ahs capital submissions 2010-13

8/21/2019 AHS Capital Submissions 2010-13

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AHS Facility Infrastructure Capita2011/12 2013/14

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Acknowledgements

This Facility Infrastructure Capital Submission was developedwith the input and involvement of many people from across

Alberta Health Services. These teams identified andprioritized the projects presented in this plan.

Special thanks are in order for our four capital working groups

Acute Care Capital Working Group

David Diamond, Senior VP Regional Hospitals Chair

Joanna Pawlyshyn, VP Royal Alexandra Hospital Co-chair

Sue Gudmundson, VP Peter Lougheed Hospital

Glenda Coleman-Miller, VP UAH, Stollery and

Mazankowski Alberta Heart Institute

Mario Chies, VP Diagnostic Imaging

Kerry Bales, VP Central Zone

D T Fi ld VP C C

Support Services Cap

Susan McKay, V

Tammy Hofer, E

Jeff Whissell, Di

Brian Van SkServices

Anthony WeeServices

Gail Hufty, VP P

Stephen Marois

Andrew Sharm

Clinical Coordin

And the following indivworking groups:

Allen Amyotte E

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AHS 2011-2014 Facil

5.3.9.

Northern Lights Regional Hospital Renovations.............. 49

5.4.Support Services ............................................................ 50

5.4.1. Asset Management Refurbishments and Demolition....... 50

5.4.2. Foothills Medical Centre Kitchen Renovation.................. 52

5.4.3. Province-Wide Laundry Consolidation ............................ 53

5.4.4. Provincial Sterile Instrument Processing......................... 54

5.4.5.

Glenrose Rehabilitation Hospital..................................... 56

5.4.6. Pharmacy Services Central Production Facility............... 57

5.5.Parkades ........................................................................ 58

5.6.Capital Transition Initiative.............................................. 58

6.0Lease Plan ........................................................................... 59

7.0Asset Divestiture Plan .......................................................... 61

8.0

Conclusion and Next Steps .................................................. 63

Appendix I: Capital Submission Link to AHS Key Focus Areas... 65

Appendix II: Capital Projects Underway...................................... 67

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AHS 2011-2014 Facil

Executive Summary

The Facility Infrastructure Capital Submission describes prioritycapital needs for Alberta Health Services (AHS) and supports our

AHS Strategic Plan as well as governments Vision 2020directional plan. The plan also anticipates major health trends andacknowledges the condition of our existing facility infrastructure.

This plan has been developed around five themes:

Improving access to high priority health services,

Improving access to rural health services,

Supporting new service delivery models with theconversion of existing sites,

Supporting re-alignment or consolidation of regional

services, and Preserving and improving the condition, functionality and

safety of sites including improved work flow.

We identify nineteen (19) capital projects ranging in value from $3

Another large and strathe implementation of temphasis on increasachieved, this shift wisystem as a whole, pwider variety of carecoordinated support of Seniors and Community

Other priority capital proimprove primary andcommunities, upgradconsolidating EMS andaddressing some partic

The Facility Infrastructuwith input from staff fro

Additional capital projeservice plans continue t

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AHS 2011-2014 Facil

1.2. AHS Strategic Plan

The plan entitled Albert Health Services Strategic Directions2009-2012 Defining Our Focus / Measuring Our Progressdescribes our corporate goals, focus and key priorities. Thestrategic plan serves as a guide into the future and will berefreshed each year to reflect the ever shifting challenges of ourdynamic health system.

Everyone throughout Alberta Health Services contributes toachieving the goals and priorities described in our strategic planwith portfolio specific action plans as tracked through individualexecutive accountability agreements.

The strategic plan has 3 goals, 8 areas of focus and 20 strategicpriorities.

The three goals, Quality, Access and Sustainability, are

essential to our future success as an organization as measured bythe health and satisfaction levels of Albertans, their ability toaccess the health system and our ability to meet these goalswithin sustainable budgets.

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AHS 2011-2014 Facility

Our population is aging. While todays percentage ofpeople 65 years and older is 11%, it is expected to reachalmost 20% over the next 2 decades as the baby boomgeneration ages.

Older people use more health services. Our Alberta healthsystem must expand the number and scope of primary andcommunity health centres to help older Albertans remainactive and healthy with special reference to the

management of chronic disease. Also, for those olderpeople no longer able to remain in their own homes, weneed to provide long term care and supportive livingfacilities that promote independence and a high quality oflife.

Albertans make substantial use of our most expensivehealth system resource acute care hospitals. Eachyear, on average, 1 in 13 people are admitted to hospital

and 3 in 10 people visit emergency. New facilities areneeded to provide people with more efficient and easilyaccessible care options including more ambulatory care,more extended hour clinics and more urgent care centers.

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4.0 Overview of InfrastructureServices are delivered through five administrative zones (seezone map). Most services are directly delivered by AHS butwe also fund many services as provided by the CovenantHealth Group and other voluntary and private partners.

AHS also has key partnerships with universities andcommunity colleges acknowledging our shared responsibility

to educate and train the health professionals of the future andsupport ongoing biomedical and health sciences research.

We are responsible for owning and operating, funding orleasing many facilities. In fact, we are one of the largestproperty owners and landlords in Canada.

At present, AHS is managing a capital program with a total

Owned Facilities 2,950,678 m 91.5%

Leased Facilities 274,255 m2

8.5%TOTAL: 3,224,933 m

2 100.0%

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If all the building spaces occupied by AHS for our many andvaried functions were converted to sports fields, it would equal550 regulation sized CFL football fields.

Managing and maintaining this huge investment is a largetask. As already noted, careful and prudent management ofour capital assets is a major theme in this Capital Submission.

4.1. AHS Owned Space

AHS owns 91% of our total facilities resource, including manyof the facilities operated by the Covenant Health Group (e.g.Edmonton Grey Nuns Hospital).

The following table provides a high level snapshot of AHSowned facilities.

PRIMARY USE NUMBER OF

AHS OWNED

FACILITIES

BUILDING

SPACE M2

Acute Care 111* 1, 782,678

Primary and Community Care 118 464,853

nursing homes and owned and operated

A surprising amoaccommodate EMSand like support ser

4.2. Functional COwned Spac

As buildings age, prperformance occurs. periodic capital invesrenovations. On averhealth facility infrastrdeterioration occurring the extent that AHS mgiven facility, the facility

or 60 years or longer.Alberta Infrastructure functional condition of less than half of our fac

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4.3. Leased SpaceAHS leases 9% of our total facility resource including manypublic health and mental health clinics located in neighborhoodshopping centres across our province. Leasing is a helpfulasset strategy when it is important to be flexible so that servicelocations can adjust to changing demographics or whenadditional space is needed quickly. However, leasing can be acostly option, particularly in boom times, and AHS presently

spends almost $60 million per year on space rentals andrelated operating costs.

AHS PAYABLE LEASES 2009

Primary Use Numberof

Leases *

LeaseRentableArea M

2

Annual TotalCost **

$

Total Cost M2

$/ M2

Administration 23 63,004 17,281,463 274.27

ClinicalCommunity

138 101,475 19,804,803 195.16

Mental Health 39 20,195 4,196,660 207.75

Warehouse /

AHS is in the processoffice type spaces, withreducing costs. In manopportunities of co-locapreferably existing AHimproved staff teamworpatient and client conve

We are also exploringhome which can be attand may be cost effectiv

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4.4. Summary of Capital Projects Underway

At present, almost $5 billion of approved capital projects are inactive design or construction. Most were initiated by the priorhealth regions with service plan assumptions and expectationsthat may not necessarily align with todays fiscal realities andservice delivery directions.

The majority of project spending involves the renovation,

replacement and/or expansion of acute care hospital services(86%), and is for facilities located in Edmonton or Calgary(84%).

