To all residents of Maple Creek and surrounding areas,
The Cypress Health Region has been invited to a number of municipal council meetings in the area to discuss issues of mutual concern, and to specifically address several targeted questions. The region has appreciated the invitations as it provides an opportunity to continue the working relationships with the municipal councils and provide specific answers to their questions.

In an attempt to increase the general awareness of current issues, provide a summary of the information being shared, and attempt to address some of the miscommunication within the communities, Cypress Health would like to share the following:

Integrated Facility Capital Project
• The Cypress Health Region has obtained Ministry support for 24 acute care and 48 long term care beds for a new integrated facility in Maple Creek. Cypress Health originally proposed these bed counts during discussions on October 13th, and has continued to support this proposal ever since.
• In determining the size and scope of a capital project, the Ministry of Health uses guidelines such as population projections, acute care utilization, and the number of long term care beds per 1000 people over the age of 75 years (note: the provincial standard is established at 110 LTC beds per 1,000 people over the age of 75 years) criteria. The Ministry of Health’s population projections until 2028 supports the sustainability of 48 long term care beds. There are additional long term care beds within and surrounding the identified catchment area (Eastend, Shaunavon, Leader, and Gull Lake). Current acute care utilization is six to seven patients per day.
• In February 2009, this project was announced as a “replacement project” by the Ministry of Health. The word ‘replacement’ does not mean that the current Cypress Lodge will be demolished. The Region looks forward to working with the community to explore assisted living options for this facility. The region does have an existing mortgage on the Cypress Lodge and it is not their intention to transfer the mortgage to the community.
• It has been quoted that the occupancy at the Cypress Regional Hospital in Swift Current is ‘over capacity’. There are days where utilization is over 100%; however, the average occupancy rate at this facility throughout the year is approximately70%.
• The enhancement of services for this new integrated facility has been discussed. The Cypress Health Region remains committed to enhanced services throughout the entire region, providing the demand meets the established criteria along with physician/staff competency and willingness. One example being addressed is ‘Oncology’ services – the Region is committed to constructing a room to be able to deliver oncology treatments. The criteria for this program are set by the Saskatchewan Cancer Agency which requires:
• A sufficient number of patients, which will ensure adequate number of treatments are administered by individual personnel (which therefore maintains the staff’s competency), and ensuring standards are met. The number of patients is monitored and determined by the Saskatchewan Cancer Agency, not the health region.
• Planned patient treatment regimens that can be safely administered in an outreach centre (this is determined by a medical specialist and not all patients are able to receive treatment outside of Regina and Saskatoon);
• A signed Memorandum of Understanding signed between the Regional Health Authority and the Saskatchewan Cancer Agency;
• On-site Hematology and chemistry lab services, on-site pharmacy services, and on site in-patient services (currently do not have on site Hematology and Pharmacy). In addition, Nursing, Pharmacy, Physician, Psychosocial support and a contact for each discipline must be available;
• Appropriate capital equipment purchases and repairs;
• Physician support be readily available during treatments, and to respond to any medical emergencies that arise during treatment. The primary care physician will provide follow-up care in consultation with the Oncologist. Physicians who are responsible for administration/preparation must be certified in accordance with the Saskatchewan Cancer Agency. Individual Physician practice/experience /preference will dictate this criteria match;
• Must have at least two Registered Nurses certified in the administration of cancer treatments;
• Must have at least one licensed pharmacist certified in the safe handling, preparation and disposal of cancer treatments who has successfully completed the Chemotherapy Certification program;
• NOTE: Each expanded specialty service (ex. obstetrics, surgical, etc.) will have its own specific set of criteria and complexities.
• The supporting communities are looking for something better than what they currently have. This new facility will:
• Integrate all services under one roof (ex. long term care patients will not have to be pushed across or take an ambulance across the street to access lab and x-ray services)
• Single point of contact for all health services (Physician, NP’s, physiotherapy, mental health & addiction, Home Care, Acute Care, long term care, EMS all under one roof)
• Enhanced long term care environment that meets current standards
• Assist in the recruitment and retention of Physicians and health professionals
• Increased Acute Care beds with built-in flexibility to meet patient demands (10 multipurpose beds that can be utilized for in-patient, long term care waiting placement, palliative care, respite care)
• Setting for a team-based approach to client care
• Sustainable model (commitment from the Region and the Ministry of Health for acute care and long term care services in Maple Creek)
• State of the Art facility wired with Telehealth, ceiling track lifts, isolation rooms, bariatric rooms and special procedure rooms
The Cypress Regional Health Authority truly feels that if we do not collectively move forward on the capital project in a timely manner, there might be a missed opportunity.

