A proposal to develop hospital workforce housing and a skilled nursing facility on a 28-acre forested plot on Edgartown-Vineyard Haven Road was approved with a strong majority by the Martha’s Vineyard Commission Thursday night.

The 14-1 vote followed extensive discussion of the pros and cons of the Martha’s Vineyard Navigator Homes project, which aims to develop 48 workforce housing units and 66 beds for patients to replace the hospital’s Windemere facility.

“This project supports one of the most important institutions on the whole Island,” said MVC land use planning committee chair Doug Sederholm. Mr. Sederholm said the LUPC voted 6-0 in favor of recommending approval, a vote informed by a condition they imposed requiring the developer to install 14 NitROE enhanced septic systems on nearby properties, offsetting Navigator’s significant nitrogen loading impact.

But prior to the vote, commissioners voiced a range of concerns about project, including traffic, municipal services impact and destruction of open space. Michael Kim worried that price of care at the facility negated any significant community benefit. According to project attorney Geoghan Coogan, beds will cost $600 a day for privately-insured patients, $689 for Medicare patients and $389 for Medicaid.

“I have a hard time seeing how a median [income] person who lives on the Island can have any benefit from this,” said Mr. Kim.

Ben Robinson worried about the project’s impact on the residential and rural community in which it will be built.

“It does represent the crossroads the Island is feeling,” he said. “This is not a project that fits the character of the Island. This is basically a suburban development.”

Mr. Sederholm spoke in favor of approval, saying the project’s housing contribution to healthcare workers far outweighs its downsides.

“What are we gonna do?,” he countered. “Say ‘nah, its too suburban?’ No.”

Kathy Newman, Christina Brown, Jeff Agnoli, Fred Hancock, Ben Robinson, Ernie Thomas Doug Sederholm, Jim Vercruysse, Michael Kim, Greg Martino, Kate Putnam, Joan Malkin and Clarence A. (Trip) Barnes 3rd all voted in favor of approval, with Brian Smith being the only no vote.

In other business, the MVC closed the public hearing for Stillpoint, a proposed education and event space in West Tisbury located on a 13-acre, forested plot south of Priester’s Pond and north of Polly Hill Arboretum. The plan, which drew a large body of supporters and detractors at previous public hearings, was continued to allow for MVC water resource coordinator Sheri Caseau to consider their nitrogen mitigation plan.

“This project is very hard to calculate nitrogen for because there are very few clear numbers,” Ms. Caseau said at Thursday’s meeting.

The project mission statement presents Stillpoint as a “gathering space for educational offerings, including but not limited to discussions, workshops, silent retreats and the arts.”

Nearby residents voiced concerns about the volume of events and their plan to host weddings to fund the organization. Ms. Caseau felt that revisions to their nitrogen mitigation plans were adequate, but that future monitoring would be necessary.

Members of the public present at the meeting made a final case to approve the project which, they said, will conserve and make use of a plot previously slated for development.

“When I saw the plans for what could happen there, it was horrifying,” said Stillpoint president Thomas Bena.

Bettina Washington spoke in support of the wedding plan. “I think we all know conservation does not come free.”

Stillpoint legal representative Marilyn Vukota summed up the plans: “All this project really features is using an existing driveway and existing spaces for parking, and repurposing an existing barn. That’s it.”

A date for commissioner deliberation on Stillpoint has yet to be scheduled.

Commissioners also voted to expand the MVC’s line of credit from $145,000 to $350,000 this week, a measure that MVC executive director Adam Turner said was a response to “high litigation expenses.” Since the commission is not allowed to carry over debt into the next year, he said, the increase will be reflected in town assessments. A vote from commissioners to approve the credit line expansion was unanimous.

Also at the meeting, commissioner Ben Robinson presented a collaborative plan between the MVC, the town of Nantucket, the Army Corps of Engineers and Mass. Coastal Zone Management to study the supply chain and carrying capacity of the two Islands. The project, which Mr. Robinson said will take full advantage of models and resources available to the corps, aims to have preliminary results in the summer of 2023.