The Neenan Achistructure Co. will present next week its plans to help Curry Health Network - from start to finish - with its hoped-for Gold Beach Hospital replacement and determine the need for an emergency room in its Brookings clinic.

The health district plans to put on the Nov. 5 ballot a measure asking for a $10 million general obligation bond to replace the new hospital in Gold Beach. If approved, voters would see a property tax increase of 76 cents per $1,000 assessed valuation over a period of 30 years. And the $10 million would assist to secure federal funds to replace the aged building, said health district CEO Andrew Bair.

Revenue generated from the tax would only be spent on the Gold Beach hospital and make improvements to its Port Orford clinic, Bair stated. Any improvements made to the facility in Brookings - notably establishing an emergency room and obtaining licensure for hospital beds - is a separate issue that will likely take a year to obtain federal approval.

"This group is expert in taking care of this," Bair said. "They do everything from developing business models and demonstrating need, walk you through certificates of need, and from there, their architectural firm coordinates everything from beginning to end."

The Fort Collins, Colo.-based firm creates business models, develops feasibility studies and guides hospital and commercial building officials through the complexities of "budgets, brainstorming and builds," according to their website.

Any proposed idea would go out to bid.

"This would add layers to our administrative time," Bair said. "We're going to go forward with someone. But this group has done this dozens and dozens of times. They come highly recommended."

The proposal

The Nennan Company, in conjunction with Portland Maine-based healthcare consulting firm Stroudwater Associates and the Dougherty Mortgage, proposes to lead multiple-day investigative and educational planning sessions with hospital board members, staff and community leaders to develop ways to increase market share, expand the network's medical services, identify financing methods and sources and improve long-term financial performance.

According to its proposal, it will gather information regarding population, resident age, incomes, insurance status and what hospital services are needed within the community.

Eventually, the firm would conceive of a conceptual site plan of a new hospital in Gold Beach, its costs and construction timelines and outline plans for improvements needed at the Port Orford clinic.

The study is estimated to cost about $100,000, and money has been put aside over the years for it, Bair said.

"It's big money," he said. "But that's the cost of full-time experts going through the application of a certificate of need."

While studies are conducted, the Neenan Company proposes to forge ahead with Brookings' certificate of need, as well, as that process is likely to take about a year.

"But we can't build a Brookings facility until the federal government says that's OK," Bair said. "We need to move forward with it even before know the outcome of the certificate of need. We feel strongly that the federal government will allow us to add beds there, but we're being cautious."

Gold Beach's hospital

The hospital board last week reiterated its stance that, without a hospital, a community cannot fare well - particularly in an isolated region like Curry County where so many residents are older and have specific medical needs.

The current facility in Gold Beach has various shortcomings, ranging from crumbling parts of the structure, a weak roof and a layout that's not conducive to patient privacy. Many of these issues Bair has tried to tackle since he was hired last spring.

"It is certain this facility is tired and cannot survive another decade; it's pretty worn," he said in June. "And when I got to town, we found the annex to be more worn out than the hospital."

His first goal was to update the hospital district's strategic plan, from which all other plans are derived. Other goals include attracting physicians to the Gold Beach facility and clinic in Port Orford, obtaining prestigious certifications, and getting sleep study, IV therapy and chemotherapy and dialysis centers operating.

Securing physicians is made more difficult when the prospective hires see the physical condition of the hospital.

"Obstetricians, an orthopedic surgeon, a pediatrician, an internal medicine specialist - these are the things you expect when you come to a community the size of Curry County," Bair said in June. "You expect to find those things and they're strangely absent. What kind of red carpet do we roll out to our physician recruits when they come to town?"

He's also walking the fine line of politics, notably involving the possibility of getting Brookings to join the hospital district. The district runs from Sixes River north of Port Orford south to Pistol River and east to the county line.

Patients from Brookings provide more than 60 percent of the district's revenue, Bair said, so they're not an unimportant group. But others who pay taxes into the district don't like that residents at the south end of the town benefit from a clinic and access to the Gold Beach hospital without being part of the network.

That debate will wait, he said, until they get the hospital replaced, the Port Orford clinic refurbished and new physicians are brought into the network.

"There's going to be a lot of activity over the next few months," Bair said. "We'll just see where it takes us."