1. QUESTIONS AND ANSWERS
Posted February 2013
NORTH ISLAND HOSPITALS PROJECT
What is the North Island Hospitals Project?
The North Island Hospitals Project (NIHP) involves construction of two new hospitals on northern
Vancouver Island. A new 153-bed hospital will be built in the Comox Valley and a new 95-bed
hospital will be built in Campbell River.
What is the North Island Hospitals Project Board?
The Project Board is a provincial government body consisting of membership from the Ministry of
Health, the Ministry of Transportation and Infrastructure, Vancouver Island Health Authority,
Comox Strathcona Regional Hospital District and Partnerships BC. The role of the Board was to
oversee the development of a business case. The Project Board is also responsible for overseeing
the procurement, design and construction of the North Island Hospitals Project.
What does the business case include?
The business case primarily involved the development of an indicative (conceptual) design for both
hospitals that included enough detail to accurately determine the required capital investment. It
also recommended that this project should be procured as a public-private partnership (PPP). The
business case will serve as the foundation for the procurement processes.
What is an indicative design?
An indicative (conceptual) design outlines the potential layout of a building, including all the rooms
and requirements identified in the business case. For example, the indicative designs for the new
hospitals include drawings that show the potential look of the hospital from the outside (artist
rendering), as well as the general layout of patient rooms, laboratories, hospital registration and
more. An indicative design serves several purposes:
• Allowing users to visualize what a design could look like;
• Providing a basis for estimating costs; and
• Serving as a starting point for proponents who will bid on the project to develop their own,
detailed competing designs.
At what stage is development of the business case and who has been involved?
The business case was completed in December 2011. Consultations with physicians and staff
began in October 2010 when work on the business case got underway. These consultations will
continue throughout the final design and construction stages of the North Island Hospitals Project.
Consultations were initiated with First Nations and Aboriginal Groups in May 2011. Follow-up
information sharing will take place with Aboriginal representatives to discuss design principles and
to seek further input on operational principles and amenities that are relevant for Aboriginal people
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2. during the design stages of the project. Engagement sessions with community organizations will
take place during the procurement and implementation phases of the project.
Can members of the public view the business case?
Business cases for major capital projects are not released publicly as they are part of the decision
documents prepared for Provincial Cabinet deliberations. Similar to other major projects, a Project
Report: Achieving Value for Money will be produced by Partnerships BC and is expected to be
released by mid 2014. The Project Report: Achieving Value for Money will include information on
project objectives, the scope of the project, project benefits and risks associated with the project.
Partnerships BC website provides comprehensive reports on all major infrastructure projects in the
Province of BC: www.partnershipsbc.ca
What is the overall budget for the NIHP?
Initial and preliminary estimates for this project indicated that the preliminary cost will be
approximately $600 million in total for both hospitals; $334 million for the Comox Valley Hospital
and $266 million for the Campbell River Hospital. The Comox Strathcona Regional Hospital District
will be contributing 40% to the overall project, approximately $240 million. Final costs of the overall
project will be determined as part of the procurement phase, concluding with financial close.
Why is Partnerships BC involved in the process?
Partnerships BC was established by the Province of British Columbia to assist, support and help
manage large public infrastructure projects through-out the province. They have extensive
experience with projects like the NIHP.
Did the business case recommend a public-private partnership (PPP)?
Yes. The Provincial government requires that any project needing more than $50 million in
provincial funding be considered as a public-private partnership to assist in achieving best value for
tax dollars. Following consideration by Treasury Board, it was determined the North Island
Hospitals Project would be built as a PPP, with the successful proponent responsible for designing,
building, financing and maintaining the site for the length of the 30 year contract.
What is a PPP?
A PPP is a long-term, performance-based contract where government has control and ownership
of the infrastructure (in this case, two hospitals) while transferring parts of the risk associated with
designing, building, financing, and maintaining major projects to the private sector. The benefits of
PPPs include value for money, increased innovation, cost certainty, and better-managed life cycle
costs.
Where will the hospitals be built?
The new Campbell River Hospital will be built at the site of the current hospital, located on 2nd
Avenue and Birch Street. The new Comox Valley hospital will be located near the intersection of
Lerwick and Ryan roads in Courtenay, next to North Island College.
Who will be building the new hospitals and what is the timeline?
On this project, as with all PPP projects, there is a specific process used to determine the preferred
proponent (or consortium) that will design and construct the new hospitals.
First, there is a Request for Qualifications (RFQ). In this stage of the NIHP, proponents who were
interested in building the hospitals had to demonstrate that they had the qualifications and
experience to manage and implement a project of this scope and size. These qualifications and
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3. experiences were reviewed, and in October 2012, three qualified proponents were invited to move
onto the second stage, the Request for Proposals (RFP).
