The Journey

Navigating Our Path: The Planning Process Unveiled

What was the process for the development of the proposed multi-site regional hospital?

The development of the proposed multi-site regional hospital by Muskoka Algonquin Healthcare (MAHC) has been a comprehensive, iterative process starting in 2012, involving extensive community engagement, exploration of various models, and adaptation to emerging financial realities and best practices in healthcare delivery.

  • Long-Term Planning: Initiated in 2012, the process focused on redeveloping aging facilities in Bracebridge and Huntsville through an inclusive and consultative approach.
  • Model Evaluation: Early in the planning, various models including a single-hospital model and renovations were considered but were not supported by the community or were found to be financially impractical.
  • Stakeholder Engagement: Over 200 engagements with stakeholders were conducted through 2023 to gather input, which included public meetings, surveys, and continuous news updates.
  • Expert Involvement: Formation of User Groups consisting of over 250 experts including staff, volunteers, patient partners, and health care leaders to collaboratively design a plan that addresses future regional needs.
  • Cost Challenges: In 2023, significant increases in health care construction costs led to a reassessment of the project’s viability under the original plans, prompting a shift towards more innovative approaches.
  • Ministry Guidance: Feedback from the Ministry of Health and Infrastructure Ontario highlighted the need for innovative solutions due to provincial trends in rising costs.
  • Exploration and Development: From November 2023, MAHC researched and developed new models based on successful regional systems across Ontario, refining their approach into early 2024.
  • Community Presentation: In January 2024, the proposed model was presented to the community, showcasing a regional plan designed to be sustainable, adaptable, and responsive to the evolving needs of Muskoka and its surrounding regions.


What are the next steps for MAHC with respect to this proposed multi-site regional hospital?

MAHC is focused on advancing the development of the proposed multi-site regional hospital through continuous consultation and iterative planning. The process involves extensive stakeholder engagement, ongoing refinement of the model based on community and professional input, and final submissions to regulatory bodies, ensuring that the health care system meets the evolving needs of the community.

  • Continued Stakeholder Engagement: Ongoing consultations will keep gathering crucial feedback from a broad spectrum of stakeholders, including physicians, nurses, staff, and community members.
  • Iterative Planning Process: The development of the multi-site regional hospital is dynamic, with continuous adjustments being made to reflect the feedback from health care professionals and community insights.
  • Final Model Development: After achieving broader understanding through these consultations, a finalized model of the proposed multi-site regional hospital will be prepared for submission.
  • Submission to the Ministry: The comprehensive proposal will be submitted to the Ministry for approval, marking a critical step toward implementation. The goal for submission is Fall 2024.
  • Extended Community Consultations: As the project progresses, further consultations will focus on specific aspects such as the design and layout of the facilities, ensuring that the infrastructure meets both functional and community aesthetic needs.


Which groups were represented in the User Groups who were involved in the planning process?

The User Groups integral to the planning process for MAHC’s proposed multi-site regional hospital were comprised of a diverse array of subject matter experts. These groups included medical professionals, MAHC staff, and dedicated volunteers, all of whom play a crucial role in patient support and health care delivery.

  • Broad Expertise: The User Groups were formed with approximately 250 experts, ensuring a wide range of knowledge and experience in healthcare.
  • Diverse Representation: Participants included MAHC staff, physicians, midwives, volunteers, and members of the Patient and Family Advisory Council, reflecting a comprehensive cross-section of hospital operations.
  • Leadership and Partnerships: Hospital leaders and key health care partners were also integral, providing strategic direction and insights into operational and clinical needs.


How were the User Groups chosen?

The selection process for the User Groups involved in the planning of MAHC’s new multi-site regional hospital was meticulous and strategic, focusing on creating a diverse and expertly informed group. The aim was to gather a wide range of perspectives to ensure the development of a well-rounded and effective health care model.

