The state will not investigate the death of Jessica Martin, who died last week after collapsing in a holding cell at the Haywood County Justice Center.

“The State Bureau of Investigation is not planning to open an investigation at this time, given the results of the autopsy,” said Noelle Talley, a spokesperson for the N.C. Department of Justice, in a voicemail message.

The autopsy report hasn’t been completed or publicly released, but Talley said the justice department received preliminary information that helped them make their decision.

Martin died on Aug. 10 at MedWest Haywood after emergency services were called to the courthouse around noon that day, but no cause of death has yet been released.

Haywood County Sheriff Bobby Suttles said that Martin had been seen, at least once, by the nurse kept on staff at the jail before she was sent to the courthouse to await her appearance. The nurse determined that Martin didn’t need to go to the hospital.

Martin fell ill before making it to the courtroom, and life-support measures were started when the ambulance arrived.

Martin was a 20-year-old Haywood County native and Pisgah High School graduate who was in the county’s jail because she didn’t show up for a court date in late July.

The charge was a holdover from her sole conviction, a 2008 drug paraphernalia charge, to which she pleaded guilty.

She was given a year of unsupervised probation and ordered to pay a fine of $331. But she never paid, and then missed both resulting court dates, in February and July.

She had been in the jail for five days before her death, and Suttles asked the SBI for an investigation.

“That’s just standard procedure for us,” said Suttles. “Not every time, but almost every time, we request the SBI.”

Martin is survived by a two-year-old son, Dillon, as well as her mother and several grandparents, all of whom live in Haywood County.

Her father, who operated heavy machinery for a local construction company, died last year.

The state might have pulled the plug on a long-range project to map landslide prone areas in the mountains, but Haywood County hopes to take matters into its own hands.

Shortly after Republican lawmakers axed the state’s landslide mapping unit and laid off a team of five state geologists, Gordon Small, a longtime volunteer with Haywood Waterways Association, began pondering how to continue on.

Small hopes to raise grant money to hire the geologists on a contract basis to do the maps for Haywood County, a project that could take 18 months and cost more than $500,000.

Haywood County commissioners this week pledged unanimous support for the idea if funding could be found.

“I’m proud of my county,” Small said afterwards. “Now the big deal is raising the bucks. The fact that the county unanimously supported it is a big, big help.”

Haywood County has had its share of landslides and destroyed homes where the occupants narrowly escaped death. Emergency workers have found themselves digging people out of rubble in pitch-black rain storms, unsure whether more of the mountain could still collapse.

“For emergency preparedness it is critical you have this in place,” said County Manager Marty Stamey.

Commissioner Bill Upton said if he was buying property or building a house, he would want to know if there was a high landslide risk.

Commissioner Kevin Ensley, a surveyor and the only Republican on the board, said the maps would hopefully encourage smart building.

“I occasionally have clients that want to develop in areas and I have basically told them they shouldn’t but they do anyway,” Ensley said.

If the county had maps like these, it could at least require more detailed engineering.

“There needs to be enough sets of eyes or a different type of development criteria for those areas,” Ensley said.

Landslide hazard mapping has faced opposition from some development and real estate interests, who fear the stigma of landslides would unfairly blacklist property.

That’s exactly what happened in Macon County, the first of just a few counties to receive landslide hazard maps. An attempt by a planning group tasked with writing recommendations for a steep-slope ordinance derailed, in part, because they used the maps as indicators of where builders might need more regulatory oversight — triggering a backlash that the maps were not accurate and were confusing.

Marc Pruett, the soil and erosion control officer for Haywood County, doesn’t understand why the landslide hazard mapping was seen as controversial.

“Wouldn’t you want to know if your brake fluid was low before you run your car down the highway at 60 miles per hour,” Pruett said.

Small thinks as a whole, buyers will look more favorably on buying somewhere if they have access to landslide risks.

“I do believe in the long term that counties that have this information will have an advantage in the real estate market,” Small said.

Opponents also feared the landslide hazard maps were a backdoor for development regulations.

Small said he was pleased that county commissioners put public safety and common sense first.

Three of the laid-off state geologists came with Small to the commissioners’ meeting this week. They were pleased to see a community openly value their work after being shot down by the state.

“We have seen more landslides than anyone else in the state, and possibly the east coast, and we hope to continue using this expertise to benefit WNC,” said Stephen Fuemmeler, one of the geologists.

Jennifer Bauer, another of the state geologists, hopes Haywood Waterways can raise the funds, not just so she will have a job but so that the work will carry on.

“Making the citizens of Western North Carolina aware of landslide hazards is something I’m passionate about,” Bauer said.

The state landslide mapping team was created in 2005 with the mission of mapping landslide hazards in every mountain county. The team only finished four counties: Macon, Buncombe, Henderson and Watauga.

