What were Alpine Health’s objectives?
The objectives for this work were to meet the future residential aged care needs of Bright and its surrounds for the next 20 years, and to do so in an affordable and timely way. The project was also to consider and assess the needs of the Bright hospital to bring it up to contemporary standards.
What work has been undertaken so far?
Initially, Alpine Health commissioned a strategic planning process, which led to the suite of projects that together comprise the vision for the development of a health precinct centred on the aged care and hospital needs.
The projects across aged care, the hospital and Hawthorn Village were then assessed in a feasibility study led by Tectura, an architectural firm, who engaged a team of planning, engineering and cost consultants.
The feasibility study has confirmed the projects are deliverable, and also the 2015 end cost of $39.25 million. The program provides for development to commence mid-2022 and be completed by the end of 2015.
We are now pulling this work together into a business case for funding partners, including government, to consider.
How has the work been funded?
Alpine Health has funded the planning and feasibility work, which has been cost-effective given we were able to leverage the planning work we had undertaken in Bright over the last 10 years.
We have received favourable feedback from the State Government in relation to funding applications to assist in the development of the plans.
How does Alpine think it can fund the program of investment?
Alpine Health has been careful to plan for and assess the most efficient suite of projects that meet the needs of the community and the services they will require of the health service.
While the development costs amount to $39.25 million across the three main projects (aged care, the hospital and Hawthorn Village), the Board considers there is a viable framework for funding the program involving contributions from Alpine Health’s capital reserves, the Bright community, and the Commonwealth and State Governments.
The funding model should not stretch the capacity of any of the funding partners and it aligns well with the responsibilities and interests of all partners. We are optimistic, given the feedback that we are receiving from the community and all levels of government, that the needs we are expressing are well-conceived, well understood and well supported.
What will it mean for the community?
Residential Aged Care ($26.5 million)
The Bright community will have a high-quality high care residential facility that is fit for purpose for caring for high need clients, including those with dementia. This will mean:
- Community members needing a high care facility will no longer have relocate to another town to receive the care they need, and so not be dislocated from their family and their community.
- The health and well-being outcomes for our aged care residents will be significantly enhanced by the quality and amenity of the facility, the services provided, and their ability to stay connected with family, friends and community.
The Hospital redevelopment ($10.75 million)
Bright’s hospital upgrade will provide significant improvements to the patient experience and outcomes; will increase the community’s access to a range of services; and deliver safety, efficiency and sustainability in the delivery of health care:
- Providing private bathrooms to patient rooms will enhance patient privacy, dignity and respect in care; improve safety in terms of infection control and the risk of unnecessary movement of patients through the hospital; and efficiency as staff time can be reallocated to the acute health needs of patients rather than the movement of patients.
- Development of a dedicated palliative care suite means the health service’s nursing and medical team, with families and carers, can deliver high-quality end of life services for patients.
- A production kitchen that has sufficient capacity for the levels and quality of food we produce will mean we can continue to serve the current and emerging needs of our patients, our residents and the clients of our home-based services across all locations.
- Replenishing the engineering infrastructure of the hospital, such as air-conditioning and water systems, that are at end of life and need renewal, significantly reduces the risk of failure in core services that can threaten the ongoing operation of the hospital.
- Adding treatment rooms to the hospital means we can expand the delivery of specialist medical and allied health services for inpatients, outpatients and residents of our new aged care facility.
Hawthorn Village ($2 million)
Once the new aged care facility is complete, Alpine Health will spend $2 million to repurpose Hawthorn Village into temporary housing for both students on placement and for health and medical workers relocating to live and work in Bright. It will also become the new home for the Alpine Institute, which runs education and training programs in health care, including nursing, providing a pathway for employment in, and skills for the sector. The training program will deliver much needed additional workforce for our needs in Bright.
Facilitation of complementary privately funded and operated facilities
Alpine Health is also seeking to facilitate the development of complementary private medical, allied health and social housing facilities on its available land in Bright.