  • Diverse Expertise and Experience: The composition of the User Groups was intentionally diverse, incorporating individuals with a broad spectrum of professional experience and expertise in health care.
  • Geographic Representation: Efforts were made to include participants from various geographic areas within the service region to ensure that the planning reflected the needs and circumstances of different communities. The makeup of the user groups was designed to be equally representative of our two hospital sites.
  • Selective Recruitment: Participants were specifically invited based on their subject matter expertise, ensuring that each group member could provide valuable insights relevant to their professional or experiential background.
  • Voluntary Participation: It was noted that not all invitees chose to participate, underscoring the voluntary nature of the group and the importance of committed involvement from those who did participate.


When will MAHC release the consultant reports and other materials related to decision-making?

MAHC plans to release the consultant reports and other crucial decision-making materials strategically, aligning with the project’s submission timeline to the Ministry and adhering to confidentiality requirements to protect the integrity of the competitive bidding process.

  • Timely Public Release: The reports and materials will be made available to the public through the redevelopment website shortly after their formal submission to the Ministry, expected to occur by Fall 2024. Some data and research used in the planning process is available now and can be viewed on the Research/Data section of our website.
  • Confidentiality Compliance: In compliance with requests from the Ministry and Infrastructure Ontario (IO), MAHC will withhold detailed costing information from public release to prevent any potential adverse effects on the competitive bidding process for the project.

This approach ensures transparency with the public while respecting legal and strategic constraints that safeguard the project’s procurement integrity and competitive fairness.

Which stakeholders were engaged in the planning process?

The stakeholder engagement process for MAHC’s redevelopment project has been extensive and inclusive, continually involving numerous interactions across a variety of platforms to ensure comprehensive community and key stakeholder input. This ongoing engagement is critical in shaping the functionality of the new health system.

  • Broad Community Engagement: Throughout 2023 and continuing into 2024, MAHC has conducted over 200 engagement sessions, including public meetings, information sessions, and interactive discussions to gather widespread community feedback.
  • Diverse Stakeholder Inclusion: Regular updates and surveys have been pivotal in capturing a wide range of perspectives and responses, reflecting our commitment to inclusivity.
  • Specific Stakeholder Groups: Engagement has specifically included MAHC staff, credentialed staff, Patient and Family Advisory Committee, volunteers, Hospital Foundations, various community organizations, and local political leaders. This ensures that all viewpoints are considered in the planning process and contribute to the ongoing development of our health services.


What changes have been made to the proposed multi-site regional hospital based on community, MAHC staff, and physician concerns?

In response to feedback from the community and health care professionals, MAHC has made several significant modifications to the proposed multi-site regional hospital design to better meet the needs and expectations of the local population and medical staff.

  • Increased Acute Care Capacity: The number of acute care beds at the Bracebridge site has been doubled from 18 to 36 to better accommodate the community’s needs.
  • Enhanced Critical Care Services: Four ICU beds have been added at the Bracebridge site, enhancing the facility’s capacity to provide critical care.
  • Preservation of Essential Services: Obstetrical labour and delivery services have been maintained at the Bracebridge site, ensuring continued access to vital maternal and newborn care.
  • Service Adjustments in Key Areas: Modifications have been made to the Diagnostic Imaging and Laboratory services to improve service delivery and efficiency.
  • Ongoing Reviews: MAHC is actively reviewing the allocation and placement of other critical services to ensure they are positioned to best serve patient needs effectively and efficiently.

These adjustments reflect MAHC’s commitment to adapting the plan based on direct input from those it will serve, ensuring that the final implementation is well-suited to the community’s and health care professionals’ specific needs and concerns.

Site Selection

What was the process for selecting the site for the Bracebridge site?

The selection of the Bracebridge site for the new hospital involved a meticulous, multi-faceted evaluation process guided by expert consultation and extensive community engagement. This comprehensive approach was designed to ensure the chosen location would meet the health care needs of the community for the next 50 years.

