ADMINISTRATIVE REPORT
Date: November 20, 1995
Dept. File #: CC 28/95
TO: Vancouver City Council
FROM: Medical Health Officer
SUBJECT: Proposed Dr. Peter Centre
INFORMATION
The General Manager of Community Services submits this report for
INFORMATION.
COUNCIL POLICY
There is no applicable Council Policy.
PURPOSE
The intent of this report is to inform City Council of the need for and
interest in developing an AIDS Day Centre with AIDS residential care
beds included and to provide information regarding collaboration with
the Dr. Peter Foundation to accomplish this goal.
BACKGROUND
Of the approximately 8,500 to 9,000 British Columbians infected with
HIV, 85% of them live in Vancouver. In August 1995, 1523 Vancouver
residents had CD4 counts (a surrogate marker indicating the stage of
their illness) of 500 or less which indicates they could have moderate
to severe symptoms of HIV/AIDS and often require treatment. The
capacity of Vancouver to provide adequate AIDS care will be increasingly
challenged as a result of the increased number of individuals projected
to yet become ill with AIDS in the next few years . The problem is
compounded by the fact that those infected are living longer, and those
impacted most are the already more marginalized residents of the city.
An AIDS Day Centre would provide to those ill with AIDS nutritious meals
and healthy supplements, nursing care, IV and other complementary
therapies, physical rehabilitation therapy, psychiatric support,
substance abuse and harm reduction counselling, support and respite for
personal caregivers, individual counselling, social events and
gatherings, and a warm, caring environment.
AIDS Day Centres currently operate in Seatle, New York, San Francisco,
and Los Angeles. Seattle's Baily-Bouschay House after which the
proposed Dr. Peter Centre is modelled reports that an individual
attending their Day Centre is four times less likely to be hospitalized.
Vancouver with the largest HIV/AIDS population in Canada has no such
health care centre. The number of HIV infected individuals seeking
inpatient care at St. Paul's and Vancouver Hospital continues to grow.
On any one day at St. Paul's Hospital, there are now 30+ HIV/AIDS
patients. There is a three month waiting list for Normandy House AIDS
residential care beds. Many of those are waiting in acute care beds,
some of whom unfortunately die in acute care before getting an
opportunity to move to Normandy House. By 1998/99, just three years
from now, it is estimated that 26,000 bed days will be needed in B.C.
for HIV/AIDS patients, 4,000 more bed days than projected for 1995. The
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overwhelming majority of those bed days will be required in Vancouver.
Those providing AIDS care and AIDS organizations have been asserting for
a number of years that an AIDS Day Centre in Vancouver to provide health
care to persons ill with AIDS was a necessary part of the continuum of
health care services. In 1993 the Dr. Peter Foundation expressed
interest in undertaking such a project. A Steering Committee with
representatives from the Dr. Peter Foundation, Vancouver Health
Department, St. Paul's Hospital, B.C. Centre for Excellence in HIV/AIDS,
AIDS Vancouver, B.C. Persons with AIDS Society, Greater Vancouver Mental
Health Services, and Lower Mainland Region Alcohol and Drug Program have
been working together to further the concept. An extensive needs
assessment during the fall of 1993 confirmed a need for and support of
an AIDS Day Centre.
Since then the Dr. Peter Centre proposal has been expanded to include 20
AIDS residential care beds. Those 20 include a proposed transfer of the
already existing 10 AIDS beds at Normandy House, a wing of Normandy
Private Hospital near Arbutus Village. AIDS organizations and user have
consistently expressed a desire to have the current 10 beds
geographically nearer the communities most affected by AIDS.
The Vancouver Strategic Plan for AIDS Care (1995 - 1998) developed
through a broad consultation process identified as high priority the
objectives of establishing an AIDS Day Centre and more residential care
beds.
DISCUSSION
The Nelson Park Site, just across Thurlow Street from St. Paul's
Hospital, is an ideal site for the proposed Dr. Peter Centre. St. Paul's
provides most of the province's AIDS care, and the surrounding
communities (the west end and downtown) contain the vast majority of
Vancouver's AIDS residents and general practitioners specializing in
AIDS.
The proposed design of the Dr. Peter Centre is consistent with the
residential and heritage content of the Nelson Park Site. Seattle's
Baily-Bouschay House is also in a residential neighbourhood.
ENVIRONMENTAL IMPLICATIONS
The Nelson Park Site would minimize the transportation necessary for
individuals going from their place of residence for treatment and meals
at the Centre; minimize the amount of transportation required to take
individuals from the Centre for tests at St. Paul's and to nearby
doctor's appointments; provide easy access for caregivers and friends,
and for out of town AIDS patients who could stay at the Centre while
undergoing tests at St. Paul's.
SOCIAL IMPLICATIONS
The proposed Dr. Peter Centre on the Nelson Park site supports a number
of social and health care goals:
- establishing such a centre responds to the collective input of a
broad base of consumer and community organizations and health care
providers;
- it is consistent with the direction in health care to provide
wherever possible care outside of a hospital, in a non-
institutional setting, and as close as possible to the community
needing the care;
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- its proximity to St. Paul's has the potential for operational
efficiencies in shared services;
- it is consistent with a model of AIDS health care delivery in other
major cities affected by AIDS but will be a first for Canada.
CONCLUSION
In summary the Vancouver Health Department in collaboration with the Dr.
Peter Foundation, other health care providers and AIDS organizations
have been working towards the development of an AIDs day health and
residential care centre in the vicinity of St. Paul's Hospital. The
Nelson Park site is considered ideal for such a centre. It is important
for council to be aware of the planning to date as part of making
decisions in relation to the Land Use Study Report and the future of
Nelson Park.
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