In the RFP stage, proponents are provided with documents that outline the functional requirements
of the new hospitals, including patient rooms, washrooms, laboratories, registration, parking,
clinical equipment and more. From this, the proponents will develop their design and construction
proposals and submit them back to VIHA. The three proponents will have approximately 6-8
months to complete their proposals. We anticipate that their proposals will be returned for review in
fall 2013.
Once they have submitted their proposals, they are evaluated and a preferred proponent is
chosen. The preferred proponent will be required to design, build, finance and maintain the
hospitals over the term of the agreement. The preferred proponent will be announced in December
2013, with construction to begin in spring 2014. It is anticipated that the hospitals will be completed
and ready for move in by the fall of 2017.
Will local companies and individuals be involved in building the new hospitals in Courtenay
and Campbell River?
We are encouraging local hire and local business participation. We will be holding Business-to-
Business meetings in the spring of 2013. These meetings will allow local companies (hotels,
caterers, contractors, other suppliers and trades people) the opportunity to meet with the
proponents to highlight their qualifications and/or services.
Site Preparation: Who will be preparing each site and when will this work begin?
The companies who will be preparing the hospital sites at this point in time are different than those
companies who will be designing and building the hospitals. VIHA is responsible for managing site
preparation through the tendering and awarding of the work to companies. This means that
interested companies have to submit a bid outlining how much it would cost them to prepare each
site. These bids are evaluated and the job is awarded to a successful company.
Comox Valley Site Preparation
In the Comox Valley, this work is expected to begin in February 2013, continuing through June
2013. Site preparation work includes tree removal, the creation of landscaped buffer zones along
the hospital and North Island College, and the installation of an 8ft fence around the
hospital/school perimeter.
Campbell River
In Campbell River, the company that will prepare the site has not yet been chosen. The tender for
this work closes on February 7, 2013. Site preparation work is expected to begin in spring of
2013.The site work will continue through fall 2013.
What services will be provided at each hospital?
The services currently available at Campbell River and St. Joseph’s will remain available
recognizing that there may be some modifications arising from technological advances, efficiencies
in service delivery and innovation in healthcare delivery. Innovation and advances in technology,
including medical innovation allow us to deliver better services with less space and make better
use of existing space. It also reduces the need to duplicate services in both facilities. Space
utilization is a high priority for this project and VIHA is working closely with the partners on the
project to ensure space is used in the most efficient and effective way. These facilities will provide
opportunity to introduce new specialized services to North Vancouver Island, for example, fixed
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4. MRI at the new Comox Valley Hospital. They will also improve VIHA’s ability to recruit and retain
physician and other health care professionals.
What about Mental Health and Addictions Services?
The original long-term plan was to shift the majority of the mental health and addiction services
(MHAS) inpatient beds from the Comox Valley to the new Campbell River Hospital. Following
consultation with physicians at both Campbell River and St. Joseph’s hospitals, it was determined
it would not be practical to move these beds. Representatives from VIHA, St. Joseph’s General
Hospital and the Chief of Staff for Campbell River Hospital met with the Comox Strathcona
Regional Hospital Board Directors at a public meeting held on November 8th, 2012 to discuss the
MHAS beds. The CSRHD board voted in favour of keeping the MHAS inpatient beds at the new
Comox Valley Hospital. Following the CSRHD Board approval, the VIHA Board of Directors also
approved this recommendation.
How were bed numbers determined?
The bed numbers for North Island Hospitals are based on future population projections, health
needs of the population and anticipated changes in how we deliver services. This is a standard
methodology approved by the Ministry of Health when forecasting the need for acute care beds.
This type of forecasting methodology is consistently applied across the Province for all health
capital planning projects.
The BC Government’s Treasury Board, the Project Board, the VIHA Executive and Board have
approved the NIHP Business Case for this project based on this bed calculation
Will there be trauma services?
There will be trauma bays in the emergency departments at each hospital site. Higher level trauma
services in the emergency department will be designed to address the type and level of patient
care required. For example, there may be specific bays for casting, eye care, and other levels of
emergency care that will be closely linked with medical imaging (x-rays) and other emergency
related services.
What about the 40 to 50 new community care beds that were promised by VIHA?
VIHA remains committed to opening up to 40-50 new community care beds in Campbell River prior
to the opening of the new hospital. Six of these beds have already been purchased. Based on
VIHA’s planning, we are looking to provide a range of bed types, including: residential care,
moderate dementia housing, reactivation and end of life beds. These community beds are integral
to the success of the NIHP, but are a separate project. The NIHP focuses on the replacement of
the acute care facilities in both communities.
What kind of management/administration will there be?
The model will be one hospital with two sites. There will be on-site management at each site.
VIHA Staff: Will I be working at both sites?
