DECISION SUPPORT DOCUMENT FOR

DECISION SUPPORT DOCUMENT FOR Board of Directors Board Committee Senior Leadership Team Other (please specify): Date Prepared: May 1, 2015 Meeting Date Prepared for: May 27, 2015 Subject: Master Program/Master Plan Ad-Hoc Steering Committee Recommendation Prepared by: Master Program/Master Plan Co-Chairs Phil Matthews & Harold Featherston DECISION SOUGHT FOR DISCUSSION/INPUT FOR INFORMATION ONLY RECOMMENDATION THAT the Master Program/Master Plan Ad-Hoc Steering Committee recommends that the Board of Directors approve the one hospital model be selected as the preferred model to ensure safe, high-quality and sustainable health care for future generations; AND FURTHER THAT the site selection target a central location that provides the best access to care for Muskoka Algonquin Healthcare s service population. SITUATION & BACKGROUND The Ministry of Health and Long-Term Care s Capital Planning Process involves 5 stages in addition to a Pre- Capital and Master Program/Master Plan process. The capital planning process is very lengthy, in some cases taking up to 15-20 years to complete as the model is refined at the various stages of the Ministry s planning process. In 2012, MAHC s Strategic Area of Sustainable Future included a Strategic Objective to develop a long-range facilities plan and clinical services plan that provides future vision for services and facility development. A Board approved Pre-Capital was completed and submitted to the Ministry of Health and Long-Term Care (MOH) in October 2012. The Ministry responded in March 2013 directing MAHC to complete a Master Program/Master Plan. MAHC engaged Resources Planning Group (RPG) to assist with the development of the Master Program/Master Plan in September 2013; Stantec was engaged in April 2014 to assist with the architectural planning portion. Initially, the Strategic Objective and Board Goal was to complete the Master Program/Master Plan and preferred model decision by December 2014, however, to allow time to ensure full exploration of all of the options, this original timeframe was extended. The following is a high level timeline estimation for MAHC to complete the Ministry s Capital Planning Process: Master Program/Master Plan & Pre-Capital Addendum Submission June 30, 2015 Submission to NSM LHIN occurs first, once that review is complete, submission to Ministry occurs and then a 6-8 week timeline for review and potential approval to proceed to Stage 1 Stage 1 Completion March 31, 2017 Ministry Approval, Proceed to Stage 2 June 2017 Stage 2 Process (12-18 months) March 31, 2018 Stage 3 5 (several more years before construction can begin) 2018-2027 Master Program / Master Plan Defined Master Program: Reflects a health care facility s present and future service role within the community Outlines current and projected future programs and services, workload, staffing, space requirements using population data forecasting to focus on how programs will change in the future (5, 10, 20 year increments) Reflects current studies, service alignments, volume projections, incorporates options for changes in service delivery Master Plan: Identifies the physical space requirements looking up to 50 years into the future, and siting of services Considers building condition and potential use of existing buildings and systems Defines long-term development strategies for specific sites and/or campuses to support the Master Program Gives basis for evaluating different models or site/building options Briefing note re Master Program/Master Plan Ad-Hoc Steering Committee Recommendation Page 1 of 7

