The Vancouver Island Health Authority (Island Health) has reissued a Request for Proposals to add 120 new beds for patients requiring a complex level of care in the Comox Valley.
Island Health says it hopes to award contracts for the new beds in early May and expects they will open for patients sometime in 2020.
That’s good news for people needing complex care, and especially for their caregivers. The glaring and long-time shortage of complex care beds in the Comox Valley has distressed caregivers, and resulted in some horrific tragedies.
It’s also good news for Comox Valley Hospital workers. A workforce staffed for 129 admitted patients has been dealing with serious overcapacity issues — up to 170 admitted patients — since the new hospital opened in October.
Most of those 30-40 unexpected patients no longer need acute care, but remain in the hospital because of the Valley’s shortage of complex care beds.
It’s a problem that dates back many years, but surprisingly the new Comox Valley Hospital was planned as if it would never have patients needing an alternate level of care.
That strategy might have worked, or at least diminished the current problems at CVH, except Island Health was slow in issuing a Request for Proposals and awarding the contract for new or replacement beds. And then, it cancelled the RFP completely.
On Sept. 30, 2016, Island Health issued an RFP for 70 new or replacement residential care beds for the Comox Valley. The press release said contracts would be awarded in April 2017 and opened in 2019.
But, on Aug. 3, 2017, Island Health cancelled the RFP, shortly after its board of directors decided the four hospice beds located at St. Joseph’s should be moved to a secular facility that could provide Medical Assistance in Dying (MAiD).
Tim Orr, the director of residential services for Island Health, told Decafnation that St. Joseph’s policy not to permit MAiD was one of several factors in the decision to cancel the 2016 RFP. The new RFP requires at least one proponent to provide end-of-life services including MAiD, and house six hospice beds.
FURTHER READING: Island Health RDP press release
What’s in the RFP?
The Island Health press release says the 120 new beds may be awarded to more than one proponent, and than the number of new complex care beds awarded to each proponent will be determined in the evaluation of each proposal.
“Should the RFP result in more than one successful proponent, at minimum, one of the selected proponents will be required to provide for six community hospice care beds and allow for the provision of MAiD (Medical Assistance in Dying) on site,” the release said.
And successful proponents must provide 3.36 direct care hours per resident day, as per provincial standards.
The release also states that the “new RFP includes flexibility for greater capacity in the future, opportunities for a full spectrum of complex care including innovative models of dementia care ….”
The community has responded to the Island Health announcement with cautious optimism.
Our sources believe that 120 new beds will relieve the stress on the new Comox Valley Hospital, but will not provide a complex care bed for everyone in the Valley who needs one.
Because there are so many nonpaid (mostly family member) caregivers in the Valley, and because only the most in need of acute care get into the hospital, that the Valley may actually need more than 150 and closer to 200 complex care beds.
Our sources expressed disappointment that the announcement didn’t include an increase in respite beds, adult daycare programs or resources for Community Health Care, a program designed to keep people at home as long as possible.
Will St. Joseph’s apply?
The wording of the RFP press release appears to open the door for The Views at St. Joseph’s to apply for additional beds without agreeing to provide MAiD on site, which is something the Catholic church opposes on ethical grounds.
The Views at St. Joseph’s already provides publicly-funded complex care beds that are mostly occupied by patients with dementia. The Views board of directors has outlined a vision for a dementia village” similar to Hogeweyk in the Netherlands.
A private operator in Langely, B.C. just announced that it will open Canada’s first “dementia village” next year. Verve Senior Living says the project will cost patients between $6,000 to $7,500 per month, but is open to working with the B.C. government to make residence more affordable.
Island Health will accept proposals until May 11, but does not say when the contract or contracts will be awarded. It generally takes a minimum of two years from awarding a contract to its completion.
The Island Health board of directors will meet at 1.30 p.m. on March 29 at the Crown Isle Resort ballroom. People may ask questions in advance to be answered in written form at the board meeting, or make 10-minute presentations to the board if they apply by March 15.
In other North Island Hospitals news, Dr. Jeff Beselt has resigned from his position as the Executive Medical Director for the Comox Valley Hospital and Campbell River Hospital. According to a Island Health spokesperson, Dr. Beselt stepped down to focus on his family. Island Health named Dr. Jennifer Grace, of Campbell River, the interim EMD for the region, which includes Campbell River, Courtenay, Comox and Mount Waddington/Strathcona. You can view a farewell video for Dr. Beselt here, and read reviews of Dr. Grace here.
