Build It, Be Far More Transparent, and Give the Perez Family Back the Land

Editorial by Troy Torres, Kandit News & Views

The everyday Guamanian couldn’t care less about the politics behind the development of a new Guam Memorial Hospital. We have waited since 2015 – when then-Governor Eddie Calvo first set out to build a new GMH – for GovGuam to mature beyond the politics of this much-needed development. Delaying development further on a debate between Mangilao and Tamuning does not serve the public interest. Delay only scrapes at the remnants of public trust and confidence in government.

The next legislature needs to spend its time debating whatever price and bond agreement upon which they can compromise with Governor Lou Leon Guerrero so that the development can happen before this hospital becomes any more expensive than it already is. We hear and understand the concerns of those who want the hospital to be built in Tamuning. We, too, advocated for the Ypao Point site.

It’s all moot now. Lou Leon Guerrero won that battle. Millions have been spent on the Mangilao location that cannot be taken back, and a hundred million dollars will be lost if the plan changes midstream and those federal funds are not obligated by December 31. For this reason alone, GovGuam cannot abandon the ongoing preparation of the Fadian, Mangilao development site. We all lose if we lose that money.

 

It’s a Done Deal Unless You Want to Piss Away $100M and Pay Back $12M From Local Funds

The legislature should not pass a statute forbidding the development at Fadian. It is too late for that. Ms. Leon Guerrero’s genius outmaneuver of her detractors when she orchestrated the purchase of the Fadian land was the nail in the coffin for the Ypao Point option. Senators had the past two years to require her to build the hospital at Ypao Point, or to otherwise pass a statute forbidding development in Mangilao. They did not.

And it is completely unreasonable to expect us, the people, to wait any longer for senators to get it together for the site selection, when the governor already has a plan ready to rock and roll. All the senators have done since 2015 was waste our time with their opposition to both Mr. Calvo and Ms. Leon Guerrero’s efforts to build a new hospital. All complaints. No solutions. Why should we wait for them to change?

Holding out hope that somehow the location of the new GMH can change from Mangilao to Ypao would be a failure to recognize one practical and governing fact. The person holding all the cards on this doesn’t want to build it anywhere but along the back road to Andersen Air Force Base. Opponents of this (no longer) option are held hostage by two indivisible factors: She refuses to build it elsewhere, and she has two years left in her term. That’s the ransom: time. If you think we should wait out her term and risk whether the next governor will even want to build a new hospital, then there’s that. But our people have waited long enough.

If we wanted a hospital built somewhere else, we should have elected someone else in 2022. Alas, we did not.

This isn’t to say that the delay was completely the fault of the senators. The governor, too, could have started building a hospital years ago if she compromised and began developing it at Ypao Point. Spilled milk.

There’s a more pressing reason the senators should not attempt to reverse the Mangilao development movement. Money.

About $12 million already has been spent according to covenants GovGuam has with federal grantors for the purchase of the land. If a hospital is not developed on that land, according to administration official Fernando Esteves, GovGuam will have to pay that money back to the grantors. That would most likely have to come from local funds, which are spoken for this fiscal year. Which senators are prepared to trigger layoffs or pay reductions if GovGuam has to repay that cash?

Then there is the matter of the $100 million in American Rescue Plan Act money that needs to be obligated by December 31 this year, or we will lose that money. According to Mr. Esteves, U.S. Treasury guidelines on the ARPA funds allow inter-agency memoranda of understanding backed by documented plans and scopes of work for proposed development to be considered as an “obligation,” within the allowable meaning by Treasury. In other words, the governor’s documented efforts and existing scope of work to use that $100 million for the site and utilities infrastructure development coupled with an MOU with an agency like Guam Economic Development Authority qualifies as an obligation.

Allowing the governor to move forward with the Mangilao development means $100 million will be obligated on time, and at least $100 million worth of new utilities and site preparation for a multipurpose state of the art medical campus will be funded by the feds. Changing course this late in the game guarantees that GovGuam will lose that money and have nothing to show for it.

 

Concerns By Doctors, Ambulatory Care, and Better GMH Management

Several doctors, including obstetricians, family practice doctors, anesthesiologists, and others who work at GMH have argued where the rest of us are unqualified to argue.

“As Ob-Gyns, we may be faced with a sudden patient emergency that is life and death, at any time,” eight doctors wrote to senators on November 20 last year. “Whether it is severe shoulder dystocia, catastrophic surgical or obstetric hemorrhage, or fetal heart decelerations, it will require an emergent response. For these reasons, all of us must be within minutes from the hospital to save the life of the mother and or her baby.”

Several doctors have warned that because many of them live and work in the Tamuning vicinity, locating the hospital elsewhere would jeopardize patient care, when seconds count.

First and foremost, this argument now is made moot by the governor’s movement on the Mangilao site. The genie is out of the bottle.

Secondly, there is an emergency room on the border between Tamuning and Dededo – Guam Regional Medical City – and another one that is a small village from Ypao: Naval Hospital.

Third, the independent Matrix report discussed the crowded traffic situation in Hagatna, Tamuning and Dededo that already impedes access to the current hospital and to GRMC.