This includes making available leased land for the development of a medical and allied health facility adjacent to the hospital and land for social housing adjacent to Hawthorn Village.
I live in the vicinity of the hospital – should I be concerned about how this might affect the liveability of my neighbourhood?
The planning work has addressed the planning needs and the particular planning frameworks of the Alpine Shire – such as building setbacks, building heights, parking, significant trees, stormwater and sewerage.
The program of development will greatly improve land that sits idle and unimproved at the moment. Alpine Health, in undertaking the development, also aims to greatly improve the amenity of the local environment. There will be plenty of parking, the buildings will be designed in a way to be sympathetic to the Alpine village theme promulgated by council, and these will be building finishes and gardens that will greatly add to the amenity of the area.
Are there any broader benefits?
The program of proposed investment is significant for economic activity, jobs and employment in Bright.
Subject to both the public and private projects proceeding, the precinct development involves a capital spend of over $45 million. This level of investment will yield significant direct and flow-on economic benefits from the investment multiplier effect in terms of income and employment in Bright.
With a multiplier of 3.5 (taken from a 2018 study Regional Economic Impacts of Public Hospital Investment by the Regional Australia Institute and NSW Health Infrastructure), the program of investment would yield $157.5 million of direct and indirect regional economic impacts.
This will lead to the creation of many hundreds of jobs during the construction phase (the Regional Australia/NSW Health report estimated that a $75 million health development in Tamworth generated 700 direct jobs in the construction phase and over 2000 in total direct and indirect jobs).
The program of projects will also release land for development elsewhere in Bright as services locate to the precinct – which will add to the indirect economic benefits of the project.
Also, the new residential aged care service will involve additional staffing due to the higher care needs of the residents. There will be a higher level of ongoing demand for health staff with higher skills who earn higher wages, and the additional employment and wages from the activity in the precinct will increase spending and employment throughout the community.
The repurposing of Hawthorn Village into the home of the Alpine Institute will bring further economic benefits in terms of the spend created by that activity and the skills that the health training facility will enable regional health services to develop and expand.
Alpine Health’s program of education that will support the bridging of internationally qualified nurses into practice in Australia will deliver a new economic activity into Bright; provide much-needed skills for the sector; and provide a culturally enriching experience for the students and the community of Bright.
What is a high care residential facility?
A high care residential aged care facility provides high-level care for people who require a lot of assistance with activities of daily living, such as feeding, dressing, cleaning and mobility.
High care facilities have rooms that enable access to mobility devices such as wheel chairs and lifts, and corridors, doorways and rooms need to be wide enough for beds to be wheeled in and out. They have more highly qualified staff, equipment and facilities for specialist medical care. They also have a warm communal homelike environment, with spacious rooms with sitting areas and attached bathrooms, a range of dining and recreation facilities, and accessible gardens.
The planning work has followed the contemporary design guidelines for residential facilities developed by the Victorian State Government. Importantly, we are planning for a facility that can cater for the higher needs of people with severe psychological symptoms of dementia.
Hawthorn Village is important to the community, what is wrong with it?
Hawthorn Village is dear to the community and Alpine Health, and it will remain a key feature of health services in Bright into the future.
As an aged care facility, it does not and cannot provide for residents that need higher care services and is not suitable for ageing in place.
It was designed as a hostel and the cost to alter it to a facility that can offer a continuum of care as residents age would be prohibitive. The unmet demand for aged care services in Bright is in a facility that can provide low through to high care. Similar towns, such as Mansfield and Myrtleford have facilities that can accommodate up to 100 residents, providing for low through to very high care, including dementia care. Bright’s Hawthorn Village has no capacity to meet that demand.
What is going to happen to the people who live at Hawthorn Village?
All those who live at Hawthorn Village will continue to live there, and the valued staff who work there will continue to work at serving our residents’ care and support needs. The project is in its planning phase and any changes to our services will need government funding support and we have a commitment to all our residents at Hawthorn Village to care for them now and into the future.
Is this a cost-cutting exercise, will you still employ the same number of people?
