The Yukon Liberals are questioning the planning process behind the new 300-bed continuing care facility announced last month by the territorial government.

Liberal leader Sandy Silver told the Star the government is "putting the horse before the cart” by allocating $6.9 million toward the project's first phase, a 150-bed facility, before consulting the community or receiving a business case analysis report.

"They're asking the public what they think, but look where we are already within the planning process,” he said.

Following an early-stage planning report and request for proposals last year, the Department of Highways and Public Works contracted T-Square Architecture for a $96,000 business case analysis and pre-concept planning report. That report is still in the works.

"Why has the government already announced that the facility will be 150 beds when it hasn't even read the report?” Silver asked.

Cathy Morton-Bielz, assistant deputy minister of continuing care, said today at a technical briefing for media that while the report has not been received, a preliminary review of the needs assessment "has confirmed the numbers.”

"This is very standard,” added Paddy Meade, the department's deputy minister.

Silver agreed, in a sense.

"We're going down a very similar road, when politicians are announcing millions of dollars for something that hasn't even gone through the consultation process yet,” he said, echoing concerns raised last month by NDP Leader Liz Hanson.

The government took harsh criticism from the Auditor General of Canada last year 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.

"When you poorly plan for these projects, the costs are downloaded onto the taxpayers because they're going to be over-budgeted,” Silver said.

"This is a huge project, this is massive, and that's going to be downloaded to the next government.”

An early-stage planning report completed in June 2013 projected the ultimate cost at $129.2 million for the continuing care facility, estimated at 194,000 square feet.

Health and Social Services Minister Doug Graham said that 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.

"I don't know what kind of community consultation you would talk about at this stage,” he told the Star last month.

"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.”

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

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

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

"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.”

Morton-Bielz reiterated her boss's rationale today, saying it was more efficient to build one large facility.

"If everything goes perfectly smoothly, we should have some kind of design options for the site — yet to be selected — within a year,” Morton-Bielz said.

The intent is to keep "people in communities as long as possible,” she added, "but people who require high levels of care come to Whitehorse.”

She pointed out that centralizing high-intensity care is not unique to the Yukon, but common across the country.

Silver said that though the facility is projected to be the "largest capital project ever for the Yukon,” it was not mentioned in the Yukon Party's 2011 election platform nor in any ministers' mandate letter.

"Where did this come from?” he asked. "Once again, we're hearing virtual silence from the government on this.”

The existing early-stage planning report, led by Kobayashi + Zedda Architects and unavailable for public viewing, 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 the new 300-bed facility.

Like all jurisdictions, the Yukon has a growing seniors population.

"It's critical that significant planning occurs to meet this growing demand,” Morton-Bielz said today, referring to long-term care.

The report projects a portion of the territory's population will grow from 3,400 people aged 65 years and older — more than 500 of whom are 80-plus — to more than 7,000 65-year-olds in 2036 — up to 3,400 of whom will be over 80.

"We're starting to have significant wait times,” Morton-Bielz said.

That means up to 550 beds will be needed in just over 20 years, and those are conservative estimates, she added.

Currently, there are 26 people waiting to access continuing care, with another 22 waiting to be assessed.

The average wait time is four months, with a range of one to 15 months depending on urgency.

"Having beds in the right place at the right time is really critical in the health care system,” Morton-Bielz said.

She noted the Yukon measures poorly compared to the Canadian average in terms of long-term care needs, with 17 per cent of the territorial population above 75 years old in a facility compared with 12 per cent nationally.

She pegged home-care visits at $35 a day, Whitehorse General Hospital out-patient visits at $270 a visit, long-term care costs at $350 per day and acute stays at more than $2,100 per day.

The report — titled New Whitehorse Continuing Care Facility: Facility Review and Functional Program — 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.