regular board meeting open meeting agenda

REGULAR BOARD MEETINGOpen Meeting Agenda

Date: February 28, 2018

Time: 6:00 pm

Location: Castlegar and District Community Complex Monashee Room

Directors will have the opportunity to participate in the meeting electronically. Proceedings are open tothe public.

1. CALL TO ORDER &WELCOMESecretary/ Treasurer Horn will call the meeting to order.

2. ELECTION OF CHAIR AND ACTING CHAIR

2.1 Secretary/ Treasurer Horn will call for nominations (3 times) for the position of Chair.

Nominees will have an opportunity to address the Board (maximum 2 minutes)In the case of an election, the vote will be conducted by secret ballot.

RECOMMENDATION:

That the ballots used in the election of the Chair be destroyed

2.2 Secretary Horn will call for nominations (3 times) for the position of Acting Chair.

Nominees will have an opportunity to address the Board (maximum 2 minutes)In the case of an election, the vote will be conducted by secret ballot.

RECOMMENDATION:

That the ballots used in the election of the Acting Chair be destroyed

(Commencement of regular agenda with elected Chair presiding)

February 28, 2018Regular Board Meeting

West Kootenay Boundary Regional Hospital District

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3. OPENING REMARKS FROM CHAIR & ACTING CHAIR

4. WKBRHD APPOINTMENTS

4.1 Appointment of Directors

RECOMMENDATION:

That the following Regional District Directors/ Alternate Directors be appointed asDirectors of the West Kootenay Boundary Regional Hospital District for 2018:

Regional District of Central KootenayGarry Jackman, Electoral Area AAimee Watson, Electoral Area DRamona Faust, Electoral Area ETom Newell, Electoral Area FHans Cunningham, Electoral Area GWalter Popoff, Electoral Area HAndy Davidoff, Electoral Area IRick Smith, Electoral Area JPaul Peterson, Electoral Area KDeb McIntosh, City of CastlegarSuzan Hewat, Village of KasloKaren Hamling, Village of NakuspDeb Kozak, City of NelsonStephen White, Village of SalmoLeah Main, Village of SilvertonJessica Lunn, Village of SlocanAnn Bunka, Village of New Denver

Regional District of Kootenay BoundaryAli Grieve, Electoral Area ALinda Worley, Electoral Area BGrace McGregor, Electoral Area CRoly Russell, Electoral Area DVicki Gee, Electoral Area EFrank Konrad, City of Grand ForksJim Nathorst, City of GreenwoodMarguerite Rotvold, Village of MidwayJoe Danchuk, Village of MontroseKathy Moore, City of RosslandMike Martin, City of TrailArlene Parkinson, Village of WarfieldTabatha Webber, Village of Fruitvale



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4.2 Appointment of Alternate Directors

RECOMMENDATION :

That the following Regional District Alternate Directors/Directors be appointed asAlternate Directors of the West Kootenay Boundary Regional Hospital District:

Regional District of Kootenay Boundary Regional District of Central Kootenay

Kirby Epp, Area A John Cathro, Area DBill Edwards Area B Pegasis McGauley, Area EDonna Wilchynski, Area C Eric White, Area FBrian Taylor, Area D Isabelle Herzig, Area GGeorge Delisle, Area E Briane Verigin, Area HPatricia Cecchini, Village of Fruitvale Laurie Watson, Area JCindy Cook , Village of Montrose Claire Paradis, Area KKevin Jolly , City of Trail Lawrence Chernoff, City of CastlegarDiane Langman, Village of Warfield Rob Lang, Village of KasloLloyd McLellan, Rossland Ulli Mueller, Village of NakuspColleen Ross, City of Grand Forks Val Warmington, City of NelsonEd Smith, City of Greenwood Jason Clarke, Village of SilvertonGary Schierbeck, Village of Midway Madeleine Perriere, Village of Slocan

Henning von Krogh, Village of New Denver

4.3 Appointment of the Executive Committee

RECOMMENDATION:

That the following Directors, in addition to the Chair and Acting Chair, are herebyappointed to the Executive Committee of the West Kootenay Boundary Regional HospitalBoard for 2017:

Arrow Lakes/Slocan/Castlegar/Nakusp: ____________Kootenay (Kaslo/Nelson/Salmo): ____________Boundary: ____________Greater Trail: ____________

5. ADOPTION OF THE AGENDA

RECOMMENDATION

That the agenda for the February 28, 2018 Board meeting be adopted as circulated.



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6. ADOPTION OF THE MINUTES

RECOMMENDATIONS

6.1 The minutes of the November 22, 2017 Board meeting be adopted as circulated.

6.2 The minutes of the November 22, 2017 Board priority setting workshop be adopted ascirculated

6.3 The minutes of the January 8, 2018 Executive Committee meeting be adopted ascirculated.

7. DELEGATIONS

INTERIOR HEALTH AUTHORITYMr. Todd Mastel, Director – Business SupportMs. Karen Bloemink, Executive Director – East, Hospitals and Communities Integrated ServicesMs. Cheryl Whittleton, Health Services Administrator Kootenay Boundary CommunityMs. Jane Cusden, Health Services Administrator Kootenay Boundary AcuteMr. Karl Hardt, Communications Director

8. BUSINESS ARISING OUT OF THE MINUTES

8.1 WKBRHD Priorities Recommendation to the Ministry of Health – October 25, 2017

Motion referred to the Executive Committee from the Oct 25, 2017 WKBRHD Boardmeeting:

“WHEREAS Interior Health has projected year over year funding needs in excess of the anticipatedfunding levels which will be allocated by the ministry it appears as though we are moving into anunacceptable situation of communities bidding up their hospital district contributions (above40%) in order to obtain a higher priority in the capital funding stream.

