Voters To Decide on Hospital Corporation May 6
Private, Nonprofit Entity Sought So New Hospital Can Be Built
By Amy Polk

Residents in Brevort, Moran, and St. Ignace townships and the City of St. Ignace will vote Tuesday, May 6, on a proposal to transfer management and assets of Mackinac Straits Hospital and Health Center to a private, nonprofit corporation, so that a new hospital can be built.

If approved, the new corporation, Mackinac Straits Health Systems, will receive $37 million in financing from the United States Department of Agriculture (USDA) for the new hospital. The new facility will replace the aging Burdette Street hospital and long term care facility, and will allow expansion and a cooperative venture with the Sault Ste. Marie Tribe of Chippewa Indians.

Of the $37 million, $26 million will be used to build the new facility and the rest will be used for financing costs and to refinance current debt, including $2.4 million owned on the Mackinac Island Medical Center.

If the transfer is not approved, the old hospital board will have to seek an alternative source of funding to improve facilities on Burdette Street, said Hospital Chief Executive Officer Rod Nelson.

The funding was approved "with the assumption that a new hospital would be built," Mr. Nelson said.

Residents in the four municipalities comprise the Mackinac Straits Hospital Authority, which has operated the hospital, and that is why they must approve the transfer. The authority was created in 1950 to raise money to qualify for a federal grant to build the existing hospital on Burdette Street in St. Ignace. The hospital board supports the move and voted February 4 to transfer the Authority's assets and debts from the existing board to the new corporation. Final approval, however, must come from the voters May 6.

All hospital authority assets, debts, liabilities, and operations of the Mackinac Straits Hospital and Health Center, Long Term Care, Mackinac Island Medical Center, Naubinway Family Health Clinic, Bois Blanc Island Clinic, and an interest in the Moses Dialysis Unit would be transferred to the new corporation.

Approval of the transfer would allow the construction of the planned hospital to begin this summer, with a target completion date of late 2009 or 2010.

Mr. Nelson said fewer hospitals are managed by public authorities, like counties and cities, these days because of the increased liability and public financial constraints.

"Ultimately, those four municipalities [that formed the Mackinac Straits Hospital Authority] would be responsible for any outstanding debt or liability incurred by the hospital," he said.

Mr. Nelson said health care services here need to improve, even if voters don't approve the transfer.

A 2001 architectural review determined that a new facility would be better than renovating the old one because of age, poor structure and condition, obsolete heating and ventilation systems, and no room for expansion at the present hospital site.

If voters approve the transfer, he Hospital Authority hopes to reach an agreement with Mackinac County Board of Commissioners about selling or leasing the current structure. The county owns the hospital building, and the authority leases the site from the county for $1 a year. The Authority is responsible for a $1.2 million bond obligation from a long term care expansion, which will continue, Mr. Nelson said.

"That's our responsibility, and that also would get transferred with the agreement," Mr. Nelson added. New Long Term Care Would Use "Residential" Model

A1.2-mill county-wide millage, originally designed to bring the hospital out of debt and guarantee around-the-clock emergency room coverage, is now used primarily to offset the cost of operating the long term care unit in St. Ignace, Mr. Nelson said. It generates $950,000 for hospital operations through a health services contract with the county.

"The long term care unit is the area of the hospital that needs funding," Mr. Nelson said, adding that it is the only department that operates at a deficit, while the other departments generate enough revenue to cover costs.

The hospital will continue to seek the millage when it expires in 2010, even if the facility is managed by the new nonprofit corporation, but, Mr. Nelson said, the health services contract will most likely be changed to reflect the support for long term care instead of general operations.

Long term care services would move with hospital operations to the new site, Mr. Nelson said. The new facility would be built near the Mackinac County Airport, on 16.5 acres in St. Ignace, that will offer room for future expansion. The two-story hospital building, with views of Lake Huron, will comprise about 85,000 square feet. The new long term care facility will be attached to the hospital and have 33,000 square feet of space.

Mr. Nelson said as health care needs grow and evolve, the facilities will be expanded and added to meet those needs.

"The key," he said, "is to develop a facility that can be flexible."

With this in mind, the new long term care unit is now being designed with four residential clusters of 15 beds. Each cluster will have a fireplace, living room, kitchen, and bathing area. The number of beds will be reduced from 75 at the current facility to 60 at the new one. Mr. Nelson said the facility serves fewer residents owing to a changing population, stricter qualifying requirements from Medicaid, and the availability of more assisted living and long term care options in the area. Right now, 72 of the 75 available beds at long term care are full, and there are no people ready to admit right now. There are 27 people now on a waiting list to be admitted sometime in the next one to 36 months, according to the hospital.

"Based on a reduced need for the beds, we have cut back, and over the last eight years, we have reduced the number of beds from 99 to 75 at the current facility," Mr. Nelson said.

The planned long term care unit can be reduced or expanded as necessary, he added, based on the needs of the area, which are changing to more assisted living.

"Our assumption is that we will continue to expand the [long term care] facility into assisted living and independent living," Mr. Nelson said.

Other facilities planned for the new hospital are a new dining room overlooking Lake Huron, physician offices for the visiting doctors who see patients here, an expanded rehabilitation unit with aquatherapy, a state-of-the-art emergency department with a drive-through, heated garage, an updated radiology department with X-ray, CAT scan, ultrasound, and digital mammography, outpatient procedure rooms, and 15 private, acute care rooms. The dialysis unit will be larger to accommodate six people instead of three. The chemotherapy unit will be expanded from four to eight stations. A new Sault Tribal Health Clinic will be integrated in the new hospital building.

These planned facilities are based on current use, a feasibility study, and are expected to help the hospital retain its current users and attract more, so the hospital can continue growing.

"In order to stay in this business, we need to upgrade our facilities, and we want to provide as much medical care here as possible," Mr. Nelson said. "We want to keep control of our health care destiny."

Information about the hospital, including its health service agreement with Mackinac County and the feasibility study for the new facility, is available at the St. Ignace Public Library.