February 9, 2005
Leaders of Maricopa County’s health system are evaluating the merits of closing down the aging Maricopa Medical Center and building a new hospital near a proposed medical school in downtown Phoenix.
Such a move could lead to county residents being asked to authorize a property tax hike to pay for the new facility.
For Maricopa Medical Center, partnering with the medical campus for a new hospital makes perfect sense, said Dr. James Kennedy, chief medical officer and vice president of medical affairs for the county health system. As the state’s second-largest teaching hospital, the county’s medical center would be a good fit with the new medical school, where students and faculty could simply walk next door for the clinical portion of their medical training, according to county health system leaders.
Plus, the new facility would give Maricopa Medical Center the fresh start it needs amid mounting maintenance costs and struggles to meet the demands of advancing medicine in an outdated facility, Kennedy said.
"If we’re going to continue to do our mission and do it well, we’re going to have to have another facility," Kennedy said. "Time has moved on and the facility hasn’t moved with it."
Last month, the county’s newly-elected special health care district board approved a resolution "to examine the benefits and detriments of building a new teaching hospital in a different location, or a partnership relationship that the district prudently can afford." Those partnerships could include the Arizona Board of Regents, local governments or one or more of the state’s universities, according to the resolution.
"We see it as our duty to at least explore this possibility," said Paulina Morris, vice chairwoman of the special health care district board and head of a subcommittee exploring options for Maricopa Medical Center. "We’re looking at all options to improve services. It’s why people voted to save Maricopa Medical Center."
In November 2003, voters approved a proposition creating a special health care district that could have the county levy up to $40 million a year in property taxes to support the county’s health system. The proposition also gave the district bonding authority. That authority was included with a new facility in mind, Kennedy said.
Should the district and the community support a new hospital on the medical school campus, voters would be asked to approve about $300 million in general obligation bonds paid by property taxes, said Bil Bruno, chairman of the special health care district. The process could take about two years, he said.
The idea faces sharp opposition from nearby hospitals. They worry that building another full-service hospital will duplicate services already offered by several other hospitals in the area, draining patients, residency training programs and other resources from competing facilities.
"I am very supportive of the new medical school. I am also supportive of Maricopa County. What I’m not supportive of is a competing facility in the downtown area," said Linda Hunt, president of St. Joseph’s Hospital and Medical Center, located within three miles of the proposed medical school campus near Van Buren and Seventh streets. "It makes no sense to me to be competing with existing resources."
Officials from the Valley’s major health systems are planning the future of the proposed medical school campus as members of a commission set up by Gov. Janet Napolitano.
Besides Maricopa Medical Center, Nashville, Tenn.-based Vanguard Health Systems, whose Arizona holdings include Paradise Valley and Phoenix Memorial hospitals, has expressed interest in building an acute-care facility on or adjacent to the proposed campus, where the University of Arizona College of Medicine would expand its medical school, said John Murphy, president and CEO of the Flinn Foundation.
"I would anticipate that other institutions will express interest, for synergistic reasons, to be near the action," he said. "Hospitals generally appreciate having an affiliation with a medical school program. Just having students generates energy."
That interest, however, may conflict with space constraints, research prerogatives and the desire by some commission members to build a specialty hospital on the proposed campus that won’t compete with existing hospitals.
Hunt said there is strong support for a specialty hospital focused on research and patients for whom standard therapies for cancer and other diseases have failed.
"It gives something to the community that we currently do not have," she said.
Kurt Salmon Associates, an Atlanta-based consulting firm hired by the Flinn Foundation to help advise the commission, said Phoenix has designated the land proposed for the medical campus for research purposes only, and that there wouldn’t be space for an acute-care hospital, said Murphy. That doesn’t mean, however, that a hospital couldn’t be built across the street.
"They need to make their decisions independently," he said.
Hospital District proponents have made no secret about Maricopa Medical Center’s deteriorating condition. Plumbing and electrical systems need upgrades, the chiller on the air conditioner is 10 years past its life span and costly asbestos remediation is needed each time the facility is remodeled.
In 2001, consultants estimated that remodeling the county hospital would cost $208 million.
"When it rains, it rains inside and outside" Maricopa Medical Center, said Charlie Gail Hendrix, a member of the special health care district board. "The employees far outshine the facilities."
The set-up of the medical center is also a challenge, without operating rooms next to the critical care unit or the burn center, which needs to be expanded, said Kennedy. The burn center is the nation’s second busiest, treating about 800 patients last year.
The county hospital is also struggling with its patient base, which has been helpful and problematic. Doctors in training benefit from the variety of ailments patients present at Maricopa Medical Center, but many of those patients lack health insurance, forcing the county to underwrite a significant amount of health services. To survive, the medical center will need to attract more insured patients while maintaining its mission as a safety net hospital, said Bruno.
"Allowing us to build (near the medical school) makes financial sense and allows us to complete our mission without reliance on public underwriting," he said. The proposal, however, could be a tough sell to competing health care providers, said Bruno.
"There’s three hospitals other than us within a threemile radius. They have programs they want to protect. They don’t want a health care district to start a program that takes patients . . . away from them," he said. "We would be concerned, too, if we had somebody build a university hospital 2.8 miles away from us."