THEREFORE, Staff be directed to contact the Ministry of Health to communicate that this will notresult in the highest priority needs being met in the order as recommended by IHA healthprofessionals. The entire process of evaluation and prioritization of needs is at risk of beingeroded. If the province will not increa5.1se the capital funding envelope to meet the needsprojected by health professionals then the Province should consider changing its legislation inorder to once again level the playing field.

Resolution adopted at the November 11, 2017 WKBRHD Executive Meeting:

MOVED by Director Kozak and seconded,And Resolved:



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That the foregoing resolution be referred to the January Board meeting for discussion.

Carried

8.2 Arrow Lakes Hospital Emergency Department RenovationThe letter from Donna Lommer, VP Support Services, Interior Health Authority, datedDecember 8, 2017, has been received.

9. NEW BUSINESS

9.1 Interior Health Authority Capital Funding Request for the 2018/2019 Fiscal Year

The letter from Donna Lommer, VP Support Services, Interior Health Authority, datedDecember 15, 2017, has been received

9.2 2018 WKBRHD Budget

The 2018 draft budget documents prepared by Secretary/Treasurer Horn, have beenreceived.

9.3 2018 Regional Hospital District Board Chairs meeting

Discussion of the planned meeting to be held in Kelowna on April 11, 2018

9.4 Service Concerns at the Kootenay Boundary Regional Hospital

The letter from Margaret Crawford of the Society for the Protection and Care of Seniorsdated Dec. 2, 2017, has been received.

9.5 WKBRHD Accounts Payable Summary

The accounts payable summary prepared by the RDCK Finance Department, has beenreceived.

10. QUESTIONS PERIOD FOR PUBLIC & MEDIAThe Chair will call for questions from the public and members of the media.

11. ADJOURNMENT

RECOMMENDATION

That the meeting adjourn at…

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Note: Regional Capital Teams have Foundation representatives

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Interior Health Authority VP Support Services & Chief Financial Officer5th Floor - 505 Doyle Ave.Kelowna, BC V1Y 0C5

Telephone: (250) 862-4025 Fax: (250) 862-4201E-Mail: [email protected]

Web: www.interiorhealth.caPage | 1

Ms. Aimee Watson, Chair West Kootenay Boundary Regional Hospital District c/o Regional District of Central Kootenay Box 590, 202 Lakeside Drive Nelson, BC V1L 5R4

December 8, 2017

Dear Ms. Watson:

RE: ARROW LAKES HOSPITAL EMERGENCY DEPARTMENT RENOVATION

In response to your letter dated November 23, 2017 I would like to assure you that Interior Health (IH) is grateful for the Regional Hospital District’s (RHD) support for this project. Funding 100% of the initial planning has allowed us to hire a consultant to review the affected areas of the emergency department space. The deliverables of the planning phase are now complete with a formal schematic design and project budget developed. This phase of the project was completed well below budget at a cost of $31,502.

We are pleased to inform you that IH’s Board has approved the construction project this week as part of its 2018/19 Capital Budget. The approved project includes all three phases of the project:

1. The redevelopment of the former operating room into two new trauma bays and clean/soiled utility room;2. The creation of new consult/exam rooms; and3. The upgrade of the remaining space of the emergency department.

You will be receiving a request to fund 40% of the $2.1 million estimated project cost. This amount includes thebuilding components as well as the required equipment. The Arrow Lakes Hospital Foundation and the Arrow Lakes Health Care Auxiliary will be contacted as to their potential interest to fund a portion of the cost, which then would impact the RHD’s contribution. The formal request to fund 40% of this project will be part of IH’s annual funding request letter, which will be sent soon.

We recognize the importance of these upgrades to the Arrow Lakes Hospital and are looking forward to the completion of this project, which will result in improved healthcare delivery to the residents of Nakusp and surrounding area.

Sincerely,

Donna Lommer, CPA, CGA, EMBA VP Support Services & CFO

/bk

cc: Jane Cusden, Acute Health Service Administrator, Kootenay Boundary Todd Mastel, Director, Business Support Birgit Koster, Director Business Support, Capital Planning

Interior Health Authority VP Support Services & Chief Financial Officer5th Floor - 505 Doyle Ave.Kelowna, BC V1Y 0C5

Telephone: (250) 862-4025 Fax: (250) 862-4201E-Mail: [email protected]

Web: www.interiorhealth.caPage | 1

Mr. Stuart Horn, Secretary West Kootenay Boundary Regional Hospital District c/o Regional District of Central Kootenay Box 590, 202 Lakeside Drive Nelson, BC V1L 5R4

December 15, 2017

Dear Mr. Horn:

RE: CAPITAL FUNDING REQUEST FOR THE 2018/19 FISCAL YEAR

Please accept this annual funding request letter for consideration and approval. Regional Hospital Districts (RHDs) enable Interior Health (IH) to continue to provide high quality health-care services to our patients, clients and residents by funding prioritized capital items. IH is truly grateful for the support the RHDs provide.

