Congressman San Nicolas hosts the U.S. Army Corps of Engineers Hawaii HQ commander on how to build a new GMH the smart way


The U.S. Army Corps of Engineers is offering GovGuam to do what it has not been able to do in the past six years: actually get a hospital construction project off the ground.  The help U.S. ACE can provide may save taxpayers hundreds of millions in costs, years in organization, planning, and development, and yield a public hospital that addresses the health and medical needs of the future.  While both the Calvo and Leon Guerrero administrations have embarked on projects to build a replacement for Guam Memorial Hospital, the U.S. ACE was only formally involved in the process this past week, when Congressman Michael San Nicolas brought them together with Guam’s senators, business and hospital leaders.  “This is the collaboration we need.” Mr. San Nicolas said.

Guam Memorial Hospital has been in a state of disrepair for a few years.  In 2019, the U.S. ACE was able to do an assessment of G.M.H., reporting later the state of disrepair it was in.  They were asked to see what kind of repairs were necessary to bring it back up to code and then make a comparison of what it would cost to build a brand-new hospital.  Lt. Colonel Eric Marshall, the Honolulu district commander of the U.S. ACE since June of last year, led the presentation for Guam leaders.

Congressman San Nicolas reached out to Mr. Marshall in June to see how U.S. ACE can help to resolve the longstanding issue.  The commander educated senators about a charette, which is an engineering term for a planning process that is used for large and complex projects like the construction of a medical facility.  Often, there are many components involved and the charette is intended to corral all the many stakeholders who are involved in a complicated project.  Lt. Colonel Marshall went on to explain that the charette would be conducive to the organizational planning and execution because it would maintain a timeline and budgetary aspects to the project as an unbiased arbiter.  “We tend to have that kind of credibility that we are not going to come in with an agenda and then we can bring multiple stakeholders together to try to find what is the optimum solution given the constraints at hand,” Mr. Marshall said, “At this stage, from what I understand about the hospital, I think that is what is needed.”

Mr. Marshall said U.S. ACE can provide a technical perspective and bring more resources to the table.  For example, the full strength of the 35,000-person army corps of engineers could be employed to weigh into this project and “a medical engineer center of expertise that we will leverage.”  He said U.S. ACE can help coordinate with the U.S. Department of Veterans Affairs, the military and the U.S. Department of Health and Human Services to make sure the hospital is adequately built and funded from all perspectives.

Don Shlack, the program manager for interagencies and international support services for the U.S. A.C.E., continued the presentation with an overview of the findings from the first assessment of the hospital facility on Guam.  There were some things that were apparent issues and other structural issues that required further testing.  This was all made available in their report.  In developing the cost estimate, they took into consideration an estimate of a one-for-one project.  This means that their estimate was based upon repairing the existing hospital with the exact same amount of square feet and bed capacity.  The cost came up to $765,000,000 which took into consideration the tasks of moving people out of parts of the hospital while working on it and swing space, to name a couple of challenges.  They discovered that building a brand-new hospital with the exact same square footage would probably cost less.  In erecting another facility, it would eliminate having to work around patients and healthcare.  This would allow for things to run much smoother and would be cheaper to lay down the infrastructure cleanly and on a new site.  Mr. Shlack pointed out in the end that this cost estimate would only be for erecting the same kind of structure and a hospital built for the future would be more ideal for growth and changes in modern health and treatment available.

This supplemental information helped to determine the utilization of the charette which would be a precursor for the architecture and engineering plans.  The output of the process would be to give a scope as to what exactly would be needed but not necessarily provide the design plans.  This would be beneficial for future transitions into modern medicine and treatment, calculating 50 years into the future versus a mere five-year model.  The budget afforded to build the hospital might not allow for all the state-of-the-art fixtures and niceties, but a charette would provide a predetermination of what financial constraints exist and what would be feasible now and how to accommodate for upgrades down the line.  It would provide enough information that there is awareness of lifetime costs and resiliency.

The timeline for the process would be lengthy, according to the U.S. ACE team.  U.S. ACE will need to find and employ a medically competent architect engineer firm, which would take about three to four months to get done.  The firm would then gather data, taking another one to two months.  And after compiling such data, the U.S. ACE will initiate the charette.  Reports would be written and the charette would be prepared.  The whole process would typically take about one to two years.  This consists of the planning phase, conceptual design and would initiate the most important kick-off of the whole execution, the blueprint, necessary for building the hospital without avoidable hiccups.


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