1. “At some time, in some way, we must all face the end of life. And most us share a common hope—that when death comes to us or to a loved one, it will be peaceful and free of pain. We hope to face death surrounded by a circle of support, feeling safe, comfortable and cared for. This is the promise of Hospice Greater Saint John.”

2. Bobby’s Hope House Our Future Residential Hospice

3. Residential Hospice Palliative Care in the Community Small, not institutional Home Away From Home Maximum of 10 private bedrooms 24 hour access for family 24 hour nursing/medical care Supported by volunteers Pain & symptom mgt. and psychosocial/spiritual support that relieves suffering encourages communication, fosters hope & prepares people for loss

4. DEATH – Today’s Reality 80% die of a chronic illness (palliative diagnosis) 20% die an acute death In Greater Saint John: 1,000 deaths / year 800 are palliative In Region 2: 1,500 deaths / year 1,000 are palliative

5. Death – Reality in 20 years Seniors account for 75% of annual deaths By the year 2025, the proportion of seniors in NB is projected to be 21% higher than the national average. “Of New Brunswick’s three major centres, Saint John is the oldest.” - Telegraph Journal, July 18th Projections for Greater Saint John: 2000 deaths/year 1600 palliative deaths 400 acute deaths

6. Where do People Die? Most want to die at home – breakdown in last weeks/months of life when 24-hour care needed Most in fact die in institutions – 90% (75% die in hospital, 15% in NH ) Saint John Regional Hospital –PCU annual palliative deaths: ~ 200 –“Other beds” annual palliative deaths: ~ 200 50% of the area’s identified annual palliative deaths occur in one Hospital

7. Palliative Patients in Acute Care Beds – Outside of the PCU Inappropriate level of care Expensive Affects access to acute care beds Not as holistic as the care offered in a Hospice setting

8. CHPCA Norms of Practice Hospice Palliative Care is a set of services offered in four settings: –Home –Hospital –Nursing Homes –RESIDENTIAL HOSPICES

9. Residential Hospice 1.Provides timely access to comprehensive hospice palliative care services Right care at the right time by the right providers Setting of Choice - non-institutional care – a home away from home

10. Residential Hospice 2.Frees Up Acute Care Beds ALOS for palliative patient in acute care bed is 22 days in comparison to 5-10 days for acute care patients Using the same bed for acute care services will reduce wait times for elective surgery and admissions from the ER

11. Residential Hospice 3.Allows More Healthcare Dollars to be Used for Acute Care Services Cost of Residential Hospice is $300/day. Cost of Acute Care Hospital Beds is $1,000 per day. Residential Hospice is cost-effective care.

12. Residential Hospice 4.Supports economic development and contributes to self-sufficiency A timely and accessible acute healthcare system is needed to attract and keep workers HPC helps families cope and enhances their ability to remain healthy, productive employees and effective family members

13. Government’s Healthcare Priorities 1. Increasing Access 2. Reducing Wait times 3. Cost containment 4. Sustainability Government & Business Priorities 1.Economic Development & Growth 2.Self-Sufficiency Residential Hospice is part of the solution!

14. Win-Win-Win-Win-Win-Win Government - Right Care (Access), Right Time (Wait Times), Right Providers (Sustainability, Cost Containment and Self-Sufficiency) Business – Supports economic development & growth Hospital – Increased access to acute care beds Patients – Setting of Choice (non-institutional) Families - Support when needed Hospice – Deliver on our Mission & Vision

15. Residential Hospice Capital Costs St. Joseph’s Convent valued at $1.66 million to build at today’s costs Sisters of Charity elected to invest in the establishment of a Residential Hospice for our community and NB – sold Hospice the property for $250,000 Would have cost over $1 million to build

16. Code Renovation Costs Elevator75,000 Architectural Improvements 150,000 Sprinkler System50,000 Plumbing Upgrades75,000 Ventilation Upgrades 128,000 Electrical Improvements 60,000 20% Contingency 107,600 Architect Fees 65,000 Total $710,000

17. Residential Hospice Annual Operations - $840,000 Expenses 0.20 FTE Medical Director 40,000 1 FTE Resident Care Manager 69,000 RN’s, LPN’s, PSW’s 666,000 1 FTE Housekeeper/Cook 25,000 Supplies, Food 35,000 Revenue Provincial Government$580,000 Hospice$260,000

18. Nursing Care:1 Nurse Manager Day Shift1 RN 1 LPN 1 PSW Evening Shift1 RN 1 LPN Night Shift1 RN 1 PSW Nursing Coverage

19. People admitted under the care of their family physician (FP) – responsible for 24- hour medical coverage FP has access to 0.20 FTE Hospice Medical Director for consultation, support and overseeing care Physician Coverage

20. The Request to NB Government 1. Make Residential Hospice part of NB’s “innovative healthcare and seniors plans” due in Fall 2007 and Winter 2008 2.Put Residential Hospice operational funding - $580,000/year - in the 2010 NB Budget. 3.Provide some capital funding to support space renovations (RDC, ACOA & CMHC).

21. Current Status 1.NB Political Agreement – Shawn Graham, Mike Murphy, Roly MacIntyre, Mary Schryer, Ed Doherty, Jack Kier, Jeannot Volpe, Trevor Holder 2.Federal Political Agreement -Tony Clement, Greg Thompson and Paul Zed 3.Community Leadership Agreement – Greater Saint John Mayors AHSC Board of Directors Saint John Board of Trade Sisters of Charity Saint John City Council Telegraph Journal

22. Residential Hospice Helping People Live With Dignity, Comfort and Peace Everyone Says Yes

23. “Realize the Dream” Capital Campaign 2007 - 2010 Hospice to fundraise $1.12 million over 2 years to renovate and ready for operations in 2010 Code Renovation Costs$710,000 Supplies/Equipment/Garden$150,000 1 st Year of Operations$260,000 Government, Foundations, Corporate, Service Clubs and Individuals

24. Residential Hospice Projected Opening Spring 2010