For the 2018/19 fiscal year we are requesting funding for the following projects and equipment:

1. Construction Projects Over $100,000

a. Emergency Department Renovation at Arrow Lakes Hospital, NakuspRedevelopment of the Emergency Department (ED) areas will provide the appropriate space capacitynecessary to support the provision of quality patient care within Emergency Services and address theimmediate service delivery challenges experienced by the site. Planning, design and renovations willimprove sight lines and visual oversight to monitor patients, improve infection control standards, addressrisk related to lack of privacy and confidentiality, improve patient flow by decreasing congestion, andprovide appropriate space for essential equipment/supplies. Renovations will provide the High AcuityResponse Team and visiting specialists’ appropriate space to deliver quality patient care. The plan for theexpanded ED is to include four exam bays, one double trauma bay, one office/exam room and onephysician dictation/multi-purpose room. The renovation will be phased to minimize disruption to emergencyservices at the site. IH is in discussion with the Arrow Lakes Hospital Foundation and the Arrow LakesHealth Care Auxiliary on their potential funding participation in this project. We will communicate back toyou the result of those discussions and if there is a change to the funding allocations for this project.

b. Boiler Room at Kootenay Boundary Regional Hospital, TrailThe scope of this project is to install two new dedicated high efficiency domestic hot water boilers andassociated storage tank to provide domestic hot water to the facility. The addition of these boilers will allowfor the decoupling of the domestic hot water system from the existing steam plant. This project will increaseenergy efficiency of the domestic hot water production. This project’s 60% portion will be funded throughthe Ministry of Health’s Carbon Neutral Capital Project initiative.

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c. Secure Room at Boundary Hospital, Grand ForksThe current secure room is to be relocated to a more appropriate location within the hospital as its currentlocation is not close to an external entrance or the ED. The current room does not meet standards and is asafety risk for staff, patients and the RCMP who sometimes need to move patients into the secure room.The scope of work will be to create a new secure room of approximately 14 square meters within theexisting ED that meets the current provincial standards.

d. Waste Water Treatment Plant at Slocan Community Health Centre, New DenverProject is to upgrade the existing 26 year old waste water treatment plant. The current system is at risk offailing which would impact patient care due to lack of sanitary services and risk to the environment withineffective treatment of effluent. The Waste Water Treatment Plant upgrades will include septic field, sandfilter, dosing tank with the associated pumps and controls to allow for improved treatment and processing ofeffluent.

2. Construction Projects under $100,000

a. Washroom Renovations, Wheelchair Access at Kootenay Lake Hospital, Nelson and KootenayBoundary Regional Hospital, TrailThe renovation of patient room washrooms to meet new infection control standards and accessibilityrequirements is required at these sites. These older facilities have accessibility issues for patients and staffwhich can lead to injuries. The scope of work includes washroom enlargement for handicapped access withnew hand washing sink, accessible toilet and infection control approved surfaces.

b. Renovate Ultrasound Area at Kootenay Lake Hospital, NelsonThis project will encompass the renovation of ultrasound rooms, washroom, and adjacent change room andoffice space at this site. The current ultrasound rooms are extremely cramped and lead to imperfectergonomics, temperature control, poor access and it is difficult to move equipment in and out of the rooms.The washroom will be enlarged using the current change room for handicap access which will alleviateaccessibility issues for patients and staff. If space allows the intent is to create a soiled utility room toenable ultrasound probe reprocessing closer to the work area.

c. Surgical Services Supply Air Fan Upgrade at Kootenay Boundary Regional Hospital, TrailThe Kootenay Boundary Regional Hospital surgical services supply air fan was installed in the year 2000and requires upgrades to meet the current air quality standards for orthopedic surgical procedures. Toimprove air quality to this area this project will commence this fiscal year. The scope of work includesupgrading the filtration standard to a High Efficiency Particulate Air (HEPA) filter, replacing the motor,controls, distribution and monitoring.

d. Replace Air Handling Unit at Kootenay Lake Hospital, NelsonThe current air handling unit and reheat heaters are 40 years old and are at the end of their useful life. Thissystem requires significant maintenance to keep it functioning and parts are no longer available. Thisproject will involve the removal of this air handling unit, reheat coils and controls and connect the areaducting to the existing central supply fan system, add new controls, reheat coils and rebalance the hospitalventilation system.

e. Secondary Egress at Friends of Friends Clubhouse, TrailThis site requires a second exit on the main floor for fire and urgent exit purposes. The scope of work willinclude opening the exterior wall on the south side or back of the clubhouse for the installation of a newegress door. A landing and staircase will then be installed to allow safe access to the ground level from thenew egress door.

