Hospital's application under commissioner review

MAT-SU -- Valley Hospital staff are waiting on pins and needles while Department of Health and Human Services Commissioner Joel Gilbertson completes his review of their certificate of need application.

"As we tick off these last few items, we tend to be more anxious, not less," Valley Hospital spokeswoman Elizabeth Ripley said. "We're anxious, but excited."

David Pierce, Certificate of Need Coordinator for the state DHSS, said he forwarded the application to Gilbertson's office Oct. 5. It was a little later than he had expected to forward it on, he said -- both he and his computer encountered viruses within the original 30 days he had to review the document; the flu virus for Pierce, and the Blaster virus for his computer. As a result, he said he asked for an additional 30 days to wrap up his recommendations.

With the document in hand, Gilbertson made use of a recent policy change that allows him to request the application be reviewed by other offices within his department.

Elmer Lindstrom, special assistant to the commissioner, said the application was referred to the Division of Healthcare Services and to the Office of Rate Review. Both referrals, Lindstrom said, were made because Valley Hospital, as an acute care facility, treats Medicaid patients. The rate review office, he said, will look at the hospital's new proposed cost of Medicaid services, and the Division of Healthcare Services, he said, will look over portions of their Medicaid program.

Lindstrom said when Gilbertson forwarded the applications, he requested officials from the offices get their comments back to him by Nov. 7.

"He'll probably ask for a briefing by the end of the following week," Lindstrom said.

From there, it's anyone's guess as to what happens next. Pierce said the commissioner essentially has three choices when considering a certificate of need application -- deny it, sign it in full or make changes and sign it.

Pierce said the document, once delivered, becomes a deliberative document and his recommendations that were forwarded with the document aren't made public until the commissioner issues his determination. He couldn't say whether he had suggested changes, approval or denial of the application, but Ripley said she could think of a few things hospital staff consider vulnerable to potential changes.

"We asked to shell in a third floor so we don't have to ask later," Ripley said. "Statistics show that we need to bring this online one wing at a time, clearly. He could say we can't shell it in. His recommendation can be specific."

Shelling in a third floor, even if it's years before it's used, Ripley said, would save the hospital construction costs down the road -- that's why it was part of the application.

Although there's no timeline mandating that the commissioner act on the application, Ripley said she's confident it won't sit on his desk for long.

"I think they're cognizant of the fact that we want to break ground next spring," Ripley said.

When and if the application is approved, Ripley said Valley Hospital's first action will be to purchase the property for the new hospital site. VHA, she said, has been holding options on the property, waiting for the approval before they make the sale final.

That's not all the hospital is waiting on. A block of funding is currently set aside for construction of sewer and water utilities at the hospital in a portion of the Congressional budget. Those funds, Ripley said, are key in providing utilities to the new facility. Equally pressing is a decision expected from the Regulatory Commission of Alaska that will determine which of the two nearby cities -- Palmer and Wasilla -- should provide sewer and water service. According to a recent RCA order, Palmer has until 4 p.m. Nov. 6 to file for a service area expansion along with one already filed by Wasilla, to compete for service to the new facility.

But other issues with the land they're planning to build on, Ripley said, have been cleared up. They cleared title to a property that was initially in question. Residents of the Best View trailer park have been given until May 15 to move their trailers. The Palmer City Council removed restrictions on the use of the property Valley Hospital now sits on in Palmer. The small issues have been cleared out of the way, she said, and it's just a matter of waiting for the last things -- the certificate of need application, the RCA decision and the money from Congress for the sewer and water services.

"Everything's really falling into place," Ripley said. "But unfortunately, everything that's left is large and political."