MVC Quizzes Hospital Again

Commission Questions Decision to Locate $42 Million Building at Current Eastville Location; Study Committee Appointed

By JAMES KINSELLA
Gazette Senior Writer

Martha's Vineyard Hospital officials said last week that no Island site other than the current one makes sense for the construction of a new hospital.

The Martha's Vineyard Commission, however, still has its doubts - and on Thursday night appointed a subcommittee to explore alternatives to the current site on Linton Lane, in the Eastville section of Oak Bluffs.

The appointment of the subcommittee, which will work with hospital chief executive officer Timothy Walsh, came at the end of a sometimes contentious two-hour session exploring the issue.

Failing to unearth a viable alternative site will make the hospital's argument that much more persuasive, commission chairman Linda Sibley said.

At present, she said, "We're still skeptical."

Mr. Walsh and Timothy Sweet, vice chairman of the hospital board of trustees, came before the commission at its meeting last Thursday to give a presentation on why they want to build a new hospital at the current site.

The hospital launched a $42 million capital campaign in July for the new building project, the largest capital campaign in the history of the Island. Hospital leaders hope to begin construction in the fall of 2006. The project will be required to clear an array of regulatory hurdles, including review by the commission as a development of regional impact (DRI).

The appearance by Mr. Walsh and Mr. Sweet last week followed a commission meeting in August, when MVC members repeatedly challenged the hospital's architects on the plan to build the hospital at the current site.

"I don't think these are the only people who have these concerns,"commission executive director Mark London said last week. "We were raising these issues a year ago."

Commission members also continued to question why the Windemere Nursing Home and Rehabilitation Center, which shares the hospital campus, necessarily must be included in any hospital relocation.

Mr. Sweet said the hospital decided to build on its current site only after a thorough exploration of building elsewhere.

"It's not from lack of thought, or lack of interest, that we're not moving," Mr. Sweet said.

Mr. Sweet told commission members he initially anticipated that the hospital would be built on a new site when planning began about three years ago.

But he said the difficulty of finding an appropriate and available site, as well as the higher costs of new construction, has persuaded him that the hospital should stay put.

Hospital officials have said that building a hospital and nursing home at a new site would cost $71 million, They estimate that selling the current site would yield $9 million, resulting in a project cost of about $62 million.

In contrast, they estimate building at the current site and retaining the existing Windemere facility will cost about $42 million.

Mr. Walsh disputed whether a facility worth $71 million should be built on the Vineyard, even if enough money could be raised for the construction.

He said the hospital would be hard-pressed to sock away the necessary depreciation funds to make repairs and eventually replace the new hospital facility at the end of its anticipated life of 40 years.

But commission members continued to find the current site a difficult pill to swallow. Key concerns include the location along one of the most heavily clogged traffic arteries on the Vineyard near a drawbridge in danger of failing and being closed for years; the susceptibility of the site to storm surges, especially in major hurricanes; and the already cramped confines of the site.

Commission member Chris Murphy of Chilmark said all the problems of the current site essentially stem from its location. To keep the hospital there, Mr. Murphy said, is to continue the problem. "Trying to put another hospital on that site just seems ludicrous," he said.

"Every decision stems from this one," Mr. Murphy said, adding:"The location is everything."

Mr. Murphy agreed with hospital representatives that Windemere should be paired operationally with the hospital, but said the facility does not need to be physically near the hospital.

A number of commissioners said they would rather see the new hospital built somewhere near the Oak Bluffs blinker intersection of Edgartown-Vineyard Haven and Barnes roads.

Mr. Sweet said a battle over a possible alternative location is not worth jeopardizing the construction of the new hospital.

"When we started, I was in no different place than you are," he told the commission. "I do not want perfect to be the enemy of good."

He also said the capital campaign currently under way is unlike any attempted on the Island.

"The amount of money that we're raising is absolutely unprecedented," Mr. Sweet said, adding:"I think we're going to hit a limit. This is too important to blow up. We're already behind."

Over the past two to three years, Mr. Sweet said, the hospital explored alternative sites, such as near the Southern Woodlands development or the Martha's Vineyard Airport. He said nothing panned out.

But commission member Ned Orleans of Tisbury, who formerly worked in commercial real estate, said he needed a current, concrete alternative to consider. Until then, Mr. Orleans said, he lacked enough information to make a decision.

Commission member James Athearn of Edgartown challenged the all or nothing stance that mandates construction of a new hospital at its current site. He called on hospital officials to apply creativity to the problem.

"We're checking this out carefully to see if any unwarranted assumptions are lying about," Mr. Athearn said.

Commission members suggested free land might be available from a town, such as Oak Bluffs, to house a new hospital. Mr. Walsh, meanwhile, put forward the idea that the other five Vineyard towns could pay the town for housing the new hospital on a continuing basis for any financial or tax impact.

But Mr. Walsh said he has assumed the land for a new hospital would be free. The $71 million, he said, was just for construction costs.

He again stressed the burden that such a price tag would place on the hospital, even if the money were raised.

"I'm not sure that would work, putting a load of expense into the institution," he said.

Mr. Walsh estimated that a $40 million facility would require $2 million to be set aside annually for depreciation. A $71 million facility, he said, would require twice that. "The concept of depreciation is to replace the asset," he said.

"It just doesn't work. You just can't make the numbers work when you're talking that kind of money," he added.

Hospital leaders also said potential donors may not be willing to commit funds for a more expensive hospitality whose feasibility is in question.

"They just don't want us to screw up," Mr. Sweet said. "They don't want to see the money go down a black hole."

As the meeting went on, Mr. Walsh openly expressed his frustration.

As for Windemere, Mr. Walsh and Mr. Sweet both said the nursing home cannot survive on its own, and in fact depends on shared services with the hospital to break even - but just barely.

Commission members wondered whether Windemere could become part of an assisted living community, which would include condominiums for aging residents who were more self-sufficient.

But Mr. Walsh and Mr. Sweet said Windemere, with 70 per cent of its residents on Medicaid, boasts a different demographic than the more upscale residents found in many assisted living facilities. Mr. Walsh said the Vineyard would need to consider what sort of population the Island wishes Windemere to serve.

"Windemere and the hospital are joined at the hip," Mr. Walsh said.

The commission subcommittee that will explore possible alternative hospital sites includes Mimi Davisson, Mr. Murphy, Mr. Orleans, John Best, Martin Crane and Paul Strauss. Staff planner and DRI coordinator Paul Foley will work with the subcommittee.