| When voters in Flagstaff resoundingly rejected Proposition 480, they did more than simply block a development plan. They issued a clear, community-wide statement: we want our hospital to stay where it is. The Northern Arizona Healthcare(NAH) proposal to abandon the long-established Flagstaff Medical Center (FMC) campus and build an entirely new facility on the outskirts of town was not what this community wanted. And it still isn’t.
NAH today does not carry the baggage that it suffered from in the past. New leadership is moving forward and the organization deserves credit for gracefully pivoting after Prop 480. But I remain concerned with the transparency of the decision-making process for how they will decide to recommend to their board where their new regional hospital should go.
I attended a recent presentation of NAH’s 2030 Strategic Plan, where NAH reiterated their commitment to building a new regional facility. I was able to ask NAH leadership to seriously consider building their new hospital in place. I was able to ask them to explain why they can’t modernize the hospital we already have. That back-and-forth was very respectful, but it was insufficient and incomplete. Their reasoning remains enigmatic to me and to many, many citizens of Flagstaff. Most importantly, I am writing this open letter to encourage NAH’s leadership and board to give its most serious consideration to building in place, and I want to pledge, to the full extent I’m able to within my role, to support helping to make this critically important outcome achievable. I want to challenge the community, as well, to embrace the strategies NAH identifies as necessary, to make staying on the hill feasible.
At the 2030 Strategic Plan presentation, NAH announced they’re conducting an analysis of five sites and plan to give a final recommendation to its board by the end of2025. The current campus is one of the considerations, though CEO Dave Cheney stresses he remains skeptical that staying-put is feasible. Unfortunately, the other four locations under consideration have never been disclosed to the public.
Cheney and the NAH leadership team have repeatedly emphasized their reasoning behind why building in place faces steep challenges. The existing campus is aging. Much of its infrastructure is outdated and inefficient; renovations would require closing portions of the hospital, potentially disrupting care; even with upgrades, they argue, the footprint is too small to meet future demand; a new facility would be more efficient, flexible, and financially viable over the long term; rebuilding in place works better in denser urban cores where care can be distributed among other local hospitals.
These are not trivial concerns. I hear them, and I intuitively understand them. I also share an urgency around the need to act. Healthcare in Flagstaff must evolve to meet the needs of a growing, aging population. The current hospital is not sufficient for today’s needs and is not poised to meet the challenges the future will bring.
Nevertheless,I remain unconvinced that building in place can’t be done. The obstacles are design challenges—challenges that can be overcome with creativity, willpower,and collaboration. I would argue that our community is ready and willing to have the patience, and to make the concessions necessary, to allow a build-in-place pathway to work.
Flagstaff is not the first city to face this dilemma. Across the country, hospitals with aging infrastructure have confronted the choice between moving and rebuilding.And in many cases, they have chosen to build in place successfully.
For example,Children’s Hospital New Orleans (CHNOLA) was faced with aging facilities and financial pressures. CHNOLA could have moved. Instead, it committed to renovating and expanding its century-old campus. By phasing construction,carefully sequencing renovations, and leveraging adjacent land, CHNOLA not only avoided disruption to patient care but also saved an estimated $250 million compared to the cost of relocation. More importantly, it preserved the hospital’s deep connection to its community while modernizing for the future.
Examples like this abound. From Boston to San Francisco, hospitals in dense, historic urban environments have learned how to build vertically, to use modular construction techniques, to acquire adjacent parcels, and to redesign circulation patterns.
NAH’s 2030Strategic Plan identifies four imperatives: put people and community first;advance clinical excellence; grow reach; and achieve financial and organizational stability. It also promises to ground decisions in the feedback of more than 4,000 community members who participated in listening sessions and surveys.
If NAH is serious about these imperatives, the path forward is clear. Putting people and community first means respecting the community’s loud, repeated call to stay in place. Advancing clinical excellence means learning from best practices around the nation that prove renovation and vertical expansion can deliver state-of-the-art care. Growing reach means improving services,not abandoning their current home. And achieving financial stability means avoiding the enormous, risky costs of building from scratch on a new site.
This is not just NAH’s decision. It is Flagstaff’s decision. Healthcare is not a commodity;it is a shared public good. The people of Flagstaff deserve a say in how it is delivered and where it is located. As a Councilmember, I pledge to tackle the challenges of building in place from every angle I can within my legal rights and responsibility. That means: being open to supporting zoning changes,helping to facilitate the right conversations about street closures, traffic rerouting, and acquisition of relevant adjacent parcels. The underutilized property behind Basha’s presents an opportunity for expansion, for example, and the current FMC campus is fragmented by public streets. I want to fully explore how the City of Flagstaff can work with NAH to vacate or reroute one or two of these streets, knitting the hospital together into a cohesive, buildable footprint. I would also be very open to considering approvals for vertical construction; towers are a proven way to increase capacity without sprawling outward. With modern design, towers can be efficient, patient-centered, and aesthetically compatible with the neighborhood. I believe residents will tolerate the disruption of their viewshed to the extent necessary to make building in place realistic.
Flagstaff has spoken. I trust NAH to take very seriously what I know they’re hearing as they conduct outreach: a strong desire to stay on Hospital Hill, to build up,not out, to embrace the current de-centralized model of care that’s already happening. I have great faith in the old adage, “Where there’s a will, there’s a way.” That cuts both ways! So, my call to action is really for both NAH and reluctant community members. Let’s work together with NAH to support whatever it is they determine they’ll need to get to yes on staying in place. Let’s shape a healthcare future together that honors our past, serves our present, and secures our shared future—on hospital hill.
The views and opinions expressed above are Austin Aslan’s alone and do not necessarily reflect those of others on Council nor the City of Flagstaff. |
