Sunday, March 20, 2022

Building for the Past: An Invitation to "Participate" in Windsor's Worst Planning Mistake Ever

On Monday, March 21, 2022, Windsor Regional Hospital (WRH) will begin hosting a series of virtual public engagements for the new hospital on County Road 42, and the urgent care centre that is to replace WRH’s centrally located acute care hospital on its Ouellette Campus. WRH also has a web portal for submitting ideas in writing.

Be warned: The questions revolve around the interior design elements of the hospital, rather than the medical functions and services to be provided to Windsor-Essex stakeholders.
"While we care about all aspects of the hospital, the purpose of this survey is to discuss the physical design of the new hospital. Only related answers will be considered."
Once again, WRH is using a contrived public engagement to bury essential questions that urgently need to be addressed. What is more important to residents: ultra-plush chairs or accessible healthcare? And we don't mean the number of steps to the door from the parking lot. Why is WRH asking the public to commit their time and energy to brainstorm secondary features that are best determined by experts: the experienced designers and architects with knowledge of best practices from other recent hospital builds?

Is this just another pro-forma exercise for a Ministry of Health check-box? Because it sure seems a lot like a repeat of the farcical public engagement process from 2015 that led to this, the worst planning decision Windsor ever made.

Everyone in Windsor-Essex should have serious doubts that WRH's latest "invitation for public participation" will address any public opinions on the fundamental issues that matter most to residents: 
CAMPP's concerns: ACUTE
Especially this key problem: How the hospital plan will impact the approximately 100,000 people who live in Windsor's central neighbourhoods - if the new hospital plan goes forward as presented.
This is a new reminder that while the greenfield hospital site adjacent to Windsor Airport is a sore point for many, the decision makers still have no intention of addressing the flaws of this ill-conceived plan, one that was obsolete long before it was announced as a "done deal" in 2015.
The need to provide healthcare where people live has never been more obvious during this time of sharply rising gas prices, heightened geo-political risk and stretched government budgets.
  • We urge you to remind the hospital planners that all residents, regardless of where they live, need – and deserve – accessible hospital services.
  • Environmental and fiscal sustainability must be key features of the plan for our future healthcare.
Below are some points you may wish to consider before submitting your own feedback.
1. What are WRH's overarching standards for this project? Will they learn from the leaders or repeat the mistakes of the past?
Very early on in its own planning process, Toronto's best-in-class Humber River Hospital, which opened in 2015, established "lean, green and digital" as its guiding motto. Its energy efficiency is a model for other hospital projects. In Windsor, where the new hospital is to be built on floodprone farmland, environmental considerations have never appeared to be important to the project's proponents.

WRH focused public attention on the prospect of bountiful surface parking and wider access roads to divert public attention from the negative medical and economic impacts of the distant hospital location.

Why is WRH seducing us with parking and road construction, rather than promoting better access to healthcare for everyone, including those who don't drive?
2. Hospitals belong where people live.
According to the Stage 1 planning documents, almost 40% of all WRH Emergency Department (ED) patients live in the central neighbourhoods around the existing hospital campuses. This is why it is critically important to retain a full range of healthcare services close to these neighbourhoods.
ER visits by FSA code
Don’t be fooled by the argument that most ED patients don’t require hospital admission: Is there any reason to believe WRH's grandiose promise that the staff will be able to perform "any and all required treatments on every patient who presents?"

What percentage of patients' medical problems are resolved in the ED? Many patients require a specialist referral -- where will these appointments for additional care take place? There have never been any announcements about ambulatory care clinics remaining at the Ouellette site.
If anything, this language suggests the large numbers of patients requiring additional specialized care will be expected to travel to the new acute care hospital after all.
3. By the way, words matter: An Urgent Care Centre and an ED provide completely different services.
WRH continues to describe the planned new downtown facility on the site of the current Ouellette hospital campus as a “Satellite Emergency Department.” Yet the excerpt of WRH's own planning documents submitted to the Ontario Ministry of Health makes it quite clear that what is being designed is a limited hours urgent care centre - definitely not an ED:
“An Emergency Department is, by definition, a 24 hour per day, 7 days a week service which operates in a hospital.” 

