HOTEL OF HOPE

a lease-to-heal model

 

 

​We need temporary housing for patients traveling to access healthcare. In Vancouver, temporary housing refers to short-term, fully furnished rental accommodations designed for flexible stays, typically ranging from a few weeks to several months. In this case, it would also apply to single-day stays.

 

Call it patient housing, lodging, accommodation, temporary housing - it's simple: it's somewhere for patients and caregivers to stay when relocated to Vancouver for medical care. It's somewhere that is obvious, convenient, suitable, affordable for all, and available, and is woven into BC's public health insurance plan.

 

Now although it doesn't have to be a hotel, it has to operate as such, with flexibility in length of stay and around-the-clock/last minute check-ins, easy flipping of rooms and managerial aspects (bookings, cleanings, enforcing rules). It is the home-away-from-home model that can be purpose-built entirely or woven into another development with patient-specific aspects worked in.

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Temporary patient housing as part of the hospital campus would make the most sense. Location is key and suitable for a local health authority or hospital foundation interest. This housing mandate could find its way into health authority and hospital foundation mandates province-wide, as you are either receiving or sending patients trying to access care. This would give way to proper data collection focused on traveling patients and act as a gateway to system navigation improvements for patients shifting between health authorities to access care.

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It would be wonderful to see hospital foundations collaborate in this effort, but first and foremost it is the responsibility of the Ministry of Health and next, the Ministry of Housing. The Ministry of Social Development and Poverty Reduction and the Ministry of Children and Family Services also fit in here. This overlapping also applies to municipalities, as the issue spans the concern of every city and town in British Columbia and the Yukon. Ironically, the municipality with the least interest is Vancouver, as Vancouver residents do not need patient housing in Vancouver, nor do they want to sacrifice residences for out-of-towners. Yet, this city is the host to those traveling to access care and benefits economically from such visitors as well as from having world-renowned healthcare in their own backyard.

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Temporary patient housing needs to be Ministry-led - not only because it is the job of the provincial government to uphold the Canada Health Act, but because 

we need the Province to adjust the ShortTerm Rental (STR) regulation - a provincial policy. STR regulations block temporary stays at residential properties if under 90 days. A temporary stay is what a patient needs, and that is why there is so much hotel usage for patients now.  Apartment buildings around the hospital once targeted patient needs and offered flexible stays, and a larger amount of Airbnbs were available (although they were still expensive). Now the only Airbnbs offered are the principal residence listings (of which you need a license for) and are rarely available. A solution is needed - not to reverse the STR regulations but to create an exception - an exemption put in place by the Province allowing residential use for temporary patient housing. This is crucial for future developments and the creation of inventory and space for patients. There are current developments adjacent to Vancouver General Hospital that would be perfect - except that they are zoned for residential - and would need a change in use that was actually legal. We need that patient exemption to the 90-day rule in order to create more legal inventory. Patients are not tourists and they deserve proper accommodations, not expensive hotel rooms and homeowner listings on the black market. 

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Furthermore, residential development partnership needs a chance because even hotel developers are lacking interest in creating patient accommodations. Hotel developments located mere blocks away from the hospital have blatantly declared uninterest to city planners. Ideally, hotel developers (specifically those adjacent to the hospital) would accept conversation around patient stays based on incentives. This could be a 20-year lease on 3 floors for patients in exchange for that extra height variance, and would clearly benefit both parties. The City of Vancouver - councillors with staff - could design policy incentives for future hotel developments, which is what's needed if patients are to rely solely on hotels.

Examples to discuss: Bosa Properties; Dunna'eh. Inquire for more details.

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To be clear, there is no official zoning specified for patient housing, and the Ronald McDonald House had to work with the city to create bespoke zoning for their project. This bespoke zoning only applies to non-profits who own and operate the entire building and the land.

 

The cost of hotel accommodation in Vancouver is simply too high for out-of-town patients, and it is not appropriate or conducive to healing. Pairing Vancouver's housing crisis with a fragile hotel market creates a puzzle patients are forced to try and solve often at their weakest stage in life. We need housing associated with healthcare visits and we need the provincial government to accept this responsibility by weaving it into the healthcare system, funding the cost so patients no longer pay out of pocket, and building in provincial policy exemptions, with the City of Vancouver following suit on hotel policy incentives. ​Secure travel funding as an umbrella approach for anyone trying to access care is the answer here, not just for oncology patients, or the Ronald McDonald House, but for everyone. It will improve patient experience, improve health, and improve the system. 

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HOW MUCH SPACE?

 

This housing demand encompasses ​market hotel rooms booked by:

 

+MSDPR (smartly redirect this funding!)

+FNHA (smartly redirect this funding!)

+Yukon patients (smartly redirect this funding!)

+middle class not receiving support

+ caregivers and hospital visitors

+Ronald McDonald House overflow (smartly redirect this funding!)

+Canadian Cancer Society (CCS) overflow (smartly redirect this funding!)

 

*CCS did in fact acquire 20 apartment leases to try and meet demand!