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3. IH-Wide Information Management Information Technology (IMIT)

In alignment with its IMIT strategy, IH is committed to taking a large leap to advance its digital platform and infrastructure to support health service operations, enable key strategies, improve quality and patient safety, and incorporate innovation to improve effectiveness and efficiency. As emphasis continues on primary and community care transformation, the IH digital platform will support exchange of information between providers to support both team-based and continuity of care. This also includes extending MyHeathPortal features and capabilities for patients to be more involved in their care. The digital platform will also focus on more advanced analytics to assist with planning, decision making and every day management functions.

This IMIT project is an IH-wide initiative costing approximately $19 million. The project’s benefits are distributed equally across IH regions; therefore the cost allocation to each of the seven RHDs is based upon population using the PEOPLE 2017, BC Statistics. The West Kootenay Boundary RHD’s percentage ratio is approximately 11%. Claims on this project will be calculated using this percentage for the actual cost distribution.

4. IMIT over $100,000

a. Vocera Expansion and Integration at Various FacilitiesThis system will provide staff members with a Vocera wearable hands free speaker phone system whichcan be used to enhance communication between staff members at the push of a button. The system will beused for staff-to-staff communication, emergency communication to increase staff efficiency and to supportWorkplace Health & Safety requirements, and will assist in improving patient care. The scope will includedeploying badges to staff and integration with the telephone system at Kootenay Boundary RegionalHospital and Kootenay Lake Hospital.

b. Electronic Emergency Department Medical Summary at Boundary Hospital, Grand ForksCurrently ED documentation is in paper format and therefore ED Physicians in rural sites have indicatedthat they would like to use electronic documentation so they can get this information into their officeelectronic medical record (EMR). This project will implement voice recognition and ED physician electronicdocumentation to enable instant availability of the ED Medical Summary within Meditech and electronictransmission to the family physician EMR.

5. IMIT under $100,000

a. Vocera Expansion and Integration at Various FacilitiesThe description of this project is the same as outlined above in 4a. Due to immediate safety concerns theprojects at Nelson Jubilee Manor and Talarico Place will commence in 2017/18 and Slocan CommunityHealth Centre will follow in 2018/19.

b. Wireless Infrastructure Expansion at Kiro Wellness Centre, TrailThe ability to connect devices wirelessly to the IH data network presents many opportunities for staff,physicians and patients to access information when and where it is needed. Wireless networks are alsorequired to operate complex integrated systems such as staff-to-staff communication systems andspecialized medical equipment linked to a centralized system via a wireless network. This project is toexpand wireless coverage to support the high demand from various clinical and physician initiatives thatrequire wireless connectivity.

c. Radiologist Diagnostic Monitor Replacement at Kootenay Boundary Regional Hospital, Trailand Kootenay Lake Hospital, NelsonThis project will upgrade specialist medical grade monitors used by Radiologists for viewing diagnosticimages like X-Rays, CTs, MRIs and Mammography. The current monitors will soon be out of warranty andIH runs the risk that they may not calibrate properly, could be subject to failure and soon will not display thelevel of quality required for medical imaging.

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6. Equipment Over $100,000

a. Waste/Cardboard Compactor with Renovation for KootenayBoundary Regional Hospital, TrailThis project will include a new commercial compactor/packer roll off combo,container, walk-on dock, container stand assembly, controls and electricalsupply to replace the existing 2000 unit at this site. To address staff, public andcontractor safety there are also renovations required to the loading dock, dockcover, driveway, the stair case/exit door and lighting.

b. Dishwasher/Conveyor System for Kootenay Boundary RegionalHospital, TrailThis energy efficient dishwasher is a fully automatic, conveyor type machinewith a blower-dryer selection. Other items within this system will include asoiled dish table, waste trough, stainless steel tray slides, overhead rack shelf,power roller rack transfer conveyor, clean dish table with backsplash and ahose clean up station. This system is replacing a 2003 machine in the foodservices department.

7. Equipment Under $100,000 (Global Grant)

We are requesting global funding for equipment that costs between $5,000 and $100,000.

We have included as Appendix 1 a financial summary of our funding request, which totals $3,531,400.

IH has noted a significant increase in construction cost escalation in recent months. Detailed cost estimates are being made obsolete within months and in some cases weeks of their creation. The main driver of this escalation appears to be scarcity of qualified sub-trades and increasing raw material costs. IH is meeting regularly with our cost estimators to ensure escalation rates are being accurately estimated, however the volatility of the construction market is making this very challenging. Please be aware during these periods of market volatility we may be put in the unfortunate situation of requesting additional funding for projects, in particular those projects with extended procurement timelines. Alternatively we may need to revisit the scope of a project(s) to fit within available funding. We will keep you apprised in the event that we face substantive changes.

Although the 2018/19 budget has been approved by the IH board, all capital spending over $100,000 regardless of funding source must also be approved annually by government. We will be providing you with information regarding notional government funding and a high level estimate for your planning purposes of the three year funding requirement, as well as a listing of IH’s major prioritized items under separate cover.

It would be appreciated if you could submit our request for funding for these items to your Board for approval. Please apprise us of the meeting date when funding will be discussed and whether you would like to have IH representatives attend to answer questions that the Directors may have. Upon approval, please send Birgit Koster copies of the relevant bylaws for our records.

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If you require further information, or if you have any questions or concerns, please contact Todd Mastel or myself directly.