Taken as a whole, capital projects already underway representa huge investment in facility infrastructure which will benefit

Albertans for many years to come. A detailed table of largerexisting projects can be found in Appendix II. This list is notcomprehensive and excludes many approved and ongoing

projects (e.g. IMP projects), as described in Appendix III.AHS has reviewed and reconsidered the scope of some planssuch as redevelopment of Medicine Hat Regional Hospital andthe Strathcona Community Hospital to ensure that maximum

Commencing in 2010, nbe managed by Albertamany construction, reindividual value of up toby AHS.

AHS will continue to haand prioritizing all newsupport our strategic dir

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4.5.4. Northern Lights Regional Health Centre $6.55 Million

The major outstanding safety issue is the redevelopment ofthe Central Services Room to meet standards for sterilization.

A $3.7 million project was approved by the previous boardprior to Alberta Health Services but capital dollars are notavailable in this fiscal year. New sterilization equipment waspurchased by the previous board but can not be installed until

renovation work is completed.There are also two projects related to the preservation of theexisting site: upgrading of the building automation systems($350,000); and upgrading of the elevator systems ($2.5million).

4.5.5. Queen Elizaof Services

Through its internal revPrairie, Alberta Healthcurrent Queen Elizabeaccommodate serviceshorizon.

If this option is necessa

the next two years for th

To update a 2002 the existing site.

To purchase adjacesite.

For detailed planninof phase I of the r

day procedures exp

This approach is tproject to redevelop

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4.6. 2010 Capital RequestsLast summer, AHS Executive submitted an abbreviated CapitalSubmission (urgent capital priorities). Two project requests havebeen approved by AHW and submitted for Treasury Boardconsideration.

Redevelopment of bone marrow transplant unit at theFoothills Medical Centre, Calgary ($25 million)* (safety &capacity issues)

Renovations to the Tom Baker Cancer Centre / Holy CrossCentre, Calgary ($14 million) (interim solution)

Other projects were identified at that time for funding by AHW,some included:

Development of Pharmacyproduction and distributioncentre, Calgary

Business case complete

Transitional, community basedmental health facilities to providefor more timely discharge ofpatients from acute care facilities

Business case complete

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5.0 Strategic Capital PrioritiesEighty-seven potential capital projects were prioritized for theinclusion in the Capital Submission using the AHS Capital ProjectPriority Screening Framework which is based on the AHSStrategic Plan. Investments were considered in five health planimprovement programs (building a primary care foundation,choice and quality for seniors, improving access, reducing waittimes, and corporate improvements) and four separate program

areas:

Primary and Community Care Acute Care

Seniors Care Support Services

Explicit criteria of: Access (clinical need, priority access), Quality(safety; efficient / effective delivery) and Sustainability (reducescosts; optimizes existing assets) were applied to screen projects.Projects ranking high across at least three criteria dimensions

were included on the prioritized list below. Projects that may beconsidered for inclusion in a future capital submission as serviceplans and finances permit are listed in Appendix V.

In keeping with strategic intent of AHS and AH&W and following

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5.2. Seniors Care

5.2.1. Seniors Care Capital Submission

Project Description / Scope of Work: Over the next 6 years,this province-wide plan will see a major increase in systemcapacity to care for our growing number of older people to beachieved through the development of additional supportiveliving units.

Our strategy will keep the number of long term care spacesconstant at around 14,000, while increasing supportive livingspace to an overall seniors care bed total of 120 continuingcare beds per 1000 population 75 years and older.

The total planned increase of bed spaces over the next threeyears is 4,488

3-Year Planned Bed Capacity Increase by Zone

2010/11 2011/12 2012/13 Total

Calgary 564 696 624 1,884

based LTC (nursing (supportive living) to mtarget was never identwas not achieved andneeds of our seniors exceeds the available c

ALC

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10 years in accordance with Albertas Continuing Care Action

Plan.

Alternate Delivery Options: This plan will be delivered inpartnership with the voluntary and private sectors that willconstruct and operate these new facilities by way ofpartnership agreements.

AHS is also working with Alberta Infrastructure to developplans and designs for modular, pre-fabricated continuing care

facilities which hold the potential for reduced capital costs andfaster project delivery.

Timelines and Implementation Plans: These projects to beinitiated as partnership projects starting as soon as possible.

Stakeholder Consultation: TBD

Proposed Funding Sources: Alberta Seniors andCommunity Supports, AI capital grants and partnership

organization fundingNeed: Immediate

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Alternate Delivery Options: Existing decentralized

approach with outpatient ambulatory urology work beingcarried out at Grey Nuns, Misericordia and Royal AlexandraHospitals along with private urology offices and clinics at theHys Centre office building.

Timelines and Implementation Plans: Estimated as follows:detailed design 3 months and construction 6 months.

Stakeholder Consultation: The Edmonton area urologists

have been advocating for this service consolidation for anumber of years.

Proposed Funding Sources: AI capital grants andfundraising

Need: Immediate


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Current Status of Project:

A functional program has been completed (April 2009).

The endoscopy suite project has been anticipated in theexisting site master plan.

Alternate Delivery Options:

The project could be phased:

o Phase 1 - $9.0 million, replacement of existing capacity

o Phase 2 - $8.9 million, introduction of new capacity

Timelines and Implementation Plans: It is estimated thatthe full project will take only 12 months to complete and muchof the design work is already completed.

Stakeholder Consultation: Site clinicians and managementstaff have been involved in preparing the functional programand completing preliminary design.

Proposed Funding Sources: AI capital grants

Need: Immediate


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Operating Expenditure Impact: Operating cost neutral or

possibly decreasing operating costs.

Risk of Non-Approval: The risk varies from actual loss ofservice, where facilities are at risk of being removed (e.g.lease expiry or change of contracted operator) to ongoing orfurther delays in ambulance response time to the public, aswell as impacts on EMS efficiency across the province.

Current Status of Project: A preliminary business case hasbeen completed with a focus on the Edmonton EMS regionalservices support facility (see Appendix VII). Planning on thetransition of other EMS facilities across Alberta is till ongoing.

Alternate Delivery Options: In the case of lease expiry andchange of ownership from contracted services andmunicipalities there are very few alternate options. Continue tolease smaller, less efficient facilities may be the option in somecases.

Timelines and Implementation Plans: Two to five years.Stakeholder Consultation: EMS administration provincewide is engaged with Capital Management in review of


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Given the significant change in the health system over the past

two years, there will need to be a review and revision of thecancer centre functional program to reflect new thinking andnew service possibilities.

Immediate work will begin to select a preferred site for thecancer centre possibly including the west campus of theUniversity of Calgary, the Foothills Medical Centre and SouthCalgary Health Campus locations.

Alternate Delivery Options: Alberta Infrastructure will beaccountable for managing this major capital project and maywish to explore the potential for an alternate financingapproach for this project given the magnitude of theundertaking.

Timelines and Implementation Plans: Given the advancedstate of planning for the interim stage of this Calgary cancerinitiative, the Tom Baker Cancer Centre and bone marrowrenovation project should be completed within 18 months to 2years.

The cancer centre will take 6 to 7 years to complete dependingon how quickly a site can be confirmed and the functional


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5.3.9. Northern Lights Regional HospitalRenovations

Project Name: Northern Lights Regional Hospital BuildingInfrastructure Improvements

Project Description / Scope of Work: The Fort McMurrayhospital badly needs to have some of its infrastructurerenewed. Three high priority areas are installation of newsterilizers in the central instrument processing department,replacement of the building management system (CCMS) andupgrading of elevators.

Rationale for Project: Preservation of a busy and importantregional hospital facility.

Relationship to Service Plan / Strategic Priorities:

Reinvesting in existing infrastructure is an underlyingtheme in the current Capital Submission.

This is an element in our proposed regional hospitalsinitiative as described earlier in this report.

Alternate Delivery Opt

Timelines and Implemcompleted within 12 to

Stakeholder Consulta

Proposed Funding So

Need: Immediate


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AHS 2011 2014 Facility

Alternate Delivery Options: N/A

Timelines and Implementation Plans: Timeline is underdevelopment. The estimated time from project funding tocompletion is 24 months.

