HomeMy WebLinkAbout2014-8-30ADVISORY COMMITTEE OF NONVOTING TAXPAYERS
Minutes of meeting 10 A.M., SATURDAY, August 30, 2014, at
4 Fairgrounds Road RECEIVED
1. Attending: Lou Bassano, Howard Blitman, David Brown, Roger
Ernst, Lucas Fischer, Don Green, Susan Matloff, Steve Meadii�4 5 t P 16 An 10 2'
(from 10:08 am), Bill Sherman, Jay Strauss, and Tony Walsh, � IA U C K ET TOWN C L E
quorum. Also present Peter Kahn and Elliott Pollack plus Dr.
Margot Hartmann, CEO and President of the Nantucket Cottage
Hospital, Michael Roberts, Chairman of the hospital Board, and
(from 10:09 am) Steve Karp, Board member and developer.
2. Materials distributed at the meeting by Roger Ernst: "Ideas re
Movement of NCH to WWC Land, as of 8/26[/14] and by Dr.
Hartmann: 33 page printout under cover "Building our
Future /Committed to Care" of August 6, 2014
3. ACNVT Chair Howard Blitman called the meeting to order at
10:01 a.m. The proposed agenda for the meeting was approved.
The minutes of the August 2, 2014 meeting were approved.
4. After introductions of ACNVT members including new member
Peter Kahn, the Chair welcomed Dr. Hartmann and Michael
Roberts, noting that Steve Karp was expected shortly. Rather than
starting with a presentation, Dr. Hartmann invited questions. Lou
Bassano's question, whether NCH would need a Certificate of
Need from the State, was answered: Yes.
5. Dr. Hartmann noted that NCH has done a major survey of services
needed on island and seeks to strike a balance in replacing its
failing building, given status as a low - volume, rural hospital. The
hospital relies on MedFlights, but they are able to respond to calls
only —2:3 times. NCH must meet a range of needs, of island
families as well as summer residents who typically have their main
hospital elsewhere but share a degree of isolation while on island.
Recent improvements at the present site include the walk -in clinic,
reworking the emergency room, and growing primary and
specialty medical capability. The potential of telemedicine is
limited by the electrical system.
6. With a campaign goal of $75 million, NCH cannot responsibly
build on an inadequate site. Funding will include $2 - 3 million
from MGH/Partners HealthCare for `soft' costs, $8 million of
forgiven NCH debt, and $10 million for a matching challenge
grant. MGH/Partners HealthCare proposes advancing no- interest
construction financing, also funds in anticipation of receiving
amounts pledged by donors. For financial sustainability of the new
hospital, especially with medical practices changing so much,
philanthropy will still be needed.
7. Michael Roberts observed that NCH services had increased overall
30% since Dr. Hartmann started as CEO at the beginning of
FY2010. The current NCH is the least efficient of Partners
HealthCare hospitals.
8. Steve Karp added that the community needs survey call for on-
island delivery of babies implies a second operating room for OBs.
More dialysis chairs are projected, also on- island chemotherapy.
9. Jay Strauss expressed concern that NCH physicians have
affordable housing and otherwise that their practices remain
profitable. Don Green added that Cape Cod Hospital could meet
dialysis needs; without single - payer, a hospital may be tempted to
offer services for financial gain that could be gotten elsewhere.
10. Dr. Hartmann said the new hospital would be as small as possible
for island lifestyle, —100 KSF, e.g., it would not offer radiation
oncology. Central nursing efficiencies will be realized. As a rural
Critical Access hospital, it needs to be seen differently from a
usual urban hospital. Per Steve Karp, fewer beds are planned.
I l.Elliott Pollack asked that an executive summary of financial
projections be made public.
12.Howard opened the issue of site selection, characterizing the
Wyer's Valley site as a poor selection and dangerous, e.g., a fuel
truck could explode. Steve Karp responded that potential sites were
vetted for NCH by an expert consultant: the facts favor Wyer's
Valley. The new hospital would be 1,000' from the new deep
wells; other uses are almost as near. The State must approve siting
in relation to the deep wells. Howard's rejoinder was why not
reconstruct on the present NCH site, which his construction
experience supports as feasible. Per Steve Karp, the present site is
too small.
13.Dr. Hartmann offered ACNVT members a tour of the present site.
She noted that NCH staffing would be impaired by on -site
construction.
14. As a possible alternative, Mill Hill Park could not be used for a
hospital without local ATM and State legislative authorization,
said Steve Karp, whereas Howard asserted that the Land Council
considered it doable. Steve Meader suggested that a replacement
for the sledding hill could be created elsewhere. In any event, the
park would be a site much larger than the present one and
physically adequate for a new hospital. Its location would not serve
the eastern end of the island as well as the more central Wyer's
Valley.
15.Bill Sherman expressed concern that upgrade of NCH's clinical
culture should accompany facilities upgrade. Steve Karp responded
by speaking of an endowment plan with 4 — 5 % yield being
allocated by an island citizens committee toward otherwise
underfunded medical needs, e.g., mental health, at a maximum of
$400,000 to $500,000 annually.
16.After setting our last meeting of the current season for 9/13/14, the
meeting was adjourned at 11:10 a.m.
Respectfully submitted,
Bill Sherman, Secretary
Draft minutes e- distributed and submitted to Town Clerk 9/5/14
Minutes adopted 9/ 13/14, hard copy submitted to Town Clerk 9/ 16/14