Sunday, July 19, 2020

The Community Speaks

In their own words: This week we're bringing you recent comments from the community

"Hospitals should be built where the majority of population live."

"After 7 years of lacklustre results the complete hospital planning committee needs to be replaced by a provincial mediator. Taxpayers can't wait forever!"
 

"The issue of access has been sidestepped again and again, as well as environmental degradation due to sprawl."

"There is a need for meaningful discussion about how the proposed hospital plan will enhance the current quality of, and access to health care services in both Windsor and Essex County. I believe these core issues need to be addressed before the 'planning process' goes any further."
 
"The selection committee did not take economics into their mega-hospital location, and now they're not accepting COVID-19 or pandemics into their mega-hospital location equation. They (location committee) are working with a flawed model. We need a community rethink of this project. Indigenous included too."
 
"Why would you build a hospital behind a man-made barrier, the airport, that reduces access from those in the city's most densely populated area. It is pure nonsense."
 
"My first thought when i heard about the single facility plan was how bad it was from a security/pandemic perspective. My concern for the core came second."
 
"We keep learning as we become more informed."
 
"The mayor must accept responsibility as well. Leadership during this difficult time does not need battle lines to be drawn; it requires creative flexibility. The decision to cancel bus service hurts a sector that is already vulnerable. Council should meet and override the mayor's decision."
 
"This COVID crisis is teaching us that one hospital is a really really bad idea. right now they are using two hospitals to separate covid from non covid. Placing a big hospital on agricultural land is a loss of good farmland when we need that land so we can feed outselves and not be at the mercy of imported foods. There were always better options but the land speculators had to be appeased."
 
"Several years ago I asked on CAMPP, what if there is a epidemic or a pandemic like SARS happening in Windsor or world wide and having just one major hospital in the middle of nowhere, not only to deal with the pandemic but with all the other things that this one hospital will have deal with. Most people rolled their eyes, thinking that I was dwelling in a science fiction world. Well. My nightmare scenario has come true. We CAN NOT HAVE JUST ONE HOSPITAL in our area of city and county.

We need to clean house and start fresh. We'll all see, decades from now, that the bean field was the wrong choice."
 
"The location is still the most important decision in regards to a new hospital. No one disputes the technical aspects and attributes of a new medical facility.

Either you believe in a strong vibrant metropolitan Windsor with a hospital downtown or you accept a hallow decaying abandoned downtown.

The location proposed on the outskirts of the municipal boundaries will contribute to a have and have not society separated by your bank balance. I hope and pray compassion and understanding will triumph over dollars and entitlement."
 
"While I fully support money being spend on improving and adding to the healthcare system in my community, I cannot support the proposed "mega-hospital" plan for Windsor-Essex.

We cannot and should not be adding to irresponsible sprawl and eliminating valuable agricultural land. This proposed building site also removes vital access to healthcare from near the downtown core and therefore puts our most vulnerable citizens at risk.

There are so many reasons why this plan needs to be revised and made transparent and available to the public."
 
"CAMPP has already provided many valid points regarding the negative impacts to be had at the social and financial levels for the City of Windsor.  As an individual who received my post-secondary education in Toronto, in Ryerson University's Architectural Science program, I fully understand and support [CAMPP’s] points. I can support their arguments for the pursuit of contemporary, progressive development for the City of Windsor, whose reputation already suffers enough as being outdated, vacant, and sprawling."

"By locating the new hospital in a more centralized part of Windsor, we can bring foot traffic and activity back into the City. We can increase the number of educated health care professionals in the City. We can provide accessible care to those who do not have personal vehicles, and we can avoid the costly nature of sprawling municipal infrastructure. We already do not have an accessible stadium for sports games and entertainment downtown, and now we are being faced with the lack of a hospital as well. This is the complete opposite to all major successful cities around the world. These are things which make a downtown experience dynamic and desirable. There are educated and cultured individuals who live here that will celebrate and promote progressive development."

"Please help us in changing the direction of this new hospital planning to revolve around a more centralized location. I am not the only one who thinks its location on the fringe will contribute to the growing consensus that our City is becoming a less and less desirable place to live."