Muskoka Algonquin Healthcare s Environment Aside from meeting the Ministry of Health and Long-Term Care s capital planning requirements, one of MAHC s priority is to ensure that we will continue to deliver the very best in health care to the communities we serve. This work ensures that investments in our services and our aging buildings, and most importantly in the people we serve, are thoughtful, appropriate and effectively meet demands both of the health care system & planning and infection control standards for the long term. There are a number of challenges that MAHC faces in meeting this priority and only add to the importance of proceeding through the capital planning process. These include: The HDMH site was built in 1978 and SMMH site was built 1964. Facility condition assessments conducted by the Ministry for both sites in 2012 determined that the SMMH site is in the fair range and the HDMH site is in the poor range. Site assessments conducted by Stantec have identified that the SMMH site has limited room for future growth. The size of the lot is below contemporary standards for healthcare facilities. Struggle to provide services to fluctuating population while maintaining quality commitment. Small program volumes across sites and the trend of moving services and funding to the community sector. Significant duplication of both capital and operational costs. In addition, MAHC has been approached by local health care partners to consider opportunities related to land development. One example is a request from Fairvern Nursing Home to consider partnering and providing land at the HDMH site for their redevelopment project. A second example was a request from the Cottage Country Family Health Team to consider providing land at the SMMH site for a medical office building project. Without a long range Master Plan, the Ministry would not consider either of these requests. Ministry of Health & Long-Term Care Trends Provincial deficit projected to be $8.5 Billion in 2015/16 Health System Funding Reform (funding formula) is driving efficiencies in system Funding is volume based Hospitals to focus on high need specialized care that can t be provided elsewhere Hospitals (Acute Care Sector) getting less funding Ministry of Health and Long-Term Care focusing on primary health care in the community major investments in Family Health Teams, Health Hubs, Nurse Practitioner clinics, nursing stations, mobile outreach, etc. Focus on technological solutions for access and care (e.g. telemedicine, home monitoring) Lengthy planning and approval process 10-20 years MAHC s Master Program/Master Plan Development Process To assist with the work required to complete the Master Program/Master Plan, the Board of Directors established an Ad-Hoc Steering Committee with representation from the Board of Directors, Physicians, Foundations and Administration. This Committee of 21 members was charged with developing the final recommended model that would best provide safe, quality, sustainable health care for MAHC s service population in the year 2030 and beyond. The process has involved extensive internal and external engagement with over 20 planning teams with membership representing front-line staff including dozens of physicians, management, community and the Board of Directors. Over the course of the project, nine separate community information sessions were hosted by MAHC; three in May 2014, three in August 2014, and three in March 2015. The attached Engagement/Feedback Summary (Appendix B) provides a summary the approach used in these most recent sessions and feedback received. In addition, several additional engagements occurred within the community (see Appendix C) As part of the development of the Master Plan, decisions regarding the long-term redevelopment of existing facilities required careful considered. In total, nine options have been explored, and over time these were reduced to three final options: o 2 Full Service Acute Sites; o Centres of Focus; o One Hospital, Central Muskoka Location. CONSULTED WITH: Ministry of Health and Long-Term Care Capital Planning Branch North Simcoe Muskoka Local Health Integration Network Master Program/Master Plan Ad-Hoc Steering Committee (Appendix A) In excess of 20 planning committees (hundreds of people) created to review programs and services over next 20 year horizon, including: Briefing Note re Master Program/Master Plan Ad-Hoc Steering Committee Recommendation May 1, 2015 Page 2 of 7

extensive Internal and External representation including staff, physicians and volunteers, and local partners such as the District of Muskoka, Emergency Medical Services, Family Health Teams and, Nurse Practitioner Clinics, Hospice, Muskoka Parry Sound Community Mental Health Service, Simcoe Muskoka District Health Unit Community Care Access Centre Physician involvement at all levels of planning and on Steering Committee Guidance with respect to planning provided by other Hospital corporations including Royal Victoria Regional Health Centre, Orillia Soldiers Memorial Hospital, Georgian Bay General Hospital, Collingwood General & Marine Hospital, Trillium Health Partners, North Bay Regional Health Centre. Consultants - Resources Planning Group (RPG), Preyra Solutions Group (PSG), Stantec, Hanscomb GUIDING PRINCIPLES To assist the MP/MP Ad Hoc Steering Committee to explore in detail and articulate Muskoka Algonquin Healthcare s future program & service planning and the related future physical infrastructure planning in an approach that was thoughtful and that would best provide safe, quality, sustainable health care in the year 2030 and beyond, the following guiding principles were adopted early in the planning process: - Appropriate space - Evidence-based (best practice) - Patient- and Family-Centered Care - Improved environmental quality - Elder-friendly (accessible/ barrier-free) - Reduced wait times - Efficient - Amenities - Compliant with Infection Prevention and Control practices - Collaborate with external care providers (campus of care) - Use of technology - Create an Environment of Wellness - Establish Strong Community Connections - Design for Flexibility and Future Change - Operational Efficiency - Creating a Positive Work Environment OPTIONS CONSIDERED & ANALYSIS Criteria Based on the process outlined above, the various workshops and sessions held with the Steering Committee, internal and external stakeholders and consultants, the steering committee developed criteria based upon Ministry evaluation criteria, along with criteria specific for MAHC s needs and environment. This criteria was utilized the complete the analysis of the options under consideration CRITERIA Patient- and Family- Centered Care Design Construction Financial Approvals Community Support SUB-CRITERIA -Quality of space -Efficient use of space -Flow of public, patients & staff -Ability to accommodate future growth & changes -Community connection -Site & building utilization -Construction phasing and ease of implementation -Impact on ongoing operations -Duration of construction -Capital cost building & site -Operational cost initial & ongoing -Fundraising capability capital needs & redevelopment needs -Alignment with MOHLTC / LHIN priorities -Municipal support -District of Muskoka support -Community feedback -Travel times -Market share -Recruitment & retention of staff/physicians/volunteers Briefing Note re Master Program/Master Plan Ad-Hoc Steering Committee Recommendation May 1, 2015 Page 3 of 7