Stakeholder Consultation: Advice and input from AHSFacility Maintenance & Engineering staff.

Proposed Funding Sources: AI capital grants andInfrastructure Maintenance Program funding

Need: 3 year

Note:The elevator upgrades for the Northern Lights RegionalHospital will be covered if permission is received to reallocateregional hospital capital funding across all five regionalhospitals as outlined in section 4.5 of this plan.


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y

5.4.3. Province-Wide Laundry ConsolidationProject Name: Province-wide Laundry Consolidation

Project Description / Scope of Work: Four green field siteprojects proposed: Lethbridge, Ponoka, Grande Prairie andnorth east of Edmonton (TBD) as high level scope

Rationale for Project: There are currently 72 laundries inoperation. Many are in poor condition in terms of facilityand/or equipment. Several have unsafe conditions related to

their equipment. Most are located in the basement of existingfacilities with limited space for growth.

Relationship to Service Plan / Strategic Priorities: Fit forthe future and living within our means

Capital Project Cost Estimate / Specific Approval beingrequested: Four (Lethbridge South, Ponoka/Red Deer,Grande Prairie and Edmonton North) fully functioning, highlyautomated linen facilities for a total of $71.0 to $101.0 million.

This project will likely be phased with the first phase being thedevelopment of a laundry facility in Lethbridge ($18.7 to $26.3million).These costs are preliminary and will be confirmed as

Stakeholder ConsultaServices.

Proposed Funding Sofunding

Need: Immediate


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Alternate Delivery Options: It is assumed that Red Deer

and Fort McMurray will always provide processing serviceswith potential need to increase their capacity to serve smallercentres. As audits are finalized, strategy to address capacitywithin the most appropriate locations will be determined, withpotential to increase capacity at larger acute centres,redevelop some existing sites, and even develop new morecentralized processing capacity to improve efficiency andeconomy of service delivery.

Timelines and Implementation Plans: Red Deer within 2years of project approval. Fort McMurray - within one year ofproject approval. Other high priority sites will be within theshort term category.

Stakeholder Consultation: IP&C, AHS Tertiary Hospitaladministration, CPSM, site specific management have beeninvolved in reviews.

Proposed Funding Sources: Capital Transition Initiative, AI

capital grants and Infrastructure Maintenance Program funding

As an interim measure, AHS would like to allocate $10 millionper year for this provincial project starting in 2011/12



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5.4.5. Glenrose Rehabilitation HospitalProject Name: Glenrose Rehabilitation Hospital, Facility

Accessibility Project

Project Description / Scope of Work: Many areas of thismajor rehabilitation hospital are not barrier free; do not meetaccessibility standards and pose a safety risk for disabledpatients. This project will see a major focus on upgrading andreplacing entrance ways, doors, ramps and wayfinding

systems.

Rationale for Project: As one of the leading rehabilitationhospitals in Canada, it is important that the Glenrose not onlyprovide a safe setting for its disabled patients but also be avisible leader in meeting or exceeding current buildingaccessibility standards in barrier free design.

Relationship to Service Plan / Strategic Priorities:

Responding to diverse needs helps ensure that theGlenrose Rehabilitation Hospital supports the needs ofdisable people and is truly client centred.

Timelines and Implem

Engage consultant 1 mo

Complete design and te

Award contracts 1 mon

Complete building reno

Total Time from Proje

Stakeholder ConsultGlenrose Hospital staff

Proposed Funding Infrastructure Maintena

Need: 3 year



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5.4.6. Pharmacy Services Central ProductionFacility

Project Name: Central Drug Production and DistributionCentre

Project Description / Scope of Work: Development of acentral production and distribution centre for pharmacyservices in leased space at East Lake site in Calgary.

Rationale for Project: The redesign and centralization ofprovincial drug production and distribution systems will helppharmacy services achieve stated objectives of improvingpatient care and safety, improving drug use controls andoptimizing drug costs, providing capacity for ongoing provincialgrowth, allowing for alignment in work flow optimization, andminimizing hospital pharmacy department capital renovationcosts.

Relationship to Service Plan / Strategic Priorities: Quality: health services are safe, effective and patient-

focused impacts the drug delivery system and

Access: appropriabuilding necessarrequirements.

Capital Costs EstimRequested: $23.9 miEast Lake drug product

Operating Expenditur

estimated to be $5,48time savings of $1,000,

Risk of Non-Approvasafety issues and potento hospital pharmacies

Current Status of Procompleted (see Append

Alternate Delivery Opbut no preferred

Timelines and Implem


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6.0 Lease PlanAlberta Health Services is working to rationalize andconsolidate our leased space to make more efficient use ofthis resource and reduce operating costs. We will do our bestto support the new AHS organization structure by locating orco-locating departments in the most appropriate location tosupport efficient delivery of services and to minimize stafftravel.

Initial lease plan work is focusing on the Edmonton andCalgary office spaces where there is both the largest amountof lease space and some of the most costly rents. Moreefficient utilization of space is requiring the standardization of

AHS space allocation which, in many cases, will mean that agrowing proportion of office, maintenance and support staff willbe placed in open concept layout (e.g. downtown Edmonton107thStreet office building).

Where early lease terminations are not possible, every attemptwill be made to sublet vacated space.

$



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7.0 Asset Divestiture PlanMention has already been made of a number of facilities thatare no longer in service and require demolition. AHS is a largeproperty holder. Not all owned lands and buildings have afuture, valid place within our long term capital submission.

Subject to careful review and required Ministerial approvals,AHS intends to divest itself of redundant, abandoned and

surplus properties.This will reduce safety risk, eliminate some ongoing ownershipcosts such as property taxes and insurance costs, andpotentially free some operating funds for reinvestment in frontline service delivery.



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8.0 Conclusion and Next StepsThe Facility Infrastructure Capital Submission is intended as aliving document which will be revisited each year to meet theever-changing needs of our very dynamic health system.This plan identifies an initial list of high priority capital projectswhich support AHS strategic directions and current fiscalrealities. The next steps are as follows:

AHS Executive review andapproval of this core capitalsubmission

Complete

Consultation with AHW, AI andAlberta Seniors and CommunitySupports

Complete

AHS Committee of the Whole

review and approval of core capitalsubmission

complete

Development of capital submission Mostly complete



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Appendix I: Capital Submission Link to AHS Key Focus Area

Area of FocusStrategicPriority

3-Year Strategy

Healthycommunities

Reduce harm associated with alcohol, other drugs andgambling by strengthening the availability of addictioninformation, prevention and treatment services

Build, replaceas needs dicta

Improvingpopulation health

Responding todiverse needs

Support policies that reduce social barriers Ensure that bof Albertans wNations advisHealth Centre

Responsive toconsumers andcommunities

Patientexperience

Foster a culture of patient focused care through out theorganization

Ensure that acentered (e.gdesign of EdmHospital)

Optimize infection prevention and control practices andpolicies across the province to enhance patient careand safety

Use best pracfacilities (e.g. patient hospit

Learning andimproving

Infectionprevention andcontrol

Implement hand hygiene strategy Complete hannumber of haAHS hospitals



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Area of FocusStrategic

Priority

3-Year Strategy

Emergencydepartment

Implement strategies to improve patient experience inemergency departments

Expand and rto enhance thER projects athe Sturgeon

Develop capital submission that aligns with needs andavailable resources

Capital submi

Document invfor physical co

Develop divesservices deliv

Infrastructureinvestmentaligned

Review all existing assets (buildings, equipment andinformation technology) to ensure they are optimally

utilized

Work with govmanage the r

Ensure that baround the wo

Fit for the future

Open toinnovation

Seek global innovations and implement best practices

Ensure that bover time to a

processes (e.

