The planned new 300-bed continuing care facility could cost $126.2 million, according to an early-stage planning report completed in June 2013.

The Yukon government has allocated $6.9 million in the 2014/2015 budget to plan a new 150-bed continuing care facility that will be built to allow for a future expansion to 300 beds.

The $126.2-million price tag is estimated for a facility that is approximately 194,000 square feet.

The report notes costs could be reduced as planning for the building evolves and possible efficiencies are discovered.

Today, Health and Social Services Minister Doug Graham called the care facility a "huge, huge building construction project.

"It's probably going to be the biggest single facility in the territory,” he told the Star. "It will be one of the biggest construction projects ever in the territory, as well.”

The Yukon Party cabinet has already approved the project, Graham said.

Yet, the community has not been consulted – and that's a real concern for the NDP.

"The big question when you look at that report is: who did they talk to?” Liz Hanson, the leader of the official Opposition, said in an interview this morning.

"It's all internal talk. There's a lot of questions, I think, that we as Yukon citizens need to have answered before the government makes the definitive move.

"In my view, this is a continuation of how they've made the most important health care decisions. They do it in a way that's behind closed doors and excluding the stakeholders that they should be making plans for. We saw that when they built the two acute care hospitals,” she said.

The government took harsh criticism from the Auditor General of Canada for its planning of the new hospitals in Dawson City and Watson Lake, in particular that it didn't complete a needs assessment nor properly consult the community.

"I don't know what kind of community consultation you would talk about at this stage,” Graham countered.

"At this stage, we know there is a need. We know that we're going to have to provide some kind of facility. We've determined the approximate need, that's why we set it at 300.”

The minister said once the preliminary planning to determine what the building will look like is completed, the government will "probably consult to some extent with seniors in the territory.”

When asked why the community wasn't consulted before the government decided to move forward with a single, large facility, Graham said the government made the determination that the Yukon can't afford to duplicate smaller facilities and pay the associated increased staffing and utility costs.

"We know from our current locations, the fact that we have, what, four or five different seniors' facilities in the city right now, we know how much extra that costs us on an annual basis .... We would like to put all of them together as well,” he said.

But Hanson questions whether such a large facility is the appropriate model for a community of 36,000 territory-wide or 26,000 in Whitehorse.

"Is the intention to centralize all of the services in Whitehorse, then?” she asked today.

"I would like to see them actually engage with the stakeholders, and that would include the potential residents, in terms of looking at what kind of patient-centred care they're going to be delivering and how it's most appropriately done.

"And does that translate into a 300-bed facility in terms of community-based care? Is this the only model that can deliver what Yukon citizens need?” she asked.

The report, led by Kobayashi + Zedda Architects, examines the Yukon's existing and projected continuing care facility needs.

It also outlines the results of a physical and functional review of Whitehorse's three existing continuing care facilities – Macaulay Lodge, Copper Ridge Place, and Thomson Centre – and describes the functional requirements of a new 300-bed facility.

The report, New Whitehorse Continuing Care Facility: Facility Review and Functional Program, is not available online for public viewing.

A copy was provided to the Star this week by the official Opposition.

Currently, there are 182 continuing care beds in the Yukon, 11 in Dawson City, with the remainder located in Whitehorse. As of early March, 27 people were on a waiting list for continuing care.

The report notes that based on various projections, the Yukon will need upwards of 320 new continuing care beds by 2021.

The need to replace the 1970s-era Macaulay Lodge and Thomson Centre – which is just 22 years old – will also factor into the number of new beds needed, the report notes.

During building reviews, the writing team found that Macaulay Lodge does not meet the building code for its current use. It scored a 49 per cent on the technical assessment and has a 7.5-year life expectancy.

The report notes that some rooms and a lot of the bathrooms at the lodge are too small for a wheelchair to manoeuvre, one of several difficulties with the space.

The report also highlights some issues with the functional space at the Thomson Centre.

It notes the facility is set to revert back to the Yukon Hospital Corp. and will no longer be the responsibility of the Department of Health and Social Services continuing care.

Graham explained today that the new facility will eventually replace the beds at the Macaulay and Thomson facilities.

He also explained that while the government expects to need more than 320 new beds by 2021 and more than that into the future, they're only planning for 300 at the new facility. That's because they'd like to see a mix of government, non-profit, and private operations within the territory.

The report goes on to underscore the need for various types of care that should be included in a new facility.

That includes respite care, specialized secure care for residents with dementia, palliative care, day care programs, stabilization and assessment facilities, facilities for obese patients, and mental health facilities.

"The lack of appropriate and adequate community resources, including supportive housing for clients whose health is at risk of deteriorating due to mental health issues, addictions, or other lifestyle factors, is a potential emerging impact on continuing care programs and capacity,” the report notes.

The consulting team recommends, in the report, building new facilities that include a minimum of 125 beds to a total new capacity of 300 beds.

It outlines advantages and disadvantages to a single large facility, two mid-size facilities of 125-150 beds each, and one larger facility of 200 beds and a smaller facility of 50 beds.

The benefit of one large facility would be the potential to maximize capital and operational efficiencies, a central location for staff and visitor access and that it could be built at once, but the government could open units only as required.

The disadvantages to a larger building include that it would limit access to ground level access to the outdoors for residents on upper levels (a 300-bed facility is envisioned as a two- or three-storey building in the report), initial large capital costs, and that it would be a larger-scale building than any other in Whitehorse.

Graham said he's not concerned about the phased construction approach the government has chosen to take nor the potential impacts of future construction on residents occupying the first 150 beds.

He explained the building will be designed in such a way to limit any disruptions to residents and operations due to future construction.

The advantages, as outlined in the report, of two 125-150-bed facilities are the potential for phased development and that more of the facility could be built on one floor, but it would also duplicate infrastructure, and it may be difficult to find two central sites that could accommodate buildings of this size.

The last option, a large 200-bed facility and a 50-bed facility for more independent residents, is the "best fit for the Yukon scale and ... the distinct care profile of continuing care residents in Yukon,” the report notes.

It would provide a less institutional setting for more independent residents, allows for the possibility of phased construction, and would allow for more ground-floor rooms.

However, it would again require two sites and it may have higher capital and operational costs than the other options.

The report recommends a single large facility be located downtown.

Graham said that would be ideal, and highlighted the importance of the location, especially considering access to shops and transit. But space is also a consideration, he noted.

The government is considering eight locations, he said, and is open to suggestions.

Hanson led off question period this afternoon by asking Premier Darrell Pasloski if he believes Yukoners want a 300-bed facility.

Graham stood up to take her initial questions on the subject.

Answering a later question from Hanson, Pasloski summarized some of his government's accomplishments in the collaberative care, assisted living and seniors' services fields.