Options As noted, there were a total of nine options considered during the collaborative planning process that resulted in agreement to evaluate the three final options. The Steering Committee outlined the advantages/opportunities, disadvantages/challenges as well as key considerations for each of the final options. This overview was shared with internal and external stakeholders during March 2015. All stakeholders were encouraged to provide MAHC with feedback and suggestions as to any further considerations with respect to these final three options. Through an electronic survey and written correspondence, more than 250 pieces of feedback were received as at April 16, 2015. The Steering Committee reviewed this feedback to determine if further considerations should be included in the final evaluation; it was agreed that the overriding theme from the feedback was to carefully consider access, and in particular access to emergency care. Briefing Note re Master Program/Master Plan Ad-Hoc Steering Committee Recommendation May 1, 2015 Page 4 of 7

Final Evaluation The Master Program/Master Plan Ad-Hoc Steering Committee completed an exhaustive evaluation of the final three options. Each Committee member was requested to rate each of the options based on the criteria and sub criteria outlined below. The results of 17 submissions were collated into this summary. Committee members discussed the summary at length and focused discussion on determining the model that would best provide safe, quality, sustainable health care in the year 2030 and beyond. Option 1 2 3 MAHC Master Plan Model Options Evaluation Rating Number of Respondents: 17 Two Full Service Acute Care Sites Centre of Focus One Hospital Central & Equitable Access Evaluation points Criteria Patient and Family Centered Care 255 149 148 247 Quality of space 85 50 50 83 Efficient use of space 85 49 53 82 The flow of public, patients and staff 85 50 45 82 Design 255 157 138 200 Ability to accommodate future growth and changes 85 42 43 83 Community connection 85 67 49 55 Site and building utilization 85 48 46 62 Construction 255 134 140 234 Construction phasing and ease of implementation 85 48 49 74 Impact on ongoing operations 85 41 41 81 Duration of construction 85 45 50 79 Financial 255 134 174 205 Capital cost - Building 85 36 55 80 Capital cost -Site 85 65 68 41 Operational cost - Ongoing 85 33 51 84 Fundraising 170 119 91 120 Fundraising capability - Capital needs 85 59 44 63 Fundraising capability - Redevelopment needs 85 60 47 57 Approvals 255 188 138 159 Alignment with MOHLTC / LHIN priorities 85 30 42 82 Municipal Support 85 80 36 45 District of Muskoka Support 85 78 60 32 Community Support 340 294 167 259 Community feedback 85 78 32 55 Travel times 85 80 51 60 Market Share 85 77 51 68 Recruitment and retention of staff/physicians/volunteers 85 59 33 76 Total 1785 1175 996 1424 IMPACT ANALYSIS / RISK ASSESSMENT / DECISION CRITERIA GOAL: To enable the Steering Committee to meet its objective and recommend the model that ensures safe, highquality and sustainable health care for future generations. The preferred one hospital site model is recommended because it: Supports a patient- and family-centered care approach through providing quality of space with the opportunity to maximize light, views and rooms sizes; Provides the opportunity to maximize clinical and operational adjacencies and provide optimal clinical flow all under one roof with no duplication of services; Ensures a stable environment that attracts and retains doctors and sub-specialties, and offers optimal working conditions that help to recruit staff; Protects the viability of core services; Is the least expensive model to build, and is the least expensive model to operate; Meets future growth needs with flexibility and growth potential and existing physical assets would become surplus; Requires only one construction phase with no impact on existing hospital operations with duration of approximately 3.5 years; And most importantly, enables MAHC to ensure a sustainable model to deliver safe, high-quality health care for the future. In addition, the Steering Committee identified the following risks associated with the preferred model: Both the HDMH and the SMMH Hospital Foundations acknowledge that the own funds portion of the project would be a significant challenge (regardless of the model) and a robust feasibility study would need to be undertaken; Briefing Note re Master Program/Master Plan Ad-Hoc Steering Committee Recommendation May 1, 2015 Page 5 of 7