  • Consultative and Strategic Planning: Supported by Urban Strategies Inc., MAHC engaged in a detailed, transparent process to identify and evaluate potential sites, ensuring the selection criteria were rigorously applied.
  • Community and Stakeholder Engagement: A broad array of stakeholders was involved in the process, including municipal and regional governments, emergency services (police, fire, paramedics), health care partners, Indigenous communities, and the general public through open houses.
  • Criteria-Based Evaluation: Potential sites were assessed against a set of robust criteria, which were informed by feedback from these community engagements, ensuring the site aligned with regional needs and expectations.
  • Due Diligence: Extensive due diligence was performed on two viable properties, which included cultural and heritage assessments, archaeological reviews, geotechnical and hydrogeological studies, as well as evaluations of environmental impact and potential wildlife interactions.
  • Final Selection: The Pine Street property was selected based on its superior alignment with critical factors such as land size, accessibility (highway and emergency), transit connectivity, and potential for low environmental impact, alongside its compatibility with regional planning directions and its ability to accommodate adjacent beneficial uses.


Who were the stakeholders consulted through engagement sessions and interviews?

MAHC engaged with a diverse array of stakeholders throughout the development process, including:

  • Town of Bracebridge
  • Town of Gravenhurst
  • District of Muskoka
  • Emergency Services (OPP, Fire and Paramedic Services)
  • Community members through open houses in January and April 2023
  • MAHC Staff, Credentialed Staff and Volunteers
  • MAHC Patient and Family Advisory Committee
  • Correctional Service of Canada (Beaver Creek Institution)
  • Muskoka and Area Ontario Health Team
  • Community health partners
  • Indigenous communities
  • Infrastructure Ontario, Ministry of Health, and Ontario Health


What were the key elements identified through stakeholder engagement for site selection?

Through the initial engagement process, we identified the following elements as important to our stakeholders:

  • Proximity to Highway 11: Evaluating the site’s accessibility in relation to Highway 11 for ease of transport and emergency response efficiency.
  • Local Transit Service Access: Assessing connectivity to local transit routes to ensure accessibility for staff, patients, and visitors.
  • Minimization of Congested Travel: Selecting locations that avoid congested district roads to facilitate smoother travel for emergency and routine access.
  • Accessibility for Gravenhurst and Surrounding Areas: Ensuring the site is conveniently located for residents of Gravenhurst and the broader Muskoka Lakes region.
  • Proximity to Medical Services and Offices: Considering the closeness to other essential medical services and offices to support comprehensive health care delivery.
  • Potential for Commercial/Retail and Housing Development: Exploring the site’s potential for future development projects, such as commercial or retail spaces and housing for hospital employees.
  • Availability of Municipal Services: Confirming the availability and reliability of essential municipal services like water, roads, and sewers at the site.
  • Primary and Secondary Road Access: Ensuring the site has effective primary and secondary road access to support various transportation needs.
  • Pedestrian and Cycling Access to Downtown: Assessing the site’s connectivity to the downtown core via pedestrian and cycling paths to enhance accessibility.
  • Environmental Impact Considerations: Prioritizing sites with minimal negative environmental impacts to promote sustainability and community health.


What are the standard planning criteria referenced in the Site Selection Overview?

The following are the planning criteria commonly used in this type of site selection process:

  • Land Use Planning Framework: Assessing the zoning regulations designated by the municipal authorities to ensure compliance and suitability for healthcare operations.
  • Capacity for Growth and Phased Development: Evaluating the potential for future expansion and phased development to accommodate evolving healthcare needs.
  • Infrastructure and Services: Analyzing the availability and adequacy of essential services such as water supply, sewage systems, and roadway access.
  • Transportation and Access: Ensuring robust transport links and accessibility for emergency services, staff, patients, and visitors.
  • Potential for Alternative Uses and Redevelopment: Considering the flexibility of the site for alternative uses or future redevelopment to maximize long-term value.
  • Integration into Complete Communities: Evaluating how the site complements existing community uses and contributes to creating holistic, integrated community environments.


How were the preliminary properties assessed?

  • Minimum Acreage Requirement: Each property must encompass a minimum of 40 acres, either alone or in combination with an adjacent available parcel, to meet development needs.
  • Location within Urban Boundary: The property must be situated within the urban boundary of the Town of Bracebridge to align with municipal planning guidelines.
  • Availability for Purchase: The property must be available for purchase, indicating the landowner’s willingness to sell.
  • Accessibility to Transportation Networks: Essential access to a provincial highway or district road is required for convenient transportation connectivity.
  • Suitable Shape and Topography: The property must have a usable shape and appropriate topography conducive to development.
  • Access to Municipal Services: There must be access to essential municipal services, including sanitary, storm service outlets, water, power, gas, and communications infrastructure.
  • Floodplain Compliance: The site must not be situated below 1.4 metres above the 1:100-year floodplain to ensure safety and regulatory compliance.


