Hospital site plan rankles crowd

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June 15, 2011 - 12:00 AM

Judy Snavely warned trustees that if they decide to build a new hospital east of town that “people will boycott” the new facility and begin efforts to rescind the vote that issued a quarter-cent sales tax to go toward its construction.
Snavely, Iola, was one of about 50 citizens who attended the Allen County Hospital trustee meeting Tuesday night, the majority decidedly against the U.S. 54 site at the east entrance to Iola.
Trustees dedicated the better part of an hour hearing their complaints and criticisms. It was not a night for the thin-skinned or faint of heart.

A GOOD share of the meeting was spent shooting down rumors.
“With the growing cost of the land, the hospital itself will get smaller,” said Margaret Lesher, a nurse practitioner who practices with Via Christi Medical Associates, 401 S. Washington Ave.
“No,” replied trustee Karen Gilpin. “No matter where we build the hospital it will remain the same size and offer the same services. We have not taken one square foot out of the design for the new hospital.”
Lesher then referred to the current hospital and how its basement provides shelter when weather threatens.
“Again,” Gilpin replied. “The new hospital plans, wherever it is to be built, have never included a basement,” but will include a safe room with extra thick walls that will work as a storm shelter.
Trustee Patti Boyd expanded on Gilpin’s comment, saying the design of the hospital and the selection of its site were “somewhat independent of each other.”
Boyd also said input from hospital staff, local physicians and nurses, and all the department heads within the hospital contributed to the design of the new hospital.
Snavely wondered why the current 50-year-old hospital could not have an additional floor added to its structure instead of building a new facility.
“The new site looks so congested,” Snavely said. “All these amenities do not have to be on one site,” referring to the possibility of a medical arts building and a Veterans Affairs clinic also being on the 17-acre site. The current hospital sits on 4.5 acres.
Chuck Richey, Iola, wondered where the “extra $13 million” is going in the project. “You’ve got $30 million, and say you’ll spend $17 million on the hospital. Where’s the rest of it going?”
Trustee Jay Kretzmeier, and an accountant by trade, explained in broad terms the breakdown of the funding including $5 million for start-up capital, $3 million in a bond service reserve fund, $1.2 million in architectural fees fees, $1.7 million in financing the project during construction, about $650,000 for the purchase of land, “and other costs that I’m not at privilege to discuss because of the confidentiality of their nature.”
Richey wondered how he could find a “true report” of trustee actions, other than the Register’s coverage which he viewed as biased. Kretzmeier said his copious minutes as recording secretary are available online at Allen County’s website. They do not, however, include discussions held in executive session.
Richey said he also feared cuts to the Medicare program and how that would affect the reimbursement rates to the hospital.
Chuck Wells, adviser to the trustees, said, “nothing in current legislation affects Critical Access hospitals such as ACH,” and that there was no reason to think it would not continue to be funded as it is “into the foreseeable future.”
Richard Schneider, LaHarpe, wondered how trustees will be able to secure contractors who will guarantee their work, “given the instability of the ground,” at the U.S. 54 site.
Phil Schultze, an engineer with Murray Construction, the firm in charge of construction management, replied that it also serves as general contractor to the project and takes full responsibility for the success of its work.
The contract with Murray Construction also stipulates that it will receive $17 million for the construction of the 60,000 square foot hospital with no cost overruns.
“We plan to complete work within the original budget and see that it doesn’t go over, including no change orders,” he said of the practice of tacking on extra costs for unforeseen expenses.
The beauty of having a construction management at-risk contract is that the responsibility of the success of the project lies with Murray Construction, said Harry Lee, chairman of the hospital trustees.
Don Hillbrant was concerned the site was still contaminated by acid used by a previous manufacturer at the site and that it would leach into surrounding soil and water.
Schultze said an inspection by the Kansas Department of Health and Environment revealed no traces of acid in the soil.
Don Britt said that as a youth he walked around the pond Hillbrant referred to. “In 1939 it was closed and then filled with sand,” Britt said.
Another citizen wondered about the safety of building a healthcare facility on top of contaminated soil.
Schultze explained that the land below the hospital would be moved to sites they had planned as parking areas, which will then be “capped” by asphalt. Any exposed land also will be capped with two feet of “clean” soil. None of the site will pose any health risks to the public, he said.
Beverly Lewis accused the trustees of being wasteful with the taxpayers’ money.
“I think you’re bilking us,” she said, and informed the crowd that she and her husband, Jim, had offered trustees 41 acres of land at $7,000 an acre north of town.
Lee replied that trustees had kept the Lewis offer confidential. “We have tried to respect the privacy of every landowner in our negotiations,” he said. “We felt we did not have the right to break any confidences out of respect for your privacy.”
Peggy Marple, an employee of the hospital who works in patient accounting, said the plan to build a medical arts building next to the hospital on the U.S. 54 site “is to benefit Family Physicians, and only Family Physicians.”
The physicians associated with The Family Physicians and the pharmacists with Iola Pharmacy have a clinic and drive-through pharmacy on land that borders the proposed site of the new hospital. Together, the pharmacists and physicians have told trustees they are willing to undertake the financing of a medical arts building where visiting specialists could practice. It is not in the hospital’s budget to build this additional facility.
This partnership with the hospital, “is the kind of relationship we have wished for,” said trustee Boyd.
It’s almost ironic that Boyd is a hospital trustee, she said, “because initially I wasn’t in favor of a new hospital,” she said. It was when she realized that only with a new hospital could the county compete for new “young” doctors that she got behind the effort.
She now sees the medical arts building as “a piece of the puzzle that the hospital really needs,” in order to attract specialists such as cardiologists, pulmonologists, neurosurgeons, orthopedists and the like.
“We have a two-fold challenge,” she said. “To take care of people and to make money as a hospital.” Visiting specialists make a big difference to the hospital’s bottom line, she said.

BEFORE the meeting began in earnest, Kretzmeier voiced his concerns about remarks he has received of the trustees’ actions.
“We’ve been accused of having ‘tunnel vision’” in their decision to locate the hospital on U.S. 54, he said, and reminded the audience that the trustees are aware of their responsibility to taxpayers of their charge to build a hospital that is also profitable.
Trustees have made “patient and deliberate” evaluations, he said, over the course of their meetings. Trustees have now met 29 times.
Kretzmeier said “any location,” for the new hospital is “very expensive,” and went through the comparables of the U.S. 54 site and that north of town on Oregon Road. At the end of the day, a difference of $315,000 surfaced, and trustees reverted to the in-town site.
Accusations that the board “flip-flopped” or had been “manipulated” by private interests, stung Kretzmeier. “There is no group or person who’s manipulating me,” he said.
He swung his vote for the U.S. 54 site, he said, when he realized the “importance of the medical office building” to that of the hospital.
“For optimum quality of care for the citizens of the county, you need to have your attending physicians close by, as well as what I call all the ‘-ologies,’” referring to specialists such as a cardiologist. “Those multitude of services are important for patient care and also add critical additional revenue to the hospital, that in my mind would offset the difference in price between the two parcels of land.”
Kretzmeier said the commitment by the physicians and pharmacists to invest in a medical arts building reduced his feeling of risk for the project. He said he’s now reserving his judgment on the U.S. 54 site until he hears about their commitment to building a medical arts clinic on the site after the news of the new soil studies.
The trustees have exercised options on the land at both sites, but have not purchased any land to date.

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