Both Foundations have expressed concern with respect to the potential impact a single site model selection could have on current fundraising campaigns. They are concerned that some current pledges may be withdrawn. In preparation for this possibility, work is underway to develop communication plans, key messages, and strategies to try and mitigate would need to be developed; Travel distances and access have been identified as key issues. The Steering Committee recommendation that the site selection criteria include a specific target for a central location that provides reasonable access for MAHC s service population/catchment area in order to minimize the impact to any particular area. The Master Program/Master Plan Ad-Hoc Steering Committee appreciates that the preferred model is a significant change from the health care delivery model that Muskoka and East Parry Sound areas have grown accustomed to. Throughout the process, the Steering Committee has listened to feedback from the community and the concerns that have been raised and reinforces that MAHC needs to be an active partner in health integration efforts and transportation initiatives that improve access to care in our community. The Board attended the feedback sessions and has had the opportunity to review the written feedback provided from the Committee. COMMUNICATION PLAN A comprehensive Communication Plan for the announcement of the final decision based on the recommendation of the Master Program/Master Plan Ad-Hoc Steering Committee has been developed and is attached see Appendix D IMPLEMENTATION & NEXT STEPS Following approval of the preferred model, the Master Program/Master Plan will be completed and the PreCapital submission refreshed for submission to the NSM LHIN by June 30, 2015. o the NSM LHIN has 15 days to acknowledge receipt and provide turnaround time for a final response from the NSM LHIN Board with respect to their position (i.e. endorsement, conditional endorsement, rejection); o upon receipt of NSM LHIN endorsement, MAHC will then receive a request to complete and submit Part A & B to the Ministry of Health & Long-Term Care who also then have 15 days to acknowledge receipt followed by their review process which is estimated to take 6-8 weeks. Site Selection: this process is typically part of the Stage 1 submission which is the next stage following the PreCapital submission and the response from the Ministry of Health & Long-Term Care. Based on experience, site selection typically spans a timeframe of 8-12 months that includes forming the evaluation committee, determining the selection criteria, preparing the Request for Proposals and then scoring the submitted responses to the RFP. There is the option to proceed immediately to the site selection process; however there is the risk of a delay in receiving a response from the Ministry of Health & Long-Term Care. There are options to mitigate this risk. o It is recommended that an education session be planned for the MAHC Board of Directors to understand the process and assist in determining the direction. SUPPORTING DOCUMENTS/ATTACHMENTS Appendix A Master Program/Master Plan Steering Committee Membership Appendix B - Engagement/Feedback Summary Appendix C - Master Program/Master Plan Communications Record March 2014 to March 2015 Appendix D - Communication Plan for Recommended Model Briefing Note re Master Program/Master Plan Ad-Hoc Steering Committee Recommendation May 1, 2015 Page 6 of 7

