Wednesday was D-Day, as in deliberation day, for the Oneida County Planning and Development Committee regarding Marshfield Clinic's application for a conditional use permit (CUP) to build a 12-bed, $30 million hospital in Minocqua.
The decision was nearly two months in the making, as the original public hearing took place in April.
The committee had to sort through nine requirements to approve or deny the CUP, with all nine required for the CUP to be granted. From the start of the process, it was the first standard - general welfare - that would make or break the vote.
In the end, that came to fruition as the committee voted to approve eight of nine standards, with the general welfare standard denied on a 3-2 vote. It was the first standard discussed, making the other eight, and the fact that only five "nay" votes were cast in the entire deliberation, a moot point.
Chapter 9.42(E) in the Oneida County zoning ordinance defines the general welfare standard as "the establishment, maintenance or operation of the conditional use will not be detrimental to or endanger the public health, safety, morals, comfort or general welfare."
Supervisor Billy Fried was the first to get a crack at the discussion.
He voted that Marshfield Clinic met the general welfare standard requirement.
Dave Hintz followed by also voting in favor of Marshfield Clinic, while addressing concerns about a potential detrimental impact to Howard Young Medical Center, which has been a major talking point throughout the process.
"Some people say it's the responsibility of the applicant to prove their proposal will not have a negative impact on the community. That's impossible to do," Hintz said. "There's a risk with proposing anything. I'm part owner of a hardware store in Three Lakes. We did not require a CUP for that because it was a long-existing business, but I can't promise five years from now a terrorist doesn't buy nails and blow something up. It's impossible to predict what may happen, but using good judgment, I feel it will have a positive impact on the community."
Scott Holewinski, Jack Sorensen and Mike Timmons cast "no" votes.
Sorensen did not see the need for another hospital in the community, something Timmons had also mentioned in that he did not feel the community could support two hospitals.
"I don't see the benefit of spending $35 million on a facility literally adjacent to an existing facility that has everything that's needed for the community," Sorensen said. "The Northwoods has a huge population that descends upon us in the summertime and then disappears in November, most of that disappears in September and what's left is not nearly what you see in the summer.
"In my opinion, this duplication of services is not required, it is not healthy for the community, and in general, does not meet standard No. 1," Sorensen continued.
After each committee member had his turn to talk, Fried expressed concern the committee was stepping outside the scope of the general welfare standard.
Leading up to deliberation, Marshfield Clinic routinely expressed concerns about questions deemed inappropriate for CUP applications and about Howard Young Medical Center's involvement in the process.
"Health care is being affected by a lot of forces outside of what we're considering today," Fried said. "I think it's important to get back to: it's a conditional use permit. Forty years we would have loved the opportunity. What if it was the Mayo Clinic? Would we be saying no to them? I think your arguments are good, but I think they're getting too broad and you're not considering that things can be flipped."
Timmons responded by reiterating his belief that either hospital could provide adequate staffing for both hospitals to survive.
"It's nothing personal and it is the recruitment-end, making sure we have staff here," Timmons said. "I do not feel - looking at our Lakeland Times and other news media - that we have the staff to get this accomplished."
Fried persisted by asking if the committee had the jurisdiction to worry about such a problem.
Sorensen looked back to the past, citing Marshfield Clinic's failed attempt to obtain a CUP for a skilled nursing facility in 2015.
"We were here 15 months ago. Back then it was the nursing facility and now it's the nursing facility on steroids," Sorensen said. "The same issues are coming up. Redundancy in services, which is one of the things that went on to the Board of Adjustment and they sustained it ... We're in the same loop we were in 15 months ago. The arguments are amazingly the same."
After the vote on the general welfare standard was taken, Fried made a motion to re-vote. Hintz seconded and Timmons was the swing vote in going back to discussion. Yet, nothing changed and the 3-2 vote stood.
Naturally, Marshfield Clinic officials were disappointed with the outcome of the deliberation.
Regional medical director Bill Melms stated he believed the proposal met all criteria necessary for the CUP and the committee was unclear about how the general welfare standard should be applied.
"Coming in, we didn't know which way it would go and obviously we were hoping it would go in favor us," Melms said. "We are very disappointed. We put a lot of work into this and we feel strongly about it. We feel that the committee was confused by the general welfare standard."
Just as naturally as Marshfield Clinic was disappointed with the outcome, Howard Young was pleased with what transpired.
Much has been made by Marshfield Clinic about Howard Young's involvement in the process as a competing business, but HYMC president Sandy Anderson says it was not about the potential of her hospital taking a hit, but both not being capable of surviving.
"I don't know. I can't speak to what could or would happen as far as people going out of business, but we do not have the volume to support two hospitals," Anderson said. "To maintain the skill set of the people that need to be in those positions to carry out the services."
Marshfield Clinic has the right to appeal the decision to the Board of Adjustment, which also declined the skilled nursing facility.
During the deliberation, Fried and Sorensen referenced Marshfield Clinic's potential interest in building a hospital in Arbor Vitae if the appeal was denied.
While Melms did not commit to building a hospital in Arbor Vitae or taking the committee's ruling to circuit court, he did say a Marshfield Clinic hospital would be built in the Northwoods.
"At the end of this whole thing, we will build a hospital in the Northwoods, whatever that takes," Melms said.
According to the Vilas County zoning office, Marshfield Clinic has inquired about land in Arbor Vitae but at this point, said Marshfield Clinic spokesperson Amber Weldon, that's what it is - simply an inquiry.
Anderson said Howard Young would have to do some additional research before making a statement.
Nick Sabato may be reached at email@example.com or via Twitter @SabatoNick.
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