THOMPSON REGIONAL HOSPITAL DISTRICT. Thursday, March 23, 2017

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1 THOMPSON REGIONAL HOSPITAL DISTRICT Regular Meeting FRIDAY, NOVEMBER 24, 2017 A G E N D A Time: 10:00 AM Place: Board Room 4th Floor 465 Victoria Street Kamloops, BC Page 1 CALL TO ORDER 2 ADDITIONS TO OR DELETIONS FROM THE AGENDA 3 MINUTES a 2017 Mar 23 Thompson Regional District Meeting Minutes DRAFT 4 DELEGATIONS Attachments: 2017 Nov 23 TRHD Board Meeting Minutes DRAFT RECOMMENDATION: THAT the minutes of the Thompson Regional District Board Meeting dated March 23, 2017 be adopted. 4.a Update on Opioid Crisis Dave Harrhy, Mental Health & Substance Use Executive Director Rae Samson, Director of Mental Health & Substance Use West Interior Health Authority 4.b Rural Update Berni Easson, Community Integration Health Services Administrator Interior Health Authority

2 Agenda Thompson Regional District Meeting Friday, November 24, c Update Tracey Rannie, RIH Administrator Interior Health Authority 4.d Minor Equipment and Capital Projects Update 5 UNFINISHED BUSINESS 6 BYLAWS James Kinakin, Director of Business Support Interior Health Authority a Capital Bylaw No. 129 Minor Equipment Report by: Chief Administrative Officer dated November 11, 2017 Attachments: Capital Bylaw No Minor Equipment RECOMMENDATIONS: 1. THAT the Thompson Regional District Capital Bylaw No. 129, be read a first time by title only. 2. THAT the Thompson Regional District Capital Bylaw No. 129 be read for the second and third time. 3. THAT the Thompson Regional District Capital Bylaw No. 129 be adopted b Capital Bylaw No. 130 Major Renovations Urgent Family Care and Teaching Centre Report by: Chief Administrative Officer dated November 11, 2017 Attachments: Capital Bylaw No Major Renovations Urgent Family Care and Teaching Centre RECOMMENDATIONS: 1. THAT the Thompson Regional District Capital Bylaw No. 130 be read a first time by title only. Page 2 of 43

3 Agenda Thompson Regional District Meeting Friday, November 24, THAT the Thompson Regional District Capital Bylaw No. 130 be read for the second and third time. 3. THAT the Thompson Regional District Capital Bylaw No. 130 be adopted c Bylaw No Provisional Budget Report by: Chief Administrative Officer dated November 15, 2017 Attachments: Bylaw No Provisional Budget RECOMMENDATIONS: 1. THAT the Thompson Regional District Provisional Budget Bylaw No. 131, be read a first time by title only. 2. THAT the Thompson Regional District Provisional Budget Bylaw No. 131 be read for the second and third time. 3. THAT the Thompson Regional District Provisional Budget Bylaw No. 131 be adopted d Capital Bylaw No. 132, Patient Care Tower Borrowing Report by: Chief Administrative Officer dated November 15, CORRESPONDENCE Attachments: Capital Bylaw No Patient Care Tower Borrowing RECOMMENDATIONS: 1. THAT the Thompson Regional District Capital Bylaw No. 132, 2017 be read a first time by title only. 2. THAT the Thompson Regional District Capital Bylaw No. 132, 2017 be read a second and third time. 3. THAT the Thompson Regional District Capital Bylaw No. 132, 2017 be adopted. Page 3 of 43

4 Agenda Thompson Regional District Meeting Friday, November 24, NEW BUSINESS 9 REPORTS and/or INQUIRIES a Proposed 2018 Thompson Regional District Meeting Dates Report by: Chief Administrative Officer dated November 4, ADJOURNMENT Attachments: Proposed 2018 Thompson Regional District Meeting Dates RECOMMENDATION: THAT the 2018 Thompson Regional District Board meetings be scheduled for 10 AM on Thursday, March 29 and Thursday, December 20, Page 4 of 43

5 THOMPSON REGIONAL HOSPITAL DISTRICT Thursday, March 23, 2017 MINUTES of a Meeting of the Board of Directors of the THOMPSON REGIONAL HOSPITAL DISTRICT held in the Boardroom on Thursday, March 23, 2017 commencing at 10:00 AM. PRESENT: ABSENT: Director K. Christian (Chair) Director R. Berrigan Director J. Jeyes Director P.A.J. Ranta Director J. Harwood Director J. Rivett Director P. Milobar Director D. Cavers (Alt.) Director A. Singh Director P.A. Wallace Director T. Lange Director R. Smith Director J. Lightfoot Director N. Menard Director C. Schaffer Director W. Macdonald Director S. Watson Director S. Rice Director R.H. Elliott Director K. Gillis Director R. Murray Director H.S. Graham Director W. Kershaw Director M. Rothenburger Director M. Lampman Director M. Macri Director D. Demare Director L. Morgan Director V. Smith Director A. Raine City of Kamloops Village of Chase Village of Ashcroft Village of Cache Creek District of Clearwater Village of Clinton City of Kamloops City of Kamloops City of Kamloops City of Kamloops City of Kamloops District of Logan Lake Village of Lytton City of Merritt Electoral Area "A" (Wells Gray Country) Electoral Area "B" (Thompson Headwaters) Electoral Area "E" (Bonaparte Plateau) Electoral Area "I" (Blue Sky Country) Electoral Area "J" (Copper Desert Country) Electoral Area "L" (Grasslands) Electoral Area "M" (Beautiful Nicola Valley - North) Electoral Area "N" (Beautiful Nicola Valley - South) Electoral Area "O" (Lower North Thompson) Electoral Area "P" (Rivers and The Peaks) District of Lillooet Squamish-Lillooet Regional District Squamish-Lillooet Regional District Columbia Shuswap Regional District District of Barriere Sun Peaks Mountain Resort Municipality STAFF: Mr. S. Gill, Chief Administrative Officer Mr. D. Rae, Director of Finance Ms. C. Black, Director of Legislative Services Mr. R. Troskot, Supervisor of IT Services 2017 Mar 23 Thompson Regional District Meeting Minutes DRAFT Page 5 of 43

