Members of the Comox Strathcona Regional Hospital District (CSRHD) are again questioning whether their mandate might be expanding.
Typically, the board, comprised of local and regional elected members for the Comox Valley and Strathcona regional districts, has overseen the 40 per cent share of capital funding, raised locally, for acute care facilities such as the North Island Hospital campuses in Courtenay and Campbell River. Even though the hospitals are relatively new, both have been affected by capacity concerns.
As a guest, Island Health chair Leah Hollins spoke to the board at the start of its strategic planning sessions on the morning of Jan. 21, alluding to the need to see beyond acute care facilities to include a whole spectrum of care needs. Island Health staff were joining the sessions to assist the regional board. Hollins referred to the many people in acute care who do not need to be and would be better served in other facilities such long-term care, assisted living and group homes.
“By supporting these types of initiatives, you will be supporting a continuum of care,” she told the CSRHD board during the online meeting.
This is especially the case, she said, when it comes to solving capacity issues at acute care sites, and she stressed capacity is not a challenge that simply affects the region or the province.
“Over-capacity is something we are seeing nationally and internationally,” she said.
Hollins also talked about the devastating impact of COVID-19 but covered some unexpected positive developments because of changes brought on by COVID-19 considerations. For example, by using virtual care, neurologists were able to cut waiting lists for MS patients of a year down to less than a month. As well, virtual appointments, she added, have allowed people in rural areas to reduce travel demands for visits.
Her comments about supporting other types of initiatives beyond acute care touched off a discussion about whether the CSRHD board would be asked to provide funding to capital projects such as residential care facilities.
Island Health staff clarified that, as in other areas, the Ministry of Health can approve a region to fund other kinds of facilities as long as the ministry has named that facility as eligible. They also reiterated a point that arose during a presentation to the CSRHD board at a meeting last fall about how much of the overcapacity at new facilities like the North Island Hospitals is from people who should be at facilities other than acute care sites. Island Health hopes this can be alleviated through more long-term care facilities for seniors.
There were still questions among the CSRHD board if it would be their own decision to take on capital costs beyond acute care facilities. Some also wondered whether they would be charged with taking on operating costs, which have not been part of the hospital district mandate.
‘The province has left it completely open,” said Jim Abram, one of the board members from the SRD.
Other board members were concerned all of this might result in a ‘pay to play’ model that could affect funding from the province for regions to add infrastructure like long-term care beds, though Island Health staff responded they will be funding beds for communities in any case.
The discussion was followed by break-out groups to look at planning issues. The groups later brought forth their main concerns raised in the sessions, including seniors’ care, opiate addiction and mental health supports. Island Health will be planning virtual meetings with different geographic groupings from the board as a follow-up to the Jan. 21 meeting.