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.