The Alternate Level of Care (ALC) Initiative, led by Health Cities, addresses one of Alberta’s most pressing health system challenges: individuals who no longer need hospital-level care but remain in hospital beds due to a lack of suitable alternatives.
Working with Alberta’s provincial health agencies, service providers, innovators, and communities, the initiative supports the co-development of transitional and longer-term care models for these patients. It serves as a live demonstration of how collaboration and innovation can drive meaningful change in the ALC system.
This initiative supports a future where no Albertan waits in the wrong place for the care they need—by building pathways that are:
Every day in Alberta, people are waiting in hospital because their next step isn’t available, funded, or coordinated. These patients include:
These patients do not fit neatly into existing categories and that is exactly why new models are needed
This initiative is a transformation in how Alberta supports individuals transitioning out of acute care and is built on four key pillars: where no Albertan waits in the wrong place for the care they need.
Transitional Bed Models
We are evaluating and co-designing transitional care models that shorten hospital stays while improving safety, comfort, and dignity for ALC patients.
Standardized Patient Pathways
Clear, consistent guidelines are being developed for how patients are supported as they move through the system, creating a smoother, more coordinated journey.
Surge Capacity Management
To respond to system pressures, we are creating dynamic protocols that allow transitional care resources to flex up or down based on patient demand.
Data-Driven Insights
Real-time evaluation will track patient outcomes, readmission rates, and system-level impacts— generating evidence to inform long-term planning and broader provincial adoption.
The initiative is structured across four strategic phases, ensuring real-world input, measurable results, and scalable insights. The timeline reflects our commitment to responsive design, collaborative delivery, and system-wide impact.
Engage with service providers across Alberta to understand existing barriers and explore potential care environments.
Goal: Build relationships, gather insights, and map out system gaps.
Source and assess innovative care models that address the core needs of ALC populations across both urban and rural settings.
Goal: Identify creative, feasible, and patient-aligned solutions ready for validating.
Develop and validate innovative models across Alberta in live environments with care providers.
Goal: Operationalize the most promising models with real-world partnerships and oversight.
Third-party evaluators assess each pilot, using shared metrics and direct participant feedback to measure effectiveness, equity, and value.
Goal: Generate evidence for decision-makers and transition to Assisted Living and Social Services (ALSS) oversight.
The ALC Initiative focuses on a growing challenge in Alberta’s health system: patients who no longer need hospital care but remain in hospital beds because appropriate care options are not available elsewhere. Working with provincial health agencies, care providers, innovators, and community partners, the Initiative supports the development of new transitional and longer-term care models. These projects aim to improve care pathways for ALC patients while helping improve system capacity.
View the individual projects below.
The Evergreens Foundation is partnering with Health Cities to trial a tech-enabled suite model in a lodge setting designed to better support residents whose care needs are increasing, including those awaiting placement into higher levels of care. Instead of undertaking a costly facility-wide retrofit, this project strategically equips 10 to 15 dedicated suites within an existing lodge with targeted technologies. This approach focuses on critical priority areas such as fall detection, wandering prevention, and incontinence monitoring. The focus on these priority areas ensures that residents who exceed traditional lodge resources, including individuals currently designated as Alternate Level of Care (ALC), can safely receive the support they need.
Integrating these targeted technologies aims to bridge the gap between standard lodge resources and more complex care requirements, ensuring timely and effective responses. Ultimately, the project will develop a scale-up playbook so this focused suite model can be replicated across other Evergreens sites and shared with provincial partners.
This project is now accepting applications through its open Call for Innovation. To learn more and submit your expression of interest, click the button below.
View Call For Innovation
Clear Path Home is a short-term validation project led by Vision Loss Rehabilitation Canada (VLRC) in partnership with Health Cities. The project tests an Occupational Therapy (OT)–led, technology-enabled vision rehabilitation model in Calgary and Edmonton to support adults with vision loss who face safety and functional risks during transitions from hospital to home or community living. By combining practical vision rehabilitation supports with structured care coordination, the model is designed to enable safer, timelier discharges; reduce avoidable discharge delays; and inform longer-term approaches that may help prevent or defer unnecessary long-term care placement and improve patient flow.
A portion of the project includes implementing and validating an AI-enabled, portable vision screening tool (with secure clinician review of results) to strengthen early identification of vision-related functional risk, connect clients to appropriate eye care professionals in a timely manner and improve triage and pathway targeting. The work will generate practical, decision-ready learnings on feasibility, outcomes, and implementation requirements across two jurisdictions, helping inform whether and how the model could be refined and expanded in future phases, including rural and remote communities.