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​Over 500 patients per day are in Vancouver for medical care. The Holiday Inn on Broadway has 197 rooms (across from  the VGH ER) and is almost always full with tenants there for medical reasons.  The Ronald McDonald House is just for families, always full with 73 rooms, and building a second house with 75 rooms to accommodate demand. Regional centers across BC display this need - take JoeAnna's House in Kelowna which is just for caregivers of patients traveling regionally to Kelowna for care; it is always full at 20 rooms and has just expanded to include 10 more. 

 

If JoeAnna's House in Kelowna can easily manage 30 rooms for caregivers, Ronald McDonald House sees the need for 150 rooms for families (pediatric patients), and the 197-room Holiday Inn is always full for medical reasons, the starting point here could really be anywhere within that window. You could "build the whole thing" or start with x number of rooms (apartment or hotel leases) and continue to compile and grow.

 

 

 

​​BUILDING OPTIONS:  

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1. Apartment Head Lease

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Cost: $2500 dollars per unit per month

 

- for 200 units: $6 million dollars per year​

​- Housekeeping ~ $500 thousand dollars per year​​

- Parking ~ $500 thousand dollars per year

- Staff (navigators, admin) ~ $250 thousand dollars per year

- Total: $7.25 million dollars per year (~ $99 dollars per night)

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​​​​Philanthropic support and/or a scalable patient copayment could reduce costs by millions of dollars.​​

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Advantages: Lowest cost for short-term solution, immediate scalability, strong alignment with hospital precincts, space in move-in ready with professional leasing, aligns with successful housing partnerships such as JoeAnna's House, ideal for data collection and system navigation services

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Disadvantages: Zoning - STR exemption for temporary patient housing needed 

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You could start with a smaller number of apartments and grow or commit to a larger amount and potentially acquire a tower with private entry within a new development You could also distribute groups of units across multiple new buildings.

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​2. Host Hotel ​

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Cost: $4,650 dollars per unit per month (for desired amount of rooms)

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​- for 20 units: $1,116,000 million dollars per year (~ $153 dollars per night)​

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​Advantages: Lower upfront capital requirements; faster time to implementation; designated and publicized as host hotel builds trust and ease in booking; could work with an existing non-profit such as Hope Air to fill and manage rooms; utilization of an existing hotel includes operations, housekeeping, on-site check-in and managerial assistance; scalable province-wide; flexible/ low commitment; move-in ready; can add on a la carte rooms outside of lease commitment; build relationship for future independent patient project (a Level for patients); can incorporate direct billing ​

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*Already have a host hotel selected, perfect match: Level Hotel & Furnished Suites on Seymour (zoned as a hotel and allows for corporate long-term stays): "The Hotel of Hope at Level"  

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​Disadvantages: Still pouring money into the hotel market instead of redirecting finances to "own building" (but removes seasonal spikes); could be cheaper with residential lease model; lease would be per-year and not necessarily a secure location (great for pilot project)​

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3. Hotel Development Partnership - a hybid hotel model with designs specific to recovery

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Cost: 

• To be explored; ideally policy incentives are in place to benefit developer whilst creating available real estate for patients (ex: 3-floor height variance = 3-floors for patient accommodation long-term lease)

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Advantages: Similar to No. 2 (Host Hotel Model) except purpose-built elements could be intertwined with new build: private entrance, infection-controlled environments, housekeeping and services aligned with immuno-compromised needs, community area for companionship, shared floor laundry room, etc.

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Disadvantages: Developers are currently uninterested without incentives; still leasing property, expenses that could be put into something owned; hotels are not always the best design for success when it comes to patients (privacy and living amongst tourists is not desireable for patients)

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​4. Ground-Up Build (Ronald McDonald House Model)

Cost:
• Capital: approximately $200 million dollars (philanthropic donations)
• Annual operating: ~ $4 million dollars (estimate and better numbers needed)
• Total operating cost per room per day ~ $55 dollars per day

Advantages: Zoning exists; purpose built, attracts philanthropic capital investments, long-term permanent solution, customizable, reduced cost to government (operations only)
 

Disadvantages: Multi year timeline, not suitable for near-term demand, land availability, increasing development/construction costs, reliance on philanthropy, zoning.​​

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"If I won the lottery, I would build a place for patients." This is what so many patients say after going through the process of trying to find somewhere to stay in Vancouver.

 

But even Ronald McDonald House is having issues with funding for their second building (Willow House) - doubt lingers on whether this is truly a possibility at this stage in the game, when our province is facing a deficit and cutting related programming instead of fueling it. 

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Another path would be to work with BC Housing in acquiring a hotel (when one came on the market) and turn it into a patient housing hotel, already zoned for hotel usage. This would still have to be paid back.​

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 ALL PARTIES WANT THE GREEN LIGHT FROM THE PROVINCE.

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An easy first step would be to address an exemption for temporary patient housing within the STR regulations. This would be huge for the possibility of future developments (that are happening now, with healthcare stakeholder interest) and cost the Province zero dollars.

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