New hospital needed, VHA clams

PALMER -- Valley Hospital Association is preparing to submit a certificate of need to the state of Alaska -- a critical step toward construction of a new, expanded facility.

Elizabeth Ripley, spokesperson for Valley Hospital Association, said she has been working to compile the weighty document for the past several weeks. Although she had hoped to send it to the Department of Health and Social Service's Division of Administrative Services by the end of next week, some key information is still being compiled and the association has moved back the target date for submittal until March 29.

Although Ripley said the delay could mean a later start on construction, it's important to have as much information as possible in the submittal.

"Anytime we push the planning process back, it's a little bit later that we get a shovel in the ground," Ripley said.

Part of the reason for the delay, Ripley said, is VHA is still working out the details of the joint venture with Triad Inc. The two groups are still working on their definitive agreement, she said, so some key portions needed for the submittal are still being ironed out.

"For the most part, it's all together," Ripley said. "We weren't able to complete our financial piece."

Ripley said a volume of information must be included in the submittal -- specific financial information, information about exactly how much space would be added, how many beds, characteristics of the area and how the hospital would meet the needs of the community are just a few of the criteria to be included. There's an area of the submittal dedicated to letters of community support that Ripley said is full of positive support from the community.

Although there is no standard to be met for levels of support, Ripley said she's documented support from the area's governing bodies, including the Mat-Su Borough and cities of Palmer and Wasilla, chambers of commerce and, through a vote in favor of the Triad/VHA joint venture, VHA's membership. Ripley said community support for the project is a strong point of the submittal.

"That's going very, very well," Ripley said. "We've received letters of support from most [area] political bodies. I think we've demonstrated this project is endorsed by more than half the community."

Another strong portion of the submittal, Ripley said, are the numbers that demonstrate that VHA's Palmer facility is simply not big enough to meet the Valley's needs.

Currently, Ripley said, the state recommends a 65 percent occupancy rate for medical/surgical beds, for example. At Valley, in 2002, there were 80 days in which the occupancy rate was between 100 and 115 percent. In the Intensive Care Unit, there were 107 days when the unit was running at 100-percent capacity. And, in the critical care unit, where a lack of bed space can mean a patient is transferred to Anchorage hospitals for treatment -- hospitals whose emergency wards are already running over capacity on a regular basis -- there were 243 days when the unit operated at 75-percent occupancy or higher. The state, she said, recommends a 70-percent occupancy rate for that unit.

But one of the most telling statistics, Ripley said, was that of the PCU unit -- where patients who are between the needs of an ICU and a medical/surgical unit are treated. Valley's PCU opened in 2002, she said, and was already operating at capacity or above. Thirty-three days, she said, reflect 100-percent occupancy rates and it operated for 145 days at the target occupancy rate of 75 percent.

"That's a snapshot that, to me, jumps right off the page," Ripley said.

Through the certificate of need, Valley is asking for two options to be considered. The first would expand its 40 beds to 76 at a new facility, and include space for an eventual 128 beds, and the second would open the facility with 128 beds.

This isn't the first time Valley has applied for an expansion, and it's not the first time a new facility has been requested. David Pierce, the state's certificate of need coordinator, said two significant expansions have been approved in recent years -- one in 1993 and one in 1998. An application was submitted in 1985 to put a 42-bed facility in Wasilla, but that application was subsequently denied.

"It was denied because … it was neither cost-effective or efficient," Pierce said. After that project was denied, Pierce said a letter of intent was sent in to Pierce's office discussing plans to build a 72-bed, $29 million facility, but he said he didn't see a certificate of need file on that project.

Pierce said his staff looks at several factors in reviewing an application -- the size of the expansion, the need for the facility, the size and growth happening in the area, quality issues, access issues and how it fits into existing services, to name a few. Comments are welcomed, but Pierce said the quality of the comments mean more than the quantity. A hundred letters saying the facility is needed may be less valuable than a few letters demonstrating clearly why the facility is needed, for example.

"We do appreciate public comments because we do think people can have a good perspective," Pierce said.

Ripley said she's very optimistic about the certificate of need, and feels the hospital's current usage rates, along with the continued growth of the Valley, more than justify the expansion.

"In terms of justifying the need, I

believe we have built a very, very solid case," Ripley said. "I'm very optimistic."