Efficient, not Extravagant, Plans Are Needed for Design of New Hospital
By Ryan Schlehuber

Efficiency, rather than extravagance, will be the focus of design plans for the proposed new Mackinac Straits Hospital in St. Ignace, said Hospital CEO Rod Nelson. The hospital hopes to provide many services and programs for Mackinac County residents and has only $26 million earmarked for construction.

With construction at the new site expected to begin in April, hospital planners have still to determine what the facility will look like, inside and outside.

Mr. Nelson announced September 14 that $37.2 million in loans were approved by the United States Department of Agriculture (USDA) for the construction of a new facility. It comes as $10.4 million in direct low-interest loans and $26.8 million in loan guarantees from Rural Development and will now allow the long term care facility to be moved to the new building.

Until design plans are created, concerns will persist about whether there is enough money in the construction budget to meet all of the hospital's expectations about services to be offered, said Mr. Nelson.

"We can't build a Cadillac with Chevrolet money, and we have Chevrolet money, that's the bottom line," Mr. Nelson told the hospital's board of trustees during a meeting Monday, October 22, after one board member suggested building a facility with an attractive exterior.

Mr. Nelson referred to a letter to the editor that was published in The St. Ignace News September 27, written by A. Richard Williams of St. Ignace, who suggested the new hospital be designed in a way that "measures up to the level of excellence that should be expected for our 'center of the fresh water world' uniqueness, identity, and spirit of place." Mr. Williams is the architect who designed the St. Ignace Public Library.

"I'm really concerned about how the interior flies with staff and with patient care," said Mr. Nelson. "I think (the exterior design) is a great community project or staff project, but I think the way this thing is designed on the interior is going to be key whether it flies long-term, or not."

Board Chairman Ron Mitchell added, "I'd rather have a million dollars more of health care in the building than a million dollars worth of facade on the outside, but the community may feel differently."

Mr. Williams has said in the past that a well-designed building does not necessarily cost any more than an institutional facade.

The new hospital, to be constructed on North State Street near the Mackinac County Airport, will replace Mackinac Straits Hospital on the corner of Hombach and Burdette streets, which was opened in 1954.

The new hospital will also include a health center for members of the Sault Ste. Marie Tribe of Chippewa Indians.

Creating an office layout is the next step in the project. Once finished, Mr. Nelson said, he can begin to assess the actual costs of building the facility and what can be implemented into it.

Discussion followed of who will enjoy the view of Moran Bay from the facility, hospital and long term care patients or general visitors and employees in the common areas.

Board member Kathy Lawnichak believes the facility should be designed in a way that allows long term care patients the best view of the waterfront. Other board members believe building the Long Term Care facility toward the back of the site, facing a wooded, peaceful landscape, would be a better idea.

The hospital, which could be either a one-story or two-story building, could be designed in a way that allows common areas, which everyone can use, to have the best view of the water, Mr. Nelson suggested.

Barb Davis, head of nursing, and other staff members visited modern hospitals in the Upper Peninsula and northern Lower Peninsula last week to gather design ideas for their new facility.

Mr. Nelson cautioned that Medicaid is being relied on to fund the hospital's Long Term Care residential program but is on the state's "chopping block" again, owing to the need to cut $430 million in the state's upcoming budget.

"We have got to make sure that Medicaid can afford to pay for this facility long-term," Mr. Nelson said. "The whole goal of the facility is to build it so that it can be paid for."

Radiation Oncology May Be

Added to New Facility

The possibility of adding a radiation oncology department in the new facility may set off alarms at other hospitals in the region, such as Petoskey's Northern Michigan Hospital (now called Northern Michigan Regional Hospital) and Marquette General Hospital, which may contend that St. Ignace is poaching their patient base.

Having such a service closer to home for people in the Eastern Upper Peninsula and Mackinac County, however, will cut down on traveling costs, said Mr. Nelson.

"People typically do not go for just one visit," he said. "There are usually multiple treatments over multiple weeks."

Petoskey is a 45-minute drive from St. Ignace, while Marquette is three hours away.

Mr. Nelson requested feasibility studies be done in both St. Ignace and Sault Ste. Marie, where such services would make the best impact. The studies are being performed by Karmanos Cancer Institute of Detroit, which would operate such a facility in St. Ignace.

"It's competition, no doubt about it," said Mr. Nelson. "Marquette can stop it for up to two years because, in their agreement with Karmanos, they have to okay any location in the U.P. If it looks like it will go (in St. Ignace), it will take two years to do it, anyway."

Money for the service will come from a separate funding pool from the United States Department of Agriculture, said Mr. Nelson.

Critical Access Hospital

Network Agreement

The board approved Mr. Nelson's request to terminate the critical access hospital network agreement with Marquette General Hospital and create one with War Memorial Hospital and Northern Michigan Regional Hospital.

"I think we need to align more with our partner hospitals, and those hospitals are War Memorial and Northern Michigan Hospital," Mr. Nelson told the board.

The agreement supports business relations for Mackinac Straits with the two other hospitals for services and collaborative projects. For example, Mackinac Straits shares rehabilitation and pharmacy services with War Memorial and will have access to Northern Michigan Regional Hospital's reference labs (for blood test results, for example) and its diabetic education program, which Marquette General will no longer be providing after January 1.

He also pointed out that War Memorial has a voting representative on the Upper Peninsula Health Plan, the U.P.'s Medicaid provider, which Mackinac Straits does not. Marquette General is the largest stockholder.

Mackinac Straits' critical access hospital network agreement with Marquette General will end in six months.