6 Thompson Regional District Page 2 of 11 Thursday, March 23, 2017 Ms. A. Gredling, Recording Secretary PRESS: OTHERS: 0 media persons 5 interested persons 1 CALL TO ORDER The Chief Administrative Officer called the meeting to order at 10:13 AM. 2 ELECTION OF CHAIR and ACTING CHAIR 2.a Election of Chair and Acting Chair The TRHD Report from the Chief Administrative Officer dated March 9, 2017 regarding the election of Chair and Acting Chair was provided to the Board for consideration. Moved by Director Singh Seconded by Director Lightfoot THAT the Chief Administrative Officer of the Thompson-Nicola Regional District be appointed Acting Chair for the purposes of conducting the Election of Chair and Acting Chair of the Thompson Regional District. Moved by Director Lightfoot Seconded by Director Jeyes THAT the Recording Secretary of the Thompson-Nicola Regional District be appointed Recording Secretary of the Thompson Regional District. Moved by Director Berrigan Seconded by Director Christian THAT those staff members present at the meeting be appointed scrutineers for the Election of Chair and Acting Chair of the Thompson Regional District Mar 23 Thompson Regional District Meeting Minutes DRAFT Page 6 of 43

7 Thompson Regional District Page 3 of 11 Thursday, March 23, b Election of Chair The CAO called three times for nominations for the position of Chair. Director Harwood nominated Director Christian. Director Christian was acclaimed to the position of Chair. 2.c Election of Acting Chair The CAO called three times for nominations for the position of Acting Chair. Director Milobar nominated Director Elliott. Director Elliott was acclaimed to the position of Acting Chair. 3 CHAIR'S ANNOUNCEMENTS Chair Christian assumed the role of Chair and made the following announcements: - Councillor Cavers was attending the meeting on behalf of Director Spina - A Regional District meeting with the Interior Health Authority is set for April 5, 2017 in Kelowna - The next TRHD meeting is scheduled for November 24, 2017 at 10:00 AM - the 50th Anniversary of the Thompson Nicola Regional District. 4 ADDITIONS TO OR DELETIONS FROM THE AGENDA None. 5 MINUTES 5.a Minutes of the Thompson Regional District dated November 24, 2016 Moved by Director Harwood Seconded by Director Ranta THAT the minutes of the Thompson Regional District dated November 24, 2016 be adopted Mar 23 Thompson Regional District Meeting Minutes DRAFT Page 7 of 43

8 Thompson Regional District Page 4 of 11 Thursday, March 23, DELEGATIONS 6.a Service to Rural Communities Paul Swain, Director of Patient Care Delivery, Interior Districts BC Emergency Health Services Mr. Swain advised the Board that BC Ambulance Services recently changed its name to BC Emergency Health Services (BCEHS) to better reflect their work. In the last year, BCEHS had over 4,000 paramedics and dispatchers in the province; paramedics responded to well over 500,000 patient events, including 474, calls and 96,000 patient transfers between facilities; ambulances travel nearly a million KM; and their ground fleet was made up of: 632 vehicles, 533 ambulances, 99 support vehicles. The BCEHS is made up of the following programs: ground ambulance; patient transfer services; dispatch operations; emergency management; critical care transport; infant transport; and community paramedicine. Community Paramedicine is a new program in BC that focuses on rural and remote communities. It is currently being implemented and has 80 full time employees. Its goal is to bridge health service delivery gaps identified in collaboration with local health care teams. Mr. Swain responded to questions from the Directors. 6.b Update on Kamloops North Shore Clinics Jason Giesbrecht, Executive Director Primary and Community Care Transformation Interior Health Authority Mr. Giesbrecht reviewed the 3 new projects in place or in development on the North Shore of Kamloops. These 3 projects take place at 2 different site locations and provide a number of needed services to patients in that area. The 1st floor of the North Shore Health Services Centre (NSHSC) opened in February and acts as a primary care clinic providing mental health and substance use counselling, nursing care, and respiratory care. The 2nd floor of the NSHSC has 6 nurse practitioners, a primary care nurse, and medical office assistants providing wrap around services. The second site is in the Northhills Mall and provides a team based approach for senior patients. It also has a primary care clinic component in addition to home health services; mental health and substance use programming, community bathing programs, a senior s health and wellness centre, and lab collection centre. Mr. Giesbrecht answered questions from the Directors Mar 23 Thompson Regional District Meeting Minutes DRAFT Page 8 of 43

9 Thompson Regional District Page 5 of 11 Thursday, March 23, c Update from Tracey Rannie, Interim Administrator of Interior Health Authority Ms. Rannie provided an overview of new work being done at the. With the opening of the new Rae Fawcette Breast Health Clinic, individuals are now able to have a number of processes completed in a single visit as all the staff and equipment is in the same place. The Ken Lepin Lecture Hall will be holding its official opening in May, Physician recruitment has been successful and the RIH cardiologist positions are almost all full, with an increase in internal medicine doctors as well. In September 2016, a new OR opened which is helping address some of the volume for the surgery waitlist. In order to further address challenges related to waitlists for surgeries, RIH has hired a Surgical Strategy Team Leader and they will be working on this moving forward. Ms. Rannie responded to questions from the Directors. 6.d Major Capital Equipment and Construction Requests James Kinakin, Director of Business Support Interior Health Authority Mr. Kinakin provided an overview of the major capital equipment and construction requests made for 2017/2018. The total request is $4.6 million with increases in construction, Information Management Information Technology (IMIT), and equipment spending planned for the coming year. Mr. Kinakin also discussed a request for funding for the Procurement Phase of the new Patient Care Tower project. The Nicola Valley General 's new ER is scheduled to be complete by September The design team is made up of a number of individuals from the hospital, physicians, and members of BC Emergency Medical Services. Mr. Kinakin responded to questions from the Directors. 7 UNFINISHED BUSINESS 7.a Service to Rural Communities Paul Swain, Director of Patient Care Delivery, Interior Districts BC Ambulance Services Moved by Director Harwood Seconded by Director Elliott THAT a letter of thanks be sent to Mr. Swain for his presentation to the Board Mar 23 Thompson Regional District Meeting Minutes DRAFT Page 9 of 43

10 Thompson Regional District Page 6 of 11 Thursday, March 23, b Update on Kamloops North Shore Clinics Jason Giesbrecht, Executive Director Primary and Community Care Transformation Interior Health Authority Moved by Director Harwood Seconded by Director Elliott THAT a letter of thanks be sent to Mr. Giesbrecht for his presentation to the Board. 7.c Update from Tracey Rannie, Interim Administrator of Interior Health Authority Moved by Director Harwood Seconded by Director Elliott THAT a letter of thanks be sent to Ms. Rannie for her presentation to the Board. 7.d Update on Major Capital Projects James Kinakin, Director of Business Support Interior Health Authority Moved by Director Harwood Seconded by Director Elliott THAT a letter of thanks be sent to Mr. Kinakin for his presentation to the Board. 8 BYLAWS 8.a TRHD Bylaw No. 125, 2017 Remuneration The report by the Chief Administrative Officer dated March 14, 2017 regarding the annual review of the remuneration bylaw to provide for adjustments as noted 2017 Mar 23 Thompson Regional District Meeting Minutes DRAFT Page 10 of 43