Strengthen application of financial managementcontrols to ensure alignment of allocated resources and

Complete stamanagement

Adhere tobudget

Living within ourmeans



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Appendix II: Capital Projects Underway

Zone ProjectApproved

Budget

(millions)

Medicine Hat Regional Hospital redevelopment $ 280.0 Complet

Bow Island Health Centre $ 5.3 Paused

Chinook Regional Hospital redevelopment $ 141.4 Completi

South

Lethbridge Hospital Parkade $ 30.0 Completi

Didsbury Long Term Care replacement $ 0.7 Project reliving rec

North Calgary Diagnostic and Treatment Centre $ 4.0 Project inrecomme

Garrison Green Care Centre $ 64.8 In constr

Peter Lougheed Hospital redevelopment $ 247.7 In constr

Rockyview General Hospital addition $ 227.7 In constr

Foothills Medical Centre McCaig Tower addition $ 567.5 In constr

S th C l H lth C $ 1 310 0 I t

Calgary



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Zone ProjectApproved

Budget

(millions)

Stollery Emergency Room (ER) expansion $ 18.0 In constr

Sturgeon Community Hospital expansion and redevelopment $ 43.4 In constr

Misericordia Community Hospital redevelopment $ 100.1 Under re

Stollery Pediatric Surgical Suite $ 25.2 Paused

Alberta Hospital Edmonton Food Depot $ 9.5 Under re

Mazankowski Alberta Health Institute Upper Floor Fit-Out $ 36.5 Paused

Edmonton Clinic South $ 484.0 In constr

Edmonton cont

Royal Alexandra Hospital Orthopedic Surgery Centre $ 81.2 Complet

Barrhead Health Care Centre $ 10.3 Deferred

Peace Country Regional Health Centre $ 250.0 Complet

Fort McMurray Continuing Care $ 3.0 Recomm

Edson Health Care Centre $ 33.2 Recomm

High Prairie Health Complex $ 63.6 Recomm

Northern Lights Hospital ER renovation $ 6.0 Paused Peace Country Hospital ER renovation $ 9.0 In constr

Fairview Physician Building $ 0.5 Flow thro

North



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Some additional continuing care projects are underway though alternate financing otherwis

(P3) projects where the capital costs of these new continuing care facilities are shared guaranteed access to these facilities by AHS placed residents.

The table below depicts AHS contributions to these projects.

Zone ProjectAHS Contribution

(millions)

Vendor Contribution(millions)

Central Michener Hill Village (Extendicare) $ 22.1 $ 42.9

Stony Plain (Good Samaritan Society) $ 14.7 $ 15.3 Edmonton

Eaux Claires (Extendicare) $ 23.4 $ 20.7

Total $ 60.2 $ 78.9



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AHSZone

Functional orPreservation

Site / Facility P

North Preservation Beaverlodge Municipal Hospital Boiler Replacement

North Preservation Bonnyville Health Centre Recaulk Windows, Skyligh

North Preservation Various Facilities Occupational Health & Saf

North Preservation St. Paul Health Care Centre Elevator Upgrades

North Preservation William J. Cadzow Healthcare Centre Various Mechanical Upgra

North Preservation St. Paul Health Care Centre Fire Alarm Upgrade

North Preservation QEII Hospital Boiler Controls Replaceme

North Preservation William J. Cadzow Healthcare Centre Upgrade Medical Gas Syst

North Preservation Cold Lake Healthcare Centre Upgrade Building Controls North Preservation William J. Cadzow Healthcare Centre 2 Low Pressure Steam Bo

North Preservation William J. Cadzow Healthcare Centre Upgrade Building Managem

North Preservation Athabasca Healthcare Centre Boiler Replacement - 2 He

North Preservation Athabasca Healthcare Centre Replace Heating Piping, V

North Preservation Northern Lights Health Center Bldg, Systems Upgrade Fi

North Preservation Northern Lights Health Center Valve Replacement

North Functional Fairview Health Complex Health Unit Relocation



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Appendix IV: Deferred Projects AHS Review RecommendatPaused Project Recommendation

Medicine Hat Regional HospitalRedevelopment

Proceed with phased renovations at hospital starting withexpansion.

Queen Elizabeth II Hospital Replacement,Grande Prairie

In the event that funding is unavailable for a hospital replaand renovations to the Queen Elizabeth II Hospital, possipartners such as the Grande Prairie Regional College.

Barrhead Health Centre Renovation andExpansion

Remain as a deferred project until rural health strategy an

High Prairie Health Centre Replacement Project to proceed into design and construction.

Fort McMurray Long Term Care Project Replace original 48 bed long term care project with largerbeds) and supportive living (70 SL4 beds) facility.

Edmonton New Transition and ContinuingCare Facility

Project withdrawn from the forward capital plan. Edmontosupportive living. Proposed 300 bed long term care facilitystrategic plan.

Didsbury Long Term Care Addition Redirecting 60 bed long term care project to new 100 bed

Lacombe Continuing Care Upgrade and Project cancelled AHS to issue RFP to build new 88 bed



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Paused Project Recommendation

Royal Alexandra Hospital BedReclamation Womens Centre andActive Treatment Centre

Project should not proceed as Edmonton has adequate a



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Appendix V: List of Proposed Capital Projects That May be C

a Future Capital Submission as Service Plans and Finances These projects were all identified as high priority projects by the prior health authorities and the

Stream Proposed Project

Primary and Community Care Expansion to St Marys Hospital, Camrose

Replacement of St Josephs Hospital, Vegreville

Bonnyville Health Centre renovationRoyal Alexandra Hospital mental health emergency department

Replacement of Rocky Mountain House Hospital

Red Deer College campus health centre

Sylvan Lake urgent care centre

Olds Hospital reclaim west wing and add community health centr

Westlock Health Care Centre redevelopment and expansionWhitecourt Health Care Centre replacement



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Edmonton Southeast Urgent Care CentreEdmonton Southwest Urgent Care Centre

Airdrie Health Centre expansion

New Brooks Health Centre

Coaldale Community Health Centre redevelopment

Taber Community Health Centre redevelopment

Lloydminster Hospital replacementRed Deer East Urgent Care Centre

Lacombe Urgent Care Centre / Health Campus

Sundre Urgent Care Centre and addition to hospital

Three Hills Urgent Care Centre renovation

Wetaskiwin Hospital expansion

Stettler Hospital expansion *

Coronation Urgent Care Centre



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Foothills Medical Centre unit 26 (young adult mental health programFoothills Medical Centre renovations maternal / baby health, Calg

Glenrose Rehabilitation Hospital projects:

Stairwell glass block replacement

Office and clinic space reclamation

Medical gases upgrade

Data cabling upgrade Smart house technology upgrades

Pool replacement

Rehabilitation enhancements

Nursing unit upgrades

Improving access to Childrens Rehabilitation

Facility enhancement

Develop negative air pressure rooms at Chinook Regional Hospita



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Royal Alexandra Hospital (RAH) opthalmology expansionRAH Womens Centre bariatric program

RAH ICU expansion by conversion of old CCU

RAH Ambulatory Care Centre

Peter Lougheed Centre (PLC) elevator upgrades and GI scope p

PLC complete 1stfloor of east wing ER expansion

PLC redevelop the Carmat Centre for HPTP, day medicine, GI enPLC east wing basement general maintenance, staff lockers an

Cross Cancer Institute level 0 redevelopment and fit-out *

Cross Cancer Institute expansion *

FMC Stevenson Advanced Cardiovascular Imaging Centre

Support Services Calgary lab services, fit-out of 7thfloor of McCaig Tower *

Red Deer Regional Hospital, food service renovation

* AHS Executive reiteration of project importance



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Appendix VI: Detailed Capital Submission for Seniors Care F

