This is the second part of a tale (read Part 1 here) of how one doctor driven by passion, faith and belief in a greater common good inspired a small rural community to build a critical access hospital, as told by Michael Curtis, VP of Business Development.
Dr Haug tells me he’s going to a conference to find out more about the new HUD mortgage insurance programs for health care facilities and critical access hospitals. Rural hospitals have had it bad of late, going bankrupt. He tells me a man named Charles Erwin (now with Dougherty Mortgage) says he can access funding for the hospital. But first Dr Haug has to work with Stroudwater Consulting to build a business plan and show how he will repay the debt. So he does. An architect by the name of Mark Johnson draws up some plans. Dr Haug forms a relationship with The Neenan Company to design and construct a solution to replace his aged facility. We manage the project from plan to construction as I work to secure equity sources for Dr Haug’s dream.
A pledge of $350,000 is made by one community member. Dr Haug scrapes together $100,000 of working capital. The community brings $50-75,000. But the project will cost $11 million to build and to meet the loan requirements, the community must raise $1 million, 10% of the entire loan amount for it to go through. “How will they manage to pull this off?” I wonder. “Will you help us or not?” asks Dr Haug. I’m not sure if I can. I’m struggling to manage pieces that won’t come together. He looks at me and says, “I don’t think you see this quite right.”
But he does. In 2003, Dr Haug will find himself and his facility invited into the new HUD 242 program which provides mortgage insurance to critical access hospitals, allowing them to access bonds at a lower rate and reducing costs to Medicare which pays for the costs of running such hospitals. But not before encountering a significant obstacle. His health. Diagnosed with liver cancer, Dr Haug spends all his working capital in the years before 2003 engaging Stroudwater, Neenan and Mark Johnson to build the community’s hospital. It’s not a good diagnosis or prognosis and he travels alone to Denver regularly to have IV chemotherapy. It is during these sessions that we meet as I take over as development manager for the project. I suggest we talk either before or after his treatment but he insists on talking through it. He says it will distract him from the pain.
I run through the decisions that need to be made, cash that needs to be raised and all the minutiae associated with orchestrating his dream. He decides we need to begin aggressively promoting the replacement facility. Inspired by his continued commitment to his dream, in spite of failing health, we manage to convince the board to write 5 checks worth $5000 each. A local bachelor in South Fork calls and wants to contribute a piece of real estate worth $600,000. He has no heirs and wants to contribute to a common good. This single act spurs multiple donations. Dr Haug continues his staggering work as the county coroner, president of the San Luis Valley HMO, and the hospital’s admitting physician while fighting cancer. I arrive one day to find him in a clinical consult with an elderly man and his family who want to know about his project so the gentleman can write a check.
The HUD loan is approved in June 2003 but the community remains tight for cash. Inspired by Dr Haug’s 
story, the county contributes a road crew and access to their borrow pit and equipment to build a road base and building pad for the hospital. A contribution worth $600,000. The dream begins to take material form. In August 2004, Dr Haug enters a 35,000 square foot, 14 bed critical access hospital with surgery, imaging lab and reference library. Who would have guessed?
It was an impossible project. My peers thought I was crazy. We took on monumental challenges. But he made me believe. He made the professional team who worked with him believe. Most importantly, he made his community believe and in the light of such inspired commitment, they pulled together to accomplish the impossible. Liver cancer finally claimed Dr Haug’s life in May 2007 but his commitment to providing quality care to his community lives on.
“Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has.” Margaret Mead.
Kirsti
Colorado only to arrive at the shocking sight of the facility at which he worked. Opened by the Sisters of St Joseph in 1907, the Rio Grande Hospital had gone out of business in 1993 and had been sold at auction to someone who wanted to operate a nursing home. The owners used 1/2 the building while the rest was left virtually abandoned. Three years later, two significant tragedies would befall the small community of Del Norte. A teenager in a rollover on Wolf Creek Pass dies of blood loss in the ‘golden hour’ after the accident. Then a few months later, a leader in the community suffers a heart attack, also losing his life in that precious hour due to a lack of access to care. Dr Haug is compelled to reopen the facility. The community raises funds to re-open the facility as a 501 3 (c) (non profit) run by the Valley Citizen’s Foundation for Healthcare, Inc. The largest contributors become board members with Norman Haug the hospital administrator. He asks the owner if they can lease some of the facility after it has been closed up for a number of years.
When I arrive, it is open. But barely. There is an administrator office and an admissions area where Dr Haug sits under an OR light and admits people. They’re making use of what they could. I wonder to myself, “how on earth can you run a hospital in this environment?” But Dr Haug had been a medic in the Vietnam War and had run a MASH unit through which close to 20,000 people had passed. He tells me he is used to operating in tents and had received government money to run the MASH unit which inspired him to replace the facility. The facility makes me nervous, but I meet with Dr Haug and watch as he continues to admit people, with a solitary open window to cool the room on a stifling hot day; all the others broken.
Here at 
New York City is one place where local government officials in a multi-agency collaboration recently unveiled a set of 
The guidelines are a pretty common-sense toolkit of strategies to tweak the exterior and interior built environment so people are directed toward choosing more active ways to move through their days. On the outside, it’s thinking about active commuting and recreation – better access to public transportation, mixed uses in neighborhoods to encourage walking as well as access to fresh foods, and ensuring that streets aren’t just for cars but safe for cyclists and pedestrians. Indoors, it’s more about activity in your daily routine – using design to steer people toward the stairs as more attractive and convenient than the elevator, for example.
Imagine being able to ‘walk through’ your new building before a shovel of dirt has been lifted. Climbing stairs. Entering a lobby. Imagine designing spaces with just a few strokes of the keyboard. Welcome to Ben and Jody’s world!
So what do Jody and Ben do when they aren’t working as a creative team with short turn around times to change the way you and I experience buildings? It seems they just can’t stop bringing things to life in the third dimension. Last year, Ben’s Storm Trooper Halloween costume materialized from cardboard and duct tape with an old bumper for the necessary blaster donated generously by Jody. This year, they hope to bring you more demo samples of 
To that end they’re experimenting with materials that aren’t just environmentally friendly or inspired by the natural world (such as 
Fantastic and somewhat controversial. This type of technology, especially creating artificial life, brings up a host of ethical, environmental, and technical questions and it’s easy to scoff at the impractical thought of our buildings building themselves. You have to admit though, on a techie science geek level, it’s fun to consider. It’s also certainly visionary to think so far outside the box of current practices, but does the key to a sustainable built environment lie in buildings that behave like biological organisms? Or should we concentrate our energy on using good old-fashioned inert materials but using them better?
Garbage in, garbage out. Boy, is that old, lazy thinking. Today, there is no such thing as garbage.
over time we all changed our habits and, just as important, our perceptions. Done with lunch, the paper sack goes in the recycle bin or, better yet, back home to use again. The Tupperware bin—back home to use again. Bottles and cans, into the recycle bin, of course. Food waste: We have compost bins in the kitchen. And so on—as we said at the start of this entry, almost 
Eight years after the 
If NCLB was about setting standards for students, the Obama administration is focusing on quality: teacher quality and quality of the educational experience. Rather than a sweeping national mandate though, Obama and Secretary of Education Arne Duncan are offering an incentive in the form of 
A system for merit pay also adds another layer of complexity to the educational system. Merit pay implies competition – do better than everyone and you’ll be compensated for it. This is why a credible system of evaluation is so essential. The 