According to WRH: "A Satellite Emergency Centre is an alternate site for patients with less serious issues who do not require all the resources available in an emergency department."

The main distinguishing feature of an urgent care centre is that it is not designated as a receiving centre for ambulance-bound patients. Thus, any CTAS level 1 or 2 [the most life-threatening] patient being transported by ambulance will automatically be routed to an Emergency Department.

WRH's planning documents [redacted by WRH without explanation] clearly state that the downtown Windsor facility will be an urgent care centre and not an ED. It will not accept ambulances. So why do they insist on calling it an ED?
Emergency vs urgent care
4. Meeting our future needs?
As a result of Windsor’s successful Economic Revitalization Community Improvement Plan (CIP), the city’s downtown area has been undergoing a resurgence, attracting thousands of new urban residents. Does anyone truly believe this area will be adequately served by an urgent care centre instead of an acute care hospital? How is this compatible with the city's long-term planning vision?

To "participate" in WRH's public engagement, prior online registration is required at this linkThis process is designed to obtain personal data and elicit cute ideas. It is not designed to obtain key information essential to planning the healthcare services to meet Windsor-Essex's future needs.

This is not an anonymous survey: You will be asked to provide your full name, email address and six-digit postal code.

The registration process also doesn't require any specific demographic information that would give key insights into whether all stakeholder groups are fairly represented. Typically, professional surveys gather anonymous data that includes age group, gender, country of birth, education and income level. WRH wants to know who you are, but they don't really want to know about you! 

What steps will be taken to reach the almost 100,000 residents of Windsor’s central neighbourhoods, among them thousands of newcomers to Canada for whom English is a completely foreign language? What about other stakeholders with barriers to this kind of engagement who stand to lose accessible hospital healthcare services under the current plan? For example, those with mental and physical disabilities, as well as people without internet access?

Will an honest attempt be made to engage First Nations stakeholders this time, or is the land acknowledgement on WRH's website just another bald attempt to check a box?
Land Acknowledgement on WRH's About page
We have submitted CAMPP’s ideas for the community’s emergency and outpatient services. We invite you to use our ideas as a starting point for your own submission.
Click here to read CAMPP's ideas
Forward to a friendForward to a friend
In their own words
Comments on the issues:
"We should be doing EVERYTHING within our means to preserve land that really isn’t required for necessary growth. In Windsor right now… the Sandwich South (900 acres of zoning amendments devised with public money by our hospital) development is someone’s unnecessary dream. There are MORE than plenty of alternatives to grow in a more sustainable manner and save that land for if and when it’s required in the future. It’s not rocket science…it’s about leadership that understands that quality of life, not just here but on the rest of this planet isn’t about “he who finishes with more wins”."
"It amazes me how many people are blind to the fact of what a disaster this will be. And it has nothing to do with it being in the City Core where it belongs, or it being put out in an inconvenient spot for the majority of people who will be using it, it has to do with the fact that things will only get worse instead of getting better. Right now, Windsor has two hospitals with two emergency rooms between them, and they sometimes have a problem dealing with the number of patients they get. Especially the emergency rooms. How is closing them and opening one hospital with one emergency and the same number of beds in it, going to improve things. Things are only going to get worse. Windsor used to have 4 hospitals for fewer people, now they will have no hospital for a larger population. The smart thing would have been to build a smaller, updated community hospital in the county and the main, bigger hospital closer to the downtown, making it convenient for everyone."
"hundreds of people walk through the front doors of our hospitals. Staff, visitors, and volunteers. Its those that are healthy that could walk or take active transportation to our hospitals. WRH staffs up to 5000. That’s [a] lot of healthy people right there that could walk to work."
"The fact is many people have no other option. At least 16% of the population don't own a car. 36% of millennial don't own a car."
"And we're looking to replace a large chunk of farmland with a hospital that has the same services and same amount of beds that we currently have.

But people don't want to question the location (especially those in the county) because it's closer for them."

