HAGÅTÑA (The Guam Daily Post) — While several doctors testified in favor of building a new public hospital in Tamuning, Guam Memorial Hospital Authority officials stand opposed to utilizing Ypao Point, the Tamuning site talked about as a potential home for the new hospital.
“As a leader, I have an obligation, I have a duty to make sure that the health care services, such as the hospital, is accessible and available to the people of Guam and the community of Guam. Not just for a certain community, like the medical community,” GMHA Administrator and CEO Lillian Perez-Posadas told lawmakers during an oversight hearing Wednesday on alternate sites for the new hospital.
William Kando, associate administrator of operations at GMHA, also objected to building a new hospital at Ypao Point. The existing Guam Memorial Hospital facility already sits on a cliff line, “in a highly corrosive environment,” and that has cut short the useful life of its utility systems and medical equipment, according to Kando.
“We’re experiencing, for example, the loss of our medical vacuum system. The useful life is 10 years. … It’s dying at six years,” Kando said.
He also told lawmakers that, prior to fixing sections of the hospital roof, GMHA is having to make epoxy injections into “massive” cracks on the roof – the result of earthquakes over the years.
“So we have direct evidence and experience with earthquakes on that cliff line in that area,” Kando said.
Ypao Point runs along the cliff some distance away from the existing hospital site and, as reported during Wednesday’s hearing, there is a fault line at Ypao Point as well.
Disagreement on location
With the existing GMH facility in overall decline, there is consensus among local leaders and health care officials that a new public hospital is needed on Guam.
However, disagreements have taken place over where the new hospital should be built and, as shown Wednesday night, over what facilities should exist on that site.
The governor’s administration has been pursuing a medical complex, which would include a public health center, a veterans administration facility and other medical facilities, in addition to a new hospital.
Ypao Point was identified as one of three sites most viable for the project, but it isn’t considered large enough for the complex.
There was some confusion Wednesday over how much of the site is available, with 25 acres cited at some point, but a map shown at the hearing identified about 27 acres of usable area at Ypao Point. That excludes land reserved for cultural facilities.
The Eagles Field area of Mangilao, federal property that was once the preferred site for the medical complex, is about 102 acres. Eagles Field is no longer available, sending the medical complex project back to site selection.
Doctors’ testimony
Doctors among the panel at the oversight hearing Wednesday indicated that it wasn’t necessary to build a complex composed of multiple facilities, which may not be totally relevant to the functions of a hospital, and that the focus should be on the hospital itself.
Dr. Jonathan Sidell, president of the medical staff at GMH, penned written testimony strongly supporting the construction of a new hospital at Ypao Point. Sidell said Guam needs a stand-alone hospital, and does not need a public health center next to the hospital, as those facilities are better suited out in the community.
Dr. Thomas Shieh essentially said the same regarding the public health center, and also said that veterans health is a federal responsibility. Shieh, a veteran himself, added that the government of Guam should be working with private clinics to accept veterans and, if the local government wanted to take on the responsibility of addressing veterans health care, a veterans facility did not need to be next to a new hospital.
Dr. Hoa Nguyen of the American Medical Center echoed sentiments that addressing veterans health is a federal issue.
Perez-Posadas disagreed.
“We have veterans who we receive at the hospital because there is no hemodialysis treatment program at Naval Hospital, none available at the military community, so we treat them. So we’re not going to turn away these veterans. We have a responsibility to care for them also and not just say that’s (for) the federal government,” she said.
Medical complex vs. stand-alone hospital
The GMHA administrator also cited the need for continuity of care and collaboration within the health care delivery system, as she defended the need for a medical complex over a stand-alone hospital.
The apparent primary reason doctors and health officials want the new hospital in Tamuning is that many of them already live there, and that mitigates the time needed to get to the hospital in emergency situations.
But Perez-Posadas said the hospital and medical complex need to be within the central part of Guam, so it is accessible to residents even in the south.
Dr. Vince Akimoto, who also practices at American Medical Center, said the 2022 Guam Medical Campus Master Plan already showed Ypao Point would service the most people. A drive-time analysis in the master plan indicated Ypao Point had the highest population percentages served, considering a drive time within 10 minutes and a time within 20 minutes.
“It would be great in the future to have, perhaps one of those smaller hospital facilities … to support the people of the south. But, by no means is it necessary to put the major acute care facility for the poor people of Guam at this point in time,” Akimoto said.
Environmental concerns
Beyond the discussion on the medical complex versus a stand-alone hospital, the Ypao Point site is also in “terrible” environmental condition, according to Department of Land Management Director Joseph Borja. Ypao Point contains structures that may have asbestos and/or lead paint, as well as nesting sites for invasive species, and the area has been used as a staging site for construction, as well as a dump site, Borja said Wednesday.
According to a Guam Department of Agriculture expert, it may take a year to two years to mitigate the invasive pests, Borja said. Following that, according to the Guam Environmental Protection Agency, it may take another year to remove debris and mitigate soil contamination from construction activities, Borja added.
Conveyance process
The medical campus master plan also states the conveyance process for Ypao Point would require amending law to give the governor authority to utilize that land. It is currently under the jurisdiction of the Chamorro Land Trust Commission, and CLTC Administrative Director Alice Taijeron has already spoken out against taking the land away from the commission.
The CLTC wants to lease that land for commercial purposes to generate revenue for infrastructure construction at the commission’s various residential and agricultural properties, according to Taijeron.
Another alternate property identified as most viable for a medical complex is under the control of the Guam Ancestral Lands Commission. That would require a GALC lease to utilize.
Speaker Therese Terlaje, head of the legislative committee on health and land, said Wednesday it’s not the Legislature’s decision as to where a new hospital will be built, but some properties will require legislative action.
Gov. Lou Leon Guerrero has earmarked $160 million in American Rescue Plan funding to help with the construction of a new hospital facility. She has until the end of December 2024 to obligate funds, and until Dec. 31, 2026, to expend them.
Ypao Point, the site of the old Guam Memorial Hospital is seen Thursday, May 18, 2023, from Two Lovers Point in Tumon.