Why was the Pine Street location chosen after the Muskoka Beach Road site was initially identified as the preliminary preferred site?

The Pine Street location was selected over the initially preferred Muskoka Beach Road site following a comprehensive due diligence process that identified it as the most suitable option for the future hospital in South Muskoka. This decision was based on several critical factors that align with long-term strategic, environmental, and operational goals.

  • Initial Site Assessment: An initial evaluation of potential sites, including Pine Street and Muskoka Beach Road, was conducted to identify viable options.
  • Extensive Due Diligence: Detailed investigations were carried out on both sites, which included cultural and heritage assessments, archaeological evaluations, geotechnical and hydrogeological studies, and environmental impact analyses.
  • Strategic Advantages of Pine Street:
      • Compliance with Ministry Requirements: The site meets all of the Ministry of Health’s requirements for size and suitability, ensuring it is fit for hospital development.
      • Optimal Location: Located near Highway 11 and the centre of Bracebridge, enhancing accessibility for emergency services and the general public.
      • Enhanced Accessibility: The site has excellent access to municipal transit systems and is planned for future road improvements.
      • Cost-Effectiveness: Pine Street offers a more affordable land cost, making it economically advantageous.
      • Environmental Considerations: The site avoids critical environmental challenges such as railways, pipelines, watercourses, and wetlands, reducing potential regulatory and development hurdles.
      • Minimal Wildlife Impact: It minimizes environmental and wildlife impacts, aligning with sustainable development practices.
      • Community Partnership: Supports a long-term partnership with the Town of Bracebridge, which owns the property, fostering community relations and ensuring local support.


What were the evaluation criteria used during the due diligence process related to the Pine Street and Muskoka Beach Road locations?

The due diligence process for evaluating the Pine Street and Muskoka Beach Road sites involved a comprehensive review of several key factors to determine their suitability for the hospital project. These criteria were designed to assess both environmental sustainability and operational feasibility comprehensively.

  • Infrastructure Assessment:
    • Grading and Fill: Evaluating the land’s contour and suitability for construction.
    • Sanitary Systems: Checking the capacity and condition of existing sanitary disposal systems.
    • Domestic Water Supply: Assessing the quality and availability of water for hospital use.
    • Easements: Identifying any legal rights or conditions that could affect property use.
  • Geotechnical Considerations:
    • Bedrock Stability: Analyzing the composition and stability of bedrock for foundational integrity.
    • Groundwater Conditions: Examining water levels and flow to prevent flooding and ensure structural safety.
  • Environmental and Ecological Factors:
    • General Environmental Impact: Reviewing potential impacts on the surrounding environment.
    • Natural Heritage: Considering effects on local natural resources and landscapes.
    • Wildlife and Habitat: Assessing the presence of species at risk and their habitats to ensure conservation compliance.
  • Cultural and Heritage Preservation:
    • Cultural Heritage: Evaluating the site’s historical significance and any impacts on cultural heritage.
  • Accessibility and Transportation:
    • General Access: Assessing the ease of access for emergency and daily operations.
    • Road Improvements and Transit: Considering existing and potential future road configurations and public transit options.
    • Parking Facilities: Ensuring adequate parking availability for staff, patients, and visitors.
  • Regulatory Approvals:
    • MTO Approval: Securing necessary approvals from the Ministry of Transportation for access and infrastructure changes.


Why has MAHC not reconsidered the Muskoka Beach Road property despite the donation offer from Muskoka Royale in January 2024?

The decision to not reconsider the Muskoka Beach Road property, despite the donation offer, is based on a comprehensive assessment of both the initial negotiations and subsequent strategic and environmental considerations. The decision-making process prioritized long-term benefits and suitability for community needs, leading to the selection of the Pine Street site.