ISSUE FOCUSSED ETHICAL DECISION MAKING FRAMEWORK The intent of this framework is to enable decision makers at Muskoka Algonquin Healthcare to address complex and challenging issues in a comprehensive and logical manner. It is a reflective process intended to stimulate discussion among decision makers that will enable them to identify explicit reasons for or against a proposed course of action, and to do that in the context of the Mission, Vision and Values. Questions relevant to Issue Focused Ethics are provided in the guideline below; some questions may not apply to every issue and other questions may need to be added. CONTEXT 1. Identify the Issue and Decision-Making Process Reflective Practice State the conflict or dilemma Determine best process for decision making 2. Study the Facts Stakeholder perspectives Evidence Contextual Features (political, economic, stakeholder satisfaction) 3. Select Reasonable Options Brainstorm options first without evaluating Start by describing your ideal situation VALUES & ETHICS 4. Understand Values & Duties Which values are in conflict? Professional or legal obligations or standards to consider? Alignment with Strategic Directions, Mission, Vision and Values STEWARDSHIP 5. Evaluate & Justify Options Possible harm to various stakeholders? Benefits? Patient outcomes quality of care Human resource implications Using Resources properly? Evaluation Plan to monitor impact? Financial implications? 6. Sustain & Review the Plan Formal evaluation process in place to monitor progress, good practices and opportunities for improvement Appeal process? Evaluation of how the decision-making process worked Briefing Note re Master Program/Master Plan Ad-Hoc Steering Committee Recommendation May 1, 2015 Page 7 of 7

APPENDIX A Master Program/Master Plan Ad-Hoc Steering Committee Membership Co-Chairs: Phil Matthews, MAHC Board Director Harold Featherston, Chief Executive Diagnostics, Ambulatory & Planning Members: Dr. Nancy Bozek, Family Physician Evelyn Brown, Board Vice-Chair Natalie Bubela, Chief Executive Officer Dr. Keith Cross, Family Physician Dr. Caroline Correia, Family Physician Gregg Evans, Treasurer Charles Forret, Board Chair Brenda Gefucia, Director Dr. Jan Goossens, Chief of Staff Dr. Biagio Iannantuono, Surgeon Dr. Kersti Kents, Emergency Physician Kevin King, Director John Kropp, HDMH Foundation Director Dr. Adam MacLennan, Family Physician Colin Miller, SMMH Foundation Executive Director Nicholas Popovich, Director Dr. Hector Roldan, Surgeon Dr. John Simpson, Medical Director Emergency Department Tim Smith, Chief Financial Officer, Corporate Services & Risk Committee Resources: Allyson Snelling, MAHC Communications Chuck Wertheimer, RPG Tim Eastwood, Stantec Stuart Elgie, Stantec

Background Hospital Care for Our Future Generations Engagement/Feedback Summary For nearly two years, Muskoka Algonquin Healthcare has been engaged in a comprehensive process to envision Hospital Care for Our Future Generations. Stakeholder and community engagement and feedback has been a valuable and critical part of this journey both internally with our staff, physicians, volunteers and community partners and externally with our communities. Approach Throughout the planning process information sessions were held with all stakeholders. A series of Community Information Sessions were held in May and August 2014 and in March/April 2015. At these sessions, groups received a PowerPoint presentation outlining MAHC s journey and progress in planning Hospital Care for Our Future Generations as well as models under consideration. Presentations to the community in the three major municipalities were followed by an opportunity to review 2-D renderings of the models and poster boards of data/information and advantages/disadvantages of each model. A two-fold information brochure was developed and distributed at each session, as well as a Backgrounder. Those in attendance were invited to engage in dialogue (questions and answers) with Board members, Steering Committee members and Senior Leadership Team members at individual stations. All stakeholders internal and external were invited to provide written input using a feedback form or to complete the online survey. The feedback received helped to shape the evolution of the different models explored throughout this journey. In March 2015, the final three models were presented for feedback. Following community sessions, the 2-D renderings of the models and poster boards were displayed in each of the Garden Courts at the hospitals. A great deal of positive feedback has been received regarding the clarity of the information provided, quality of speakers, and presentation format. Internal Town Hall Sessions Attendance April 2014: ~15 staff/physicians/volunteers August 2014: ~35 staff/physicians/volunteers March 2015: ~40 staff/physicians/volunteers April 2015: ~35 physicians Community Information Sessions Attendance May/June 2014: ~65 people: Huntsville 30; Bracebridge 20; Gravenhurst 5. August/September 2014: ~205 people: Huntsville 68; Gravenhurst 20; Bracebridge 74. March/April 2015: ~820 people: Gravenhurst ~80; Bracebridge ~300; Huntsville ~400 people. Summary of Written Feedback Received To Date Formal Resolutions received from: Bracebridge Chamber of Commerce District of Muskoka Township of Algonquin Highlands Town of Bracebridge Town of Huntsville Township of Lake of Bays Township of Muskoka Lakes Township of Perry Hospice Muskoka Petitions: Received from Huntsville area, approximately 3,000 4,000 signatures; Received from Bracebridge area 678 signatures Electronic Mail and Written Correspondence: Received 55 Survey Monkey Responses: 315 Note: inclusive of submitted hardcopy feedback forms August 2014/March 2015. Respondents could choose more than one option and more than one response from each IP address was allowed. Hospital Care for Our Future Generations Engagement/Feedback Summary Page 1 of 3