2013/14Facilities / Beds Opening in 2010/2011

Bed Spaces

Facility Location LTCSpecialty

LTCSubtotal

LTCSL4D S

Calgary

Triple A Monterey Calgary 0

Agecare BCG Calgary 0 1

Intercare Southwood Calgary (6) 6 0

Calgary Homeless Fnd Calgary 0

Calgary Homeless Fnd Calgary 0

Schizophrenia Group Home Calgary 0

CW Garrison Green Calgary 150 50 200

NEW Capacity Calgary 0 60

Prince of Peace Manor Calgary 0 3

Carewest Fanning Calgary (16) 16 0



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Bed Spaces


LTC

Subtotal

LTCSL4D S

McLeod Residence Edmonton 0

Rosedale St Albert St Albert 0 1

Place Beausejour Beaumont 0 18 2

Balwin Villa Edmonton 0 64 1

Covenant Villa Caritas Edmonton 30 30

Bedford Village Edmonton 0 72

Rosedale Morinville Morinville 0 24Rosedale St Albert St Albert 0 24

Lifestyle Options - Whitemud Edmonton 0 58 2

Innovative Housing Villa Marguerite Edmonton 0 85

Salvation Army Supportive Housing Edmonton 0 15

Sheppards Care Asborne Edmonton 0 30

30 0 30 390 6

Central

Good Shepherd Lodge Wetaskiwin 0 3

Heritage House Vegreville 0 3



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Bed Spaces


LTC

Subtotal

LTCSL4D S

Memory Lane Transition Camrose 4 4

Bethany Meadows Camrose 0 3

Continum Sunrise Camrose 0 8

4 4 8 24 4

South 0

NEW Med Hat 0 7

GSS Prairie Ridge Raymond 2 2Legacy Lodge Lethbridge 0 24 5

GSS Cardston 5 5 24 4

Extendicare Lethbridge Lethbridge (34) (34)

AHS Cardston Health Centre Cardston (20) (20)

AHS Grandview Nursing Home Cardston (34) (34)

Extendicare Lethbridge Lethbridge 0 48 5

Extendicare Lethbridge Lethbridge (62) (62)

St Michael's Health Centre Lethbridge (48) (48)

Agecare Orchard Manor Brooks 0



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Facilities / Beds Opening in 2011/2012

Bed Spaces


LTCSubtotal

LTCSL4D S

Calgary

Brenda Strafford Okotoks Okotoks 29 29 24 9

NEW AgeCare Walden Calgary 0 33 1

NEW Elder Care High River 0 22 8

Intercare Brentwood Calgary 53 53

Didsbury TBD Didsbury 0

Oikwon Foundation Calgary 0 24 6

Rocky Ridge Calgary 0 6

Brenda Strafford Bow View Manor Phase 1 Calgary 0 3

82 0 82 103 4

Edmonton

Rosedale South Edmonton Edmonton 0 1

GSS Stony Plain Centre Stony Plain (85) (85)

GSS Stony Plain Centre Stony Plain 120 120



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Bed Spaces

Facility Location LTC

Specialty

LTC

Subtotal

LTC SL4D S

(70) 1 (69) 12 2

South

AHS Taber Health Centre Taber (60) (60)

GSS NEW Facility Taber 5 5 36 5

AHS Bassano Health Centre Bassano (8) (8)

Playfair Lodge Bassano 0

Newbrook Lodge Brooks 0

St Michael's Health Centre Lethbridge (52) (52)

Oyen Lodge Oyen 0

(120) 5 (115) 36 6

North

Whispering Pines Lodge Grand Cache 0

Chantelle Grande Praire Care Centre Grand Prairie (60) (60)

NEW Chantelle Facility Grand Prairie 60 60 6

NEW Points West Facility Grand Prairie 50 50 8



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Facilities / Beds Opening in 2012/2013

Bed Spaces


LTCSubtotal

LTCSL4D S

Calgary

Brenda Strafford Bow View Manor Phase 2 Calgary 0 4

Father Lacombe Calgary 0 4

Forest Grove Calgary (250) (250)

Forest Grove Calgary 250 250

NEW Capacity Calgary 0 60 2

Triple A Millrise Care Centre Calgary 0 5

Wing Kei Calgary 0 24 6

Covenant Health Calgary 0 20 8

(250) 0 (250) 104 5

Edmonton

Extendicare Eaux Claires Edmonton 180 180

Extendicare Holyrod Edmonton (83) (83) 6

Extendicare Somerset Edmonton (113) (113)



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Bed Spaces

Facility Location LTC

Specialty

LTC

Subtotal

LTC SL4D S

NEW Capacity(was specifically York Creek Lodge)

CrowsnestPass

6

Bow Island Pleasant View Lodge Bow Island 0

(48) 0 (48) 0 1

North

AHS Grand Cache CC Grand Cache 6 6

Barrhead Hillcrest Lodge Barrhead 0NEW Facility Boyle 0

NEW Facility Slave Lake 0 2

NEW Build Fort McMurray 0 1

NEW Build Westlock Foundation Westlock 0

Peace River Heritage Towers Lodge Peace River 0

Peace River Sutherland Place Peace River (12) (12)

NEW Facility Points West Peace River 0 8(6) 0 (6) 0 2



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Appendix VII: Business Cases

(see attached)

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AHS Facility Infrastructure Capita2012/13 2016/17

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Acknowledgements

This Facility Infrastructure Capital Submission was developedwith the input and involvement of many people from acrossAlberta Health Services who identified and prioritized theprojects presented in this plan.

Participants in our December 8thCapital Project RequestsPrioritization Workshop

Lori Anderson, VP, Calgary Zone

Kerry Bales, VP, Central Zone

Bev Culham, Director, Strategic & Integrated ServicePlanning South

Janice Cullen, Director, Process & Facility Planning

Dr. Tony Fields, VP, Cancer Care

Deb Gordon, Senior VP, Major Tertiary Hospitals

Kathryn Gowling, Executive Director, Planning &D i S i

Brent Skinner, EIntegration

Brian StevensGovernment Inte

Marianne Stewa

John Switzer, Planning

Alison Tonge, E

Heather ToporoCare & Chronic

Grant Walker, V

Andrew Will, Ex

And the following indivithe development of our

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Appendix I: Capital Submission Link to AHS Key Focus Areas 55

Appendix II: Capital Projects Underway .................................... 57

Appendix III: Infrastructure Maintenance Plan Active Projectsby Zone ............................................................................... 61

Appendix IV: Deferred Projects AHS ReviewRecommendations .............................................................. 87

Appendix V: List of Proposed Capital Projects That May beConsidered for Inclusion in a Future Capital Submission as

Service Plans and Finances Permit .................................... 89

Appendix VI: Detailed Capital Submission for Seniors CareFacilities across Alberta to 2016/17 .................................... 95

Appendix VII: Needs Assessments ........................................... 97


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Other priority capital projects are aimed at specificopportunities to improve primary and community care services,

increase access to acute care services and reduce wait times,and replace or upgrade essential building infrastructure.

The Facility Infrastructure Capital Submission has beendeveloped with input from staff from across AHS. It is a workin progress. Additional capital projects may be added in thefuture as our service plans continue to evolve.


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1.2. AHS Strategic Plan

The plan entitled Albert Health Services Strategic Directions2009-2012 Defining Our Focus / Measuring Our Progressdescribes our corporate goals, focus and key priorities. Thestrategic plan serves as a guide into the future and will berefreshed each year to reflect the ever shifting challenges ofour dynamic health system.

Everyone throughout Alberta Health Services contributes toachieving the goals and priorities described in our strategic

plan with portfolio specific action plans as tracked throughindividual executive accountability agreements.

The strategic plan has 3 goals, 8 areas of focus and 20strategic priorities.

The three goals, Quality,Access and Sustainability , areessential to our future success as an organization asmeasured by the health and satisfaction levels of Albertans,

their ability to access the health system and our ability to meetthese goals within sustainable budgets.



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1.3. Becoming the Best: Albertas 5-Year

Health Action PlanBecoming the best is an action plan for Albertas healthsystem which was published by the Government of Albertaand Alberta Health Services in December 2010. It outlines 4strategies. The AHS Capital Submission aligns with this5-year action plan.