11 Thompson Regional District Page 7 of 11 Thursday, March 23, 2017 within the bylaw and reviewed for consistency with changes was considered by the Board. Moved by Director Ranta Seconded by Director Lange THAT Thompson Regional District Remuneration Bylaw No. 125, 2017 be read a first time by title only. Moved by Director Lightfoot Seconded by Director Gillis THAT Thompson Regional District Remuneration Bylaw No. 125, 2017 be read a second and third time. Moved by Director Berrigan Seconded by Director Schaffer THAT Thompson Regional District Remuneration Bylaw No. 125, 2017 be adopted. 8.b TRHD Bylaw No. 126, 2017 Annual Budget The report by the Chief Administrative Officer dated March 9, 2017 regarding the annual budget for 2017 was considered by the Board. Moved by Director Elliott Seconded by Director Harwood THAT the Thompson Regional District 2017 Annual Budget Bylaw No. 126, 2017 be read a first time by title only. Moved by Director Harwood Seconded by Director Wallace THAT the Thompson Regional District 2017 Annual Budget Bylaw No. 126, 2017 be read for the second time by title only and carried through three readings Mar 23 Thompson Regional District Meeting Minutes DRAFT Page 11 of 43

12 Thompson Regional District Page 8 of 11 Thursday, March 23, 2017 Moved by Director Elliott Seconded by Director Murray THAT the Thompson Regional District 2017 Annual Budget Bylaw No. 126, 2017 be adopted. 8.c TRHD Capital Bylaw No. 127, 2017 Major Equipment and Renovations The report by the Chief Administrative Officer dated March 9, 2017 regarding the Major Equipment and Renovations requests for 2017 was considered by the Board. Moved by Director Berrigan Seconded by Director Kershaw THAT the Thompson Regional District Capital Bylaw No. 127, 2017 be read a first time by title only. Moved by Director Harwood Seconded by Director Schaffer THAT the Thompson Regional District Capital Bylaw No. 127, 2017 be read a second and third time. Moved by Director Harwood Seconded by Director Wallace THAT the Thompson Regional District Capital Bylaw No. 127, 2017 be adopted. 8.d TRHD Capital Bylaw No. 128 RIH Patient Care Tower The report by the Chief Administrative Officer dated March 14, 2017 regarding the contribution of funds towards the procurement phase of the Patient Care Tower at Mar 23 Thompson Regional District Meeting Minutes DRAFT Page 12 of 43

13 Thompson Regional District Page 9 of 11 Thursday, March 23, 2017 Moved by Director Harwood Seconded by Director Macdonald THAT the Thompson Regional District Capital Bylaw No. 128, 2017 be read a first time by title only. Moved by Director Macdonald Seconded by Director Murray THAT the Thompson Regional District Capital Bylaw No. 128, 2017 be read a second and third time. Moved by Director Elliott Seconded by Director Gillis THAT the Thompson Regional District Capital Bylaw No. 128, 2017 be adopted. 9 REPORTS and/or INQUIRIES 9.a 2016 Thompson Regional District Financial Statements The report by the Director of Finance dated March 14, 2017 regarding the 2016 financial statements of the Thompson Regional District was considered by the Board. Moved by Director Elliott Seconded by Director Lightfoot THAT the 2016 Audited Financial Statements of the Thompson Regional District be approved. 9.b 2016 Financial Information Act Disclosures The report by the Chief Administrative Officer dated March 9, 2017 regarding the Financial Information Act disclosures for 2016 was considered by the Board Mar 23 Thompson Regional District Meeting Minutes DRAFT Page 13 of 43

14 Thompson Regional District Page 10 of 11 Thursday, March 23, 2017 Moved by Director Singh Seconded by Director Lightfoot THAT the Thompson Regional District Statement of Financial Information for the year ended December 31, 2016 be received and made available for public inspection. 9.c 2016 Director and Committee Member Remuneration and Expense Report Thompson Regional District The report by the Chief Administrative Officer dated March 9, 2017 regarding the Director and Committee Member remuneration and expenses for 2016 was considered by the Board. Moved by Director Wallace Seconded by Director Murray THAT the Thompson Regional District Director and Committee Member Remuneration and Expense Report for 2016 be approved and made available for public inspection. 9.d Medical Professionals Recruitment Fund 10 NEW BUSINESS None. The report by the Chief Administrative Officer dated March 16, 2017 regarding the establishment of the Medical Professionals Recruitment Fund on an ongoing basis was considered by the Board. Moved by Director Murray Seconded by Director Macdonald THAT the Thompson Regional District Medical Professional Recruitment Fund in the amount of $30,000 per year be implemented on an on-going basis Mar 23 Thompson Regional District Meeting Minutes DRAFT Page 14 of 43

15 Thompson Regional District Page 11 of 11 Thursday, March 23, ADJOURNMENT Moved by Director Wallace Seconded by Director Murray THAT the meeting adjourn at 12:05 PM. Certified Correct: Chair Corporate Officer 2017 Mar 23 Thompson Regional District Meeting Minutes DRAFT Page 15 of 43

16 ADMINISTRATION DEPARTMENT BOARD REPORT TO: Chair and Board of Directors DATE: November 11,2017 FROM: SUBJECT: Chief Administrative Officer Capital Bylaw No. 129 Minor Equipment RECOMMENDATIONS: 1. THAT the Thompson Regional District Capital Bylaw No. 129, be read a first time by title only. 2. THAT the Thompson Regional District Capital Bylaw No. 129 be read for the second and third time. 3. THAT the Thompson Regional District Capital Bylaw No. 129 be adopted. Approved for Board Consideration CAO BACKGROUND: In the fall of each year the Interior Health Authority has presented a list of minor equipment that they wish the Thompson Regional District to cost share at 40%. Accordingly, find attached their letter dated November 7, 2017 making this request for cost sharing of minor equipment. DISCUSSION: The list of minor equipment is in the amount of $ 2,195,365 and the 40% requested for cost sharing is $ 878,146. The vast majority of the equipment proposed is for ; however, equipment is also included for health facilities in Ashcroft, Barriere, Clearwater, Lillooet, and Merritt. The $ 878,146 cost sharing amount requested was anticipated and included in the 2017 budget. Accordingly, if the Board chooses to cost share, it can be accommodated within the 2017 budget and tax rate. Capital Bylaw No. 129 Minor Equipment Page 16 of 43