Feedback Graphs April 2015 (following March 2015 Engagement Sessions) Please select the model(s) you feel you can support? (Feel free to select more than one option): % that responded to specific question Answered: 195 Skipped: 15 0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 70.00% 80.00% 2 Full Service Acute Sites (Not Status Quo) 69.23% Centres of Focus (Hybrid) 22.56% One Hospital (Central Location) 30.77% % of total survey respondents Total respondents: 210 0.00% 10.00% 20.00% 30.00% 40.00% 50.00% 60.00% 70.00% 2 Full Service Acute Sites (Not Status Quo) 64.29% Centres of Focus (Hybrid) 20.95% One Hospital (Central Location) 28.57% Respondent Locations 139 Respondents Provided an Address Huntsville Bracebridge Emsdale Novar Port Sydney Dwight Gravenhurst Dorset Perry Township Toronto Utterson Windermere Burk's Falls Mactier Oxtongue Lake Ryerson township Sault Ste. Marie Sprucedale 5.76% 4.32% 3.60% 3.60% 1.44% 1.44% 1.44% 1.44% 1.44% 0.72% 0.72% 0.72% 0.72% 0.72% 0.72% 9.35% 18.71% 43.17% Hospital Care for Our Future Generations Engagement/Feedback Summary Page 2 of 3

Feedback Graph September 2014 (following August 2014 Engagement Sessions) Please select the model(s) you feel you can support? (Feel free to select more than one option): Hospital Care for Our Future Generations Engagement/Feedback Summary Page 3 of 3

APPENDIX C Master Program/Master Plan Communications Record March 2014 to March 2015 Updated: May 6, 2015 *please note the following chronology does not include individual media inquiries or letters/emails received and responded to by MAHC on this topic Timeline/ Date Audience Tool Deliverable/Method March 13, 2014 Internal Board of Directors Board Meeting Verbal Update April 10, 2014 Internal Board of Directors Board Update April 4, 2014 Internal Staff, Physicians, Volunteers Town Hall Meeting Notice April 17, 2014 Internal Staff, Physicians, Volunteers Town Hall Meeting April 23, 2014 External - NSM LHIN Briefing/Planning meeting May 8, 2014 Internal Board of Directors Board Update May 16, 2014 External - Community - (Public/Patients) Newspaper advertisements May 21, 2014 External - Community - (Public/Patients) Dedicated MP/MP Webpage May 21, 2014 Internal - Board of Directors/Foundations Board of Directors Key Messages May 22, 2014 External Leaders Mayors, MP, MPP, LHIN CEO & Board Chair Letter May 22, 2014 Internal - Staff, Physicians, Volunteers; MP/MP Ad-Hoc Steering Committee Email Notice of Info Sessions May 23, 2014 External Media Email Notice of Info Sessions May 26, 2014 External - Community Huntsville Community Info Session May 27, 2014 External - Community - Bracebridge Community Info Session May 28, 2014 External - Community - Gravenhurst Community Info Session May 30, 2014 Internal MP/MP Ad-Hoc Steering Committee Committee Meeting Communication Brief June 2014 External Community reps Create Focus Groups June 9, 2014 External Municipal Leaders Lunch Meeting June 9, 2014 External Community Huntsville Forester June 26, 2014 External Community CEO Blog June 23, 2014 Internal/External AGM June 30, 2014 External Community Groups Invitation for Speakers Bureau July 7, 2014 Internal/External Stakeholders Workshop #1 July 12, 2014 External Lake of Bays Association Speakers Bureau July 17, 2014 External Community - (Public/Patients) Community Health Bulletin July 18, 2014 Internal MP/MP Ad-Hoc Steering Committee Committee Meeting July 20, 2014 External - Donors Speakers Bureau July 24, 2014 External Municipal Council Candidates Information Package Communications Rollout Plan/Checklist: Master Program/Master Plan Communication Rollout Record Page 1 of 4