AHW / AHS

5-Year ActionPlan Strategy AHS Cap ital Submission Contr ibut ion to St rategy

Improve accessand reduce waittimes

AHS is proposing projects to increase capacity in highrisk obstetrics. The continued expansion of seniorscare facilities will also have a major, indirect, impacton acute care wait times.

Provide moreoptions forcontinuing care

The Capital Submission proposes a continuedexpansion of continuing care capacity across Albertawith an emphasis on supportive living. Funding is also

requested to refurbish or replace older long term carefacilities.

1.4. 2011-2015 H

The Health Plan describto transform the delivproviding a patient foaccessible and sustaina

To transform the sysservice area improvemcorporate improvement

1. Building a Primary2. Improving Access

3. Choice and Qualit

4. Enabling Our PeoHealth Services

5. Enabling One Hea

In combination, theseprograms will both capbecoming one health



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2.0 Major Health Trends

Compared to much of the world, Alberta has a healthy anddiverse but aging population. At a glance:

Alberta has a population of 3.7 million. It is the fastestgrowing province in Canada the population is expectedto grow to 4.7 million by 2035

11% of the population is 65 years or older and this isexpected to increase to 20% by 2031

7% of the population is between 0 and 4 years Our population is increasingly diverse, with 16% foreign

born and 5.8% Aboriginal people

Alberta is home to the 3rdhighest Aboriginal population inCanada, about 60% of whom live in urban areas

Top non-official language spoken at home is Chinese

Average household income is $94,000 dollars

11% of families are female lone-parent families (3% arel l t)

Leading causes of d

heart disease and (such as chronic pneumonia), injuries


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Alber tans make substant ial use of our most expensivehealth system resource acute care hospitals. Each

year, on average, 1 in 13 people are admitted to hospitaland 3 in 10 people visit emergency. Access must beimproved to primary care networks and a range of team-based, evidence informed and patient centered primaryhealthcare services. AHS should develop more and betteralternatives to hospital admission for conditions suitable forcommunity management, including rapid assessmentservices, responsive health care and acute caremanagement, with a focus on avoiding unnecessary

admission and unplanned hospitalization. It is alsoimportant to design processes and facilities with a focus oninclusion and best use of technology in emergency rooms,ambulatory care centres and clinical support services.New facilities are needed to provide people with moreefficient and easily accessible care options including moreambulatory care, more extended hour clinics and moreurgent care centers.

Our population is growing and the number of births isincreasing dramatically. We need to ensure that



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AHS 2012-2017 Faci li ty

The relocation of the air ambulance services from the

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The relocation of the air ambulance services from theEdmonton City Centre Airport presents a unique opportunity to

share resources among government air services, STARS andAHS air ambulance services.

Preserving and improving the condition, functionality andsafety of health facilities including improving work flow

Many of our existing facilities are old and do not meet currentbuilding codes or support best practice health service delivery.We are recommending the eventual replacement of hospitalsin Cardston, Rocky Mountain House and Vegreville once zone

integrated service plans are completed. It is also increasinglyevident that the Northern Lights Regional Hospital exteriorbuilding envelope is deteriorating and needs to be replaced.


4 0 Overview of Infrastructure

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4.0 Overview of InfrastructureServices are delivered through five administrative zones (seezone map). Most services are directly delivered by AHS butwe also fund many services as provided by the CovenantHealth Group and other voluntary and private partners.

AHS also has key partnerships with universities andcommunity colleges acknowledging our shared responsibilityto educate and train the health professionals of the future andsupport ongoing biomedical and health sciences research.

We are responsible for owning and operating, funding orleasing many facilities. In fact, we are one of the largestproperty owners and landlords in Canada.

Owned Facilit ies 2,921,522 m2 89.9 %

Leased Facili ties 330,373 m2 10.1 %

TOTAL: 3,251,895 m2 100.0 %

At present, AHS is benefiting from a capital program with atotal construction value of approximately $4 2 billion Major


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Approving and implementing Capital planning activities 4 3 Shelled Spa

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Approving and implementing Capital planning activitiesbased on set priorities in line with the strategic goals of

AHS.In some cases, such as the Rocky Mountain House Hospital,buildings have deteriorated to the extent that continued safebuilding operation cannot be taken for granted. Such facilitiesneed to be replaced to ensure no unanticipated or prolongeddisruptions in service delivery.

Also, there are a small number of facilities, such as the formerPicture Butte Hospital, former Claresholm facility and buildings

at the Alberta Hospital Edmonton (AHE) site which are vacant,decommissioned and in rapidly deteriorating situations. Suchfacilities should be demolished as they are a safety hazardand community eyesore.

Abandoned Bui ld ingsEstimated Demolition CostsIncluding Asbestos Removal

Picture Butte Hospital

former Claresholm facility AHE buildings 1, 2, 5, 8, 11, 14 & 25

$ 4.81 Million

4.3. Shelled Spa

Recent large capital pro

shelled space whicdevelopment.

Facility

Mazankowski Alberta HeartInstitute

Alberta Childrens Hospital

FMC McCaig Pavilion

Peter Lougheed Centre

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AHS will continue to ha

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4.5. Summary of Capital Projects Underway

At present, over $4.2 billion of approved major capital projectsare in active design or construction. Many were initiated bythe prior health regions with service plan assumptions andexpectations that may not necessarily align with todays fiscalrealities and service delivery directions.

The majority of project spending involves the renovation,replacement and/or expansion of acute care hospital services(90%), and is for facilities located in Edmonton or Calgary

(63%).Taken as a whole, capital projects already underway representa huge investment in facility infrastructure which will benefit

Albertans for many years to come. A detailed table of largerexisting projects can be found in Appendix II. This list is notcomprehensive and excludes many approved and ongoingprojects (e.g. IMP projects), as described in Appendix III.

A number of previously approved projects were paused bygovernment in April 2009. Some of these projects remaindeferred (see Appendix IV)

AHS will continue to haand prioritizing all new

support our strategic dir

4.6. 2011 Capita

Last July, AHS providedand Infrastructure withperiod starting in 2011/1

The status of the 20 poutlined in the following


2011/12-2013/14 Capital Project Requests

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p j q

Project Status Raymond Health Centre redevelopment Under review by AHW / AI as potential

CTI funded project

Wainwright Health Centre redevelopment /replacement

Under review for possible initiation ofprogramming study

Sewer line replacement option to beinvestigated as interim measure

Boyle / Athabasca Health Centre redevelopment Under review by AHW / AI as potentialCTI funded project

Co

Construction of supportive living and long termcare facilities

Submitted to Alberta Treasury forconsideration as part of Budget 2011

Seinit

Southern Alberta Forensic Psychiatry Centreredevelopment

Under review by AHW / AI as potentialCTI funded project

Peter Lougheed Centre Womens Healthredevelopment

$11.3 million approved as part of 2010AHW Capital Plan

Co Fu

Northern Alberta Urology Centre, Edmonton Approved through scope reduction

within Edmonton Clinic South budgetand fund-raised contribution

Co

Fu


Project Status

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Project Status

Phased Obstetrical renovations at Red Deer

Regional Hospital

Under review by AHW / AI as potential

CTI funded project

Pre

sub AI

ren

Northern Lights Regional Hospital renovations To be reconsidered for funding as partof 2011/12 IMP funding

Chiller, roof and elevator redevelopment anddemolition of selected facilities

To be reconsidered for funding as partof 2011/12 IMP funding

Deam

Foothills Medical Centre kitchen replacement Under review for possible initiation of

programming study

Stu

Laundry / linen services consolidation Under review by AHW / AI as potentialCTI funded project

Sterile instrument processing upgrades Under review by AHW / AI as potentialCTI funded project

Bu Stu

profac

Glenrose Hospital facility accessibility project To be reconsidered for funding as partof 2011/12 IMP funding

Central production facility Pharmacy Services Under review by AHW / AI as potentialCTI f d d j t

Stu



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5-Year ActionProject Descripti on

Grant FundingRequested

Completed

N d B

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Plan PrioritiesProject Descripti on Requested