Sincerely,

Donna Lommer, CPA, CGA, EMBA VP Support Services & CFO

/at

Encl. Appendix 1 ~ Summary of Regional Health District Funding Request for 2018/19

cc: Aimee Watson, Chair, WKBRHD Jane Cusden, Acute Health Service Administrator, Kootenay Boundary Todd Mastel, Director, Business Support Lorne Sisley, Corporate Director, Facilities Management and Operations Birgit Koster, Director Business Support, Capital Planning

Interior HealthWest Kootenay Boundary

Summary of Regional Hospital District Funding Requestfor 2018/19

Appendix 1

Location

Construction Projects over $100,000

Arrow Lakes Hospital Nakusp Emergency Department Renovation $ 2,100,000 $ 840,000 $ 840,000

Kootenay Boundary Regional Hospital Trail Boiler Room 500,000 200,000 200,000

Boundary Hospital Grand Forks Secure Room 400,000 160,000 160,000

Slocan Community Health Centre New Denver Waste Water Treatment Plant 360,000 144,000 144,000

Construction Projects under $100,000

Kootenay Lake Hospital Nelson Washroom Renovations, Wheelchair Access 98,500 39,400 39,400

Kootenay Boundary Regional Hospital Trail Washroom Renovations, Wheelchair Access 95,000 38,000 38,000

Kootenay Lake Hospital Nelson Renovate Ultrasound Area 95,000 38,000 38,000

Kootenay Boundary Regional Hospital Trail Surgical Services Supply Air Fan Upgrade 95,000 38,000 38,000

Kootenay Lake Hospital Nelson Replace Air Handling Unit 85,000 34,000 34,000

Friends of Friends Clubhouse Trail Secondary Egress 60,000 24,000 24,000

IH-Wide IMIT

Regional Various 2,011,000 804,400 804,400

IMIT over $100,000

Kootenay Boundary Regional Hospital Trail Vocera Expansion and Integration 450,000 180,000 180,000

Kootenay Lake Hospital Nelson Vocera Expansion and Integration 285,000 114,000 114,000

Boundary Hospital Grand Forks Electronic Emergency Department Medical Summary 170,000 68,000 68,000

IMIT under $100,000

Slocan Community Health Centre New Denver Vocera Expansion and Integration 76,000 30,400 30,400

Nelson Jubilee Manor Nelson Vocera Expansion and Integration 75,000 30,000 30,000

Talarico Place Castlegar Vocera Expansion and Integration 75,000 30,000 30,000

Kiro Wellness Centre Trail Wireless Infrastructure Expansion 53,000 21,200 21,200

Kootenay Boundary Regional Hospital/Kootenay Lake Hospital

Trail/Nelson Radiologists Diagnostic Monitor Replacement 36,000 14,400 14,400

Equipment over $100,000

Kootenay Boundary Regional Hospital Trail Waste/Cardboard Compactor with Renovation 465,000 186,000 186,000

Kootenay Boundary Regional Hospital Trail Dishwasher/Conveyor System 296,000 118,400 118,400

Equipment Under $100,000 (Global Grant)

All Facilities Equipment between $5,000 and $100,000 948,000 379,200 379,200

TOTAL $ 8,828,500 $ 3,531,400 $ 3,531,400

Facility Total Budget Equipment/Project Description 2018/19 Funding Request RHD Share

TO: WKBRHD BOARD OF DIRECTORSFROM: Stuart Horn, Secretary/TreasurerSUBJECT: Preliminary Draft 2018 Budget ScenariosDATE: February 28, 2018 Open Regular Meeting

PURPOSEStaff was requested to prepare preliminary budget scenarios for 2018 based on the IHA CapitalRequest Letter.

Please note that these budget scenarios are subject to change based on the final 2017 numbersand any Board recommendations.

ANALYSIS AND IMPACT ON TAXATION AND RESERVES (Attached at Schedule A)

Scenario Net Contribution toCapital Reserve

Tax Requisition Increase/(Decrease)from 2017 Taxation

Scenario A $258,050 $4,816,337 0%Scenario B $(220,000) $4,341,787 (9.9%)Scenario C $660,000 $5,221,787 8.4%Scenario D $1,160,000 $5,721,787 18.8%

The net reserve contributions indicated above reflect that in each of the budget scenarios the2018 contributions to reserves are offset by the Arrow Lakes Hospital project contribution of$840,000 paid from reserves as required by bylaw. This project has been included in thebudget scenarios as it is part of the $3.5 million IHA capital request. Although some of this cashoutlay may be made in 2019, staff has included it all in 2018 as the payment schedule, orestimates of, has not been provided.

Attached at Schedule B is a reconciliation of the reserve balance as at December 31, 2017. Thereconciliation includes all commitments to date for the Arrow Lakes Hospital as well as theKootenay Boundary Regional Hospital.

The KBRH project Phase 1 will also be paid from reserves with costs coming during 2018. Thiswill be included in future iterations of the budget based on further information received fromIHA on the potential payment requirements in 2018.

Should Phase 2 and 3 of the KBRH Sustainability project go forward, the current estimate ofapproximately $24 million for those phases would result in a 40% share of $9.6 million for theWKBRHD. After commitments to date shown in Schedule B, the reserve balance will be $5.2million after the Arrow Lakes Hospital project and KBRH Phase 1 is complete.

