When two clashing camps see distance from different perspectives
By Frank Whitman
Gov. Lou Leon Guerrero’s original plan was to build a new medical campus on the Navy-owned Eagles Field property in Mangilao. However, the plan fell through due to a dispute between the governor and the legislature over transparency issues. The Joint Region Marianas eventually withdrew the draft lease contract after the governor decided to give up the fight for Eagles Field. This time, she is locked in a new battle with the medical community over an alternative site for the $1 billion project.
Guam healthcare providers expressed their support for locating a new Guam Memorial Hospital at Ypao Point in Tamuning during a legislative oversight hearing Oct. 19. The hearing was called by Speaker Therese Terlaje who chairs the Committee on Health, Land, Justice and Culture, after Sen. Chris Barnett introduced a bill which would require that a new GMH be built in Tamuning. The bill was introduced Oct. 13.
Support for the Ypao Point location comes despite opposition from Gov. Lou Leon Guerrero, who favors a location in Adacao, Mangilao.
The physicians based their support for the Ypao site primarily on the lack of easy access to Adacao which is located off Route 15, a two-lane road commonly referred to as “the back road.”
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Ypao Point is adjacent to the current GMH and was the site of the hospital from 1956 to 1978. On June 23, 2015, a claim of interest was made by Francis A. Perez, son of the original registered landowner, Francis D. Perez, who conveyed the property to the government of Guam with a specific understanding that theb property would be used as a hospital facility.
During the hearing, Dr. Thomas Shieh, president of the Guam Medical Association, presented slides with information from a study of potential sites for the new hospital prepared by the Matrix Design Group Inc. for the Office of the Governor at a reported cost of $6 million. He showed several slides from the study with tables indicating that Ypao Point would be the preferred site over Adacao based on select criteria. These included population density, travel distance, emergency response time and distance from clinics to the hospital.
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At the legislative hearing, Shieh said, “Proximity of the clinics to the hospital saves lives. It’s not about money. It’s about saving lives.”
An analysis of drive times to the proposed hospital sites indicates that 24.4 percent of Guam’s population or 35,686 people live within a. 10-minute drive of Ypao Point while 8.6 percent or 13,731 people live within 10 minutes of Adacao, according to the Matrix study.
“The optimum time to get the patient to the hospital is 10 minutes; 20 minutes OK; 30 minutes, acceptable,” he said. “When you get past 30 minutes, the outcome is not acceptable, which means death and morbidity.”
In addition to getting patents to the hospital quicker where they can begin receiving critical - possibly lifesaving – care sooner, shorter drive time also means physicians and other providers can get to the hospital and begin providing care.
Currently, nearly all major clinics and ancillary service providers are located within five to 10 minutes of the Ypao site. “That is incredibly important, to have a site with accessibility, with multiple routes you can access,” said Dr. Denise Taitano-Ritter, family medicine physician at American Medical Center. “In addition to that, how quickly can your specialists get to that site – your OB gyn, your cardiologists, your radiologists?”
She told of a recent medical emergency involving her mother who had to be rushed to the GMH emergency room where she received care and “had the best possible outcome,” Taitano-Ritter said. “The infrastructure is what it is because it makes sense for our people. Having Ypao Point as the location allows for multiple access points to get to the hospital whether there is a vehicle collision, inclement weather, road construction, we can still access that spot. Additionally, our specialists are there; they will be there in a minute’s notice because minutes matter. When you think about heart attacks and strokes, you’re going to want your specialist to be there as soon as possible.”
It is also important for the clinics and other providers to be near each other as they often need to borrow supplies and equipment from each other, often at critical times, doctors said.
The Matrix study also stated construction costs for the Ypao Point site would be lower as compared to Adacao, which “was incompatible with existing land use and current zoning. Rezoning and preparing this site for a medical campus would result in significant disruption during development.”
Objections to the Ypao site were addressed during the hearing. GMH employees and members of the Leon Guerrero administration favored Adacao.
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It has been said that the Ypao site at 35 acres of usable land is too small to accommodate the planned facilities. The physicians have replied that many hospitals they know of are built on less land. “GRMC is an example; they built on less than eight acres,” Shieh said.
There has been concern about a fault line running beneath the Ypao site posing a danger from earthquakes. Sen. Jesse Lujan questioned that concern in light of the Summer Towers condo development next to the current GMH. “I’m just wondering how those four towers were given the right to build,” Lujan said. “You have two towers that are 16 floors, you have two towers that are 19 floors.”
Terlaje noted that the Matrix study did not contain the words fault, seismic, geological or geologic. “I don’t think those considerations have been made yet,” she said.
Emanuel Torres, mission manager for debris mission for debris related to super typhoon Mawar for U.S. Army Corps of Engineers, testified that he expected all eligible waste at Ypao Point to be removed by Nov. 1, which Terlaje said “is the best news I’ve heard in a long time.”
The site has been used as a dump over the years and the feasibility of cleaning it up to an acceptable level to be used as a hospital had been questioned. Terlaje also announced that a proposed laboratory for the Centers for Disease Control and Prevention will be built next to the University of Guam rather than as part of the proposed medical complex.
In addition, the Guam Behavioral Health and Wellness Center will be expanding its facilities at its current site. “Ypao is the only choice, or somewhere in Tamuning, said Dr. Hoa Nguyen, primary care physician and principal partner at AMC. “Just pick one where access to care for the majority of patients is the key to survival.”
Last month, the governor proposed a bill seeking to acquire pieces of ancestral land in Acadao, which she insists is a more favorable site to build a new medical facility. The bill, if enacted into law, would authorize the Guam Ancestral Lands Commission to commence negotiations for the sale or lease of the marked properties to the Guam Economic Development Authority.
She later launched an online petition seeking to draw community support for her plan to build a medical complex in Acadao.
According to an information sheet that accompanied the governor’s petition, governor’s office, the Acadao would provide “increased access for southern and central residents. Building a medical complex in central Guam decreases drive times for southern residents who currently have limited options for healthcare. Don't forget the south.”’
The administration also argued that road widening along Route 15 is already in the Department of Defense’s plans.” Building a medical complex in this area will take full advantage of their highway improvements, freeing up more DPW funding for village roads,” the information sheet stated.
The Acadao area has less congestion and traffic— an estimated 1,000 cars— compared to Tamuning
In response to critics who argue that Guam needs just a new hospital and not a medical complex, the governor said, "Our people deserve more than just a hospital. They deserve a modern medical complex."
The governor is seeking to build a complex that would integrate a hospital with a public health center, a behavioral health and wellness center, a pharmacy, specialty care clinics, a Veterans Administration office and a medical providers’ clinic.
"As a nurse and as your governor, I want our island to have access to the best in healthcare services," the petition reads. "Limiting ourselves to building a stand-alone hospital ensures we only receive standard hospital care." (With additional reports from Mar-Vic Cagurangan)
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