"It should be illegal to build on farmland. I see this happening daily and it scares the crap outta me. (1) more pavement = more flooding (2) more pavement = higher temperatures (3) we no longer have enough farmland to feed the world"
"We need to build up not out for housing, industry, retail. Think what is was like here in Essex county 200 years ago, I can't fathom what it will look like in 200 years in the future."
"City Planners need to mandate a new to old ratio. For every new development house they must redevelop, renovate or build X number of homes or units in established urban areas."
"There is still room within the city of Windsor for more building. We need more apartments and one-level homes, for seniors who want to downsize in their own neighborhoods. We need more low income housing, apartments and town homes. "
"My grandparents had a beautiful 50 acre mixed farm in LaSalle which is now covered with monster homes. I can’t go back there as I’m reminded of what was lost."
"Paving 60 acres of floodlands is looking smarter every day."
"Pouring asphalt across a flood plain...priceless"
"Ontario is in massive debt why would we pick the location that costs the most? Over 150 million dollars extra just on infrastructure the other sites don't need. Also adding busses to accommodate that location which isn't on current bus routes like the other locations are."
"Hwy 42 & 9th Conc. is right in the middle of the Upper Little River flood plain. Building a 10 storey MegaHospital adjacent to and in the flight path of a busy, existing International airport sound like the script to pending disaster. "
"It is not a done deal until it gets built, until then it is up to the logical members in our communities to convince the leaders and provincial govt that building in the proposed spot would be a grave mistake."
"Right now every mayor in this county, including Windsor are building sprawling or planning to build more sprawling subdivisions as fast as they can, everywhere they can. All the while giving lip service to climate change. All they are accomplishing is to bankrupt their grandchildren before they’re born."

Sunday, June 27, 2021

Emergency Fundraiser Update - Week 5


Dear CAMPP friends and supporters,

This week we were delighted to receive a $1,000 donation from CUPE Ontario towards our Emergency Fundraiser. The Canadian Union of Public Employees, an organization with a strong history of advocacy, is Canada’s largest union. Thank you, CUPE Ontario, for supporting CAMPP's efforts to keep hospitals where people live!

From CUPE's Ontario's website:
"With over 280,000 members, CUPE Ontario is a strong voice for rights and fairness for our members and our communities. We work at the provincial level for legislative, policy and political change on issues affecting public services, equality, healthy communities and a better Ontario for everyone."

Since launching our Emergency Fundraiser just five weeks ago, many of you have sent us donations, in varying amounts. To each of you, we are so grateful for your support.

CAMPP still needs to raise $32,000 more to pay our court-ordered $55,750 legal bill. Although the deadline to pay this bill has passed, we are continuing to ask for contributions so we can work towards putting this behind us.

We know you don't like this situation, but we regard this as the price of keeping healthcare equitable, inclusive and accessible.

Everyone in Windsor Essex deserves a better healthcare plan.

Click here to donate to our GoFundMe
Please note: you can also etransfer your donation directly to our account using our email address:
In their own words
Local residents commented last week:
"Your description of the unfolding of the Adie Knox decision illuminates once again how decision-makers in Windsor see community impacts and citizen engagement as peripheral to their actions. One can't help conclude, as with the hospital site selection, that development is the priority, rather than the health and well-being of the community and the environments we live in. Not only is this conduct appalling in its disregard for the role of community in planning, but also the short sightedness, the inequitable criteria behind decisions, the failure to acknowledge environmental and sustainability implications, the utter lack of accountability, and a failure of recognition of the historic, present and future context of the Windsor Essex region and its peoples."
"Having core health care services and functioning public services contribute to a Liveable City that Windsor should be constantly striving towards."
"A brief parable: A homeless person is given a can of tuna by a generous citizen. The homeless person is still hungry without a can opener. The generous citizen walks away feeling complete and full. Heaven forbid if the homeless person speaks up, objects or even suggests this to be inappropriate. The generous person can correctly state the fact: you asked for food, I have given you food.