WKBHRD Board Report – 2018 Budget Scenarios February 28, 2018 Page 2

Of note is that the long term loan from 2007 for Grand Forks Hospital was paid off in 2017. Thisprovides over $600,000 in cash flow in the budget for 2018.

RECOMMENDATION:

That the Board receive this report for information.

ATTACHMENTS:Schedule A – 2018 Preliminary, Draft Budget Scenarios.Schedule B – 2017 Reserve Balance with Commitments

Draft for Board Discussion - February 28, 2018 Schedule ADraft For Discussion

Subject to Change

A B C D2017 2017 2018 2018 2018 2018

Estimated Scenario A Scenario B Scenario C Scenario DBudget Actuals Budget Budget Budget Budget

REVENUE 0.0% -9.9% 8.4% 18.8%

Tax Requisition Total 4,816,337$ 4,816,337$ 4,816,337$ 4,341,787$ 5,221,787$ 5,721,787$ Contributions from Capital Reserves 840,000 840,000 840,000 840,000 Grants in Lieu of Taxes 8,000 13,456 9,500 6,000 6,000 6,000 Investment Income 85,000 10,802 75,000 75,000 75,000 75,000 Surplus Previous Year 2,967,117 2,967,117 1,627,070 1,627,070 1,627,070 1,627,070

TOTAL REVENUE 7,876,454$ 7,807,712$ 7,367,907$ 6,889,857$ 7,769,857$ 8,269,857$

EXPENDITURES

Capital Grants:Section 20(3) Expenditures:A. Commitments from prior periods 3,143,986$ 3,529,214$ 1,692,252$ 1,692,252$ 1,692,252$ 1,692,252$ B. Current Projects for Hospitals & Hospital Facilities 2,077,480 - 3,531,400 3,531,400 3,531,400 3,531,400 B.1 Minor Equipment Global Grant 377,400 377,400 379,200 379,200 379,200 379,200 F. Contributions to Capital Reserve Fund 994,075 994,075 1,098,050 620,000 1,500,000 2,000,000

Total Capital Grants 6,592,941$ 4,900,689$ 6,700,902$ 6,222,852$ 7,102,852$ 7,602,852$

Debt Servicing:A. Servicing Current Debenture Issues 1,147,506$ 1,147,506$ 527,506$ 527,506$ 527,506$ 527,506$

Total Debt Servicing 1,147,506$ 1,147,506$ 527,506$ 527,506$ 527,506$ 527,506$

Other ExpensesSection 17(2) Expenditures Administration Agreement 85,857$ 85,857$ 87,574$ 87,574$ 87,574$ 87,574$ Director Remuneration 23,000 21,445 25,000 25,000 25,000 25,000 Director Travel Expenses 16,000 15,265 16,000 16,000 16,000 16,000 External Audit 7,200 7,000 7,000 7,000 7,000 7,000 Officer Travel - - - - - - Insurance 600 725 725 725 725 725 Office Supplies 350 - 200 200 200 200 Meeting Expense 3,000 2,155 3,000 3,000 3,000 3,000

Total Other Expenses 136,007$ 132,448$ 139,499$ 139,499$ 139,499$ 139,499$

TOTAL EXPENDITURES 7,876,454$ 6,180,643$ 7,367,907$ 6,889,857$ 7,769,857$ 8,269,857$

Surplus/Deficit -$ 1,627,070$ (0)$ (0)$ (0)$ (0)$

Residential Property Tax per $1,000 of Assessment 0.2677 0.2414 0.2903 0.3181Assessement

100,000$ $26.77 $24.14 $29.03 $31.811798834101 200,000 53.55 48.27 58.06 63.62

250,000 66.94 60.34 72.57 79.52 300,000 80.32 72.41 87.09 95.42 350,000 93.71 84.48 101.60 111.33 400,000 107.10 96.55 116.11 127.23

WEST KOOTENAY-BOUNDARY REGIONAL HOSPITAL DISTRICT - 2018 DRAFT Budget Scenarios

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Schedule B

West Kootenay Boundary Regional Hospital DistrictFebruary 28, 2018 Open Regular MeetingReserve Reconciliation as at December 31, 2017 with projected commitments.

Amount ($)

Balance at December 31, 2016 11,217,006$

Contribution 2017 + 994,075Interest (Estimated) 2017 + 84,000

12,295,081

2017 Commitment for KBRH Phase 1 411,000Future Commitment for KBRH Phase 1 5,829,000

6,055,081

Commitment for Arrow Lakes Hospital 840,000

Reserve Balance after Commitments 5,215,081$

DRAFT: For Discsussion Only and subject to Change

Notes:Commitments are based on adopted bylaws to date.No further contributions to reserve have been included absent Board direction.