17 November 11,2017 Page 2 of 2 Subject: Capital Bylaw No. 129 Minor Equipment CONCLUSION: The minor equipment list presented is consistent with past practice and is within the scope of the 2017 TRHD budget. Attachments Capital Bylaw No. 129 Minor Equipment Letter from IHA dated November 7, 2017 Capital Bylaw No. 129 Minor Equipment Page 17 of 43

18 THOMPSON REGIONAL HOSPITAL DISTRICT CAPITAL BYLAW NO. 129 WHEREAS the Board of Directors of the Thompson Regional District proposes to expend money for the capital expenditures described in Schedule A attached hereto and forming an integral part of this bylaw; AND WHEREAS those capital expenditures have received the approval required under Section 23 of the District Act; NOW THEREFORE the Board of Directors of the Thompson Regional District enacts the following capital expenditure bylaw as required by Section 32 of the District Act; 1. This bylaw may be cited for all intents and purposes as the Thompson Regional District Capital Bylaw No. 129, The Board hereby authorizes and approves expenditure of money necessary to complete the capital expenditures as described in Schedule A attached hereto totaling eight hundred and seventy eight thousand, one hundred and forty six ($878,146) dollars. 3. The payment of the portion that the Regional District is responsible for, shall be funded through monies budgeted in the current year of operation. 4. The Board hereby delegates the necessary authority to the Treasurer to settle the terms and conditions of the expenditure. READ A FIRST TIME this 24 th day of November, READ A SECOND TIME this 24 th day of November, READ A THIRD TIME this 24 th day of November, ADOPTED this 24 th day of November, Corporate Officer Chair Capital Bylaw No. 129 Minor Equipment Page 18 of 43

19 Facility Community Equipment/ Project Description Equipment under $100,000 Ashcroft & Community Health Centre Ashcroft & Community Health Centre Barriere Health Centre Dr. Helmcken Memorial & Health Centre Dr. Helmcken Memorial & Health Centre Ashcroft THOMPSON REGIONAL HOSPITAL DISTRICT SCHEDULE A TO CAPITAL BYLAW NO. 129 Estimated Total Cost Xray Machine, Portable 40% Regional District Funding Previously Approved 60% MOHS/IH Funding 95,000 38,000 57,000 Ashcroft Freezer, Walk-in 50,000 20,000 30,000 Barriere Fridge 7,500 3,000 4,500 Clearwater Stretcher 6,750 2,700 4,050 Clearwater Ceiling Lift, Bariatric (x2) 25,000 10,000 15,000 Gillis House Merritt Cart, Hot Food 11,745 4,698 7,047 Gillis House Merritt Tub 22,060 8,824 13,236 Hillside Centre - Interior Adult Psychiatric Centre Kamloops Tub 32,470 12,988 19,482 Hillside Centre - Interior Adult Psychiatric Centre Hillside Centre - Interior Adult Psychiatric Centre Kamloops Community Dialysis Unit Kamloops Home and Community Care Lillooett & Health Centre Lillooett & Health Centre Lillooett & Health Centre Lillooett & Health Centre Lillooett & Health Centre Lillooett & Health Centre Kamloops Kamloops Kamloops Ceiling Lift, Bariatric (x2) Ceiling Lift, Bariatric (x2) Ultrasound Machine 16,700 6,680 10,020 31,835 12,734 19,101 42,280 16,912 25,368 Kamloops Stretcher 6,000 2,400 3,600 Lillooet Light, Procedural 6,000 2,400 3,600 Lillooet Xray Machine, 95,000 38,000 57,000 Portable Lillooet Bed, Patient (x2) 15,000 6,000 9,000 Lillooet Stretcher 6,000 2,400 3,600 Lillooet NCPAP Option for Transport T1 Ventilator 8,150 3,260 4,890 Lillooet Cast Cutter/Vac 6,000 2,400 3,600 Capital Bylaw No. 129 Minor Equipment Page 19 of 43

20 CAPITAL BYLAW NO. 129, 2017 Page 3 of 6 Facility Community Equipment/ Project Description Nicola Valley & Health Centre Nicola Valley & Health Centre Nicola Valley & Health Centre Overlander Extended Care Overlander Extended Care Overlander Extended Care Estimated Total Cost 40% Regional District Funding Previously Approved 60% MOHS/IH Funding Merritt Vaccine Fridge 13,810 5,524 8,286 Merritt Stretcher (x2) 13,000 5,200 7,800 Merritt Bed, Patient (x2) 16,290 6,516 9,774 Kamloops Fridge, 3 Door 6,205 2,482 3,723 Kamloops Parallel Bars, 8,330 3,332 4,998 Hydraulic Kamloops Lift, Portable 7,715 3,086 4,629 Ponderosa Lodge Kamloops Lift, Floor (x2) 18,910 7,564 11,346 Ponderosa Lodge Kamloops Lift, Sit to Stand 16,975 6,790 10,185 (x3) Ponderosa Lodge Kamloops Ceiling Lift (x7) 111,905 44,762 67,143 Kamloops Phototherapy 13,000 5,200 7,800 Blanket (x2) Kamloops Ceiling Lift 16,000 6,400 9,600 Kamloops Phototherapy 6,500 2,600 3,900 Blanket Kamloops Ureteroscope (x2) 30,200 12,080 18,120 Kamloops Surgical Scrub 5,850 2,340 3,510 Sink Kamloops Colonovideoscope 42,810 17,124 25,686 Kamloops Xray Unit, Digital 34,700 13,880 20,820 Kamloops Ventilator, 24,510 9,804 14,706 Mechanical Kamloops Cast Cart, 6,000 2,400 3,600 Stainless Steel Kamloops Defibrillator Analyzer (Biomed 13,945 5,578 8,367 Kamloops Test Equipment) Cysto-Nephro Videoscope, HD Flexible (x2) 36,650 14,660 21,990 Capital Bylaw No. 129 Minor Equipment Page 20 of 43

21 CAPITAL BYLAW NO. 129, 2017 Page 4 of 6 Facility Community Equipment/ Project Description Kamloops Kamloops Kamloops Kamloops Cysto-Nephro Videoscope, HD Flexible (x2) Cysto-Nephro Videoscope, HD Flexible Ultrasound Machine Washer Disinfector, Vernacare Estimated Total Cost 40% Regional District Funding Previously Approved 60% MOHS/IH Funding 36,650 14,660 21,990 18,355 7,342 11,013 52,200 20,880 31,320 13,755 5,502 8,253 Kamloops Warming Cabinet 5,005 2,002 3,003 Kamloops Ventilator, Critical 70,000 28,000 42,000 Care Kamloops Auto Scrubber 8,665 3,466 5,199 Kamloops Fridge, Walk-in 77,115 30,846 46,269 Kamloops Washer Disinfector, Vernacare 7,015 2,806 4,209 Kamloops Medical Freezer, 8,955 3,582 5, degrees Kamloops Chair, 9,725 3,890 5,835 Programmable Kamloops CD/DVD Burner 16,000 6,400 9,600 Kamloops Ultrasound Doppler 9,925 3,970 5,955 Probe Kamloops Bed, Patient 7,715 3,086 4,629 Kamloops Bed, Patient (x2) 15,425 6,170 9,255 Kamloops Stretcher (x2) 11,630 4,652 6,978 Kamloops Bed, Bariatric 23,545 9,418 14,127 Kamloops Stretcher (x5) 29,660 11,864 17,796 Kamloops Stretcher 6,255 2,502 3,753 Kamloops Bed (x2) 19,135 7,654 11,481 Capital Bylaw No. 129 Minor Equipment Page 21 of 43