FURTHER READING:Canada’s first “dementia village;”BC retirement home chain sold to murky Chinese ownership group
This article has been updated to include Rebecca Lennox’s announcement to seek re-election.
This article has been further updated to include Bob Wells announcement to run for mayor of Courtenay
Courtenay City Council member David Frisch announced early last week that he is running for mayor.
Frisch is the second sitting councillor to enter the mayoral race, just 225 days away. Erik Eriksson launched his campaign for mayor several months ago. Then, late in the week, Bob Wells announced that he would also compete for the mayor’s chair.
That makes half of the existing Courtenay Council running for mayor. It means there are now three open seats on council and two of the mayoral candidates will no longer serve on Courtenay council.
Mayor Larry Jangula remains undecided about whether to seek re-election. In early January, Jangula told Decafnation it was “too early” to decide and that his decision will be based on his wife’s health, his own health and “an examination of who might be running.”
Jangula is out of town and could not be contacted after Frisch’s announcement.
FURTHER READING: Who’s in, who’s out for Election 2018; Eriksson announces mayoral bid
Frisch told Decafnation that he’s running because he’s the best person to keep Courtenay growing in a healthy direction.
“I’m running for mayor because I have a vision to keep Courtenay’s natural beauty, access to recreation, and affordable living for generations to come,” he said. “My focus is on fostering an inclusive community and planning for growth in a responsible way, balancing economic needs with the need for a healthy and vibrant community.”
Frisch was the top vote-getter in the 2014 election and is serving his first term on council. He received 3,671 votes, hundreds more than his nearest competitor at 3,033.
“I’ve had the privilege to serve with the mayor and my fellow councillors for four years and have learned a lot,” he told Decafnation. “When I imagine how the valley will look in another 10, 20 or 30 years, I can’t think of anyone better to create an inclusive, people driven agenda.”
By seeking the mayor’s chair, Frisch, Wells and Eriksson will give up their council seats.
“The fact that my seat as a councillor will need to filled is only an invitation for another community minded leader to step up,” Frisch said. “The people of Courtenay will take care of choosing that person and I can work with whoever that may be.”
Rebecca Lennox, another first-term council members announced on Facebook late Thursday that she would also seek re-election.
“International women’s day is here so I thought I would tell you that I have decided to run in the 2018 election,” Lennox posted. “It has been my greatest honour to serve on council these last years and I will always be so grateful of the opportunity to do so. If I am lucky enough to be elected for a second term I will continue to do my best in the role of councilor.
“I hope to see a few more ladies round the table next time as one out of seven is not a great balance,” she wrote.
And newcomer Kiyoshi Kosky, who recently sought the provincial NDP nomination, said he is running for a council position.
In an email interview several weeks ago, when Frisch was considering a mayoral run, he told Decafnation:
“As mayor, I plan to embrace the opportunities we have and lead our community to grow in an environmentally responsible way while capitalizing on our opportunities for economic growth – particularly in internet technologies, destination tourism, and retirement living,” he said.
“This includes doing as much as possible to support affordable housing options for young adults, families and seniors, as well as doing the much needed long range transportation planning to keep us all moving.
“My role as mayor will allow me to lead the city to engage with the people of Courtenay and create a long range plan particularly for sustainable development and efficient transportation.”
Voters go to the polls on Oct. 20. Candidates for the 2018 municipal election must file during a 10-day period beginning Sec. 3.
The Vancouver Island Health Authority (VIHA, or Island Health) board of directors will hold their March meeting in the Comox Valley.
It’s an opportunity for Comox Valley and Campbell River residents flummoxed by the myriad errors in planning the new hospitals to ask questions or make presentations to the directors and Island Health executives.
The board will meet from 1.30 p.m. to 3 p.m. on March 29 at the Crown Isle Resort ballroom located at 399 Clubhouse Drive, Courtenay.
With the Comox Valley Hospital still running over capacity — due in large part to the shortage of long-term care beds — citizens might ask when Island Health will re-issue the Request for Proposals to build “new or replacement” beds.
Island Health originally issued an RFP for 70 “new or replacement” beds in 2016, then abruptly withdrew it last summer after deciding to move the community’s four hospice beds to a facility not operated by a religious organization.
Citizens might also ask when Island Health will correct planning errors such as the location of landing pads for emergency transport helicopters, the lack of space for storing health records and other oversights detailed in a series of articles on Decafnation.