  • Initial Decision Context: The offer discussed by the Muskoka Beach Road property owners during community sessions was not included in the original negotiations and decision-making phases, which influenced the initial property assessment.
  • Comprehensive Cost Evaluation: Although the donation offer post-decision was acknowledged and appreciated, the acquisition costs considered at the time of decision were based on multiple factors beyond just price, such as long-term operational and maintenance expenses.
  • Environmental Constraints: The Muskoka Beach Road site is affected by a Provincially Significant Wetlands designation, which complicates development and increases the costs associated with constructing road access and other necessary infrastructure.
  • Strategic Suitability: The comprehensive evaluation determined that the Pine Street location better meets the project’s needs due to its proximity to downtown Bracebridge, accessibility to transit and emergency services, and reduced environmental impact.
  • Community and Fiscal Responsibility: The Pine Street site was also found to offer lower costs for required infrastructure, making it a more financially responsible choice benefiting the taxpayers of Bracebridge over the long term.



What are the plans for the new hospital sites and the future of existing properties?

MAHC is committed to developing two new hospital facilities at separate sites while effectively repurposing and managing the existing properties. Construction is scheduled to start in 2029 and is expected to span three years.

  • New Hospital Developments:
    • Huntsville Site: A new hospital will be constructed on the currently owned land, leveraging existing resources and infrastructure.
    • Bracebridge Site: The new facility will be built at the Pine Street location, a site chosen for its strategic benefits to the community and healthcare service delivery.
  • Utilization of Existing Sites:
    • Huntsville Existing Site: The possibility of repurposing the existing hospital site for administrative and non-clinical uses is being explored. This would lead to the optimization of the space and resources.
    • Bracebridge Existing Site: The current property will be sold, and the proceeds will contribute to the funding of the new hospitals, aligning with financial strategies to support the redevelopment project.
  • Construction Timeline:
    • Start Date: Construction is planned to commence in 2029, following detailed preparations and finalizations of plans and permits.
    • Duration: The construction of each hospital is estimated to take approximately three years, culminating in state-of-the-art health care facilities designed to meet modern medical standards and community needs.

What are the details regarding the construction plans, costs, and strategies for the new hospital sites?

  • Square Footage and Design:
    • Square Footage Plans: The square footage for each hospital site will be tailored to meet the specific needs of the specialized care to be provided and will be determined by the plan approved by the Ministry.
    • Finalization and Approval: Details on square footage are part of an ongoing planning process and will be disclosed once approvals are obtained from the Ministry and final plans are set.
  • Costing Details:
    • Land Preparation at Pine Street: The cost for preparing the Pine Street site will be determined once the multi-site regional hospital design is completed.
  • Comparison to Residential Construction:
    • Cost Differences: The costs associated with hospital construction are substantially higher than those for residential projects due to stringent building codes and requirements specific to health care facilities, such as enhanced air exchange systems, wider hallways, privacy considerations in patient rooms, and comprehensive building system redundancies.
  • Construction Phasing and Funding Stability:
    • Site Construction Priority: The decision on which site to build first will be guided by the Ministry of Health and Infrastructure Ontario. This determination will be based on the financial implications of undertaking two simultaneous construction projects versus a phased approach.
    • Handling Rising Construction Costs: The project is viewed as a single endeavour by the Ministry and Infrastructure Ontario, with a robust costing analysis that includes provisions for cost escalation and inflation. This approach ensures financial preparedness to continue development of the second site despite potential increases in construction costs.


Why is MAHC’s redevelopment project perceived as more expensive compared to the Midland hospital renovation?

  • Clarification of Reported Costs: The reported $100 million cost for the Midland hospital renovation as cited in a January 2024 CTV News article was incorrect, resulting from a misquote attributed to the Mayor of Midland. Efforts were made to correct this misinformation through a requested article retraction.
  • Comparable Project Costs: Upon clarification, it has been confirmed through recent discussions with the CEO that the actual costs of the Midland hospital renovation are aligned with those of the MAHC redevelopment project. Both projects are projected to have similar financial scopes, reflecting the extensive nature and scale of modern healthcare facility upgrades.