POWASSAN – After two hours of debate the future of a new medical building in Powassan looked more secure than it did when council started its sit down with the Health Team Board.
Discussion at the Tuesday night regular council meeting started with a rough tone as Coun. Todd White laid out in detail five main points of contention, taking more than an hour to go through them, with few interruptions.
However, by the end of the meeting the two sides both expressed relief for the clearing of the air and clarifications offered by the Health Team board and staff.
The turning point in the meeting came from a direct question from Coun. Dave Britton to Dr. Scott Houghton.
“In the present situation with the four doctors that we have now, can we grow that 5,300 number?” asked Britton, referring to patients registered with Powassan doctors in the existing municipally-owned medical centre.
“Not by a lot,” replied Houghton, before explaining adding patients to a doctor’s clientele can be a long process and is far from an exact process with some physicians choosing to take on different patient loads and not fully implementing the health team of nurses, a social worker and others they would be discouraged to take on a heavier caseload.
After the answer from Houghton, about an hour-and-a-half into the meeting, the Health Team representatives appeared to have more space to better explain their creation and business case with chair Sheila Latour and executive director Anna Gibson-Olajos taking the lead.
Gibson-Olajos explained how the price from the developer, Gary Eides, is dependent on financing, contractor and architect arrangements for April 16 to proceed with construction design and building start and how changes to the principle design means having to renegotiate with the Ministry of Health for its 80 per cent funding of the Health Team.
“One thing the Ministry has been clear on is it will not spend any more money on an architect and someone else will have to pay for that if there are any changes,” said Gibson-Olajos.
The Health Team was at the meeting to present it’s lease agreement to the municipality to cover half of a 10-year lease cost of the new building, about $155,000 each year, in accordance with the Ministry of Health agreement.
The lease would be for the doctor’s portion of the building, while the Ministry would cover the space occupied by support staff, such as nurses. On the table is a tender from Eides for a 7,426 sq. ft. building on King Street east of Main Street.
White was aggressive in his questioning of the deal along with other points he outlined at the beginning of the meeting as he pulled out emails to Mayor Peter McIsaac from Health Team members. At the outset he gave five issues, including delays in receiving information from the Team, whether a new building was warranted, council’s moral responsibility towards how the project has proceeded, whether the existing medical centre could be expanded, and how the Health Team left the direct control of council.
Health Team lawyer John D’Agostino addressed the lack of information saying a previous move in 2010 that removed files about the Health Team from the municipality would be reversed, saying they were rightly the property of the municipality.
White’s line of inquiry also revealed the Health Team had gained 1,100 patients in the past year and the existing four doctors are concerned with the current patient load of 5,300 in the existing facility because of shortcomings in soundproofing and privacy.
Also questioned by White and other councillors was whether the building was too big considering the 2010 goal was 10,000 patients in a catchment area stretching from East Ferris to nearly South River to Chisholm and the Loring area.
“I’m not buying into, ‘If you build it they will come,’ mentality. I think the number of patients without a doctor is a lot less then you’re predicting,” said White.
McIsaac took the same line saying, “ I doubt there was 5,300 people without a doctor (when the Health Team application was approved). I know at this table there are people who live in this community but have a doctor in North Bay.”
Houghton took the line of questioning explaining registering patients takes time, himself taking four years to fill his practice at the medical centre when there were only two doctors at the Medical Centre.
“When you built the current building 20 years ago it wasn’t full at the beginning,” said Houghton.
Later in the meeting added the Ministry of Health has started many Family Health Teams across the province, building some spaces to big for demand, and took that into strong consideration before approving the current design.
Another major point of contention for White was the lack of public tendering for the new site.
“A ratepayer came to me and said I have a better property for this and I was never allowed to bid on this building,” said White, who then went on to say he had personally paid for legal advice on the matter. Citing municipal and provincial procurement policies White said the Health Team hadn’t done anything illegal in their bid process, but thought it was morally wrong.
Later in the meeting Latour said three bidders, including Eides, approached the board with proposals.
“At no time did we go and solicit any developer about a property,” said Latour adamantly.
A brief history from Gibson-Olajos pointed to an orginal proposal from a developer of the now vacant former Windsor Hotel and Giesler Boat Works sites for $40 a square foot.
“We got a price from him …and we went, ‘Woah’,” said Gibson-Olajos.
During the later bidding process between the three developers the Eides tender came in the lowest at $29.50 including built-in furnishings and medical grade materials and design – both features an extra in the other bids for $32 and $37 per square foot.
“When you compare the bids you can really see the value,” said Gibson-Olajos.
White dominated the discussion throughout the night, questioning even why the Health Team was not fully controlled by council.
“We did what the Ministry told us to do. When we were approved we were told to incorporate as a not-for-profit,” said Latour.
Responded White, “Don’t play this innocent victim thing here.”
White’s attitude at this meeting and previous discussions became an issue in itself with D’Agonstino taking a moment to address it.
During one of many exchanges with White during the two hour discussion, D’Agonstino said, “They felt so intimidate and so torn they reached out and asked for help in proceeding,” said D’Agostino.
Houghton made clear that the doctors of the Health Team are looking for some cooperation.
“If we lose this opportunity it will be a long time (for it to return),” said Houghton, previously noting the Health Team is already having a hard time recruiting nurses because of the space. “I don’t know what doctors would want to get on board and do this all over again. It took a lot of time and effort to get this far… We’re just looking to provide better service to the community and the new building would be a big part of it.”