The Vancouver Island Health Authority (Island Health) has reissued a Request for Proposals to add 120 new beds for patients requiring a complex level of care in the Comox Valley.

Island Health says it hopes to award contracts for the new beds in early May and expects they will open for patients sometime in 2020.

That’s good news for people needing complex care, and especially for their caregivers. The glaring and long-time shortage of complex care beds in the Comox Valley has distressed caregivers, and resulted in some horrific tragedies.

It’s also good news for Comox Valley Hospital workers. A workforce staffed for 129 admitted patients has been dealing with serious overcapacity issues — up to 170 admitted patients — since the new hospital opened in October.

Most of those 30-40 unexpected patients no longer need acute care, but remain in the hospital because of the Valley’s shortage of complex care beds.

It’s a problem that dates back many years, but surprisingly the new Comox Valley Hospital was planned as if it would never have patients needing an alternate level of care.

That strategy might have worked, or at least diminished the current problems at CVH, except Island Health was slow in issuing a Request for Proposals and awarding the contract for new or replacement beds. And then, it cancelled the RFP completely.

On Sept. 30, 2016, Island Health issued an RFP for 70 new or replacement residential care beds for the Comox Valley. The press release said contracts would be awarded in April 2017 and opened in 2019.

But, on Aug. 3, 2017, Island Health cancelled the RFP, shortly after its board of directors decided the four hospice beds located at St. Joseph’s should be moved to a secular facility that could provide Medical Assistance in Dying (MAiD).

Tim Orr, the director of residential services for Island Health, told Decafnation that St. Joseph’s policy not to permit MAiD was one of several factors in the decision to cancel the 2016 RFP. The new RFP requires at least one proponent to provide end-of-life services including MAiD, and house six hospice beds.

FURTHER READING: Island Health RDP press release

What’s in the RFP?

The Island Health press release says the 120 new beds may be awarded to more than one proponent, and than the number of new complex care beds awarded to each proponent will be determined in the evaluation of each proposal.

“Should the RFP result in more than one successful proponent, at minimum, one of the selected proponents will be required to provide for six community hospice care beds and allow for the provision of MAiD (Medical Assistance in Dying) on site,” the release said.

And successful proponents must provide 3.36 direct care hours per resident day, as per provincial standards.

The release also states that the “new RFP includes flexibility for greater capacity in the future, opportunities for a full spectrum of complex care including innovative models of dementia care ….”
Community reaction

The community has responded to the Island Health announcement with cautious optimism.

Our sources believe that 120 new beds will relieve the stress on the new Comox Valley Hospital, but will not provide a complex care bed for everyone in the Valley who needs one.

Because there are so many nonpaid (mostly family member) caregivers in the Valley, and because only the most in need of acute care get into the hospital, that the Valley may actually need more than 150 and closer to 200 complex care beds.

Our sources expressed disappointment that the announcement didn’t include an increase in respite beds, adult daycare programs or resources for Community Health Care, a program designed to keep people at home as long as possible.

Will St. Joseph’s apply?

The wording of the RFP press release appears to open the door for The Views at St. Joseph’s to apply for additional beds without agreeing to provide MAiD on site, which is something the Catholic church opposes on ethical grounds.

The Views at St. Joseph’s already provides publicly-funded complex care beds that are mostly occupied by patients with dementia. The Views board of directors has outlined a vision for a dementia village” similar to Hogeweyk in the Netherlands.

A private operator in Langely, B.C. just announced that it will open Canada’s first “dementia village” next year. Verve Senior Living says the project will cost patients between $6,000 to $7,500 per month, but is open to working with the B.C. government to make residence more affordable.

What’s next

Island Health will accept proposals until May 11, but does not say when the contract or contracts will be awarded. It generally takes a minimum of two years from awarding a contract to its completion.

The Island Health board of directors will meet at 1.30 p.m. on March 29 at the Crown Isle Resort ballroom. People may ask questions in advance to be answered in written form at the board meeting, or make 10-minute presentations to the board if they apply by March 15.

In other North Island Hospitals news, Dr. Jeff Beselt has resigned from his position as the Executive Medical Director for the Comox Valley Hospital and Campbell River Hospital. According to a Island Health spokesperson, Dr. Beselt stepped down to focus on his family. Island Health named Dr. Jennifer Grace, of Campbell River, the interim EMD for the region, which includes Campbell River, Courtenay, Comox and Mount Waddington/Strathcona. You can view a farewell video for Dr. Beselt here, and read reviews of Dr. Grace here.

FURTHER READING:Canada’s first “dementia village;”BC retirement home chain sold to murky Chinese ownership group