22 CAPITAL BYLAW NO. 129, 2017 Page 5 of 6 Facility Community Equipment/ Project Description Estimated Total Cost 40% Regional District Funding Previously Approved 60% MOHS/IH Funding Kamloops Ceiling Lift 16,180 6,472 9,708 Kamloops Ceiling Lift, 58,890 23,556 35,334 Bariatric (x3) Kamloops Ceiling Lift 16,180 6,472 9,708 Kamloops Video Conferencing Equipment 12,555 5,022 7,533 Kamloops Forklift, 6,660 2,664 3,996 Manual/Hydraulic (Hybedlift) Kamloops Integrated 27,000 10,800 16,200 Diagnostic Set Wall System (x4) Kamloops Cytospin 15,800 6,320 9,480 Kamloops Transducer, Broadband Curved Array 9,200 3,680 5,520 Kamloops Transducer, 7,900 3,160 4,740 Broadband Linear Array Kamloops Floor Scrubber 8,665 3,466 5,199 Kamloops Transducer, Broadband (x2) 19,500 7,800 11,700 Kamloops Colonoscope, Adult 171,225 68, ,735 (x4) Kamloops Pump, Sigma (x4) 21,550 8,620 12,930 with batteries Kamloops Transducer, TEE 36,250 14,500 21,750 Probe Kamloops Exam Table with 29,840 11,936 17,904 stool (x4) Kamloops Treadmill 40,000 16,000 24,000 Kamloops Electrocardiograph (x2) 30,000 12,000 18,000 Kamloops Echo Software 8,000 3,200 4,800 (Smart Stress) Kamloops Defibrillator 30,000 12,000 18,000 Kamloops Diagnostic Set (x4) 23,200 9,280 13,920 Capital Bylaw No. 129 Minor Equipment Page 22 of 43

23 CAPITAL BYLAW NO. 129, 2017 Page 6 of 6 Facility Community Equipment/ Project Description Kamloops Ultrasound Machine with Abdominal/Cardiac Probes Estimated Total Cost 40% Regional District Funding Previously Approved 60% MOHS/IH Funding 65,000 26,000 39,000 Kamloops Ceiling Lift (x2) 30,000 12,000 18,000 Kamloops Kamloops Surgical/Ligasure Generator with FT10 option Serving Counter, Cold Food 5,395 2,158 3,237 7,850 3,140 4,710 Budget Overage Allowance 125,000 50,000 75,000 Total $2,195,365 $878,146 $1,317,219 Capital Bylaw No. 129 Minor Equipment Page 23 of 43

24 Mr. Sukhbinder Gill, Chief Administrative Officer Thompson Regional District Victoria Street Kamloops, BC V2C 2A9 November 7, 2017 Dear Mr. Gill: Re: Additional Capital Funding Request In addition to our funding request letter dated December 21, 2016, we would like to request funding for specific minor equipment purchases for this fiscal year. Attached please find a detailed listing of equipment which Interior Health has approved for purchase. We are asking that Thompson Regional District cost share at 40% of the total purchase price. We would appreciate it if you could submit our request for funding of $878,146 to your Board for approval. Upon approval, please send Birgit Koster a copy of the relevant bylaw for our records. Thank you for considering this request and if you require further information, please contact James Kinakin. Sincerely, Donna Lommer, CPA, CGA, EMBA VP Support Services & CFO /at Encl. cc: Minor Equipment Funding Request Ronaye Elliott, Acting Chair, TRHD Doug Rae, Director of Finance/Deputy Administrator, TRHD Tracey Rannie, Acute Health Service Administrator, James Kinakin, Director, Business Support Birgit Koster, Director Business Support, Capital Planning Interior Health Authority 5th Floor Doyle Ave. Kelowna, BC V1Y 0C5 Web: VP Support Services & Chief Financial Officer Telephone: (250) Fax: (250) donna.lommer@interiorhealth.ca Capital Bylaw No. 129 Minor Equipment Page 24 of 43 Page 1

