The rocky road to Sonoma Valley Hospital’s new wing

The saga of “the new” Sonoma Valley Hospital is finally nearing its end. The hospital is ready to showcase its new wing with a celebratory debut from 10 a.m. to 4 p.m. Saturday, Nov. 16.

On its path to this moment, Sonoma Valley Hospital crossed both rocky roads and periods of unwavering community support. It is a story 20 years in the making, which at times had a way of tearing the town apart, before a solution could be found to build a safe hospital that the community could support.

It all began with an earthquake down south. On Jan. 17, 1994, a 6.7-magnitude earthquake rocked the Los Angeles neighborhood of Northridge. Between the initial tremor and its myriad aftershocks, 11 hospitals were damaged and thus unable to treat injured residents, adding to the chaos that followed the quake. The following September, the state legislature passed SB 1953, requiring all hospitals to meet rigorous seismic building codes in the sections of the hospital used for emergency care or acute patient services, such as the surgical department.

Like more than 50 percent of the hospitals in California, officials at Sonoma Valley Hospital learned that its three wings did not meet the new state standards after a series of engineering reports completed in 1998. But, hospitals were given until 2005 to make a plan for how to evolve their facility to meet those standards. That deadline was later extended to 2008, and eventually 2013, when the legislature realized it would be impossible for many of California’s cash-strapped district hospitals, like Sonoma, to retrofit or rebuild in time.

When the engineering report came out, Sonoma Valley Hospital was facing difficult financial times, and knew there was no money to tackle this expensive problem. Officials turned to Sutter Health Systems to operate the district-owned hospital, and the Sonoma Valley Health Care District board signed a management contract that required Sutter to operate the hospital, assume the hospital’s $9 million in debt and build a new facility in compliance with SB 1953.

The partnership got off to a rocky start and by 2001, Sutter announced it would not build a new hospital, citing the limited land available at the hospital’s current site on Andrieux Street. A new hospital would require more acres, Sutter said. The management agreement fizzled out in 2002, the same year that the hospital went to the community for the first of many rounds of taxpayer support.

That March, voters overwhelmingly passed a $130 parcel tax to boost the hospital’s bottom line by $2 million a year, enough to give administrators time to pull it out of the financial hole that nearly bankrupt the hospital in the wake of the partnership with Sutter.

After a few years of fighting to keep the hospital out of the red, the board and newly hired CEO Bob Kowal again set their sights on a new hospital building. A variety of architects had studied the hospital and agreed with Sutter’s assessment that the Andrieux Street site was too small to build on. A 43-member facilities study group was formed to consider alternative options from the community and Bay Area architects. Thinking that the hospital would have to relocate, Kowal found four properties that could hold the new 150,000-square-foot facility with 70 beds, but not one of the landowners was interested in selling.

In 2005, due to its size and location, hospital administrators favored a piece of land at the corner of Fifth Street West and Leveroni Road, historically home to Sonoma’s diminishing farmland. With unwilling sellers, the hospital board instead turned to eminent domain to obtain the property. The architecture firm Anshen and Allen was hired to design the project. The firm figured it would cost $100 million for a state-of-the-art facility.

In 2006, the hospital launched Measure C, a $148 million bond measure that included funds to purchase the Leveroni property by way of eminent domain. It was the spark that started the wildfire that would boil across the town, as neighbors fought over everything from the importance of preserving the hospital to the size of the project. It got so ugly that the hospital withdrew its campaign for Measure C before voters even hit the ballot, essentially killing the measure.

It was time for a fresh start. A group of concerned citizens formed the Sonoma Valley Hospital Coalition in June 2006, dedicated to finding a solution that would work for the community. Meetings were held every Monday for months, and every suggestion was considered. Ideas ranged from a privately funded medical spa on Eighth Street East, to what amounted to a floating emergency department – both of which were eventually deemed unfeasible. The hospital’s administration also came forth with its own proposal, a scaled back version of the Measure C plan that called for a $98 million hospital that could fit on any 15-acre parcel of land. They learned the community would not support obtaining land through eminent domain. But yet again, the proposal proved unpopular with voters, who said it was too big and too expensive. Ultimately, both Kowal and boardmember John MacConaghy retired amidst the controversy early in 2007.

Carl Gerlach, who had worked with the hospital as a consultant, was hired as the replacement hospital CEO and immediately looked for new solutions to a now-old problem. Current hospital board Chair Bill Boreum, who replaced MacConaghy on the board, credits Gerlach with having the vision to think outside of the architects’ reports and find an answer closer to home.

After seeing construction fees rise on many hospital projects, Gerlach realized the hospital could see significant savings if there was a way to avoid the normal building process. Traditionally, municipalities hire an architect to design a project, before sending it out to construction companies to bid their best prices. But problems arise because costs can increase drastically if the builders needed to change the design to meet construction standards, necessitating an architect to update the plans for an additional fee.

School districts in the state had successfully used a process called design-build, in which an entity proposes both a design and a construction fee for a single project. The fee only increases if the school decides to change the design. But it was not a process that was allowed under state law, the hospital would need an exception to move forward with the effort.

Officials turned to a variety of politicians for support, but it was ultimately the late Sen. Pat Wiggins who agreed to carry SB 1699, which granted a one-time exception exclusively for Sonoma Valley Hospital, creating a pathway for the project to move forward in a design-build process. The bill was introduced in 2008 and passed shortly thereafter, clearing the way for the new solution to the lingering seismic problem.

A fresh set of architectural eyes determined that, if the hospital replaced its central utility plant and moved its emergency and surgical departments, it would meet the standards of SB 1953. There was just enough space to build a new wing in the hospital’s existing west parking lot, which would house the seismically sound emergency and surgical department. Vallejo-based Otto Construction paired up with Sacramento architectural firm Nacht and Lewis to bid on the project, creating a $31 million design that would meet the needs of both the hospital and taxpayers.

But, the hospital had to get the public to agree to pay for it, an uphill challenge considering the near decade of mistrust. In 2008, the board sought a $35 million general obligation bond to cover the cost of the new wing and central utility plant, as well as allow the hospital to refinance $4 million in existing debt. It was overwhelming approved by Valley voters as an acceptable solution to the long-standing hospital conundrum.

Finally, the hospital had both the plan – and the cash – to move forward. In 2010, after successfully leading the hospital to this point, Gerlach relinquished his role and the board hired current CEO Kelly Mather. Charged with overseeing the construction project, she quickly realized that the bond measure would cover the cost of building the new wing, but not the purchase of new medical equipment. To make the new wing financially successful, Mather knew it needed to appeal to a wide variety of specialists, and that meant updating the hospital’s antiquated equipment.

With the support of the board and a dedicated committee of volunteers, she launched an $11 million capital campaign in 2012 to complete the new wing with the high-tech equipment modern doctors seek. She also began to lure doctors from around the country to practice medicine in the new wing, ensuring that when the facility opened, it would be a moneymaker. The hospital now has specialists ranging from bariatrics and otolaryngologist to urology and spine surgery, who are all eager to begin working in the state-of-the-art facility.

Just weeks before the hospital marks its grand opening on Saturday with festivities, barbecue and tours of the new wing, it got the final donations needed to complete the $11 million capital campaign. Since the new wing will open free from debt, it can immediately begin raising revenues.