Commission Peppers Architect with New Hospital Questions

Gazette Senior Writer

Members of the Martha's Vineyard Commission last week raised serious doubts about the wisdom of expanding the Martha's Vineyard Hospital at its current Oak Bluffs site.

Hospital architects came before the commission Thursday night to give an informal presentation on proposed building plans, and were rocked by a series of questions and comments challenging assumptions underlying the $42 million building project.

While commission members agreed that the hospital should be expanded and updated, a number of them said the hospital should move away from its site off traffic-clogged Beach Road. Given that they had raised similar concerns at a meeting last October on the hospital plans, they asked why those concerns still had not been addressed.

Near the conclusion of the two-hour session, commission chairman Linda Sibley said pointedly that the questions raised by the commission really should be addressed to hospital trustees and hospital chief executive officer Timothy Walsh.

But neither Mr. Walsh nor any hospital trustees attended the Thursday night meeting. The only spokesmen present were Ken Chisholm, director of the Windemere Nursing Home and Rehabilitation Center, and three architects with Thomas, Miller & Partners LLC, the firm in Brentwood, Tenn. that is designing the new hospital.

"I would like them to come in and make a presentation to the commission and convince us it makes sense," Mrs. Sibley said of Mr. Walsh and the hospital directors.

The meeting marked the second informal discussion hosted by the commission on the hospital building plan. The plan will eventually be reviewed by the commission as a development of regional impact (DRI).

Marc Rowland, the Thomas, Miller partner in charge of the hospital project, told the commission that renovating the hospital at its existing site could save up to $29 million compared to moving the hospital to a new location.

He said building the hospital and the nursing home at a new location would cost $71 million. The hospital might realize up to $9 million on the sale of the existing property, which he said would drop the cost to about $62 million - still $20 million more than renovating the hospital at its Linton Lane location.

Mr. Rowland said discussions between hospital directors and possible donors revealed that the hospital probably would not be able to raise $62 million, and that $42 million was a more tenable goal.

"The clock is ticking, and something needs to be done," Mr. Rowland said. "You're not in danger of losing your hospital, but it's on life support. Our professional opinion is the work must be done, and very soon."

In early July hospital trustees announced the launch of the $42 million capital campaign - by far the largest building campaign ever undertaken on the Vineyard using private donations.

Mr. Rowland also said the hospital directors believe that finding an appropriate site for the hospital would be difficult.

But commission members quickly zeroed in on a key assumption in the hospital plan: that the nursing home must remain linked, both physically and operationally, with the hospital.

Mr. Rowland stood by the assumption. "It does not stand on its own. It's linked at the hip," he said, both in terms of efficiencies and diagnostic services.

"If the hospital moved without the nursing home, that would be the death of the nursing home," he added, reflecting what he said was the sentiment of hospital trustees.

But commission member Dr. Martin Crane, a governor's appointed member to the commission and a physician, said Windemere is a long-term care facility rather than an acute care facility. As a result, he said, Windemere patients would not need on-site access to the diagnostics of a hospital, and could be transported as necessary to the hospital.

Mr. Rowland and Mr. Chisholm replied that Windemere's connection to the hospital provides cost savings that has allowed the nursing home to realize a surplus after years of losses. Mr. Rowland said nursing homes on the mainland face financial challenges, and that running a nursing home on an Island poses even more hurdles. Mr. Chisholm said his time is shared between the nursing home and the hospital, which saves money.

"This little system works very well together," Mr. Chisholm said. "This allows 81 people to stay on the Island."

Commission member Ned Orleans requested a copy of the report on which the hospital board of directors based its decision. Mr. Rowland said there was no report.

Mrs. Sibley quickly got down to basics. "I think they should move the whole thing," she said.

"Our purpose in coming here tonight is to start a discussion," Mr. Rowland replied. "We started with a schematic design. There isn't anything cast at this point . . . [but] the hospital board wanted to move forward on this site."

Vineyard Haven resident Harriet Barrow, who attended the meeting, said keeping the hospital at its current Beach Road site made little sense. Ms. Barrow said she had spoken with emergency medical technicians on the Vineyard who were horrified that the hospital planned to stay in its current location, given the traffic congestion emanating from the nearby Five Corners intersection in Vineyard Haven.

Commission members went on to raise questions about the access road and parking components of the plan. Mrs. Sibley also questioned the proposed exterior of the new hospital.

"I don't recognize that," she said. "It looks like a large hotel in the mountains. It doesn't look like Martha's Vineyard," she said.

MVC executive director Mark London suggested that the Thomas, Miller architects consult with Vineyard-based architects to come up with a more Island-oriented design.

The current plan calls for demolishing a portion of the 1929 cottage hospital and building the new hospital there. The hospital would stand two stories tall, with medical facilities on the first floor and patient rooms on the second floor. The plan also calls for the building to tie into the Oak Bluffs sewer system rather than using its existing on-site treatment plant. Mr. Rowland said the town system has the capacity to handle the hospital's sewage.

Vineyard Haven resident Chris Fried asked about alternative energy generation, such as solar power. Mr. Rowland said under state law a hospital must have steady power, so the current plan calls for no alternative energy source.

Dr. Crane asked Mr. Rowland what he would drop from the plan if he could. "It's always difficult to work with an existing building. If that constraint wasn't there, it would make our tasks less challenging," the architect replied.

Mr. Rowland also said the $42 million budgeted for the project would go considerably further on the mainland, where construction costs are not as high.

Questioned about the state of the fund raising campaign, Mr. Chisholm said the hospital had progressed a little further than the $20 million in pledges announced earlier this summer, but he declined to go into detail. "Our feeling is that we will reach our $42 million," he said.

The commission is expected to schedule a third informal discussion about the hospital plan for sometime later next month.

Reached by telephone yesterday, Mr. Walsh said family obligations prevented him from attending Thursday's meeting. "I think there was a little bit of a miscommunication on our part," he said. "We didn't understand this was a full-blown meeting."