"Plenty of people mentioned the lack of appropriate redundancy throughout the planning and discussion period, plenty of times."
 
"No one disagrees with the need for a hospital and the concept of mostly private rooms."
 
"No one objects to needing these features within our local hospital or hospitals. This pandemic is a problem but it shouldn’t mean that we toss aside good planning or addressing other issues with the current proposal."
 
"The last time we didn't fight against a proposal brought up by the City, we got an overpriced aquatic center that is losing money to the point where they want to close profitable pools like Adie Knox.

The time before that was the WFCU center where we have inadequate parking and a loss in downtown revenue. The Windsor Express realized the shortfalls of playing at the WFCU center and are looking to relocate downtown in the old barn.

The City has a track record of making poor decisions with ventures like this in regards to ideas and locations. The underground passage on riverside was another but luckily we got in front of that one.

If we don't fight for the best idea in regards to this "Mega" hospital than we will regret it down the road like the Aquatic Center and the WFCU center."
 
"Disregard COVID-19 and the implication that it could be with us for a long time (like the flu virus, it may return yearly). Okay, let's pretend pandemics should not affect where the location of the mega-hospital should go. All this that we have learned from this pandemic so far cannot be included in any discussions regarding the mega-hospital location. Out with the new, in with the old. As in evidence. This mega-hospital location issue must include newly-gained medical information (COVID-19) to ensure the healthcare the residents of Essex County deserve. To do so otherwise would be an insult to healthcare and to those who expect excellent healthcare."

"I feel bad that a few people ignored the results of the site selection process and put it in the bean field in the first place. I am thankful that CAMPP is standing up for those in the downtown core and west end who don’t have a voice."

Thank you for your many messages. Please continue to send us your comments so we may share them with our readers.

Sunday, July 12, 2020

Mega-hospital site selection: Is there still a valid contract?


How was the July 2017 deadline
for the $6M new Windsor-Essex
hospital deal extended?
Was public trust compromised?

Monday, July 13, 2020 is the fifth anniversary of the signing of the Agreement of Purchase and Sale of the County Road 42 site for Windsor Essex’s proposed new hospital, along with the development of Sandwich South.

It was confidently promoted as a done deal.

A year ago, on July 9, 2019, when it was clear the ownership of the $6M parcel of land had not yet transferred, we wrote an eblast asking questions around public trust. 

Another year later, the answers to these questions are as elusive as ever. And the land deal has yet to be done.

Copy of Agreement of Purchase and Sale

What has changed in five years?
The land registry record shows that, as of July 2020, five years after the initial giddy location announcementthe legal owner of the irregularly shaped 60 acre property, with an assessed value of just $400,000, is still Michael O’Keefe Farms Inc.:

Owners names
Excerpt from parcel register

On July 17, 2015, CTV News reported that “The 60 acres required for the hospital will be purchased for roughly $100,000 an acre, pending approval from the province.

So, has the province approved the $6M O’Keefe farm purchase yet?
There is no evidence that approval for the purchase of this 60 acre (24 ha.) parcel of unserviced farmland -- with an assessed value of just $6,817 an acre today -- has been granted. 

Was the Agreement of Purchase and Sale quietly extended?
According to the terms of the Agreement of Purchase and Sale, the property should have been transferred to Windsor Regional Hospital by July 21, 2017, nearly three years ago!

The contract provides for the possibility of a one-time extension:

…The parties agree that the Completion Date shall occur no later than July 21, 2017..If… the Buyer has not received any approval reasonably necessary for the redevelopment of the Property as a hospital, the Buyer shall have the unilateral right to extend the Completion End Date for a further [one hundred and eighty (180) day period] on written notice to the Seller no later than [May 31], 2017.

It’s now July 2020. Was an extension duly requested as required under the terms of the purchase agreement? If so, what happened after January 17, 2018, 180 days after the original completion date?

Is there still a valid contract? Is this procurement process open, fair and transparent?

Three years after the original completion date provided in the agreement, it’s completely unclear whether the purchase agreement is still valid.

Was a clandestine postponement of the deal negotiated beyond the one-time 6-month extension provided in the contract?