Over time, one learns that it is best to just give up and say 'thank you for the can of tuna'."
"[Council, mayor and administration] mistakenly believe they are here to lead our community. I wish we had some people that were here to serve our community instead."
"The bigger issue is the lack of consultation with residents regarding any of this mayor’s schemes/projects and a majority of counsel willing to support whatever he proposes."
"Appalling that the student body wasn’t consulted given their contribution. Appalling!"
"It’s not good enough to on one hand write [reduced car dependency] into plans and try to awkwardly and often with much hostility, half implement these alternative measures and on the other hand plan a massive urban sprawl development undermining any responsible forward plans established in terms of reduced car dependency. The courage and the will need to truly be there!"
"Something is not right, when Council does not consider/support the majority of delegations of Windsor Residents."
"why can't City Council listen to the residents"
"The city is out of touch with residents remember that next election"
"There is the hospital site, the Adie Knox pool, the steetcar on the waterfront - what next? Does the populace get a choice on anything?"

Sunday, June 20, 2021

Another critical, rushed Windsor decision-making process


Limited ranking exercise dressed up as "consultation"

On Monday, June 21, 2021, Windsor City Council will be debating a $42M plan to redevelop the Adie Knox Community Centre in West Windsor, where 56% of children live in poverty. The plan includes the closure of the 25m indoor swimming pool - a neighbourhood treasure. A shared services agreement with the University of Windsor promises the relocation of most swimming programs to the university's new Lancer Sport and Recreation Centre. There are many valid questions about how this will work in practice, as well as social and other barriers that may inhibit neighbourhood residents from using the university facility.

The actual investment might be far less than $42M, according to political commentator Frazier Fathers. He warns that the plan's details show that 40% of the project cost is a buffer for construction cost, consultants and contingencies. He also notes that funding for the redevelopment may come at the cost of maintaining existing city amenities.

For years, area residents have actively campaigned to keep the Adie Knox pool open. As recently as December 2019, they successfully lobbied to keep it from the chopping block. Yet, two weeks ago (just 18 months later and during the same Council term), the closure of Adie Knox pool was suddenly announced.

Where have we seen this before?
To satisfy the plan's public consultation requirements, the City of Windsor conducted a single week-long survey from June 8-15, 2021. Respondents were invited to rank their priorities from a predetermined list of possible amenities for the redeveloped centre. The pool, the amenity that is so important to area residents, was not included as an option.

A one-week survey (extended to 2 weeks!) for a $2 billion hospital project?
The Adie Knox consultation process is eerily similar to the May 2015 ranking exercise for the site selection criteria for the new $2 billion County Road 42 hospital. It was the only online community engagement opportunity that hospital planners have ever offered residents!

In May 2015, respondents were asked to select their 10 top priorities for the hospital from this list of 32 predetermined criteria:
  • Official Plan designation
  • Site amenities (trails, nature, restaurants, shopping)
  • Topography
  • Zoning
  • Visibility
  • Servicing (established or potential)
  • Impact of restrictions
  • Proximity to EMS/Police
  • Geotechnical features
  • Parcel shape and geometry
  • Roadway capacity
  • Drainage
  • Parking potential
  • Arterial/Collector Road Access
  • Rivers/Streams (Archeological)
  • Flexible Site development
  • User Access (roadway, drop-off, loading)
  • Vegetation
  • Parcel size
  • Transit Route (established or potential)
  • Protected wetlands
  • Service catchment area
  • Pedestrian/bicycle access
  • Wind
  • Provisions for allied services (e.g. Long-Term Care, Pharmacy, Office)
  • 2 Road frontage
  • Noise
  • Relationship with other institutions (Research or Education)
  • Distance to US
  • Air Quality
  • Neighbourhood compatibility
  • Helicopter flight potential
Click on the survey box above to see the 32 predetermined site selection criteria
and accompanying descriptions 

Criteria failed to capture what really matters to the average person on a day-to-day basis
Outraged residents were vocal in their criticism of this very poorly constructed exercise. The one thing that mattered the most to the majority of people was whether the hospital was to be built in an established urban neighbourhood, or in an undeveloped area.

Yet, completely missing from the list of possible priorities was any language relating to the consequences triggered by the chosen location. For example, the impact to Windsor's established neighbourhoods of removing two urban acute care hospitals, which collectively support more than 5,000 healthcare jobs, wasn't addressed. Environmental concerns relating to increased commuter trips, construction on active farmland, potential flood risks to downstream neighbourhoods, and the enormous costs to taxpayers of creating new municipal infrastructure to develop and service an exurban hospital site were all excluded too.