Timeline/ Date Audience Tool Deliverable/Method July 29, 2014 Internal MP/MP Workshop #2 July 30, 2014 External Huntsville Rotary Club Speakers Bureau August 5, 2014 Internal/External Key Messages August 8, 2014 Internal MP/MP Ad-Hoc Steering Committee Committee Meeting August 8, 2014 Internal Staff, Physicians, Volunteers Update Memo August 11, 2014 Internal MP/MP Workshop #3 August 12, 2014 External District of Muskoka Planning Meeting August 13-14 & 20-21 External - Community - (Public/Patients) Newspaper advertisements August 13, 2014 External Probus Club of Central Muskoka Speakers Bureau August 13, 2014 External Media/Community Media Release August 15, 2014 Internal MP/MP Ad-Hoc Steering Committee Committee Meeting August 20, 2014 Internal Staff, Physicians, Volunteers Town Hall Meeting Memo August 21, 2014 Internal Board of Directors Information Session August 26, 2014 Internal Staff, Physicians, Volunteers Town Hall Meeting August 26, 2014 External - Community Huntsville Community Info Session August 27-28, 2014 Internal Physicians Physicians Forum August 27, 2014 External - Community Gravenhurst Community Info Session August 28, 2014 External - Community Bracebridge Community Info Session August 28, 2014 External Community Webpage update August 29, 2014 External Community CEO Blog September 2, 2014 Internal Staff, Physicians, Volunteers Update Memo Sept. 2-14, 2014 Internal Staff, Physicians, Volunteers Options Display - HDMH September 5, 2014 Internal MP/MP Ad-Hoc Steering Committee Committee Meeting September 8, 2014 External Leaders Mayors, MP, MPP, LHIN CEO & Board Chair Lunch Meeting September 11, 2014 Internal Board of Directors Update Sept. 15-26, 2014 Internal Staff, Physicians, Volunteers Options Display - SMMH September 18, 2014 External District of Muskoka Planning Meeting September 23, 2014 External Bracebridge-Muskoka Lakes Rotary Club Speakers Bureau September 26, 2014 Internal MP/MP Ad-Hoc Steering Committee Committee Meeting September 29, 2014 External Foundations/Auxiliaries Key Messages October 2, 2014 External - Rotary Club of Huntsville/Lake of Bays Speakers Bureau October 10, 2014 Internal MP/MP Ad-Hoc Steering Committee Committee Meeting October 30, 2014 Internal MP/MP Ad-Hoc Steering Committee Committee Meeting (Evaluation of Models) Communications Rollout Plan/Checklist: Master Program/Master Plan Communication Rollout Record Page 2 of 4