If so, is this in compliance with the Broader Public Sector Procurement Directive? It applies to organizations receiving more than $10M in Ontario government funding, including hospitals. The Directive is based on five key principles that allow organizations to achieve value for money while following a procurement process that is fair and transparent to all stakeholders:

5 principles for Public Service procurement
Was a competitive procurement process ever conducted?
Back in 2015, during the first phase of the controversial site selection process, the GEM site -- the only other short-listed site -- scored higher than the County Road 42 site.

Were the owners of the GEM consortium -- with full knowledge that the County Road 42 deal was priced at $100,000 an acre -- ever invited to submit a new competitive bid after the contract’s original July 21, 2017 expiry date?
The data (made available only after a CAMPP supporter filed a Freedom of Information request) overwhelmingly indicated the GEM site was superior to the O'Keefe site on County Road 42.

“They were number one going into phase two.” 
                -- Windsor Regional Hospital CEO David Musyj,
                           commenting on the GEM site on Tecumseh Road

However, GEM lost in phase two of the bid process because of a $1.8M difference in land price. Yet the calculation:

  • excluded tens of millions of dollars in necessary infrastructure upgrades on County Road 42
  • included material changes after Richard Spencer, the Consulting Engineer for both shortlisted sites, submitted his calculations.
Mr. Spencer explained the issues in a January 25, 2016 letter of complaint, and this January 19, 2019 LPAT Participant Submission:

Had our analyses been used as originally submitted by our firm, and if the significant cost of road improvements had been taken into account as outlined in our attached letter, it is my opinion that the County Road 42 property would not have been selected as the most efficient and cost-effective site for the proposed acute care hospital facility.

Furthermore, City Council should have been made aware of the differences between our firm's servicing reports and the figures that were ultimately used for this project, in order for them to make an informed decision on the matter
               
                    --  Richard C. Spencer, M.A.Sc., P.Eng,
                    President of RC Spencer Associates,
                    Consulting Engineers

As the Windsor Star’s Anne Jarvis wrote in her January 8, 2016 column: “So for a [land price] difference of 0.1 per cent, the second-best site catapulted into first place.” She also pointed out:

The Tecumseh Road site is more a part of Windsor’s existing core than a field on the edge of the city. A new hospital there, along with proposals for an urgent care centre on the west side and enhanced care at Hotel-Dieu’s downtown and west side campuses, would further address legitimate fear of sprawl that could hollow out the core.

But, said [Site Selection Committee Chair] Renaud, “It was never one of the criteria. There was never one suggestion made that we had to consider hollowing out the urban core.”

-- Anne Jarvis, Columnist for The Windsor Star, January 8, 2016

Mr. Renaud's astonishing abrogation of responsibility for the health and well-being of the city reflects a major flaw in the hospital site selection process. This couldn't have been an accidental oversight, because 154 of 364 comments specifically explained the need for an urban hospital site in the public survey circulated before the site selection critera were finalized. 

This also stands in stark contrast to the words of Dr. Theresa Tam, Canada's Chief Public Health Officer:

“[D]ecision-makers and planners at all levels should take a multi-sectoral, collaborative approach and consider health as an important outcome, as appropriate, when making infrastructure planning decisions...

...Our communities are changing and often expanding through urban sprawl rather than by building compact and complete communities.

Urban sprawl has been linked to sedentary lifestyles, easy access to unhealthy food, less physical activity and higher rates of obesity.

One of the key results of urban sprawl that may explain some of these impacts is more time spent driving.”

-- Dr. Theresa Tam, Canada's Chief Public Health Officer

We all want this provincial healthcare investment in our community!
There’s no debate that we need new healthcare infrastructure. However, the process must be managed transparently and with the best interests of all residents in mind. The Chair of the new hospital site selection committee candidly acknowledged the risks of further hollowing out of Windsor's central neighbourhoods were never considered. This is a particularly shocking admission for a $2 billion project intended to enhance the health and wellbeing of the community.