($ million)Needs

AssessmentBu

Improve accessand reduce waittimes

Develop Level III NICU in shelled space atAlberta Ch ildrens Hosp ital to help meetgrowing Obstetrical activity in Calgary

$ 4.6 Completed [to

Southern Alberta Forensic Psychiatry Centreredevelopment

$ 16.5 Preliminarybusiness case

[to

Phased obstetrical renovations at Red DeerRegional Hospital

$ 17.0 Preliminarybusiness case

[to

Grey Nuns vascular surgery i ntegratedoperating theatres

$ 19.0 - 24.0 Completed [to

Provide moreoptions forcontinuing care

Seniors Care New capacity

LTC replacement

$ 140.0

$ 1,046.3

New capacity plancompleted

LTC replacementplan initiated

Strengthenprimary care

Consolidation of Health Centre withCommunity and Primary Care in Taber

TBD Completed [ucostin

con

Construction of new Peace River PrimaryCare Centre to consolidate physician andcommunit y health services

TBD Completed [to

Consolidation of Health Centre withCommunity and Primary Care in Raymond

$ 4.7 Preliminary businesscase completed

[ucostin


5-Year ActionPlan Priorities

Project Descripti onGrant Funding

Requested Completed

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Plan Prioritiesj p q

($ million)p

Failing healthfacilities Redevelopment / replacement of WainwrightHealth Centre $ 148.5 - 185.6Preliminary business

case completed[to

Boyle / Athabasca Health Centreredevelopment

$ 6.6 Initiated [to

Major building infrastructure preservationprojects including:

- -

Replacement of exterior buildingenvelope at Northern Lights RegionalHospital. Existing envelope is not airor moisture tight and there is aserious deterioration of buildingfabric

TBD Preliminaryinvestigationcompleted

Replacement of chillers and halonsystems to eliminate use of CFCs

$ 20.9 Preliminary businesscase completed

[coscon

Demolition of selected AHS ownedfacilities

TBD Preliminary businesscase completed

[coscon

Sterile Instrument Processing upgrades TBD Preliminary businesscase completed

Detailed study

initiated

[to

Heliport replacement and upgrade $ 11.2 Assessment [to


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Current Status of Project: Philanthropic support for theproject capital costs is currently being established through the

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project capital costs is currently being established through theAlberta Childrens Hospital Foundation (ACHF) and the

Calgary Health Trust (CHT).

Al ternate Delivery Opt ions: All available NICU physicalcapacity in the Calgary Zone is maximally deployed at present.Capital projects currently in programming or construction willadd Level II capacity (3 beds at PLC and 18 beds at SHC).Their timelines cannot address the present capacity shortfalland safety risk. The addition of Level III NICU beds at FMCwould require renovation of the 5thfloor, which is considered to

involve extreme logistical challenges and infrastructurelimitations.

Timelines and Implementation Plans: 18 months (?) fordevelopment of functional program, detailed design,construction, and clinical implementation.

Stakeholder Consultation: Growing NICU demands wereidentified by the Provincial Neonatal Intensive Care Working

Group and in the Interim Maternal Newborn Capacity Plan forCalgary (both 2008).


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Al ternate Delivery Opt ions: Alternative, but less desirable,delivery options include:

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delivery options include:

Status quo (patient and staff safety compromised and nocapacity to perform two endovascular procedures as thesame time);

Purchase additional mobile fluoroscopy unit (patient andstaff safety concerns persist); and

Convert existing ORs into two hybrid Ors (too small toadequately accommodate the equipment).

Timelines and Implementation Plans: It may take two yearsor more to complete this project. To be determined atbusiness case stage. It would be helpful to revisit the GNCHsite master plan at the same time as the business case isbeing developed to ensure that the expansion of the hybridORs does not unduly harm other site program developmentpriorities.

Stakeholder Consultation: The following individuals and

groups have been involved in developing the needsassessment:


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Current Status of Project: The seniors care CapitalSubmission is foundational and will continue to be monitored

Need: Immediate

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and updated regularly. Work is being initiated on a

communications and consultation plan to engage key leadersand obtain understanding and support for this major AHSinitiative on the part of the public, providers, communityleaders and other stakeholders.

Facility design guidelines have been jointly developed byAlberta Infrastructure, Alberta Health and Wellness, AlbertaSeniors and Community Supports, and AHS and are currentlyunder review.

Also, a joint AI, AHW, ASCS and AHS continuing care serviceplan partnership committee is developing recommendationsfor the allocation of capital funding to identified high prioritylong term care and supportive living projects over the next 5 to10 years in accordance with Albertas Continuing Care ActionPlan.

Al ternate Delivery Opt ions: This plan will be delivered in

partnership with the voluntary and private sectors that willconstruct and operate these new facilities by way of


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Current Status of Project: The project has been identified byAlberta Health Services as a high priority. Also, the April 2011

t f th H lth Q lit C il f Alb t ( i f th

was released on May 5and Design Services std t ti

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report of the Healthy Quality Council of Alberta (review of the

safety implications for patients requiring medevac services toand from the Edmonton International Airport) recommendedthat a new facility dedicated to medevac aircraft and groundfacilities be built at the Edmonton International Airport. Thisshould include space to accommodate:

The transfer of patients from air to ground ambulance thatis out of the elements.

New facilities to allow uninterrupted rest periods for flightcrews.

Storage of necessary equipment.

Al ternate Delivery Opt ions: Co-location of all services at theEdmonton International Airport (EIA) was reviewed. Alternateoptions include co-location of STARS at a tertiary hospital site,working with fixed wing providers only or doing nothing.

Timelines and Implementation Plans: Three to five yearsfrom approval to proceed. Process will involve functional

documentation, as we

proposed hospital siteswith EMS managementinterviews were condCovenant and FM&E discuss the possibility oany of these sites.

Proposed Funding So

Need: Three year


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Operating Expenditure Impact: Even though impact ofimproved building envelope on the operating cost hasnt beeninvestigated to date it is safe to assume that the operating

Information and sup

Information and su

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investigated to date, it is safe to assume that the operating

cost will be less as better performing building envelope willpreserve heat and eliminate thermal bridging.

Risk of Non-Approval: Upgrades and renovations to thefacility building envelope must be addressed. A status quoapproach allows continued deterioration and carries significantrisk of building envelope failure, service disruption andcontinuing health and safety concerns for both patients andstaff.

Current Status of Project: The project has been identified byAlberta Health Services as a high priority.

Al ternate Delivery Opt ions: There is no potential foralternate procurement as the building envelop is associatedwith AHS owned facilities.

Timelines and Implementation Plans: Immediate repair andrenovation of the failing building envelope sections are

required.

Information and su

teamProposed Funding So

Need: Immediate


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FacilityEstimated

CostComments

Old H it l d C C t 60 000

Facility

B h d H lth C t

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Olds Hospital and Care Centre 60,000

Sundre Hospital and Care Centre 260,000

Drumheller Health Centre 90,000

Hanna Health Centre 75,000

Three Hills Health Centre 60,000

Stettler Hospital and Care Centre 90,000

Castor Our Lady of the RosaryHospital

140,000

Coronation Hospital and CareCentre 90,000

Consort Hospital and Care Centre 300,000

Rimbey Hospital and Care Centre 200,000

Ponoka Hospital and Care Centre 175,000

Tofield Health Centre 220,000

Daysland Health Centre 220,000

Killam Health Care Centre 100,000

Hardisty Health Centre 80,000

Barrhead Healthcare Centre

Beaverlodge Municipal Hosp

Boyle Healthcare Centre

Edson Healthcare Centre

Fairview Health Complex

Fox Creek Health Care Cent

Grimshaw/Berwyn CommunHealth Complex

High Prairie Health Complex

Manning Community HealthCentre

Mayerthorpe Healthcare Cen

McLennan Sacred HeartCommunity Health Centre

Peace River Community Hea


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5.6. Parkades

An essential feature of urban hospitals is car parking. While Planning work has alsoF hill M di l C

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p p g

AHS is a strong proponent of public transit, staff car pooling,staff cycling and other transportation management strategiesto minimize car traffic and protect the environment, privatevehicle transportation remains the dominant form oftransportation for both the people we serve and our staff andphysicians.