Timeline/ Date Audience Tool Deliverable/Method November 6, 2014 Internal/External Key Messages November 10, 2014 Internal Steering Committee Email Update Letter November 10, 2014 Internal Proposed Hybrid Workshop Members Email Letter November 13, 2014 Internal Board of Directors PowerPoint Update November 14, 2014 Internal Leadership Team (Managers) Update Memo November 14, 2014 Internal Staff, Physicians, Volunteers Update Memo Week of November 17, 2014 External Leaders Mayors, MP, MPP, LHIN CEO & Board Chair Letter/In-person meetings November 18, 2014 External Community/Media Media Release November 18, 2014 External Community Webpage Update November 25, 2014 Internal Leadership Team (Managers) Leadership Forum November 25, 2014 Internal Hybrid Model Working Group Workshop Meeting December 18, 2014 Internal Hybrid Model Working Group Workshop Meeting January 6, 2015 Internal Staff, Physicians, Volunteers Memo re Operational Assessment January 8, 2015 External North Muskoka Probus Club Speaker s Bureau January 9, 2015 External Bracebridge Rotary Club Speaker s Bureau January 13, 2015 External Community CEO Blog January 14, 2015 External - Leaders Mayors, MP, MPP Lunch Meeting January 28, 2015 Internal Staff, Physicians, Volunteers Update Memo January 29, 2015 Internal Staff, Physicians, Volunteers Memo re Petition February 4, 2015 External Bracebridge Probus Club Speaker s Bureau February 12, 2015 External Community Big Ideas Column by Natalie Bubela February 17, 2015 External - Leaders Mayors, MP, MPP External Foundation Boards External Media (Radio & Newspapers); Website (posted online) Open Letter from Board Chair February 25, 2015 Internal Staff, Physicians, Volunteers Town Hall Meeting with MP/MP Update February 26, 2015 Internal Sub-Hybrid Model Working Group Workshop Meeting March 2, 2015 Internal Staff, Physicians, Volunteers Letter from Board Chair & Invitation to Info Sessions March 4, 2015 Internal - Hybrid Model Working Group Workshop Meeting March 4, 2015 External Community (Public/Patients) (flyer in What s Up Muskoka) Letter from Board Chair & Invitation to Info Sessions March 6, 2015 External Meeting with District of Muskoka Planning Meeting March 5/6, 2015 External Seasonal Residents via Muskoka Lakes Association Email NewsBite re: Letter & Invitation to Info Sessions March 9, 2015 Internal MP/MP Ad-Hoc Steering Committee Committee Meeting Communications Rollout Plan/Checklist: Master Program/Master Plan Communication Rollout Record Page 3 of 4

Timeline/ Date Audience Tool Deliverable/Method March 12, 2015 Internal Board of Directors Regular Meeting March 12, 2015 External Media, Community Media Release March 12, 2015 External Community (Public/Patients) Community Health Bulletin March 13, 2015 External Leaders - Mayors, MP, MPP, LHIN CEO & Board Chair Information Luncheon March 18, 2015 External Community (Public/Patients) What s Up Muskoka Advertisement March 19, 2015 External Community (Public/Patients) MuskokaRegion.com Advertisement March 20, 2015 Internal MP/MP Ad-Hoc Steering Committee Committee Meeting March 23, 2015 Internal Staff, Physicians, Volunteers Town Hall Meeting March 23, 2015 External Huntsville Town Council Invitation to Regular Meeting March 24, 2015 Internal Leadership Team Regular Meeting March 23, 2015 External Gravenhurst Community Community Info Session March 24, 2015 External - Bracebridge Community Community Info Session March 25, 2015 External Huntsville Community Community Info Sessions March 25, 2015 External Community (Public/Patients) Webpage update feedback period begins March 25, 2015 External Community (Public/Patients) Muskoka Magazine advertisement Board Chair letter March 30, 2015 External Community (Public/Patients) CEO Blog March 30, 2015 External Gravenhurst Rotary Club Speaker s Bureau March 30, 2015 External Almaguin Highlands Health Centre Committee Meeting April 2, 2015 External NSM LHIN CEO, Vice Chair Update Meeting April 8, 2015 Internal Physicians Town Hall Meeting April 15, 2015 External Community Feedback period closed April 20, 2015 Internal - Medical Advisory Committee Regular Meeting April 23, 2015 External District of Muskoka Meeting with Public Works & Planning, Stantec April 23, 2015 Internal MP/MP Ad-Hoc Steering Committee Committee Meeting May 1, 2015 Internal MP/MP Ad-Hoc Steering Committee Committee Meeting Communications Rollout Plan/Checklist: Master Program/Master Plan Communication Rollout Record Page 4 of 4