Managers’ Resignations
• The Cypress Health Region has indeed received the resignations (on two separate days) from the Health Services Manager in Maple Creek and Leader. These were voluntary resignations and not for all the same reasons. The former Manager in Leader is remaining as a casual registered nurse. Due to privacy and confidentiality of these human resource issues, the Region cannot speak to the specifics surrounding the resignations; however, we recognize the tremendous demands on these positions.

Recruitment of Physicians
• Yes, it is true that the health region has been in contract negotiations with a physician currently practicing within the region re: the opportunities in Maple Creek. Cypress Health has successfully completed these contract negotiations with this physician – an effective start date for this physician to join the Primary Health Care clinic will be announced soon.
• The health region has not, in any way whatsoever, discouraged these negotiations and potential transfer. In fact, the ability to have another fully licensed College of Physicians and Surgeons’ physician practicing in Maple Creek would solve many of the Region’s challenges in relation to physician recruitment. This would:
• eliminate the requirement for Physicians to be mentored at a physician clinic in a community other than Maple Creek until they pass their CAPE exam,
• provide the Maple Creek Primary Health Care Clinic with the opportunity to serve as a mentoring clinic for other International Trained Graduates (IMGs) within the health region
• provide physician stability within the community of Maple Creek, and
• eliminate some of the temporary disruptions in the region.
• The Region is also in active negotiations with another South African-based physician for Maple Creek.

Temporary Disruptions of Service
• Maple Creek will be facing a temporary disruption during the timeline of December 28 at 7 a.m. – December 31 at 7 p.m. The Region was able to secure a locum physician to reduce a potential 10-day disruption down to four days. The region does not promote or prefer temporary disruptions any more than the public. There is a lot of planning and time invested in trying to prevent a disruption before such a plan is implemented, and another considerable amount of time (including consultation with staff and unions) is needed to coordinate such a plan when it is necessary.
• Shaunavon Hospital is in the midst of a temporary disruption (reduced services in effect) during the dates of November 30, 2009 – January 4, 2010.
• Leader Hospital will be facing a temporary disruption from January 4 – 8, 2010.
• Temporary reductions of service are initiated by the region when it is determined that there are insufficient numbers of health care professionals available to provide specific health services at a facility. In order for an acute care facility to remain open there must be a physician, registered nurse and lab/x-ray staff, as per provincial legislation/standards/criteria.
• Some examples of when a temporary disruption is declared include:
• The unavailability of physician on-call services – situations such as when the community’s physician or physicians are temporarily away from the community, require some well-deserved holiday time or time away from the on-call responsibilities, part-time temporary replacement assistance (i.e. ‘locums’) cannot be found, or the physician is not fully licensed by the College to provide medical coverage without the presence of a fully licensed colleague to provide support.
• Unavailability of registered nursing coverage – situations such as when replacement staff are not available to assist, where there is a limited supply of casual staff to provide coverage when permanent nursing staff are on leave.
• Unavailability of lab and/or x-ray staff coverage
As per normal practice, the health region will continue to welcome invitations to municipal council meetings and will make every effort to attend when invited. Cypress Health is committed to move towards the construction of a new integrated health facility in the community of Maple Creek and to continue its recruitment efforts for physicians and other health care professionals.

If you have any further questions or require clarification on this information, please send an email to info@cypressrha.ca or phone Brenda Schwan at 306.778.5105.

Thank you for your understanding, patience and support.
Tyler Bragg, Chairperson, Cypress Regional Health Authority
Jim Hornell, Chief Executive Officer, Cypress Health Region