While the majority of staff will work at one of the two sites, there may be some staff that choose to
work at both sites and some programs may have staff that work out of both sites.
What will be the process for transferring staff from St. Josephs to VIHA?
VIHA and St. Joseph’s management have begun to meet with the unions representing the current
staff at each site. The goal of these meetings is to develop plans for integrating St. Joseph’s staff
into VIHA, as well as identify how staff will be transferred into the new buildings. This process will
be completed at least a year in advance of the opening of the new buildings.
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5. It is known that some services will be transferred to the consortium (preferred proponent) that will
be building and operating the new hospitals. At this time these services will only include facilities
management related services, such as HVAC (heating, ventilation and air conditioning) or
responsibilities related to general building maintenance. Affected staff will be identified early in the
process and in negotiation with the unions representing these staff, options and alternatives will be
developed. The new facilities will have an increased number of beds so it is anticipated that all
clinical staff wanting to be transferred to the new buildings will be accommodated. In fact, there
may be a need to recruit some new staff.
When will we know the process for transfer?
Projected opening date of the new sites is fall 2017. We will work diligently to give as much notice
as possible to each of the communities.
How do we ensure that acute care needs continue to be addressed, developed and
supported while the new hospitals are being built?
It will be business as usual at the current Campbell River and St. Joseph’s hospital sites. Plans
and requests for service enhancements and space allocations will continue to be considered as is
currently done now, throughout the new hospitals construction period. As well, regular
maintenance and repairs will continue.
How do we support physicians and staff in planning and transition to the new hospital while
assuring adequate resources to provide quality care at St. Joseph’s and Campbell River
Hospital?
There are funds in the project budget to ensure that staff can be backfilled to work on the
development of the new facilities, without impacting staffing and patient care.
How will physicians and staff be involved in the design of the new facilities? How much has
already been decided?
To date, over 20 user groups (300 people) made up of clinical and non-clinical staff have been
extensively involved in the creation of RFP documents that will be given to the three proponents to
guide the development of their proposals. Clinical and non-clinical staff will also be consulted
during the RFP process as proponents develop their proposals. In addition, there will be numerous
opportunities for clinical and non-clinical staff to provide input during the design and construction
phase with regard to clinical flow, room and department design, clinical equipment purchases and
overall functionality of both facilities, as well as their importance in relation to the North Island
healthcare service delivery model.
Comox Valley
Will Pastoral Care be valued and supported in the new hospital?
Pastoral care will continue at the new Comox Valley Hospital. VIHA’s Spiritual Health program has
a positive relationship with pastoral care at St. Joseph’s Hospital and the two groups meet
regularly regarding pastoral care practice. For more information on the VIHA Spiritual Care
program visit http://www.viha.ca/spiritual_care/
What does this mean for plans for a Hospice/Palliative Unit to be located on the SJGH site?
St. Joseph’s and the Hospice Society will continue with their partnership for the development of a
Hospice/Palliative Unit on the St. Joseph’s site.
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6. What will happen at the The Views?
The 125 complex care beds in The Views will not transfer to the new hospital. The current plan is
for The Views to remain at the St. Joseph’s site and will be discussed as a part of the new role for
St Joseph’s.
Will residents of The Views have to move?
As part of any plan to renovate The Views, all efforts will be made to minimize disruptions for the
residents. The details regarding how residents might be impacted would be part of a formal plan
and communicated at that time.
What will happen to the SJGH Foundation?
The St. Joseph General Hospital Foundation performs a valuable role in raising funds to support
capital projects and the purchase of equipment for SJGH and for the Views. The SJGH Foundation
has been considering how they may continue to play a role in this important work with the move to
a new hospital. VIHA and the St. Joseph’s Foundation will be meeting to discuss this topic.
What happens to the SJGH Foundation’s assets – will they stay in the community?
The position of the Foundation has always been to honor the requests of the donors and this
principle would apply to the Foundation’s assets.
The SJGH Foundation serves both the acute care and The Views. How will this work with
the new hospital?
The Foundation has been considering their role in supporting both The Views and the hospital.
Given the transfer of acute care services to the new North Island Hospital, the Foundation will be
considering the best way to continue with this acute care support.
The SJGH Foundation has raised funds for specific projects, for example, Palliative and
Hospice Care. What will happen to these funds?
It is always the goal of the Foundation to honor the request of donors giving to specific projects. In
this example designated funds for Palliative and Hospice Care would be used to support this
specific program.
What will be the process to explore a new role for St. Joseph’s?
There are many exciting possibilities for a new role for St. Joseph’s. Discussions will start with the
VIHA Board of Directors and the Diocese of Victoria. Further discussions and planning will involve
staff, physicians, members of the community, and other agencies.
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Excellent care – for everyone, everywhere, every time.