FURTHER READING: Online forms for questions and presentations to the Island Health board
The board will only consider questions submitted in advance using an online form available on the Island Health website.
But, curiously, the board won’t speak to those questions at the Courtenay meeting. They will answer them in written form to be distributed at the meeting and uploaded to the Island Health website.
Individuals or groups planning a presentation to the board must apply using an online form at least 14 days in advance of the meeting (a March 15 deadline).
The Island Health board includes two area directors: Anne Davis, program coordinator for the Comox Valley Transition Society; and, Claire Moglove, a retired lawyer and former Campbell River city council member.
FURTHER READING: The Decafnation series on the Comox Valley Hospital
This article has been updated to include a statement from NDP MLA Ronna-Rae Leonard.
There’s a new water controversy bubbling up in the Comox Valley, and once again the province has dumped another problem on local elected officials.
The B.C. government has approved a controversial groundwater licence for a water extraction and bottling operation on a two hectare property on Sackville Road in the Merville area. They did it despite a strong objection from the Comox Valley Regional District and without public consultation or regard for community concerns.
“The province does this all the time,” said Area B Director Rod Nichol. “We have to clean up the mess and look like the bad guys.”
Nichol compared the water extraction issue to the recent Raven Coal Mine battle and myriad less high-profile issues, such as highway development.
About 200 people attended the CVRD’s Electoral Areas Services Committee meeting Monday (March 5) to protest and urge the CVRD to deny the water extraction applicants a necessary zoning change. The property is current zoned rural residential and would need to be zoned light industrial.
Instead, the committee unanimously endorsed a staff recommendation to refer the rezoning application to various agencies, CVRD committees and K’omoks First Nations. The intent is to build a baseline of data about the source of water (aquifer 408) and how a water bottling operation might impact agriculture and other existing users and potential long-term effects on the surrounding watershed.
NDP MLA Ronna-Rae Leonard emailed this statement to Decafnation:
“I can understand the concerns of Merville residents, as water is a precious resource for any community. My understanding is the ministry performed a detailed technical review of the proposal and noted no concerns about aquifer capacity. I’ve also been reassured that existing well users would get priority in a drought. The project still needs CVRD zoning approval though, and as the local MLA I will be monitoring the situation closely.”
Christopher Scott MacKenzie told the committee that he originally drilled a well for domestic purposes. But after his wife, Regula Heynck, insisted on testing and discovering the water had high pH levels (alkaline), the couple envisioned a viable family business.
MacKenzie claimed the alkaline water has health benefits and is “something the community needs … it’s really unique”
A protester disrupted MacKenzie with concerns about how neighbors’ drinking supplies might go dry. He replied that dry wells would be “hit and miss,” and that people “would just have to understand it.”
MacKenzie and Heynck have recently moved to the Valley from Ringenberg, Germany, and took out a building permit to locate a $14,613 mobile home on the property.
MacKenzie is the son of the late Keith MacKenzie, who served as president of the Courtenay Fish and Game Club after retiring as carpentry foreman from Candian Forces Base, Comox. His tours of duty included a stop in Germany.
The core issue
The province has already approved a groundwater licence that enables MacKenzie/Heynck to extract 10,000 litres per day or 3.65 million litres per year. But the CVRD must approve a rezoning application to permit “water and beverage bottling” as a principal use on the property.
Alana Mullaly, the CVRD manager of planning services, said the province has jurisdiction on what happens below grade. The CVRD has jurisdiction over what can happen above grade.
She said denying the rezoning application would not cancel the provincial groundwater license.
Without a zoning change, MacKenzie/Heynck cannot conduct water bottling operations as the principal use of the property.
But it’s unclear whether a denial of the rezoning application would mean only that they could not construct a bottling facility on the property or that they could not operate a commercial enterprise from the property even without a physical structure.
The CVRD opposed the water extraction application made to Ministry of Forests, Lands, Natural Resource Operations and Rural Development (FLNRORD) on the basis that it was inconsistent with the Rural Comox Valley Official Community Plan Bylaw No. 337, 2014, and the zoning bylaw.
There are environmentally sensitive areas surrounding the property, including many farms and Agricultural Land Reserve areas that rely on groundwater.
Area C Director Edwin Grieve warned that aquifers eventually get pumped down and he wondered what effect that would have on the water supply for nearby farms. He noted that climate changes have caused Portuguese Creek to dry up in the summer.
