Guam Medical Campus

It is no secret that Guam’s existing public medical infrastructure is aging, and in desperate need of replacement. In an Army Corps of Engineers Study in 2019, the cost of repairing GMH is greater than the cost of rebuilding a brand new facility. Additionally, planned improvements are not strictly limited to GMH. The face of behavioral health is expanding locally, requiring more complex care. DPHSS services are spread throughout the island because of limited rental space and no true headquarters since their facility in Mangilao was damaged by a fire. The possibility for shared services, such as a pharmacy, training facilities, and others gives Guam’s residents more value for the money spent and allows for more state of the art capabilities.

The current proposed location is on Route 15 in Mangilao. The deliberation concerning this site was discussed and studied over a number of years, but specific criteria included site size, access to patient populations, proximity to existing underserved communities, potential for medical and economic expansion, and other factors.

The hospital alone is expected to cost approximately $600 million to $800 million. The source of funds includes the American Rescue Plan funding in addition to funding covered under Public Law 36-56 sponsored by Senator Joe San Agustin.

There is much in the way of infrastructure work to be undertaken during the project. For the first construction of the laboratory, disruption is expected to be minimal as this project is connecting to existing utility infrastructure so it will look similar to any of the small construction projects that have occurred on Route 15 in the last several years such as the construction of Eagle’s Mart across the street. Road expansion does also include an access road north west of the site primarily for “emergency vehicles” when the project is complete. Pre-completion if significant movement of materials and equipment are planned, this road may also be utilized for this purpose. All infrastructure expansion is geared towards enhancing the infrastructure of the residents of Mangilao including road expansion, increased access to sewage, and a more robust power grid. Construction outside of normal business hours is not expected.

As seen in numerous studies over the past decade, Guam’s public medical facilities have been aging. Department of Public Health and Social Services (DPHSS) no longer has centrally located operation and the Guam Memorial Hospital (GMH) facility is reaching the end of its useful life as a public hospital. These same studies, along with apparent observation, indicate that past and existing facilities are too small to meet Guam’s current medical needs and it is becoming increasingly difficult to meet accreditation standards. Guam’s existing Veteran’s Clinic (Community Based Outpatient Clinic – CBOC) is also too small and lacks in inpatient services to meet the medical needs of Guam’s aging and growing veteran’s population. Updated surveys and assessments demonstrate that Guam needs additional and expanded medical services to meet modern standards and, requires a central and larger footprint with an ability to expand for future and or emergency needs. A centrally located “campus” with a larger footprint addresses improved access for Guam’s southern and central population, provides for upgraded utilities for surrounding population, space for back-up utilities to improve operations during emergencies, allows for planning for multiple access points, allows for easier public accessibility for all public health services, addresses the space needs for all public health agencies (to include an expanded CBOC) today and into the future. The COVID19 pandemic of 2020 highlighted the severe space shortages of delivering needed medical services with existing facilities (space for mass testing, shortage of laboratory facilities, suspending a number of routine and outpatient medical services not related to the pandemic). Guam’s existing medical facilities and infrastructure are hard-pressed to address a mass casualty or public health emergency event. If both were to potentially occur simultaneously, it is reasonable to assume that Guam’s existing medical services infrastructure may not be able to handle such a load. A Campus would allow Guam the opportunity to become a medical regional hub, for the benefit of many Pacific Island entities (the Commonwealth of the Northern Mariana Islands – CNMI, Palau, and the Federated States of Micronesia – FSM), easing the medical burden and cost of regional Pacific islanders. A Campus would also improve the economic opportunity for Guam for Medical Tourism within the region and acting as an economic driver for the surrounding area.

No. The 1st priority of the Medical Campus is a replacement GMH and it will be the 1st facility to be built before any other medical facility is even begun.

The Old GMH facility’s rate of deterioration demonstrated that full exposure without any distance nor buffer to elements (particularly salt spray) is much higher. The previous “Old GMH” at Ypao Point was already too small to meet Guam’s medical needs towards the end of the 1970s. Ypao Point’s usable space would not allow for an “expanded” GMH to meet even today’s needs, nor large enough to host a Medical Campus. In order to build an “expanded” GMH to meet Guam’s current hospital needs, vertical construction would be the “only” option. However, this would require a deeper and wider foundation than most 3-4 story structures. There is a seismic fault line on Ypao Point. Videographic evidence produced by the Department of Land Management (DLM) indicates that there may also be costal caves forming under Ypao Point today. Being surrounded on 3 sides by an ocean cliff line means multiple access points are virtually impossible. Ypao Point is located in the most densely developed and heavily trafficked location in Guam, creating tremendous challenges for both construction and emergency vehicle access from any part of the island. A significant portion of Ypao Point has been identified for and is currently being utilized for CHamoru cultural arts. Constructing a hospital would necessitate its, at minimum temporary but also likely permanent removal, as space is scarce for even a single hospital alone.