The ability for first responders – those tasked with providing life-sustaining care prior to emergency room hospitalization – keep patients alive from emergencies that happen on the road, in your home or office falls on our government’s investment into the Guam Fire Department.

And David Lubofsky, a citizen who has crusaded for better medical outcomes and accountability since the wrongful death of his son on October 31, 2018, is right about the real problem facing GMH. For as long as anyone can remember, GMH has been mis/undermanaged. Accountability for its mistakes and less than standard outcomes has been lacking, according to several reports by the Centers for Medicare and Medicaid Services. Whether we build a hospital in Ypao, Mangilao, or Cocos Island, if we don’t fix GMH’s systemic management and operational issues, we will continue to settle for medical care that scares us and leads to death and maiming.

The incoming legislative health committee chairwoman, Sabrina Salas Matanane, should make GMH management improvements or outright reform a top priority of her tenure.

The governor has said she anticipates the new GMH to open its doors in 2029. That means there are five years of life left in the current GMH operation. How much faith do we have that a major catastrophe won’t happen in that time? Senators and the governor need to prioritize improvements to the current facility and operation. Major improvements. As senators consider the price tag for the new GMH, they must also set the necessary funds aside for improvements to the current operation.

 

Vision For a New Urban Center and Economy

Ms. Leon Guerrero’s vision behind her push for Mangilao is what we consider most inspiring about this program. She and her surrogates have said she wants the medical campus built along the eastern corridor linking south to north for the urban development of what would become a new city.

The $100 million in utilities connections that will lead from Route 10 Mangilao into Fadian along Route 15, and the road expansion of that highway will create opportunities for economic development beyond the typical Hagatna through Yigo areas. More undeveloped residential and commercial lots will be that much closer to new water, sewer, and power lines. Hundreds of acres of Chamorro Land Trust properties along the back road to Andersen might be improved and ready for residential lease because of this development. And since the hospital will serve military and buildup auxiliary consumers and will be fronting a routed road, opportunities present themselves for the federal government to pick up the tab for infrastructure improvements.

The government of Guam always is so embroiled in the minutiae of trying to meet even fundamental obligations that leadership more often than not fails to plan for the future with vision. The governor’s medical campus program proposal is visionary. It calls on reasonable minds to imagine the manageable and inevitable increase in our population with robust and sustainable social and economic growth. She is planning for our future.

Some might call it a pipe dream, or otherwise an expensive endeavor. Our people are worth it. Guam’s children and future generations deserve this investment. The government has wasted so much of our money on other matters; why not invest our tax dollars and debt service into this vision? Because it isn’t simply about a hospital. It isn’t just about a broader medical complex that can mean expanded education into medical fields, medical tourism, and the attraction of specialty services. This is about expanding our economy. This is about taking advantage of our time and resources as citizens to birth something greater for the next generation and those to come.

 

The Trouble With Land Condemnation and the Governor’s Less-Than-Ideal Conduct

Acquiescing to the governor’s Mangilao program comes at a cost. The exercise of eminent domain – the taking of private property by the government to fit a public purpose – is aggressive. We are told Dr. Joel Joseph, one of the landowners whose property is being condemned, planned to build a veterinary hospital at that location. We don’t know what the other landowners planned to do with their land before all this came to be, but we sympathize with any of them who are not happy with this taking. But it is neither unprecedented nor a reason to change course at this point. The government of Guam for years has exercised eminent domain in order to achieve public purposes. We have taken (and compensated landowners) land in order to build a dump, fix bridges, and expand roads. A hospital arguably is far more important than any of those previous projects.

Then there is the manner in which Ms. Leon Guerrero achieved the Mangilao land grab: under cover of darkness. Since the governor began her quest to build a new hospital, much of her movement has been made silently and without the benefit of the white hot light of public scrutiny. At times she and her administration were dishonest with the public and the legislature. For example, Guamanians found out about her efforts to build the hospital on Eagle’s Field only after the media uncovered her conversations with military officials. She continues to claim that the military was never going to return the Eagle’s Field land to the government of Guam, but a letter in black and white from the Secretary of the Navy says otherwise.

Anti-corruption advocate Ken Leon Guerrero was arrested for sitting in a government meeting, where details of the original hospital development plan were being discussed behind closed doors.

The governor and her people have been combative with senators. She has refused to compromise. She has refused to engage. She has refused to be fully transparent of what will end up being a $1 billion development we all will pay for.

Ms. Leon Guerrero is getting her win with the location she wants, and with it, she will be further along in Guam’s now-decade old endeavor to build a hospital than her predecessor ever got. We hope that she changes how she operates this program by first committing to transparency and public engagement; and, of course, civil discourse with senators.

 

Give Back Ypao Point

Finally, there is something the Thirty-Eighth Guam Legislature should do about Ypao Point. Give it back. That property was deeded by the late Frank Perez to the government of Guam for the sole purpose of the government operating a public hospital there. It sits undeveloped since the old GMH was abandoned four decades ago. It is a valuable piece of property that can do wonders for tourism and the economy if the government gets out of the way of progress.

Senators and senators-elect, give that property back to the estate of Frank Perez. If there’s market interest in it, we are sure the Perez family can have it developed for the benefit of our economy.