Grieve said the applicant deserved due process and that the gathering of more information is important.
But Grieve also said earlier that “we could save the applicant a lot of time and money and deny it now.”
CVRD staff will refer the rezoning application to a number of agencies, First Nations and its own relevant committees. Not date was set for staff to report to the CVRD board.
If the application passes through the Area C Advisory Planning Commission, then the CVRD would hold public hearings.
In the meantime, people can express their views on the proposal to Tanya Dunlop, senior authorizations technologist, at firstname.lastname@example.org.
Nearly a month after Decafnation published the first of four articles that spotlighted problems at the new Comox Valley Hospital, the Vancouver Island Health Authority (VIHA) has issued a press release in response.
The VIHA statement released on Feb. 2 says, in part:
“Recently, there have been public statements focused on the North Island Hospital Comox Valley campus. While we know there are inaccuracies in some of these statements, we also acknowledge there are truths.
“This is a normal part of a change of this magnitude and we want to assure our staff, physician partners, patients, volunteers and the communities that the hospital serves, that we are listening and working very hard to make necessary improvements.”
These sentences contain several troubling statements.
WHAT DO YOU SAY? — Decafnation invites health care workers and others to respond to the VIHA press release with a comment below or on the Decafnation Facebook page.
First, the VIHA release repeats a claim by CVH Medical Director Dr. Jeff Beselt made to a reporter for 98.9 The GOAT that the first Decafnation article published on Jan. 15 wasn’t entirely accurate.
Decafnation immediately made repeated requests for Beselt to specify those inaccuracies. Those requests were ignored until this week.
But the errors Beselt points out have nothing to do with any of the serious issues raised in our four-part series.
Here are the three errors in the first article to which Beselt says he was referring:
1 — The cost of the Comox Valley Hospital was $331.7 million, not $350 million. We rounded up the original estimate. We’ve also requested data on any cost overruns, which are not uncommon in construction projects.
2 — The hospital building is not ‘owned’ by Tandem Health. Beselt himself errs here. We did not report the building is “owned” by Tandem. We said the building is “leased” from Tandem. It is more correct to say the building is ‘managed’ by Tandem Health under a 30-year operating agreement. It’s interesting to note that VIHA pays Tandem Health a monthly fee for these management services.
3 — Decafnation stated that St. Joseph’s General Hospital was overcapacity on the day it closed. Beselt says that St. Joe’s was not overcapacity on that day because patient numbers were reduced for purposes of the move to the new hospital.
He’s correct for the reason he states. But the point was that St. Joe’s had been overcapacity frequently for several years before the move — a result of having to place people in acute care beds that no longer need that level of care. Further, it was known on the day St. Joe’s closed, and during the construction of CVH, that the roughly 30-40 percent of patients needing an alternate level of care (ALC) would transfer over.
It is Decafnation’s policy to correct errors of fact quickly, so each of the articles now make note of these three corrections and one other similar error in the third article of the series.
The more troubling statement in the VIHA release is that the problems Decafnation has reported are “… a normal part of change of this magnitude ….”
It’s true that some of the issues, including staff morale, relate to former St. Joseph’s staff members habituating to the VIHA culture, and our articles reported on that.
But that doesn’t account for all of the specific problems we have identified, such as not planning for overcapacity, not recognizing that the spacious floor plan would require higher staffing levels, forgetting to include whole departments and later squeezing other departments to fit them in and not providing sufficient residential bed capacity and adequate access to other services for unpaid caregivers in the Comox Valley.
Not to mention failed heliport planning at both Comox Valley and Campbell River sites.
We could go on, but these hardly seem like “normal” parts of a well-considered planning processes. Especially when our sources say they repeatedly raised these and other specific concerns in public and employee meetings during the planning stage.
Did VIHA management simply not listen carefully to its front-line workers during the planning process? VIHA says it did, but there’s a large contingent of north Island hospital employees who strongly disagree.
The VIHA release also says it is “working hard to make necessary improvements.” We reported that in our series, too, and hope to someday see the results of that effort.
But neither Beselt or other VIHA executives would say what specific actions they have taken or plan to take. Decafnation would love to report on those measures and how they have mitigated some of the employees’ uneasiness and mistrust.
The fact is, Decafnation accumulated a multitude of information about which the taxpaying public should be concerned. We only published the portion of this information that we could independently verify and collaborate.