The publicly available evidence suggests Windsor-Essex hospital planners:
  • secretly extended its completion date beyond the contracted deadlines, and
  • openly ignored external infrastructure costs and demonstrated risks to Windsor's urban core from increased urban sprawl
This goes far beyond whatever opinion you may have about the best location for the new hospital. It is a fundamental matter of accountability and public trust. In the absence of an accountable and transparent process, we have every right to doubt whether the public interest is being properly served. 

WE DEMAND BETTER!
Please continue to reach out to elected municipal and provincial leaders.

1.  Demand proper oversight of this $2 billion investment. The status of the County Road 42 land deal needs to be brought into the open. If the contract has expired, decision makers face a timely opportunity to launch a new search for a more responsible hospital location.

2.  Demand the appointment of an independent facilitator. The concerns over accountability and public trust need to be addressed before proceeding to the next stage of hospital planning.

Windsor-Essex residents deserve better decision making. 

 

Sunday, July 5, 2020

When Optics Tell a Different Story, Part 2

A lack of diverse, authentic voices
 plagues hospital decision making in Windsor-Essex
Part 2

If you missed Part 1, read an archived copy here.
 
RECAP: In Part 1 we examined the composition of the new hospital site selection committee, as well as the ultimate decision makers and process gatekeepers: those who speak for the entire community at the Ministry of Health and in Queens Park. We also wrote about the Windsor Essex Economic Development Corporation (WE EDC), who recently hired the lobbyist firm Crestview Strategy to create an "interactive grassroots campaign" to promote the hospital project.

What the composition of these groups demonstrates is that decision making power in Windsor-Essex rests in a narrow and privileged demographic:
This tight power structure is evidenced by those endorsing the hospital plan in WE EDC's promotional campaign videos. For example, two of the five "testimonials" posted to date are from high level administrators at Windsor Regional Hospital (WRH):
  • Kevin Marshall is WRH's Director, Facilities & Capital Planning. He serves on the steering committee for the new hospital plan and appears to be the lead WRH contact for many of the planning documents submitted to the Ministry of Health for approval. He reports to the CFO
  • Karen Riddell is WRH's VP, Critical Care, Cardiology, Regional Stroke, Trauma & Clinical Support Services
Another local power broker adds his voice
A fifth testimonial was added on July 2, 2020: Noah Tepperman, owner of Tepperman’s Furniture, Mattress, Appliance & Electronics Store. He is the third generation to lead this prosperous local family-owned business (est.1925).
Currently "one of the largest independent home furnishings stores in Canada," Tepperman's has retail locations in Windsor, Chatham, Sarnia, London, Kitchener and Ancaster, according to its website. Noah Tepperman is also:
  • A former director of the Windsor Regional Hospital Foundation, from 2006 to 2012
  • Convener and co-chair of ProsperUs, a high profile initiative (led by United Way) that's committed to "align resources to ensure that the most vulnerable, and the most promising members of our population – our children and youth – succeed in their education, career and life." Its prominent community partners include WRH and WE EDC
  • Past president of the federal Windsor-Tecumseh NDP Riding Association, a party with an unequivocal commitment to diversity and accountability:
“We value equity and diversity. We recognize the identities we hold may grant or deny us privilege. We also recognize we have multiple identities that intersect. New Democrats have a special responsibility to create space, to listen to diverse voices, and to respect and promote emerging leadership.

As we come together, whatever our role within the Party, we reaffirm our collective commitment to mutual respect and accountability, mindful that all persons deserve dignity, equality and respect.”

 
Excerpt from the Equity Statement,
which is read aloud at the outset of NDP meetings

Who stands to lose the most under the new WRH plan? Those who live near the current WRH hospital campuses.
Windsor's neighbourhoods within a 5 km radius of downtown -- home to almost 25% of the Windsor-Essex Region's total population -- are also home to tens of thousands of new Canadians, visible minorities, and people living in low income or with disabilities. A large number of these residents are elderly or have chronic medical conditions and deliberately choose to live in the neighbourhoods closest to WRH's Met and Ouellette campuses.

Many of the residents of Windsor's most central neighbourhoods have little political clout. They (and their caregivers) often experience transportation and economic challenges in their everyday lives that most middle class suburban residents never have to face.

