Project lead: Other

Other project lead: The County of Simcoe, Regional Municipal Government

• Local authorities
• Older People’s Association
• Social or health care provider
• Volunteers
• Private sector

How collaboration worked: Collaboration with many business partners, including internal and external stakeholders, was instrumental in achieving the expansive latitude of housing and programs included as part of this continuum as well as in securing crucial resources to ensure the financial viability of this project. The County forged significant relationships with government, public and private agencies, community interest groups, clients, media, and local residents in bringing this vision to life. Federally, the County partnered with the Government of Canada, New Horizon funding to create a sustainable intergenerational gardening program. This seed money led to the development of a community “greenhouse” on the new campus. With increased public interest and awareness of the needs of this vulnerable population, also grew an increased disposition to provide support for local development by contributing to a community fundraising campaign. Provincially, the County received capital funding from the Ministry of Municipal Affairs and Housing directed through a federal/provincial capital funding program to support the creation of 40 new affordable housing units. Our existing 107-bed long-term care home received capital funding from the Ministry of Health and Long-Term Care to support the redevelopment of the home into a beautiful and more functional Class A facility. These partnerships were further augmented with tremendous support from the North Simcoe Muskoka Local Health Integration Network (NSMLHIN) who approved and funded an additional 36 long-term care beds and a new level of service in the provision of convalescent care. During the planning phase, the NSM LHIN co-hosted partnership forums with the County that fostered a number of onsite collaborations that included the: co-location of the Victorian Order of Nurses and on-site programming; the delivery of meals on wheels in partnership with the Canadian Red Cross; the provision of equipment and campus-wide access to the OTN with a broader community outreach component; and an enhanced partnership with Georgian College that led to the establishment of a new satellite part-time Practical Nurse program hosted at Georgian Village. In addition, the NSM LHIN provided one-time funding for the purchase of a 16-passenger accessible van and several small multi-passenger shuttles. As a regional level of government, capitalizing on the strengths of our internal support departments provided significant fortitude in such areas as housing, Information Technology (IT), Finance, Procurement, Fleet and Property, Communications, Planning, Roads, Forestry and By-law, Library, Emergency Management, Paramedicine, and Long-Term Care and Seniors Services. The last, but certainly not least of our government relations focused on our local municipal partner; the Town of Penetanguishene. Working together throughout the project, the Town provided a spectrum of support that ranged from such things as signage approvals, building permits and inspections, to the waiving of development charge fees, connecting local pedestrian, bus routes and municipal trail systems. Georgian Village also raised funding as part of the overall project as a result of the generosity of our local residents and many partnered agencies. In addition to all levels of government, the County fostered many other partnerships in achieving an entire continuum of services. Working with our attending and local physicians, a Family Health Team was established on site by a lead physician as a significant component of this model. Initially operating with two (2) physicians and a nurse practitioner, the Village Clinic offers improved access to primary care, lends itself to house calls when needed, utilizes OTN to access other health-care specialists, and has the capacity to double their services in future. The expansive list of services outlined within the Community Hub, is a direct consequence of strengthening existing and forging new partnerships to improve access through a “one-stop shopping” concept. Having access to a host of paramedical supports and essential services such as lab, ensures seniors have timely and accessible care to maintain their optimal level of health. Further, a natural extension of this environment has been the provision of Health and Wellness Clinics that facilitate client education focused on health promotion in such key areas as chronic disease management, nutritional care, healthy living, exercise, and medication management. Other areas of focus include nursing and paramedic student placements in partnership with local community colleges and training facilities. Currently, Georgian Village Senior Campus continues to foster several collaborative service arrangements which include VON SMART program, Red Cross Home Support Services, Seating and Mobility Clinics, Ontario Telemedicine program, Georgian College collaboration for education and placement of students, Penetanguishene Library, County of Simcoe Regional Library Cooperative, Georgian Village Hair Salon, Audia Hearing Centre, Community Living Huronia, Wendat, Rosewood, Georgian Bay General Hospital, North Simcoe Muskoka LHIN, local physicians, pharmacies, Town of Penetanguishene, NSM Behavioral Support Services, Waypoint Mental Health, Alzheimers Society, NSM Palliative Care Network, Hospice Huronia, Lifelab, Achieva Health, Religious Services, Bayshore HomeHealth for Nursing, Paramed for PSW, Penetanguishene Seniors Council, First Nations, Metis Nations. In summary, involving a broad spectrum of collaborators in the business plan generates financial and operational support, builds capacity, enhances communications, expands service options, and lends significant credibility to the overall concept.