West Kootenay Boundary Regional Hospital District2017 Schedule of Apportionment

Section 24 of The Hospital District Act

For Board Discussion March 22, 2017

MunicipalityElectoral Area

COMPLETED 2018 Converted Assessments

Regional District of Central Kootenay 06-CK06-CK Castlegar 184,304,72906-CK Nelson 260,573,56406-CK Kaslo 17,321,48506-CK New Denver 7,803,425 06-CK Nakusp 24,307,56106-CK Salmo 11,857,95906-CK Silverton 4,542,750 06-CK Slocan 4,220,127

514,931,600

06-CK Area A (portion) 34,104,20706-CK Area D 38,283,46806-CK Area E 96,492,04506-CK Area F 89,496,31206-CK Area G 38,786,98306-CK Area H 80,110,53906-CK Area I 42,073,50106-CK Area J 59,823,62406-CK Area K 39,457,190

518,627,869

SubTotal for Regional District 06-CK 1,033,559,469

08-CS Area B 7,366,578

SubTotal for Regional District 08-CS 7,366,578

Regional District of Kootenay Boundary 16-KB16-KB Grand Forks 69,025,24516-KB Greenwood 7,664,594 16-KB Rossland 70,255,81016-KB Trail 176,143,55016-KB Fruitvale 22,753,69916-KB Midway 11,800,41116-KB Montrose 11,320,42816-KB Warfield 17,455,074

386,418,81116-KB Area A 68,155,82516-KB Area B 39,552,76216-KB Area C 78,016,87516-KB Area D 52,656,55316-KB Area E 133,107,228

371,489,243

SubTotal for Regional District 16-KB 757,908,054

1,798,834,101

SubTotal for Municipalities 901,350,411SubTotal for Electoral Areas 897,483,690

1,798,834,101

Regional District of Columbia-Shuswap 0

Total for West Kootenay-Boundary Regional Hospital District

Total for West Kootenay-Boundary Regional Hospital District

Page 1 of 1

Greetings Mike, Here is our submission below. Margaret

From: Margaret Crawford <[email protected]> Date: Saturday, December 2, 2017 at 1:14 PM To: Kathy Moore <[email protected]> Subject: Letter of Submission to the Select Standing Committee on Finances and Government Services

October 11, 2017——Castlegar, B.C.

Letter of Submission to the B.C. Select Standing Committee on Finances and Government Services

We, concerned citizens of the West Kootenays, have been dismayed by the erosion of services provided at our Kootenay Boundary Regional Hospital in Trail, B.C. since 2001. This erosion has resulted in a toxic environment at our hospital in which there is very low staff morale and confidence. Being micro-managed from an urban centre (Kelowna) just does not work as there is a great lack of understanding as to what a rural community needs and deals with, particularly in the winter months.

This centralization of services requires patients to travel four hours one way to Kelowna, to pay for accommodation and meals there and, in many cases, to find someone to drive them or some method of transportation there and back. Greyhound Bus is wanting to reduce services between Trail and Kelowna to two trips a week. There is a volunteer driver program out of Castlegar, but it costs $250.00 a day to Kelowna and most seniors can not afford this. If the patient has to stay over-night, and often you would have to do so, then the patient must pay for the driver’s accommodation as well as their own. This gets very expensive!

To our citizens, this is not cost-effective for anyone and we feel that providing medical services closer to home is a much more viable solution.

Along with the diminution of other services, we want to address the issue of the loss or cutting back of key physicians and surgeons at KBRH—-Dr. H. Ukpeh, our paediatrician, Dr. V. Loyola, our pathologist, Dr. A. deGreef, our plastic surgeon. Others have seen their hours cut or their ability to provide services reduced. Dr. Ukpeh and Dr. Loyola have both now relocated, in spite of wanting to stay in this area. Dr. deGreef is still here and wanting to stay. Last fall (2016) the manpower committee of Interior Health said that there was enough work in this area for two full-time plastic surgeons. This past spring, one new plastic surgeon was hired with a specialty in hand surgery. This is the area on which he wishes to focus. By the end of June 2017, IH said that they were not recruiting any further plastic surgeons beyond the one they had hired in May 2017. IH claims there is no longer any wait list for plastic surgery, but in actual fact, there is a very long waiting list. October 2016 there was a waiting list of 2,000 patients. Where did they all go?

We understand that Fernie, B.C. has been given funding under the Rural Coordination Centre of B.C. in order to provide surgical and obstetric services locally because studies have shown that delivery of these services closer to home is more cost effective. Would this same funding be available to us here in the West Kootenay?

We need the funds to restore the lost services at Kootenay Boundary Regional Hospital. Please hear us on this important issue!

Sincerely,

The Society for the Protection and Care of Seniors, Trail, B.C,

On Dec 7, 2017, at 12:08 PM, Mike Morrison <[email protected]> wrote:

Greetings Mike,

We are members of the Society for the Protection and Care of Seniors here in Trail and have heard ongoing concerns from staff over the years since the inception of IHA regarding KBRH.

October 11/17 we did a verbal/written submission to the Select Standing Committee on Finances and Government Services in Castlegar. We feel that the WKRHospital Board should be aware of these same concerns and Mayor Moore of Rossland suggested that we email you for advice as to how to proceed. We are enclosing a copy of our letter of submission, but have other documentation as to what we have tried to do over the past year since the fall of 2016 to no avail. We will forward the latter to you if you wish.

QUESTIONS: —Is it important for a delegation to present our submission to the WKRHospital Board at their January 24/18 or subsequent meeting? —We are wondering if the WKRHospital Board has the ability to request a confidential and anonymous survey be conducted of KBRH staff, including physicians, surgeons and unionized/ non-unionized staff.