25 Interior Health Thompson Regional District Minor Equipment Funding Request 2017/2018 IH Fixed Asset # Facility Community Equipment Description Total Budget 40% RHD Share I Ashcroft & Community Health Centre Ashcroft Xray Machine, Portable 95,000 38,000 I Ashcroft & Community Health Centre Ashcroft Freezer, Walk-in 50,000 20,000 I Barriere Health Centre Barriere Fridge 7,500 3,000 I Dr. Helmcken Memorial & Health Centre Clearwater Stretcher 6,750 2,700 I Dr. Helmcken Memorial & Health Centre Clearwater Ceiling Lift, Bariatric (x2) 25,000 10,000 I Gillis House Merritt Cart, Hot Food 11,745 4,698 I Gillis House Merritt Tub 22,060 8,824 I Hillside Centre - Interior Adult Psychiatric Centre Kamloops Tub 32,470 12,988 I Hillside Centre - Interior Adult Psychiatric Centre Kamloops Ceiling Lift, Bariatric (x2) 16,700 6,680 I Hillside Centre - Interior Adult Psychiatric Centre Kamloops Ceiling Lift, Bariatric (x2) 31,835 12,734 I Kamloops Community Dialysis Unit Kamloops Ultrasound Machine 42,280 16,912 I Kamloops Home and Community Care Kamloops Stretcher 6,000 2,400 I Lillooett & Health Centre Lillooet Light, Procedural 6,000 2,400 I Lillooett & Health Centre Lillooet Xray Machine, Portable 95,000 38,000 I Lillooett & Health Centre Lillooet Bed, Patient (x2) 15,000 6,000 I Lillooett & Health Centre Lillooet Stretcher 6,000 2,400 I Lillooett & Health Centre Lillooet NCPAP Option for Transport T1 Ventilator 8,150 3,260 I Lillooett & Health Centre Lillooet Cast Cutter/Vac 6,000 2,400 I Nicola Valley & Health Centre Merritt Vaccine Fridge 13,810 5,524 I Nicola Valley & Health Centre Merritt Stretcher (x2) 13,000 5,200 I Nicola Valley & Health Centre Merritt Bed, Patient (x2) 16,290 6,516 I Overlander Extended Care Kamloops Fridge, 3 Door 6,205 2,482 I Overlander Extended Care Kamloops Parallel Bars, Hydraulic 8,330 3,332 I Overlander Extended Care Kamloops Lift, Portable 7,715 3,086 I Ponderosa Lodge Kamloops Lift, Floor (x2) 18,910 7,564 I Ponderosa Lodge Kamloops Lift, Sit to Stand (x3) 16,975 6,790 I Ponderosa Lodge Kamloops Ceiling Lift (x7) 111,905 44,762 I Kamloops Phototherapy Blanket (x2) 13,000 5,200 I Kamloops Ceiling Lift 16,000 6,400 I Kamloops Phototherapy Blanket 6,500 2,600 I Kamloops Ureteroscope (x2) 30,200 12,080 I Kamloops Surgical Scrub Sink 5,850 2,340 I Kamloops Colonovideoscope 42,810 17,124 I Kamloops Xray Unit, Digital 34,700 13,880 I Kamloops Ventilator, Mechanical 24,510 9,804 I Kamloops Cast Cart, Stainless Steel 6,000 2,400 I Kamloops Defibrillator Analyzer (Biomed Test Equipment) 13,945 5,578 I Kamloops Cysto-Nephro Videoscope, HD Flexible (x2) 36,650 14,660 I Kamloops Cysto-Nephro Videoscope, HD Flexible (x2) 36,650 14,660 I Kamloops Cysto-Nephro Videoscope, HD Flexible 18,355 7,342 I Kamloops Ultrasound Machine 52,200 20,880 I Kamloops Washer Disinfector, Vernacare 13,755 5,502 I Kamloops Warming Cabinet 5,005 2,002 I Kamloops Ventilator, Critical Care 70,000 28,000 I Kamloops Auto Scrubber 8,665 3,466 I Kamloops Fridge, Walk-in 77,115 30,846 I Kamloops Washer Disinfector, Vernacare 7,015 2,806 I Kamloops Medical Freezer, 40 degrees 8,955 3,582 I Kamloops Chair, Programmable 9,725 3,890 I Kamloops CD/DVD Burner 16,000 6,400 I Kamloops Ultrasound Doppler Probe 9,925 3,970 I Kamloops Bed, Patient 7,715 3,086 I Kamloops Bed, Patient (x2) 15,425 6,170 I Kamloops Stretcher (x2) 11,630 4,652 I Kamloops Bed, Bariatric 23,545 9,418 I Kamloops Stretcher (x5) 29,660 11,864 I Kamloops Stretcher 6,255 2,502 I Kamloops Bed (x2) 19,135 7,654 I Kamloops Ceiling Lift 16,180 6,472 I Kamloops Ceiling Lift, Bariatric (x3) 58,890 23,556 I Kamloops Ceiling Lift 16,180 6,472 I Kamloops Video Conferencing Equipment 12,555 5,022 I Kamloops Forklift, Manual/Hydraulic (Hybedlift) 6,660 2,664 I Kamloops Integrated Diagnostic Set Wall System (x4) 27,000 10,800 I Kamloops Cytospin 15,800 6,320 I Kamloops Transducer, Broadband Curved Array 9,200 3,680 I Kamloops Transducer, Broadband Linear Array 7,900 3,160 I Kamloops Floor Scrubber 8,665 3,466 I Kamloops Transducer, Broadband (x2) 19,500 7,800 I Kamloops Colonoscope, Adult (x4) 171,225 68,490 I Kamloops Pump, Sigma (x4) with batteries 21,550 8,620 I Kamloops Transducer, TEE Probe 36,250 14,500 I Kamloops Exam Table with stool (x4) 29,840 11,936 I Kamloops Treadmill 40,000 16,000 I Kamloops Electrocardiograph (x2) 30,000 12,000 I Kamloops Echo Software (Smart Stress) 8,000 3,200 I Kamloops Defibrillator 30,000 12,000 I Kamloops Diagnostic Set (x4) 23,200 9,280 I Kamloops Ultrasound Machine with Abdominal/Cardiac Probes 65,000 26,000 I Kamloops Ceiling Lift (x2) 30,000 12,000 I Kamloops Surgical/Ligasure Generator with FT10 option 5,395 2,158 I Kamloops Serving Counter, Cold Food 7,850 3,140 Budget Overage Allowance 125,000 50,000 Total $ 2,195,365 $ 878,146 Page 2 Prepared by: Interior Health ~ Capital Accounting Department Capital Bylaw No. 129 Minor Equipment Page 25 of 43 11/7/2017

26 ADMINISTRATION DEPARTMENT BOARD REPORT TO: Chair and Board of Directors DATE: November 11, 2017 FROM: SUBJECT: Chief Administrative Officer Capital Bylaw No. 130 Major Renovations Urgent Family Care and Teaching Centre RECOMMENDATIONS: 1. THAT the Thompson Regional District Capital Bylaw No. 130 be read a first time by title only. 2. THAT the Thompson Regional District Capital Bylaw No. 130 be read for the second and third time. 3. THAT the Thompson Regional District Capital Bylaw No. 130 be adopted. Approved for Board Consideration CAO BACKGROUND: Attached is a letter from the Interior Health Authority (IHA) requesting that the TRHD Board cost share in the development of the Urgent Family Care and Teaching Centre within the Clinical Services building at in the amount of $ 1,360,000. DISCUSSION: We have received this request from Interior Health for contribution to the development of an Urgent Family Care and Teaching Centre within the Clinical Services building at. This request for major capital renovations was not expected. However, we were made aware earlier this year that Interior Health may ask for a funding contribution to the clinic that was developed on the North Shore of Kamloops, but that particular project was fully funded by Capital Bylaw No. 130 Major Renovations Urgent Family Care and Teaching CentrePage 26 of 43

27 November 11,2017 Page 2 of 2 Subject: Capital Bylaw No. 130 Major Renovations Urgent Family Care and Teaching Centre the provincial government. We had anticipated possible funding for the Kamloops North Shore project, and thus had included provisional amounts in the 2017 budget for that project. As we will not be getting a request to fund the North Shore project, the amounts budgeted for that project can be used for this request. The $ 1,360,000 amount that has been requested can be accommodated within the provisions of the 2017 budget. Accordingly, if the Board chooses to cost share it will be accommodated within the 2017 budget and tax rate. CONCLUSION: The development of the Urgent Family Care and Teaching Centre as presented was not anticipated but can be accommodated within this year s budget and taxation strategy. Further, the amount requested, $ 1,360,000, can be accommodated within the budget in 2017 without any impact on taxation. Attachment(s) Capital Bylaw No. 130 Major Equipment and Renovations IHA Request Letter Capital Bylaw No. 130 Major Renovations Urgent Family Care and Teaching CentrePage 27 of 43