Older people’s involvement: Older people were involved in the age-friendly practice at multiple or all stages

Details on older people’s involvement: A wide range of activities were conducted that included client surveys, focus groups, informant interviews, public and government consultations, environmental scans, review of local socio-economic factors, growth considerations, and contracting professional expertise to complete a formal market study. This was further augmented with the creation of a project steering committee comprised of more than 30 internal and external stakeholders that assisted to inform decision making and ensure ongoing

Has the impact of this age-friendly practice been analysed: Yes

Was the impact positive or negative:
Positive

Please share with us what you found in detail:
The first objective focused on increasing local housing capacity for seniors. This was achieved by expanding the original 107 unit long-term care home to a 282 unit campus continuum that now houses approximately 320 seniors within five different types of housing. With the opening of the campus, wait lists and wait times for LTC and affordable housing decreased. The campus achieved full tenancy within the first year and continues to operate with a very high occupancy. However, with the continued growth of an aging demographic, wait list demand and associated wait times have begun to creep back up. The second objective focused on promoting an aging at home environment that fosters healthy aging and supports the changing needs of older adults so that they can remain independent in their home as they continue to age. This campus is complete with a wide range of amenities, a continuum of housing options, and a suite of services that encourages social engagement, active living, and ensures supports are available as needed. Since opening in the fall of 2013, the campus has observed a minimal turnover rate of less than 2% annually. Of the residents living in community housing, approximately 30% access additional services offered on site and more than 90% participate in our social and/or recreational programming. The third objective focused on increasing the sustainability of County operations by reducing the County’s municipal subsidy for the long-term care home and increasing annual reserve contributions to support ongoing asset maintenance and reinvestment in services. As a result of economies of scale and operational efficiencies realized with an additional 36 long-term care beds and an expanded campus setting, the municipal tax levy for Georgian Manor decreased substantively. Owning the largest annual subsidy of the County’s four homes as high as $1.1 million, post-redevelopment Georgian Manor became the most efficient home with a reduced subsidy of $468,000. This was further complemented with an increase in annual reserve contributions by more than five times its former amount. As a significant employer in the local community, the fourth objective was aimed at strengthening the local economy. An additional 45 new jobs were created increasing the local economic impact by $3.6 million annually. The final objective was to maximize funding opportunities to support this capital project. With this in mind, extensive consultations took place with numerous stakeholders over a period of several years in order to secure funding. As a result, the County obtained funding from: a federal program; two provincial ministries; the North Simcoe Muskoka LHIN; community donations; and other sources to capture 80% of all project costs.

Evaluation report: County-of-Simcoe-Building-a-Seniors-Campus-2017.pdf

Feedback:
The Georgian Village Seniors Campus conducts an annual Resident Satisfaction Survey to obtain feedback from the older adults residing in the facilities. Over the last 4 years, the response has been very favorable. In addition, All 5 housing categories within Georgian Village Senior Camps have lengthy wait list demonstrating preference to live in this state-of- the-art campus.

