services,” said HSRC Commissioner George Lund.

The Commission issued preliminary decisions (Notices of Intention to Issue Directions or
“Notices”) and announced that there will be a response period. Interested organizations and
individuals are invited to comment on the HSRC recommendations by November 30, 1998.

Report highlights

Highlights of the report include:
 A comprehensive hospital system consisting of one hospital on one site:
    A new site will be developed for a consolidated facility. Once the new building is
       available, the Scollard St. and McLaren St. sites of the North Bay General Hospital
       as well as the North Bay Psychiatric Hospital will no longer be used as hospitals
 The capacity of the hospital to 2003 will be 352 beds, including acute care, sub-acute
   care, rehabilitation, mental health and complex continuing care
 Enhanced services for the elderly in the entire Nipissing District include:
    364 more places in non-institutional services such as supportive housing, long-term
       home care, attendant care and adult day care
 $39.3 million reinvestment annually in services in the entire District of Nipissing:
    $25.1 million for community mental health services;
    $6.2 million for long-term care;


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     $3 million for rehabilitation;
     $2 million for complex continuing care;
     $1 million for home care; and
     $1.8 million for sub acute care which is a new service for patients who do not
      require acute care but require skilled therapy or nursing care on a short-term basis to
      regain function and return home.
 Up to $111 million capital cost to consolidate all hospital services at a new site in North
  Bay
 $900,000 for renovations at the Sudbury Algoma Hospital
 The HSRC advises the Ministry of Health to transfer mental health services provided at
  the North Bay Psychiatric Hospital to the consolidated hospital site in North Bay and to
  the Sudbury Algoma site. The HSRC also intends to direct a new public hospital
  corporation to operate all longer-term, child and adolescent, and forensic mental health
  services for northeastern Ontario.

New Hospital Option Selection

Lund said: “Given the size of the hospital we estimated, we preferred to locate all services
at a single site. This will be better for patients and better for the people who provide their
care. Our decision to call for the creation of a consolidated hospital facility followed a
careful examination of all the options in light of our criteria of quality, accessibility and
affordability. Reasons of patient care quality improvement were the decisive factor in
choosing a one site option at a new site.”

The location of the consolidated hospital will be determined by the North Bay General
Hospital, which will seek a location with sufficient space and which is accessible to the
population it serves.

The HSRC reviewed the possibility of using the three existing sites as locations to
consolidate hospital services as well as a new site. The McLaren St. site, the smallest of all
the existing sites, is too small to house all required services. The Scollard St. site also has
serious size limitations, particularly when required parking and green space are included.
The North Bay Psychiatric Hospital (NBPH) site, while large, is located far from the
population of the city and the existing buildings are in poor condition.

The HSRC also assessed a two-site option, Scollard and NBPH. The HSRC judged that the
long-term improvement of quality of patient care in mental health is lesser in this approach
than in a one-site option and that the Scollard site would require significant modifications
and would need additional land which will have to be acquired from the city and/or may
entail expropriation of a few homes in the area.




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Mental Health Decisions

The HSRC design calls for a significant change in the provision of mental health services.
The change is based on Ministry of Health policies and guidelines regarding the shift to
community services from hospital mental health services.

The HSRC is calling for an increase in community services as long-term mental health beds
are reduced. Savings in the hospital mental health sector must be directed to community
services before bed reductions can occur.

Further, the HSRC is calling for a major organizational change in mental health services.
Management of services at the NBPH will be entrusted to the Sudbury Algoma Hospital,
which will significantly reconstitute its board to assume a regional mandate. A new public
hospital will result, tentatively named the Northeast Mental Health Hospital (NMHH).

The NMHH will operate beds at two sites, the Sudbury Regional Hospital (longer-term and
child and adolescent mental health beds) and the consolidated North Bay General Hospital
(longer-term and forensic beds). The NMHH will also provide services through satellite
clinics and seek to develop contractual relationships with Timmins and Sault Ste. Marie
hospitals to help provide mental health services in those communities.

A Joint Executive Committee of the NMHH, the North Bay General and Sudbury Regional
hospitals will ensure joint planning on mental health matters and the sharing of support
services.

French Language Services

The HSRC plan calls for the strengthening of French Language Services by directing the
North Bay General Hospital to seek designation to provide services in French. The hospital
will need to develop and implement a plan to provide French Language Services with the
assistance of the Ministry of Health.

Children’s Services

The HSRC heard concerns from the community regarding the need for improved children’s
health services. As a result, the HSRC is calling on the Ministry of Health to address the
problems of access and lack of coordination of children’s health services, with a needs
assessment study to be completed by the Ministry. Further, the HSRC calls on the Ministry
to consider developing a children’s treatment centre by consolidating existing services into a
single organization to serve the children of North Bay and Nipissing District.




