New Hospital Costs Going Up

$50 Million Is a New Estimate; Leaders Plan Public Meeting for This Saturday to Unveil Update on Their Thinking

By JULIA WELLS

Leaders at the Martha's Vineyard Hospital are moving forward with an ambitious plan to replace the badly decayed 30-year-old hospital on Linton Lane in Oak Bluffs - but they got a hard reality check recently when they saw the price tag attached to the new plan.

What was outlined as a $30 million project a few short months ago has now rocketed up to $50 million - and that's after a hard-nosed job of cutting out a lot of extras.

The number translates to $366 a square foot for the hospital portion of the building and $160 a square for the separate professional building. Hospital architects say a good chunk of the number can be pegged to what is known as the Island factor - the higher cost of building on the Vineyard.

With a specialized building project like a hospital - built entirely from concrete and outfitted with complicated systems essential to a medical facility - the Island factor is even higher than usual.

"Sticker shock? I'll say - we all had it," said Tim Sweet, a hospital trustee who is chairman of the strategic planning committee.

Mr. Sweet said the $30 million that was floated by hospital leaders a few months ago to accompany a concept plan was a mistake - mainly because it was attached to an older plan that had been revamped to reflect today's dollars.

This much is now true: $50 million is the cost attached to the plan for a new hospital.

"It was such a down moment for us - for some reason the difference between those two numbers looms large. All of us thought that $30 million was a lot, but doable. Is $50 million doable? We hope so, because we still believe that this is the right plan as we look to the long term," Mr. Sweet said. He added:

"But let's say we get past all this sticker shock, here is the real question: Is this right for Martha's Vineyard, is it too much for Martha's Vineyard, is it more than we can afford on Martha's Vineyard? We want to hear from the community on this. I am not sure what the right answers are, but what we are very sure of is that this is what the Vineyard needs, both today and for the future. Is it breathtakingly expensive? I'll say. But what's the alternative? Doing nothing is out of the question."

The people of the Vineyard will have a chance to look at the numbers and hear more about the plan at a meeting hosted by hospital trustees tomorrow afternoon. The meeting begins at 2 p.m. in the Performing Arts Center of the Martha's Vineyard Regional High School.

Unveiled in concept form early this fall, the new master plan for the hospital calls for demolishing the leaky, ailing circa 1972 building and replacing it with a new three-story plant, in the same location in the Eastville section of Oak Bluffs. A separate professional building is planned for administration and doctors' offices.

The new building is planned at 125,000 square feet - an increase from the present 90,000 square-foot building, but not a huge increase.

Mr. Sweet said if the building was renovated, the size would increase nearly that much just to meet state building codes.

"And here is the reality: Our hospital building has been neglected and it's in terrible condition and it's not going to be here much longer. To fix it up would cost $18 or $19 million - and to spend $18 or $19 million and only end up with an upgraded version of an inefficient building - well, to me that just doesn't make sense," Mr. Sweet said, adding:

"What do we want? We want a first-rate diagnostic center. When it comes to tertiary care we say we're 80 miles from the best in the world. Nobody objects to making the trip to Boston for a horrible event, but for something that is routine, it's insanity to go to Boston."

In the annual hospital appeal letter that just went out to Vineyard residents, Mr. Sweet describes his own ordeal last year when he suffered a heart attack and was flown to Boston after first receiving treatment at the Vineyard hospital.

"It is no exaggeration to say, without the emergency care provided by MVH, I would not be here to sing the praises of our Island hospital. My understanding of how important it is to have a quality hospital on our Island is no longer just an intellectual exercise," Mr. Sweet wrote in the letter.

Mr. Sweet and hospital chief executive officer Tim Walsh spoke this week about the current condition of the hospital - and about the next step. Mr. Walsh, who is the former chief financial officer at the hospital, has tackled an array of stubborn financial problems at the hospital with good results: for the second year in a row the hospital is now on target to break even or see a small operating gain.

Financial problems at the Windemere Nursing Home and Rehabilitation Center continue to drain resources at the hospital. Mr. Walsh said this week that he finally won a hard-fought battle with the state for more reimbursement, and that will help the problem for this year. But he was less sanguine about the future. "Nursing homes are all dependent on the state and Medicaid and it's just impossible to predict what will happen," Mr. Walsh said.

Mr. Sweet and Mr. Walsh said the new, $50 million version of the plan includes $6.5 million in cuts. Among other things planners have decided not to demolish the original 1929 cottage hospital, which is still in sound condition, and they eliminated 21,000 square feet from the professional building and 5,000 square feet from the hospital building.

Mr. Sweet said hospital trustees have voted to commit $500,000 to move into the next phase of the building project - the active planning phase.

Hospital architect Mark Rowland will present the latest version of the plan on Saturday.

"This facility we are building can be as good or as mediocre as we want - and when I say we, I mean the community," Mr. Sweet concluded.