Yes, see page 37 (or page 2-17) of the Master Plan. There are other sources indicating a fault line in the Ypao Point Area

• https://www.pacioos.hawaii.edu/metadata/gu_nps_all_geofaults.html
• https://en.m.wikipedia.org/wiki/File:Geologic_map_of_Guam_%28cropped%29.jpg
• https://www.researchgate.net/figure/Geologic-map-of-Guam-Source-USGS_fig2_238078712

The Master Plan describes the pros and cons of each site considered. However, it also indicates that Ypao Point is not large enough to accommodate an expanded GMH with ancillary services, nor is it large enough to accommodate a medical campus, along with other non-ideal conditions. Please see Master Plan page 30 (or page 2-10) and page 36 (or page 2-16).

No. While the medical campus is envisioned to house public medical health facilities, it is also intended that a larger footprint will allow for private medical facilities, as well. In addition, GovGuam will provide various incentives to ease the cost of any establishment of private practices in the area. It should be noted that the goal is to expand the overall healthcare infrastructure for the entire island and the region, not decrease it. To this end, it would still be beneficial for the people of Guam to continue to have private healthcare providers in Tamuning, as well as Barrigada-Mangilao, while seeking to attract additional medical specialties.

Improved access for southern and eastern portions of Guam’s population, with improved access options for western and northern populations (considering the existence of Guam Regional Medical City (GRMC) in the northwest of the island and Naval Hospital in the southwest of the island) is critical. The proposed site for a new medical campus will take advantage of one of the few remaining central locations of Guam that is still large enough to host a medical campus with an expanded VA clinic. Barrigada-Mangilao is a location that is relatively underdeveloped which would lead to less congestion, easier and potentially quicker construction, the possibility of multiple access points, and would take advantage of the Department of Defense (DoD) plans to widen and improve Route 15. The proposed site provides a distance buffer to elements, likely leading to a longer-lasting new GMH and other healthcare facilities. The proposed site will allow for an expanded central DPHSS which is non-existent today. The proposed site is large enough to allow for planning/construction to address potential medical needs of a public pandemic-like emergency or a mass casualty event, without having to suspend non-emergency public medical service delivery (as was the case during the COVID-19 pandemic in 2020). Construction of a medical campus in this proposed location will ease the normal traffic conditions of Marine Corps Drive through Tamuning (both north and south bound) and re-distribute a significant amount of traffic along this vein, leading to improved flow and emergency vehicle movement all around. A Medical Campus could expand economic development opportunities for the surrounding area.

No (Answers available from the Governor’s Nov 27, 2023 public outreach)

A larger area of land will allow for future expansion and give our community room to grow, anticipating our future public health needs. Larger space allows DPHSS to better address Public Health emergencies (COVID-19 pandemic) and provides improved access for patients and the community. A larger space allows for GMH to address potential mass casualty events immediately, on its own footprint. This would provide for an increased quality of care with safety, health and financial benefits for the people of Guam.

Having a larger space already identified allows GovGuam to collaborate with Veterans Affairs. In addition, proximity to a hospital allows veterans access to various services in a central location.

Unfortunately, the CDC Lab had to utilize its existing for federal grant for construction within a certain number of years. This meant that an alternate site had to be finalized and could not wait for Legislative approval.

No, DLM has confirmed that Route 15 is actually a 100-foot-wide right of way from Route 10 all the way up to the back gate of Andersen. Any widening of Route 15 will NOT require any private land condemnation, nor purchase of private land or any land-swap.

No. Although “Urgent” and “Emergency” Care may sound the same as they both call for immediate attention, the level of care and capability between the two is vastly different. “Emergency”, or “acute” care is a higher level of medical attention that is needed to address life-or-death situations, addressed in a hospital’s Emergency Room. ERs are equipped and staffed to handle the most serious and critical emergencies. “Urgent” care represents a lower level of care for patients presenting with Non-Life-Threatening conditions that may need immediate attention. Urgent care clinics are NOT equipped or staffed to provide care for life-or-death emergencies. Should a patient present at an urgent care clinic with a life-threatening-condition, that clinic will likely recommend proceeding to the nearest Emergency Room immediately. Please also see “Urgent Care versus Emergency/Acute Care”

• https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/emergency-vs-urgent-care-whats-the-difference
• https://healthy.kaiserpermanente.org/health-wellness/healtharticle.difference-between-urgent-and-emergency-care
• https://www.aurorahealthcare.org/services/primary-care/urgent-care/urgent-care-vs-emergency-department#:~:text=Urgent%20care%20is%20a%20good,you’re%20experiencing%20an%20emergency.
• https://www.scripps.org/news_items/4231-should-you-go-to-the-emergency-room-or-urgent-care