Sincerely,

Janice Androsoff, President SPCS (phone-250-362-9501) Margaret Crawford, Board member SPCS (phone-250-368-5054)

WEST KOOTENAY BOUNDARY REGIONAL HOSPITAL DISTRICTDIRECTOR STIPEND PAYMENTS AND ACCOUNTS PAYABLE SUMMARYNov Dec 2017

DIRECTOR STIPENDS (details attached) 3,854.00$

ACCOUNTS PAYABLE (details attached) 112,401.21$

TOTAL 116,255.21$


Invoice Date Description Invoice # Amount Paid

Interior Health Payments27/11/2017 WKBRHD BYLAW 237 C2 6017023_2 1,957.44$27/11/2017 WKBRHD BYLAW 238 C2 6017025_2 2,870.20$17/11/2017 WKBRHD BYLAW 267 C1 6018013_1 37,065.71$12/04/2017 WKBRHD BYLAW 255 C7 6315002_7 3,438.57$13/12/2017 WKBRHD BYLAW 265 C1 B/L 265 1 63,739.04$

Other

REGIONAL DISTRICT OF CENTRAL KOOTENAY15/11/2017 WKBRHD EXPENSES R170409 245.75$

CASTLEGAR RECREATION DEPARTMENT23/11/2017 WKBRHD ROOM RENTAL/COFFEE Nov 23 2017 356.36$

RECEIVER GENERAL22/12/17 WKBRHD REMITTANCE CRA 2017 Dec 22 2017 238.83$

109,911.90$


Director Expense ReimbursementsEmployee # Name: Invoice # Amount Paid1004 CUNNINGHAM, HANS NOV 22 2017 81.54$1014 GRIEVE, ALISON K NOV 22 2017 46.70$1015 HAMLING, KAREN E NOV 22 2017 181.38$1017 JACKMAN, GARRY A NOV 22 2017 142.90$1021 MCGAULEY, PEGASIS P NOV 22 2017 72.80$1024 PETERSON, PAUL T NOV 22 2017 222.98$1025 POPOFF, WALTER A NOV 22 2017 31.20$1027 ROTVOLD, MARGUERITE R NOV 22 2017 196.98$1036 MCGREGOR, GRACE E NOV 22 2017 111.70$1041 WORLEY, LINDA NOV 22 2017 45.14$1058 BUNKA,ANN NOV 22 2017 28.50$1069 DAVIDOFF, ANDY NOV 22 2017 42.02$1075 WATSON, AIMEE NOV 22 2017 146.02$1085 RUSSELL, ROLAND NOV 22 2017 130.42$1091 WEBBER, TABATHA NOV 22 2017 75.30$1092 DANCHUK, JOE NOV 22 2017 72.70$1102 KOZAK, DEB NOV 22 2017 46.80$1103 HEWAT, SUZAN NOV 22 2017 261.13$1104 NEWELL, THOMAS NOV 22 2017 85.70$1108 SMITH, RICK NOV 22 2017 12.48$1112 WHITE, STEPHEN NOV 22 2017 74.26$1118 NATHORST, JIM NOV 22 2017 174.10$1119 PARKINSON, ARLENE NOV 22 2017 61.78$1122 JOLLY, KEVIN NOV 22 2017 60.74$1122 JOLLY, KEVIN OCT 25 2017 55.54$1123 CLARKE, JASON NOV 22 2017 28.50$

2,489.31$

Total Accounts Payable Nov Dec 2017 112,401.21$

Stipend


Emp.# Name Given Name Chair Stipend Travel Time Stipend Total Total503 Cunningham Hans 110.00$ 110.00$513 Grieve Alison 110.00$ 110.00$514 Hamling Karen 60.00$ 110.00$ 170.00$516 Jackman Garry 49.00$ 110.00$ 159.00$520 McGauley Pegasis 110.00$ 110.00$523 Peterson Paul 73.00$ 110.00$ 183.00$524 Popoff Walter 110.00$ 110.00$526 Rotvold Marguerite 73.00$ 220.00$ 293.00$537 McGregor Grace 49.00$ 110.00$ 159.00$540 Worley Linda Jean 110.00$ 110.00$545 Bunka Catherine 49.00$ 110.00$ 159.00$568 Davidoff Andy 110.00$ 110.00$573 McIntosh Deborah 110.00$ 110.00$574 Watson Aimee 165.00$ 98.00$ 220.00$ 483.00$578 Russell Roland 49.00$ 220.00$ 269.00$580 Webber Tabatha 110.00$ 110.00$581 Danchuk Joseph 110.00$ 110.00$585 Newell Thomas 110.00$ 110.00$586 Kozak Debra 110.00$ 110.00$592 Smith Ricky 110.00$ 110.00$601 White Stephen 110.00$ 110.00$605 Nathorst Jim 60.00$ 110.00$ 170.00$606 Parkinson Arlene 110.00$ 110.00$608 Jolly Kevin 110.00$ 110.00$653 Clarke Jason 49.00$ 110.00$ 159.00$

Report Totals 165.00$ 609.00$ 3,080.00$ 3,854.00$

3,854.00$

regular board meeting open meeting agenda

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