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A Provincial Perspective on the HSRC

On April 27, the Commission released Change and Transition, the Commission’s
perspective for people who require home care, long-term care, mental health, rehabilitation
and sub-acute care and associated reinvestments.

Implementing Change and Transition will mean that in Ontario in 2003 as compared to
1995/96, there will be 17,000 more nursing home beds; 24,000 more people will be
supported in their homes or a home-like setting which will meet their health care needs; and
80,000 more patients will be helped to recover in their homes following an acute care
hospital stay. There will also be 1,200 more rehabilitation beds and 1,600 sub-acute care
beds in Ontario hospitals. In total, the Commission is recommending a $900 million
reinvestment in these important services.

The Commission is also recommending the largest capital spending program in the history
of Ontario’s public health care. The Commission has called for $1.8 billion in renovations
and new construction to develop modern hospitals with the best equipment available rather
than maintaining under-used buildings and duplicating services.

The HSRC is a group of volunteers appointed by the Ontario government to redesign the
Ontario health system. It is an independent agency of doctors, health care educators,
hospital administrators, former hospital board members and other experts.

The public can obtain information on the HSRC or a copy of this report by visiting the
HSRC internet web site at http://www.hsrc-crss.org or calling toll-free 1-888-534-8396.

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Contact:      Paul Kilbertus (416) 327-5504

Fact Sheet Attached

version française disponible




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Fact Sheet

          Summary of Health Services Restructuring in North Bay
Inpatient Bed Requirements
 Category of Beds                        Total in Operation    Total in 2003 in    Total in Sudbury in
                                           in North Bay in       North Bay          2003 for needs of
                                               1998/99                            northeastern Ontario
 Acute Inpatient                                  168                151
 Sub-acute                                          0                13
 Local Rehabilitation                              10                29
 Complex Continuing Care                           10                42
 Adult Acute Mental Health*                        52                30
 Longer-term Mental Health*                       229                61                   31
 Forensic*                                         26                26
 Child and Adolescent Mental Health                 0                 0                   12
 Total Beds                                       495                352
 Operating Rooms                                    6                 7
 Procedure Rooms                                    0                 4
 Regional Rehabilitation**                          0                 0                  6***
* Currently sited in North Bay Psychiatric Hospital
** Includes one transition to independent living space
*** Sited in Sudbury as part of a regional program

Long-Term Care Services in Nipissing District
                               Current beds/       Proposed                         Change
                                  spaces      beds/spaces to 2003            #           %
 Complex continuing care                 114*                   72                (42) 36.8% decrease
 Long-term care                           742                  742                   0     0% increase
 Supportive housing/long-                 736                1,100                364 49.5 % increase
 term home care
*As per 1998-99 operating plan

Estimated Costs of Capital Investment
 New Construction                                        $80.4 million
 Renovations                                             $ 0.8 million
 Ancillary Costs                                         $18.7 million
 Furnishings & Equipment                                 $ 8.0 million
 Site Development Allowance                              $ 3.0 million
 Total Capital Estimates                                 $110.9 million




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Annual Service Reinvestment Summary
 Home Care                                            $1 million
 Sub-Acute Care                                     $1.8 million
 Mental Health Services*                           $25.1 million
 Rehabilitation                                       $3 million
 Long-term Care (places)                            $6.2 million
 Complex Continuing Care                              $2 million
 Joint Replacement                                  $0.2 million
 Information Technology Systems                               tba
 TOTAL                                             $39.3 million
*For all northeastern Ontario


 Sudbury Algoma to Reconstitute its Board with a Regional Mandate
                  in Long-Term Mental Health
                    North Bay Psychiatric
                          Hospital
                         (North Bay)

                                          Divest Governance

                         Sudbury Algoma Hospital
                                (Sudbury)

                                          Reconstitutes its Board and
                                          renames the
                                          hospital

                   Northeast Mental Health Centre



Summary of Total Acute Care Hospital Expenses and Savings

 1995/96 NET EXPENSES *                                             $57,123,362
          Clinical efficiencies                                     -$5,690,742
          Program transfers                                         +$2,065,453
          Support services efficiencies                             -$1,112,391
          Administrative efficiencies                               -$2,755,471
          Site Closure                                                       $0
          Transfer materials mgt.                                     +$36,693
          Change in selected expenses                                        $0
 TOTAL SAVINGS                                                      -$7,311,161
 REVISED EXPENSES                                                   $49,812,471
* Net Expenses from OCDM




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