28 THOMPSON REGIONAL HOSPITAL DISTRICT CAPITAL BYLAW NO. 130 WHEREAS the Board of Directors of the Thompson Regional District proposes to expend money for the capital expenditures described in Schedule A attached hereto and forming an integral part of this bylaw; AND WHEREAS those capital expenditures have received the approval required under Section 23 of the District Act; NOW THEREFORE the Board of Directors of the Thompson Regional District enacts the following capital expenditure and borrowing bylaw as required by Section 32 of the District Act; 1. This bylaw may be cited for all intents and purposes as the THOMPSON REGIONAL HOSPITAL DISTRICT CAPITAL BYLAW NO. 130, The Board hereby authorizes and approves the borrowing and expenditure of money necessary to complete the capital expenditures as described in Schedule A attached hereto totaling One Million, Three Hundred and Sixty Dollars ($1,360,000). 4. The payment of the portion that the Regional District is responsible for, shall be funded through monies budgeted in the current year of operation. 5. The Board hereby delegates the necessary authority to the Treasurer to settle the terms and conditions of the borrowings. READ A FIRST TIME this 24 day of November READ A SECOND TIME this 24 day of November READ A THIRD TIME this 24 day of November ADOPTED this 24 day of November Chair Clerk Capital Bylaw No. 130 Major Renovations Urgent Family Care and Teaching CentrePage 28 of 43

29 CAPITAL BYLAW NO. 130, 2017 Page 2 of 2 SCHEDULE A THOMPSON REGIONAL HOSPITAL DISTRICT CAPITAL BYLAW NO. 130 Name of Facility Project or Equipment Description Urgent Family Care and Teaching Centre RHD Share $1,360,000 Total $1,360,000 Capital Bylaw No. 130 Major Renovations Urgent Family Care and Teaching CentrePage 29 of 43

30 Mr. Sukhbinder Gill, CAO Thompson Regional District Victoria Street Kamloops, BC V2C 2A9 November 9, 2017 Dear Mr. Gill: RE: ADDITIONAL FUNDING REQUEST FOR THE URGENT FAMILY CARE AND TEACHING CENTRE This letter is to request funding for this routine capital investment project which will be commencing in fiscal year 2017/18 at the in the Clinical Services Building. Interior Health (IH) is currently working on required internal approvals, design and a cost estimate. The Urgent Family Care Centre is consistent with the strategic direction of both IH and the Ministry of Health and supports a team-based primary care model. In order to alleviate acute care pressures, non-emergent care can be delivered safely outside of the emergency department of an acute care facility and in a more appropriate community setting, which provides a model of care that works for care providers, patients and the broader system of care. This proposed model of care is supported through a partnership between IH, the Thompson Region Division of Family Practice, and the University of British Columbia (UBC) Department of Family Practice. This program and its targeted location have been selected to improve patient access to urgent care services in the Kamloops area. It will reduce wait times, increase access to primary care, reduce workload for IH staff and physicians, reduce congestion in the emergency department and improve patient flow. Furthermore, by facilitating the attachment of patients to the UBC Teaching Centre, patients with non-emergent ongoing concerns will have access to longitudinal care; thereby reducing the likelihood of future emergency department visits and/or the further unnecessary deterioration of their condition. The goal is to open the doors to this new centre before April Due to these aggressive timelines, construction work will commence forthwith. We now formally request funding from the Thompson Regional District (TRHD) for 40% of the project s cost estimate of $3.4 million in the total amount of $1,360,000. We would appreciate it if you could now submit this formal funding request to your Board for approval at your November 24 th, 2017 meeting. IH representatives will be attending to answer questions the Directors may have. Upon approval, please send Birgit Koster, Director Business Support, Capital Planning copies of the relevant bylaws for our records. Interior Health Authority 5th Floor Doyle Ave. Kelowna, BC V1Y 0C5 Web: VP Support Services & Chief Financial Officer Telephone: (250) Fax: (250) donna.lommer@interiorhealth.ca Capital Bylaw No. 130 Major Renovations Urgent Family Care and Teaching CentrePage 30 of 43 Page 1

31 If you require further information, or if you have any questions or concerns, please contact James Kinakin or me directly. Sincerely, Donna Lommer, CPA, CGA, EMBA VP Support Services & CFO /at cc: Ronaye Elliott, Acting Chair, TRHD Doug Rae, Director of Finance, TRHD Tracey Rannie, Acute Health Service Administrator, RIH James Kinakin, Director, Business Support Brent Kruschel, Chief Project Officer and Corporate Director, Capital Planning Birgit Koster, Director Business Support, Capital Planning Capital Bylaw No. 130 Major Renovations Urgent Family Care and Teaching CentrePage 31 of 43 Page 2

32 ADMINISTRATION DEPARTMENT BOARD REPORT TO: Chair and Board of Directors DATE: November 15, 2017 FROM: SUBJECT: Chief Administrative Officer Bylaw No Provisional Budget RECOMMENDATIONS: 1. THAT the Thompson Regional District Provisional Budget Bylaw No. 131, be read a first time by title only. 2. THAT the Thompson Regional District Provisional Budget Bylaw No. 131 be read for the second and third time. 3. THAT the Thompson Regional District Provisional Budget Bylaw No. 131 be adopted. Approved for Board Consideration CAO BACKGROUND: Attached is the proposed 2018 Provisional Budget for the Thompson Regional District, as required by the District Act, Section 23. DISCUSSION: Total expenditures for 2018 have been budgeted at $ 169,383,253 which is up $ 143,795,429 from the 2017 amount of $ 25,587,824. Included in the 2018 Expenditures is final and full funding of the Clinical Services Building at (RIH), along with provisions for Capital projects, minor equipment and carry forward projects. At its September 16, 2017 meeting, the Board approved a contribution of up to $ 173 million towards the new Patient Care Tower at RIH and this budget includes expenditures of $ 22.5 million towards this project in Further, this budget includes the provision to borrow $ million towards the Patient Care Tower next fall. The exact time of borrowing and the methodology of borrowing is Bylaw No Provisional Budget Page 32 of 43

