"Local Hospital Projects May Need Green Seal - Officials Propose Environmentally Friendly Standard", (c) Stephen Smith, The Boston Globe, June 12, 2008

Hospital and nursing home building projects would have to be environmentally friendly to win crucial state approval under sweeping regulations proposed yesterday by Massachusetts health authorities.

If the measure is endorsed by the state Public Health Council this fall - and members of that panel expressed broad enthusiasm for it yesterday - Massachusetts would become the first state to tie approval of healthcare construction to green standards increasingly adopted by office builders.

Three of the biggest hospital expansions in New England have already embraced green construction standards, incorporating foliage on roofs, windows that let light stream into interior corridors, and floors that eliminate the need for noxious cleaning solvents.

"These are facilities whose intent is to improve the health of the patients who use them," said John Auerbach, the state's public health commissioner. "So it's very appropriate that they should be excellent role models for the rest of the building construction industry" in hewing to environmental standards.

Under the proposal from the Department of Public Health, healthcare facilities seeking to expand or renovate would have to abide by practical green building standards but not achieve the highest ratings, which can be prohibitively expensive.

The guidelines emphasize using materials that conserve energy, water faucets that are controlled by automatic sensors, refrigerant that limits ozone depletion, and bicycle racks to encourage staff members to leave their cars home.

Still, some members of the state Public Health Council, which sets health policy, questioned yesterday whether the proposed standards are sufficiently rigorous. The earliest the rules will be adopted is October, public health authorities said.

"My gut feeling is that we ought to be setting a little bit of a higher standard," said Dr. Alan C. Woodward, a member of the council and former president of the Massachusetts Medical Society.

The measure was hailed by a longtime champion of making healthcare environmentally sensitive, who predicted it would be warmly received by major teaching hospitals. But Bill Ravanesi, Boston campaign director of the environmental advocacy group Health Care Without Harm, said the proposal could face resistance in some quarters.

"You're going to get push-back from the smaller community hospitals that are deeply in the red and some of the nursing homes," said Ravanesi.

A spokesman for the state's largest confederation of healthcare organizations, the Massachusetts Hospital Association, said that hospitals statewide are committed to projects that adhere to green construction standards. And the association spokesman, Rich Copp, said that hospitals view the proposed standards as a measured approach.

When Brigham and Women's Hospital opens a new $380 million addition within the coming month, there will be no shiny vinyl floors or urinals sloshing with water. The hospital voluntarily opted to conform with green building standards, though the guidelines seemed daunting seven or eight years ago when the Carl J. and Ruth Shapiro Cardiovascular Center was being planned.

Initially, "the healthcare construction industry was scared to death" of green-building certification standards, said Arthur Mombourquette, vice president for support services at the Brigham. The main concern was cost.

"Everyone thought we couldn't meet the standards, and even if we could, it would be prohibitively expensive, so why bother?" said Mombourquette. "Quite frankly, that was in the back of my mind seven or eight years ago."

But as green construction became more technologically feasible, Mombourquette said, he and other hospital executives warmed to the concept. So, for example, instead of installing those glistening vinyl floors that are such a staple in most hospitals, the Shapiro building will use rubber. That way, the floors will not be sealed with a chemical finish, and solvents won't be needed to get rid of stains.

And during construction, 90 percent of building scraps were recycled, with separate bins for wood, plastic, and metal.

Brigham executives estimate that following environmentally responsible standards added about $2 million to construction costs.

At Massachusetts General Hospital, in the midst of the most expensive hospital expansion in state history, administrators think that green building procedures will make the expected $600 million project 2 to 3 percent more expensive. Like the Brigham, Mass. General's design allows natural light to fill the new building, which includes 150 patient rooms, 29 operating rooms, and an expanded emergency department.

Half of the roof will be covered with vegetation, and gardens will grace the inside atrium. Executives said they hope to improve health and the bottom line.