Parking facilities are being included in our new major projects,such as the Calgary South Health Campus and the Edmonton

Clinic, and expanded for our growing regional hospitalsincluding Lethbridge and Red Deer. Debt financing is beingused to fund these new parkades and parking lot expansions.Persons who use these facilities provide, through parking fees,the revenue to pay back the loans over time.

Location Size Project Budget Comments

Chinook RegionalHospital

810

Stalls

$30,000,000 Parkade constructionongoing with completion

expected in August 2011.Edmonton Clinic 1 200 $76 300 000 Above ground parkade

Foothills Medical CenCalgary cancer infrastru

Preliminary planning alsstructure for the new Gr


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6.0 Lease PlanAlberta Health Services is working to rationalize and Finally, Real Estate

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g

consolidate our leased space to make more efficient use ofthis resource and reduce operating costs. CapitalManagement Real Estate Services does its best to supportthe AHS organization structure by locating or co-locatingdepartments in the most appropriate location to supportefficient delivery of services and to minimize staff travel.

As various programs such as EMS and AADAC work to betterintegrate their programs within AHS, Real Estate Services has

had to scramble to address unanticipated space issues or toreorganize space. In some cases, existing offices have beenrenovated to support increased efficiencies in work processand space utilization.

Initial lease plan work has focused on the Edmonton andCalgary office spaces where there is both the largest amountof lease space and some of the most costly rents. Space isbeing consolidated as opportunities occur. For example, the

AHS Edmonton corporate office has been moved from leasedspace in Manulife Place to owned space within the Seventh

y,

Resources in the develoalternative workplace aAHS employees to weligibility criteria are mprovide significant benreduce office space pre


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7.0 Asset Divestiture PlanAHS is a large property holder. Not all owned lands and The details were provi

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buildings have a valid, future place within our long term capitalplan.

Subject to careful review and required Ministerial approvals,AHS intends to divest it self of redundant, abandoned andsurplus properties including:

Picture Butte Hospital

Raymond Care Centre

Cardston Grandview Nursing Home Red Deer Nursing Home

Drumheller Environmental Services Building

Drayton Valley Thrift Shop, and

Three lots in Banff

In addition to the above, AHS also would like to proceed withthe demolition of a number of additional properties whileretaining ownership of the lands. These buildings are in poor

Asset Management contained within our 20

None of these buildinHospital Edmonton, haarchitectural interest.


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8.0 Conclusion and Next StepsThe Facility Infrastructure Capital Submission is intended as a

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living document which will be revisited each year to meet theever-changing needs of our very dynamic health system.

This plan identifies an initial list of high priority capital projectswhich support AHS strategic directions and current fiscalrealities. The next steps are as follows:

AHS Executive review and approval ofthis core capital submission

Complete

Consultation with AHW, AI andAlberta Seniors and CommunitySupports

Complete

Development of capital submissiondetails for identified high prioritycapital projects including needsassessments and provision of same toMinistries of Health and Wellness and

Infrastructure subject to AHS Boardreview and approval

May 31, 2011


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Area of FocusStrategicPriority

3-Year Strategy Cap

Fit for the Infrastructure Develop capital submission that aligns with needs and Capital submission

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future investmentaligned

available resources

Review all existing assets (buildings, equipment andinformation technology) to ensure they are optimallyutilized

Document inventofor physical condit

Develop divestiturservices delivery

Work with governmdatabase to help mowned facilities

Open toinnovation

Seek global innovations and implement best practices Ensure that buildinaround the world

Ensure that buildinover time to accomprocesses (e.g. usnew Cochrane He

Living withinour means

Adhere tobudget

Strengthen application of financial managementcontrols to ensure alignment of allocated resources andexpenditures

Complete standardmanagement policon financial contro

Ensure robust processes are in place to identify and Creation of centra


Appendix II: Capital Projects Underway

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Zone Project ApprovedBudget

(millions)

Status

South Medicine Hat Regional Hospital redevelopment $ 199.8 In design

Bow Island Health Centre $ 5.3 In design

Chinook Regional Hospital redevelopment $ 112.7 In design

Lethbridge Hospital Parkade $ 30.0 In construction

Calgary Foothills Medical Centre McCaig Tower addition $ 567.5 In construction (impacte

South Calgary Health Campus $ 1,310.0 In construction

Richmond Road Diagnostic and Treatment Centre $ 58.3 Completing construction

Strathmore Continuing Care Centre $ 17.5 To be reinitiated

Calgary cancer infrastructure plan (phase 2) $ 141.0 In planning

Vascular surgery program enhancement, PeterLougheed Centre

$ 25.0 In planning

Womens health program redevelopment, PeterLougheed Centre

$ 11.6 In planning


Zone Project

ApprovedBudget

(millions)

Status

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Alberta Hospital Edmonton Food Depot $ 9.5 In construction

Edmonton Clinic South $ 484.0 In construction

Edmonton cancer infrastructure plan $ 62.0 In planning

Pediatric intensive care unit expansion, StolleryChildrens Hospital

$ 8.7 In construction

Endoscopy suite expansion, University of AlbertaHospital

$ 14.5 In design

North Peace Country Regional Health Centre and CancerCentre $ 520.0 In planning

Fort McMurray Continuing Care $ 25.0 In functional program

Edson Health Care Centre $ 108.0 In planning

High Prairie Health Complex $ 89.8 In planning

Northern Lights Hospital ER renovation $ 6.0 In construction

Grande Prairie QEII Hospital ER/endoscopy renovation $ 9.6 In construction

Fort McMurray Primary Care Centres $ 28.2 In design


Some additional continuing care projects are underway though alternate financing otherwis(P3) projects where the capital costs of these new continuing care facilities are shared guaranteed access to these facilities by AHS placed residents.

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The table below depicts AHS and Alberta Seniors and Community Supports contributions to th

Zone ProjectAHS / Govt Contr ibut ion

(millions)

Vendor

(m

Calgary Didsbury Supportive Living (Bethany Care) $ 10.0 $

Central Stettler Supportive Living (Points West) $ 8.8

Edmonton Stony Plain (Good Samaritan Society) $ 14.7 $

Eaux Claires (Extendicare) $ 23.4 $

Total $ 56.9 $


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Appendix III: Infrastructure Maintenance Plan Active Projects

AHS Functional or

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Zone Preservation Site / Facility Pr

Functional Various Tray Assembly

Preservation Various Environmental Review of

Functional Various 2010-11 IMP Projects Co

Preservation Various Regional Roofing Repair

Functional Various Provincial Legacy Contin

Calgary Preservation Airdrie Community Health Centre Security Upgrade

Calgary Functional Alberta Children's Hospital Construct, Vestibules E

Calgary Functional Alberta Children's Hospital Dental Clinic

Calgary Preservation Banff Health Centre Tub Area Tile Floor Repl

Calgary Functional Banff Mineral Springs Hospital Domestic Hot Water Tan

Calgary Functional Banff Mineral Springs Hospital Chiller Replacement

Calgary Preservation Bethany Care Centre Calgary Replace Elevator 5

Calgary Functional Bethany Care Centre Calgary Replace Elevator 2

Calgary Functional Black Diamond Public Health and Community Care Fire Alarm System Repla


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AHSZone

Functional orPreservation

Site / Facility Pr

Central Preservation Drayton Valley Hospital and Care Centre Roof Replacement

C t l F ti l D h ll E i t l H lth & S t S i F ilit E l ti

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Central Functional Drumheller Environmental Health & Support Services Facility Evaluation Central Preservation Drumheller Health Centre Flooring Upgrade

Central Preservation Drumheller Health Centre Nurse Call and Wireless

Central Pres

ahs capital submissions 2010-13

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