The Good Samaritan Society is collaborating with Health Cities to transform underutilized supportive living centres into specialized Alternate Level of Care (ALC) environments. This initiative focuses on repurposing an existing facility in the Edmonton area to provide a safe, dignified step-down setting for patients transitioning out of acute care. The program is specifically designed to support adults with complex mental health and addiction histories who require more specialized care than shelters or traditional long-term care models can safely provide.
To support this new model of care, the project co-designs and implements targeted technologies across a defined care environment. Through extensive consultation, the team has identified five key areas where technology can alleviate operational pain points: infrastructure, real-time monitoring and risk management, workforce workflow, resident independence, and staff upskilling. By validating this technology-enabled framework, the Good Samaritan Society aims to ease pressures on the acute care system while directly improving resident safety and overall quality of life.
View Call for Innovation
Rise Care, in partnership with Health Cities, is advancing a digitally enabled “Trial at Home” model designed to support both Alternate Level of Care (ALC) patients and those at risk of becoming ALC— individuals at heightened risk for falls, frailty, hospitalization, and transition to higher levels of care— to safely transition from hospital to home. The project focuses on medically stable individuals who no longer require acute care, but face delays in discharge due to gaps in coordination, assessment, or community supports. Using a Comprehensive Geriatric Assessment (CGA), the Advanced Practice Nurse develops a structured, individualized home-based care plan that integrates coordinated clinical care, remote monitoring, and community-based supports, enabling earlier discharge while maintaining safety, stability, and continuity of care.
This project is assessing a standardized, repeatable hospital-to-home transition model that integrates clinical oversight, digital tools, and community services with a personalized, restorative care approach—designed to rebuild strength, restore function, and reduce frailty, enabling a safe and seamless transition home. By aligning hospital discharge planning with in-home assessments, restorative supports, and proactive monitoring, the model is designed to reduce hospital days, improve patient outcomes, and ease pressure on both acute care and home care systems. The work will generate learnings on system impact, including hospital days avoided, patient experience, and cost-effectiveness, to inform broader adoption and scale across Alberta.
The SmartCare™ Clinic for Seniors is a community-based innovation clinic launched through the Alternate Level of Care (ALC) Initiative led by Health Cities, in partnership with Sage Seniors Association and Care2Talk Health. The project combines primary care, wrap-around community supports, and real-world innovation testing to better support older adults living with complex health and social needs.
Built on Sage’s existing ALC wrap-around model, the clinic integrates virtual, in-person, and home-visit care with coordinated supports such as care planning, navigation, mental health services, and social prescribing. The initiative is designed to help stabilize seniors in the community, improve care coordination, and reduce avoidable hospital utilization.
The clinic also serves as a real-world innovation environment where digital health tools, remote monitoring technologies, and new care workflows can be tested directly within active care delivery. By embedding innovation into frontline practice, the project creates a practical pathway for evaluating, refining, and scaling solutions that improve access, continuity, and patient outcomes across Alberta.
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Calgary Rural Primary Care Network (CRPCN) has partnered with Caregivers Alberta and Assisted Living Alberta to better understand access to respite support for caregivers living in rural communities. Health Cities is supporting the project through its partnership with CRPCN. The project is looking to help reduce avoidable hospital admissions that happen as a result of hard-to-find, hard-to-access, or unclear pathways for caregivers to access respite support.
The project aims to understand the caregiver, system, and provider experience, and clarify what is needed so caregivers can be safely supported at home. In this first phase, the team is building a practical, decision-ready picture of what exists today and what’s missing: completing an environmental scan, mapping current respite/caregiver services and workflows, identifying data gaps, and engaging caregivers, providers, and system partners to validate real-world barriers and opportunities. The outcome will be a clear set of prioritized recommendations – with implementation considerations and options for scaling – so partners across primary care, home care, continuing care, and community supports can strengthen pathways that keep people safely at home and relieve pressure on acute care.
Carewest, in partnership with Health Cities, is in the early stages of piloting a new Right-Housing discharge pathway designed to help people move into housing and support settings that better match their needs. The project focuses on individuals who no longer require more intensive care environments but may still benefit from community-based supports. By helping people transition to the right setting at the right time, the project aims to improve quality of life while making better use of continuing care resources.
Through the pilot, the team will develop an approach to identify individuals who may be a good fit for lodge-style housing, support their move, and help them settle successfully into their new community setting. The project will also explore practical technology supports, such as wearable devices, improved information sharing through existing systems, and client and family portals, to help people remain safe, connected and supported.
Learnings and outcomes from the pilot will help shape a Right-Housing pathway that could support broader use in Alberta in the future.
Our project team reviews all submissions and inquiries related to the ALC Initiative. We will follow up with proponents whose proposals show alignment and potential, or where further information is needed.
To contact our team directly, please email alc@healthcities.ca.
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