Building for the future: ProsperUs to the community's rescue?
ProsperUs, in Coming Togetherits inaugural (July 24, 2019) report, focuses on three primarily low income neighbourhoods and the barriers for young people living in them. These neighbourhoods include Downtown and West Windsor (The report also names Leamington, which is served by Erie Shores Health Care, that community's acute care hospital):
ProsperUS map
ProsperUs lists five key themes it considers to be a foundation of success: family financial stability, health & nutrition, access to housing, transportation and social inclusion.
CAMPP wholeheartedly agrees that these elements support individual and community success.

However, given the organization's commitment "to align community resources," how can ProsperUs community partners legitimately promote the $2 billion hospital infrastructure investment in Sandwich South? An investment far removed from the residents in the neighbourhoods the organization was formed to support, and furthermore, one that will hollow out the economic viability of those same neighbourhoods?
“We need to do lots of work with the community
and they need to be involved as well,”
admitted Dave Cooke, co-chair of the steering committee
                  for the new hospital in 2015.               
Since 2015, the only concrete progress for the proposed County Road 42 hospital project is that increasing numbers of residents are alarmed about the planned closure of the two accessible WRH urban acute care hospital campuses. Yet in sharp contrast to the WE EDC campaign, the residents calling for a more responsible hospital location are neither financed nor amplified using public tax dollars.

The WE EDC campaign underscores how planners (elected and unelected) promoting the new hospital project are still operating in an impenetrable "panic room." These power brokers hide behind purported inclusivity and benevolence. But to date, they've stayed safely distanced from the tens of thousands of residents who stand to lose the most if the County Road 42 hospital site moves forward as proposed.

The weakness of their elite bubble is highlighted by the repeated failed attempts to find a groundswell of genuine community support for the hospital plan.

Now is the right time for Windsor's Mayor Dilkens to prove his commitment to inclusive community consultation.

This is a perfect moment to formally and robustly introduce authentic, new and diverse voices in the planning of the new Windsor-Essex hospital system!

Mayor Dilkens, elected to represent all Windsor residents, recently declared his commitment to diversity by recognizing that  "It is important to talk with people who can make us see the world differently."

Here are some ways this can be immediately achieved -- without resorting to tokenism -- and without negatively affecting the provincial funding for our new hospital:
  • We call upon the Board of Directors of WRH to restructure the membership of all decision-making committees involving hospital planning to accurately reflect the community's broad diversity of perspectives and lived experiences.
  • We call upon Ontario's Ministry of Health to appoint an independent facilitator to oversee the open community discussion that Windsor-Essex residents deserve, before proceeding to the next stage of hospital planning
  • We invite community organizations in leadership positions like United Way and ProsperUs, and their partners, to join CAMPP's call for an independent facilitator to listen to and address residents' concerns about the location of the new hospital
We also ask that local councillors question financial decisions related to hospital planning funneled through WE EDC, which receives its funding from Windsor and Essex County municipalities.
 
Only then will Windsor-Essex leaders
be in a position to choose the best location
for the new hospital.

Sunday, June 28, 2020

When Optics Tell a Different Story, Part 1

A lack of diversity plagues hospital decision making
in Windsor-Essex
Part 1

Decision making for the new Windsor Essex hospital system rests in the hands of a small group of elite and politically connected power brokers. This group bears little resemblance to the region's increasing ethnic and socio-economic diversity.

Elected and unelected officials have created a tightly controlled power structure to promote the deeply flawed exurban development plan. Their top-down approach and highly selective messaging are designed to satisfy a homogenous, mainly middle class suburban and rural audience.

This strategy has not only created a deepening divide in the community; it has served to bury the voices and healthcare needs of tens of thousands of residents. Especially affected are those on fixed incomes, those with impaired mobility, and those who are dependent on public transit for their transportation needs.

However, this small group of decision makers - among them Windsor mayor Drew Dilkens and Windsor Regional Hospital (WRH) CEO David Musyj -- wish you to believe otherwise...
For example, Mayor Drew Dilkens recently declared his commitment to diversity when he wrote in a Facebook post, "It is important to talk with people who can make us see the world differently."

Indeed.

