Cambridge Hospital Plans $40 Million Reconstruction

Even as hospitals close their doors in cities across the nation, victims of a changing health care system, the city owned Cambridge Hospital is looking to expand.

But concerns of neighborhood residents and cautious city councillors will have to be answered before the hospital can go ahead with a proposed $40 million reconstruction.

Hospital officials testified at a public hearing Monday night that the current facility cannot accommodate the diversity of programs its staff wants to offer or fit the most technologically advanced equipment.

The crowded waiting rooms and emergency room and the lack of private rooms are disrespectful of the hospital's patients and not conducive to good communication between doctors and their patients, officials said.

"There are health care requirements in the city that are not being met because we simply lack the facilities in the hospital. We've run out of room," said Richard deFilippi, the chair of the hospital's governing board.

Most people present at the meeting agreed that the hospital, which is located near the border between Cambridge and Somerville, needs more space to carry out its mission.

City and hospital officials and neighborhood groups have discussed the options in meeting the hospital's demand for space for more than two years, said City Manager Robert W. Healy.

But Cambridge and Somerville residents are still concerned about the effects of the hospital's expansion.

The current proposal for the hospital site would cost $40 million, make the building four stories tall and provide it with about 200 parking spaces, according to speakers advocating the expansion.

Although this represents a cut from the hospital's original request for six stories and 300 parking spaces-a project which would have cost about $57 million according to city manager Robert W. Healy-people are still worried about the costs and financial risks of the project.

While half of that money would come from the hospital's savings, which amount to $50 million, the other half would be debt issued in the form of city bonds as part of the city's 1994 fiscal year budget.

"The tax-payers are being asked to underwrite the risks," said John R. Pitkin, the president of the Mid-Cambridge neighborhood association and co-chair of the Cambridge Hospital Advisory Committee. Pitkin said some Cantabrigians hoped this would mean they would have to contribute less to the hospital through their taxes in the future.

Others fear that changes in health care policy to be proposed by the Clinton administration would leave no place for the hospital, which relies on government subsidized medical care programs for much of its income.

"A large part of our compensation comes from Medicaid. Every day these things are changing," said Councillor Alice K. Wolf. "We want to make sure that in this changing environment we are able to continue our commitment."

Neighbors of the hospital are also concerned about the physical consequences of the hospital's expansion. One man who lives across the street from the hospital said that there isn't enough room for the hospital to grow.

"They don't have enough room, haven't had enough room since the last expansion, haven't been able to solve the problems of the last expansion," the neighbor said. "There's just not enough room in a four-acre space for what they already have, let alone add to it."

Pitkin said he understood the neighbors' concerns. "In general, hospitals have a reputation for being very poor neighbors, in part because the health care business as practiced in hospitals does have an unavoidable, undesirable impact," he said.

Concerns that Pitkin and city councillors said needed to be addressed include the increased use of the hospital's loading dock, which would accompany expansion, and the inconveniences the construction would cause to people who live on Line Street, which is adjacent to the hospital.

Some people have suggested satellites at alternate locations rather than an expansion of the current site. However, none of these have been found suitable by hospital officials, who feel that the future of the hospital is dependent on this project.

John G. O'Brien, the chief executive officer of the hospital, said that he thought that if this project were not carried out, "Cambridge Hospital would wither and die over time."

Healy, who agreed that the hospital would not be able to stay competitive without this expansion, said he was confident of the fiscal roundness of the move. "The benefits to me outweigh the risk on the fiscal side. I'm a believer, and I'm not easy to convince," he said.

Most people involved with the process felt that the plan could continue to move forward. "We've come a long way. We have a long way to go. But we have a process in place to deal with these issues," Pitkin said.