Expansion plans:
Yes. Georgian Village Seniors’ Campus has applied for funding with the Ministry of Health & Long Term Care Home Development and Redevelopment program to increase their Long Term Care beds from 143 to 146. Georgian Village is also looking to further augment their services by applying to a recent call for proposals from the North Simcoe Muskoka Local Health Integration Network in order to expand their in-home services to the broader community that will extend the existing outreach component of this site. In addition, the County of Simcoe is currently conducting a feasibility study to redevelop the existing Simcoe Manor Long Term Care Home in Beeton, Ontario, into a similar senior’s campus model as Georgian Village Seniors’ Campus. We have applied for an additional 34 long term care beds in addition to the existing 126 beds. With the increased prevalence of behavioral needs and in-house expertise, 16 of the new beds would be utilized to support a Specialized Behavioral Unit. Given that construction would be occurring on the existing location, to avoid decanting long term care residents to temporary accommodations, “Simcoe Village Campus Continuum” has been planned in a phased approach. As part of Phase 1, this redevelopment looks at building the Home so beds can be opened for operation by December 31, 2022. This will utilize a total of 30 acres. The Redevelopment’s core components are modeled after our Georgian Village Campus to ensure a complete, efficient and sustainable continuum of services and housing for our aging population. The feasibility plan includes the existing 32 unit supportive housing apartments, 32 affordable housing units, 9 unit co-housing complex, 40 life lease suites, 40 retirement suites, 10 market rental semi-detached town homes and 10 life lease garden homes. The proposed site design would include parking lots, a perimeter ring road to provide the required internal access points, community hub, retail space, gathering place, outdoor amenities, walking trails and green space. The project is proposed to target a minimum LEED® Silver Certification and is subject to Council approval.

Reflections:
Municipalities are well-positioned to move forward with this kind of innovation in creating our own campuses of care for seniors. As a level of government, municipalities are financially stable, open and transparent organizations, with longstanding and far-reaching partnerships, and are the vanguard of services that benefit older adults including affordable housing, financial assistance, transportation, planning, physical infrastructure, long-term care and community health; just to name a few. By working in collaboration with other levels of government, service providers and community stakeholders, municipal governments are already targeting initiatives that support age-friendly community planning. These include important strategies such as: retrofitting homes to improve accessibility; sustaining investment in subsidized housing; supporting the delivery of affordable rental housing; investing in accessible, and convenient public and active transportation; and creating accessible streets and trail systems. It must be acknowledged that some municipalities face a significant financial burden in operating their long-term care home under the current provincial funding structure. As such, we must continue to advocate to the province for more appropriate financial support. Building a seniors’ campus continuum allows these municipalities to leverage their many assets to both increase seniors support and reduce the associated taxation of their constituents. As stewards of our communities and our people, this level of government is well poised to leverage an entire foundation of municipal services and community partnerships and must move forward to provide the needed leadership to support our seniors in the future.

Challenges:
Rural Community Socio-economic Challenges: In addition to the need for more person-centered, coordinated and seamless access to health services, an important factor to consider in understanding the health care needs of our seniors is the additional limitations associated with living in small rural communities. Twenty-three per cent of all seniors live in rural areas and small towns in Canada. (Age-Friendly Rural and Remote Communities: A Guide) Though there are many obvious benefits of living in the beautiful and charming communities of rural Ontario, limited housing options and transportation, along with fewer health, social and community support service options, place older adults at higher risk of social isolation and poorer health status. Often there may be rural areas which cannot accommodate their older adults in seniors’ housing, local retirement or long-term care homes. Seniors that are constrained in their choices, may become displaced from their home, long-time community, and social network; forced to move to other locations where more suitable housing and supports are available. Having previous experience providing many of the housing options encompassed within the proposed project scope, projected growth in the aging demographic, extensive wait lists for long- term care and affordable housing, and a market analysis confirming the need for additional seniors’ housing, our initial review of potential competition was unremarkable. Addressing the rural service challenges was based on smart, targeted and innovative interventions, resulting in the development of a seniors’ campus continuum with multiple housing options, socialization, health and personal care services, and healthy lifestyle amenities offering seniors a one-stop shop within a healthy aging environment. However, as the project moved forward with initial planning approvals, the County quickly faced opposition from private enterprise disputing the inclusion of a “retirement home” as one of the newest elements in municipal housing alternatives. As a consequence, additional resource time and attention was required to re-substantiate the business case and validate for the public and a relatively new municipal council. The 42-unit retirement home remains a viable part of the campus development, as originally planned, and continues to operate successfully within this campus setting. Learning from this experience, it is highly recommended that a competitor analysis is completed for each specific housing element to help anticipate, prepare for, and possibly prevent challenges such as this.