He had participated in a June 19, 2020 online panel with local Black, Caribbean and African leaders. The panellists discussed "barriers to justice and equality and opportunities for Windsor to be the most inclusive, respectful, loving and connected community possible."
Mayor Dilkens' stated desire for inclusivity echoes WRH CEO David Musyj's promise from a May 2015 CBC interview:

...the most inclusive, transparent, fullsome process that will result in the best decision for the location of the new hospital. What we have been told is that we have put together such a process up this point by trying to get the community involved.”
Perception is Reality
Optics (and actions) that tell a different story
Completely contrary to these laudable stated goals, the decision making process for the planned new regional hospital system has been tightly dictated by a small group with little of the racial, economic or cultural diversity that characterizes the Windsor-Essex population.
"Currently there are over 170 ethnicities and 70 spoken languages making Windsor the fourth most ethnically diverse city in Canada."
                        -- City of Windsor, Cultural Mapping Community Stories
1.  A Narrow, Privileged and White Demographic
Pictures of the Site Selection Committee members

One glance at the members of the WRH site selection committee confirms an astonishing lack of diversity.

Six of them are current or former WRH Board members.

They share an abundance of high profile professional backgrounds and prominent board appointments, representing a narrow, privileged and largely white demographic.
  • One of the members professed a desire to speak for the Francophone community. While that's admirable, who represents BIPOC (Black, Indigenous, People of Colour) or newcomers to Canada, and those who live in the region's most densely populated neighbourhoods (clustered near Windsor's downtown and the city's west end)?
Who speaks for the particular challenges of those who are wheelchair bound or dependent on public transportation to get around? Are any of the committee members single parents, perhaps with limited resources and several children? Or is anyone on the committee disabled, with no family support system to rely on?

Was this committee ever capable of truly understanding, predicting and planning for the entire community's future needs?
 
2.  The Men Wielding The Most Power
More disturbingly, our regional diversity isn't reflected among those steering the hospital planning through the municipal and provincial approval and oversight processes.

These men are the ultimate decision makers. These spokespeople and process gatekeepers have the loudest and most persistent presence in the local media. They are the power brokers who directly speak for the "entire" community at the Ministry of Health and in Queens Park.
 
But do these men truly represent everyone?
From the top, in clockwise direction: David Musyj, co-chair of the new hospital steering committee and CEO of Windsor Regional Hospital, Gary McNamara, Mayor of Tecumseh and Warden of Essex County,Tom Bain, Mayor of Lakeshore and former Warden of Essex County, Glenn Ackerley, Fairness Advisor, Drew Dilkens, Mayor of Windsor, Dave Cooke, co-chair of the new hospital steering committee and former chair of the Erie St. Clair LHIN.
 
3.  A "Father Knows Best" Approach To Communication
The Windsor Essex Economic Development Corporation (WE EDC) recently hired the lobbyist firm Crestview Strategy ("We make, change, and mobilize public opinion") to "stage" a taxpayer-funded "grassroots" campaign.

This approach perpetuates the monolithic top-down PR style (complete with bait and switch tactics) that characterizes nearly a decade of hospital planning and decision making:
"...now we’re providing a platform for a more co-ordinated and effective message.”
 
         -- Stephen MacKenzie, CEO, WE EDC, describing his organization's six-figure taxpayer funded campaign to manipulate residents into supporting the exurban hospital plan.
The ethnicity and professional backgrounds of the four people in the video testimonials posted in June 2020 to promote WE EDC's "interactive grassroots campaign" certainly don't represent the reality of Canada's fourth most diverse city:
From the top left, in clockwise direction:
  • Karl Lovett, International Brotherhood of Electrical Workers Local 773
  • Joe McParland, Forward 42
  • Karen Riddell, WRH Vice President, Critical Care, Cardiology, Regional Stroke, Trauma and & Clinical Support Services
  • Kevin Marshall, WRH Director, Facilities & Capital Planning

Stay Tuned! In Part 2, we'll look further at those influencing the push for the County Road 42 new hospital location. We'll also discuss ways greater diversity in decision making can be immediately achieved -- without resorting to tokenism -- and without negatively affecting the provincial funding for our new hospital.