33 November 15, 2017 Page 2 of 2 Subject: Bylaw No Provisional Budget something that will need to be examined as we get closer to fall Funding of the full contribution will be explained during a presentation at the meeting on November 24, Also included in this budget is a contribution to the capital reserve of $ 127,500,000. The Capital Reserve Balance at the end of the 2018 fiscal year will be $ 138,650,000. The 2017 residential tax rate was $.5075 per one thousand of residential assessment. The 2018 tax rate proposed is $.5075 per one thousand of residential assessment. The average property paid $ in 2017 and the average house will pay $ in 2018 based on the 2017 assessment ($ 275,495) and exclusive of new growth. CONCLUSION: The commitment of $ 173 million towards the Patient Care Tower at RIH has been accommodated in this budget by way of either borrowing the funds ($ Million) or budgeting the expenditure in the year. A residential property located within the TRHD will be assessed a property tax of $.5320 cents per thousand of assessed value ($ on a home valued at $ 100,000). This equates to an average residential property paying $ in 2018, which is the same as it was in Attachment 2018 Provisional Budget Bylaw No. 131 Bylaw No Provisional Budget Page 33 of 43

34 THOMPSON REGIONAL HOSPITAL DISTRICT BYLAW NO. 131 A BYLAW TO ADOPT THE PROVISIONAL BUDGET FOR THE YEAR 2018 The Board of Directors of the Thompson Regional District, in open meeting assembled, enacts as follows: 1. This bylaw may be cited as the "Thompson Regional District 2018 Provisional Budget Bylaw No. 131, 2017". 2. Schedule "A, attached hereto and made part of this bylaw, is the Provisional Budget for the Thompson Regional District for the year ending December 31, READ a FIRST time this 24 day of November, READ a SECOND time this 24 day of November, READ a THIRD time this 24 day of November, ADOPTED this 24 day of November, Corporate Officer Chair Bylaw No Provisional Budget Page 34 of 43

35 THOMPSON REGIONAL HOSPITAL DISTRICT 2018 Provisional Budget Bylaw 131 Schedule A Provisional Annual Provisional Budget Budget Budget REVENUE Tax Requisition Total $15,160,000 $15,220,000 $15,220,000 Long Term Borrowing ,500,000 Transfer From Reserve 0 1,000,000 4,050,000 Surplus from Previous Year 10,535,916 9,367,824 22,613,253 TOTAL REVENUE $25,695,916 $25,587,824 $169,383,253 EXPENDITURE General Operations: Debenture Debt - Principal 71,153 71,153 0 Debenture Debt - Interest 19,307 19,307 0 Equipment/Capital Projects 20,430,456 25,322,364 41,708,253 Transfer to Capital Reserve 5,000, ,500,000 Temporary Borrowing Interest 100, , ,000 Total Expenditures General Operations 25,620,916 25,512, ,308,253 Section 20(2): Expenditures 75,000 75,000 75,000 Reserve Total Section 20(2) 75,000 75,000 75,000 Surplus- Current Year TOTAL EXPENDITURE $25,695,916 $25,587,824 $169,383,253 Bylaw No Provisional Budget Page 35 of 43

36 THOMPSON REGIONAL HOSPITAL DISTRICT 2018 Provisional Budget Section 20(2) Reserve Fund for Future Expenditures Bylaw 131 Schedule B Provisional Annual Provisional Budget Budget Budget SOURCE OF FUNDS: Balance at beginning of year $1,048,860 $1,048,860 $1,048,860 Transfer from Operating Fund Total funds available $1,048,860 $1,048,860 $1,048,860 APPLICATION OF FUNDS: Grants to Facilities $0 $0 $0 Treasury Board Minor Projects Emergency items, works or services 1,048,860 1,048,860 1,048,860 Total application of funds $1,048,860 $1,048,860 $1,048,860 BALANCE AT END OF YEAR: $0 $0 $0 Bylaw No Provisional Budget Page 36 of 43

37 ADMINISTRATION DEPARTMENT BOARD REPORT TO: Chair and Board of Directors DATE: November 15, 2017 FROM: SUBJECT: Chief Administrative Officer Capital Bylaw No. 132, 2017 Patient Care Tower Borrowing RECOMMENDATIONS: 1. THAT the Thompson Regional District Capital Bylaw No. 132, 2017 be read a first time by title only. 2. THAT the Thompson Regional District Capital Bylaw No. 132, 2017 be read a second and third time. 3. THAT the Thompson Regional District Capital Bylaw No. 132, 2017 be adopted. Approved for Board Consideration CAO BACKGROUND: At the TRHD meeting on September 16, 2016 the Board approved the contribution of up to $ 172 million towards the construction of the $ 417 million Patient Care Tower at. The attached bylaw would allow the TRHD to borrow up to $ 130 million dollars towards this. DISCUSSION: The masterplan done for the was completed a number of years ago. As a part of the masterplan, two phases were identified. Phase 1 was the construction of the Columbia Street Clinical Services building at an approximate cost of $ 70 million. Phase 1 has been completed now. Phase 2 of the masterplan was the construction of a Patient Care Tower. Capital Bylaw No. 132, Patient Care Tower Borrowing Page 37 of 43

38 November 15, 2017 Page 2 of 2 Subject: Capital Bylaw No. 132, 2017 Patient Care Tower Borrowing A business plan for this phase has been completed and is expected to cost $ 417 million. The TRHD Board committed a funding contribution of up to $ 172 Million to this phase of the project. The Patient Care Tower project is currently in the detailed planning stage with 3 companies shortlisted to bid on the project. It is anticipated that construction on this project will commence in the fall of In anticipation of this schedule, reviewing cash flows and being mindful of the interest environment, ie interest rates expected to increase in the next couple of years, it may be prudent to borrow the amount needed to fund the cash flow prior to the full amount being needed. This would allow the TRHD to lock in the cash at lower interest rates. While contracts for the project will not be signed until the summer of 2018 it would not be prudent to borrow funds in the MFA spring debt issuance; however, it may be worthwhile to borrow in the fall debt issuance. We will know by late summer 2018 as to the status of the project and its scope. Accordingly, you can find attached to this report a request to adopt Capital Bylaw 132, 2017 to provide the TRHD the authority to borrow up to $ 130 million. The debt servicing of this amount has been factored into the taxation rates that were established in CONCLUSION: The TRHD Board made a commitment to fund unto $ 172 million towards the Patient Care Tower at. The attached bylaw will provide the authority to borrow up to $ 130 million to fund this commitment. The borrowing is expected to take place in the fall of 2018, assuming the project scope and final pricing is determined by late summer Attachment(s) Capital Bylaw No. 132, 2017 Patient Care Tower Borrowing Project update IHA Press Release dated Oct 31, 2017 Capital Bylaw No. 132, Patient Care Tower Borrowing Page 38 of 43