There will be no decrease in funding with any proposal we develop. Rather, we are planning for our services to increase, including in in-home care and hospital care. Our services in residential aged care will increasingly be directed to high care, which takes a significantly higher level of staffing and resources.
What is wrong with the provision of aged care services in Bright?
Bright has been well served by Hawthorn Village as a hostel, but with ageing in place, we know that the demand for high care residential aged care will increase, and we needed to take steps to understand and plan to meet that need.
There are no comparable communities to Bright in regional Victoria that do not have access to a significant number of high care residential aged care beds.
What will this mean for me as I age?
The projects address the current and emerging needs of all residents of the Bright community. The plans that Alpine Health has developed and will enact in collaboration with the community of Bright and the State and Federal Governments, means Alpine Health can service those needs as and when they arise.
How is the organization going about this work?
The organization is in the mid to late stage of developing its strategy, plans and business case for development. It has brought together and updated a large amount of work that has been done before, as well as commissioned new work in areas such as needs assessment, options analysis, planning, engineering and design.
The work is being led by the Chief Executive of Alpine Health and a Project Control Group and is drawing on internal as well as external resources and expertise.
The strategy and the project feasibility study has been completed, with the feasibility study confirming the projects can be delivered, and the scope and cost of the works.
Alpine Health is now drawing this all together into a coherent business case for government and other funding partners to consider.
What will the changes cost and how will they be funded?
The plans have determined what the Bright Community needs as an aged care and hospital facility that is fit for purpose for the future. It has determined the scale of what is needed, the scope of services it would accommodate, what it would look like, what it would cost, where it should be located, how it would be operated, and a funding model that enables the development and sustains the facilities into the future.
While the plans provide for high-quality facilities, they are appropriate to need, they are not ‘gold plated’ and they are affordable and deliverable.
What will happen to Hawthorn Village?
Alpine Health sees Hawthorn Village as a key strategic health service asset in Bright. When the new aged care facility is complete, Alpine Health will spend $2 million to repurpose Hawthorn Village into temporary housing for students on placement and for health and medical workers relocating to live and work in Bright.
It will also become the new home for the Alpine Institute, which runs education and training programs in health care, including nursing, providing a pathway for employment in the sector. This will save Alpine Health significant expenditure on rental accommodation, it will relieve pressure on the facilities at Myrtleford, and it will bring much needed additional skills into our health service.
What about the hospital, where are the plans for improving this facility?
Shortfalls in the service capability of the hospital have been considered and form a component of the strategy. The hospital requires $10.75 million of improvements, comprising:
- a new production kitchen ($3.65 million);
- reconfiguring the nine acute rooms so they have private bathrooms and establishing a new palliative care suite ($3.9 million); and
- creating additional consulting, allied and community health facilities ($2.8 million).
Core services infrastructure such as air conditioning that is at end of life will also be renewed.
I want to stay in my own home as I age, what is in this for me?
Alpine Health is committed to supporting the community to remain in home as long as is practicable. alpine@home's Home Support services provide a range of home care services to help frail aged people living in the Alpine Shire to live safely and independently in their homes, and we intend for this program to grow and to continue to serve the community into the future.
What about the Bentley Woods plans for a new facility?
Alpine Health understands that Bentley Woods is not proceeding with its plans for a new aged care facility in Bright. Hence this project has a heightened level of importance for the community of Bright and surrounds.
Where does the local medical clinic fit into the picture?
Hospital patients and residents of acute aged care facilities require ready access to a broad range of specialist, medical and allied health services. Staff training and development is also key to the sustainability of services in our community.
The opportunity to improve the connectivity and engagement of a full range of medical and allied health services for Bright is a key component of the plans, as are the training and development needs of our workforce.
What does the Aged Care Royal Commission mean for the project?
Many aspects of the areas of inquiry of the Commonwealth’s Aged Care Royal Commission are complementary to this work. Alpine Health also expects that aged care funding reform, and new capital funding programs to support high level care, including dementia specific care, will only help to facilitate the implementation of the plans.