Respondents were required to provide their names and email addresses. This inhibited hospital insiders (contractually obligated to refrain from negative comments) from airing any concerns they might have.

Especially bafflingly, respondents were not required to provide any demographic information. Standard requirements for professional surveys such as age, gender, income and postal codes were not collected.
What followed was a public admission of consultation failure!
Site Selection Committee Chair Bob Renaud, who was also Chair of the Windsor Regional Hospital Board, acknowledged to The Windsor Star on January 7, 2016: "the committee did not consider what effect removing two hospitals might have on the city core, however, since that was not one of the criteria his group was asked to assess."

Years earlier, an exurban hospital location was already in the agenda, long before any public consultation, however limited, was conducted -- only 600 people responded to the 2015 ranking survey -- just 0.15% of the regional population! In 2009, when hospital planners submitted planning documents to the Ministry of Health, they had already identified a "greenfield" site as their preferred choice. Since then, they have never shown any signs of deviating from this intention, even in light of sustained public pushback and new data and policies proving it is an outdated development model.

In the 364 written comments to the 2015 ranking survey, the local community clearly communicated their concerns about the negative impacts of locating the new hospital far from the region's most densely populated neighbourhoods: 154 asked for an urban hospital site, compared with 103 who favoured a rural site. There were also 18 complaints about the survey itself.

With 50% more respondents specifically asking for a site where people already live, the failure to incorporate this in the final site selection criteria was a critical failure in the consulting process. It showed an unacceptable unwillingness to address public concerns.

Similar to the way local officials have executed their years-long unrelenting campaign to remove the Adie Knox swimming pool, hospital decision makers treated public consultation as a box to be checked off while continuing to plan according to a predetermined agenda.

Read the 364 comments here
Emergency Fundraiser Update - Week 4

Dear CAMPP friends and supporters,

Thanks to your generosity, we brought Windsor Regional Hospital (WRH) a cheque for $20,683 raised in under three weeks!

Several more donations came in since then, but CAMPP still needs to raise $34,000 more to pay our court-ordered $55,750 legal bill. We know you don't like this situation, but this is the price of keeping healthcare equitable, inclusive and accessible.

Each contribution is a message to decision makers at all levels of government that hospitals belong where people live. 

Everyone in Windsor Essex deserves a better healthcare plan.

In their own words
Several supporters wrote comments relating to resilience:
"The big issue is no one in this region should be okay with going from two hospitals to one. We gain no beds from this plan even though our population is growing and we are already below provincial average of beds per capita. Why are we not pushing for more as a region?"
"A new hospital is more than just medical science. It encompasses all aspects of “Urban Planning and Related Social Conscience and Service”. The new Mega-hospital thought and current forecast development process is flawed.

Putting all eggs in one CCU hospital basket in a CoVid type future challenge, in my opinion does not measure up to a soundly based Windsor-Essex Region public health Mega-hospital forecast."
"Many years ago at one of the few town hall meetings I asked what would happen if the hospital was shut down due to a flu epidemic. The answer was "no problem" the doctors and nurses could enter from another entrance. I asked what if they had spent lunch together in the cafeteria with the public. I was blown off by my question. Bottom. Line, one hospital only certainly jeopardizes the region. We need a plan B. It's only logical to have a contingency to fall back on."
"A few years ago my mother had a surgery postponed twice due to a problem with the sterilizing equipment at Hotel Dieu, thankfully it wasn't an emergency and she was able to wait it out, but what about emergencies if there is only one hospital. A city the size of Windsor deserves to have two stand alone hospitals, even if it is a little more expensive, especially if they expect it to grow to , up until now, unheard of annual numbers, as some of their reports suggest ( and some don't of course) The redundancy in emergencies is essential."
"Building this hospital across from the Airport puts it smack dab in the middle of a flood plain that will cause extreme flooding to the Little River corridor. Riverside and areas going East will be the recipient of basement flooding."