Following publication of the series, readers have expressed further concerns and also related patient experiences relevant to the issues raised in our articles, which we also have not published.
Starting today, however, Decafnation is publishing a selection of those observations. The point is to illustrate the breadth and variety of concerns about the building, changed procedures and how VIHA has managed the transition from St. Joseph’s.
We encourage readers to continue sharing their comments on this website or on our Facebook page.
We also encourage VIHA to not gloss over these concerns or dismiss them in public statements by trying to discredit sincere reporting. We hope instead that VIHA undertakes corrective measures that specifically address overcapacity, understaffing, low morale, health care worker safety, excessive overtime and other issues.
North Island communities deserve a great hospital. Decafnation will support every real effort to achieve that goal.
Note: This is just one sample of a voluntarily submitted comment from a single reader that was not posted to our website or Facebook page. You can view publicly made comments on those sites HERE and on the articles themselves, which are posted HERE. Decafnation has not verified this particular reader’s information.
“During an appointment for a procedure at the CV hospital in mid December, I noticed many things about the “flow” for the patient is pretty makeshift at that new hospital. The way sound carries around the admitting desk is about the worst design possible. Sound travels very well among the chairs in the waiting area which are located across the hall from admitting. It also travels well from one admitting kiosk to the next. So patients hear way too much about each others’ admitting process. On the contrary, voices don’t carry well from the admitting kiosks across the hallway to the patient waiting area, and there is no PA system, so you can’t hear your number being called.
“As a result of the sound design, I was able to overhear a conversation between an admitting clerk and another person about the staffing situation that day. They were quite far away from the desk and trying to be discreet, but I still heard it due to the acoustics.
“Apparently the centralized staffing process isn’t working well. They started the day with one person short, but nobody told them. This caused them to fear that their coworker was missing or maybe had an accident or something.
“Signage isn’t very good. It is nearly impossible to find one’s own way from admitting to “minor day procedures” (which isn’t a good name for a place that seems to only do endoscopy). Most of the patients arriving on the same day as my procedure had mistakenly gone to the second floor surgical unit, gotten lost, and then finally were guided by an employee to the “minor day procedures” waiting room.
“Upon arriving at the department, I noticed that area where the receptionist would normally sit was unlit and not staffed. I found out by overhearing another conversation later that the department was short a unit clerk, and running behind schedule due to misdirected patients and no unit clerk to round them up. Instead of a receptionist, there was a whiteboard on an easel where someone has crossed out the word “minor”(day procedures) and changed it to “important!”. Whoever wrote that knows how the patient feels…anytime you are going under anaesthetic, it feels pretty “important” to the patient and the family. The white board stated that the patients should take a seat and someone would come out to greet them.
“When my name was called, I was guided into the department, given a gown and a pillowcase, and directed to a change room. After putting all my personal belongings into the pillowcase, I was directed to place the pillowcase on a small metal cart, alongside many other blue pillowcases that contained other patient belongings. I thought it was weird that there were no lockers, because I had a similar procedure at St. Joe’s a few years ago and I was given a locker and a key. Patients must leave their full pillowcases in the hallway inside the department during their procedures. I then noticed a handwritten sign on a wall that read “LOCKERS!”.
“I was then guided to an area where one of the stretchers is located. The stretcher is still located in the curtained-area, and there are five chairs all crowded alongside the stretcher in a curtained area and you are pretty much knee-to-knee with all the other male and female patients who are also gowned. This encourages a great deal of unsolicited patient “sharing” about their individual medical conditions.
“I later heard from a friend who works at CVH that the original plan was to send gowned patients back to the main “minor procedure” waiting room to wait alongside all the patients and family members who are in street clothes. On the day of my procedure, there would not have been enough chairs there for all of us, and also I would not feel comfortable standing there in a gown among so many clothed strangers. So at that point, I understood why we were all ushered to a makeshift waiting area inside the department.
“After my procedure was finished, I was directed to the pile of pillowcases to retrieve my belongings and sent to a patient bathroom to change back into my clothes.
“At every interaction, the staff and my doctor treated me in a very caring professional way. The procedure went very well and I felt the staff all did an excellent job of mitigating the shortcomings of the staffing situation and the limitations of their physical surroundings. But after over $600 million dollars (Editor’s note: rough estimate for both hospitals) was spent on the project, the patients, staff, and doctors all deserve better.”