The unit was working on Jackson County when it was halted in its tracks. Haywood County was next in line for landslide mapping when the program was killed.

To get involved or contribute, contact Haywood Waterways Association or Small at 828.734.9538.

Nearly every town has one — a five-lane road lined with fast-food stores, gas stations and grocery stores — and most sport a few. But those, it turns out, may have been a bit of a mistake.

The N.C. Department of Transportation has kicked five-lane roads to the curb in favor of landscaped medians. Throw in some sidewalks and street trees, and there’s an uncanny resemblance to the boulevard design lobbied for by new urbanists and smart growth advocates over the years — although the DOT’s version is decidedly larger and more utilitarian.

Despite a paradigm shift dating back at least a decade, the design is still being embraced by the mainstream, particularly in the mountains where there are few examples of boulevards.

“Part of that is a trickle down from Raleigh,” said Wade Walker, an engineer and transportation planner with the Charlotte firm Fuss and O’Neill. “The DOT central office has basically admitted it is going to take time for this thinking and philosophy to trickle down into the individual districts. It is like turning around an air craft carrier. You can’t do it overnight.”

When Derrick Lewis started working for the DOT road design unit in 1997, everyone was still designing five-lane roads for nearly every application.

“It was the standard at one time to be five lanes,” Lewis said.

By the end of the decade, however, five-lane roads were on the way out.

“It was probably more of a project by project decision at first and at some point it made a swing in the other direction,” Lewis said.

At first, medians cropped up only along part of a road, with a combination of a middle-turn lane and a landscaped middle, much like the Old Asheville Highway in Waynesville; it was designed in the late 1990s when the five-lane design was beginning to fall out of favor.

Now, medians are the standard for commercial roads.

Lewis said he was an early convert to medians.

“I was one of the ones trying to get people trying to think about putting a median in,” Lewis said.

He oversaw feasibility studies for makeovers of N.C. 107 in Sylva and South Main in Waynesville — and both have proposed medians.

The DOT hasn’t necessarily embraced medians for their aesthetics, but for their ability to move more traffic without adding more lanes every couple decades.

Traffic moves faster with a median. Without cars darting in and out of parking lots across lanes of oncoming traffic motorists aren’t as brake-happy.

“You feel like they are about to cut out in front of you,” said Joel Setzer, head of the DOT division for the 10 westernmost counties. “Once you start getting congestion, and you have one person that has to come to a stop to make a turning maneuver, it creates an accordion effect, or slinky effect. That stop leads to congestion all down the stream.”

Businesses are often the opponents to medians, however, fearing they would lose prospective customers cut-off from making left turns into their parking lots. And so the DOT acquiesced by installing that middle-turn lane.

“In the past they just kowtowed too much to adjacent property owners,” Waynesville Town Planner Paul Benson said.

Far from being newfangled, boulevards historically were the design of choice for the flagship artery of a city, moving high volumes of traffic through town, yet flanked by high dollar commercial real estate.

“It is basically reinventing an old idea,” said Scott Curry, an urban designer and planner with the Lawrence Group, one of the state’s most well-known and progressive planning firms based in Davidson. “Boulevards are one piece of rediscovering design that is more oriented toward the pedestrian.”

So where did the DOT go wrong all those years?

“For many years, street designers and transportation engineers have been preoccupied with the volume and speed of cars only,” said Curry. “The car became the singular focus of what people planned and designed for.”

Enter the boulevard.

“When it is done effectively it is a good compromise between accommodating through moving traffic and local traffic and pedestrians,” Curry said.

Waynesville and Sylva are at a crossroads, ones that will irrevocably shape the character of their communities.

Both towns are clamoring for a makeover of their commercial avenues — South Main Street in Waynesville and N.C. 107 in Sylva — but neither likes the plans that the N.C. Department of Transportation came up with.

Instead, both communities want to do their own street plans, drawing from new urbanist philosophies that use street design as a springboard for creating vibrant and lively shopping districts where not only cars but people feel at home.

But traffic is a fact of life, and whether the communities can marry the needs of the thoroughfares with their lofty visions remains to be seen.

Read more:

• Waynesville primed for makeover of South Main

• Fast for cars or pleasing for people? Tug of war rages over 107

• The advent of the boulevard, the death of the five-lane

• A look in the rearview at N.C. 107

The oft-threatened closure of the state prison in Haywood County has finally come to pass, but by now, it hardly comes as a surprise.

“Every year, they would always say it is going to close,” said Haywood Commissioner Kirk Kirkpatrick.

And so every year, county leaders appealed to mountain legislators to save the prison, who in turn mounted political pressure on their colleagues in the General Assembly to put the prison back in the budget.

The prison was spared the chopping block, but the victory was always short-lived, giving way the following year to cries of “here we go again” and another round of lobbying.

“I think our representatives at the state level had indicated inevitably it was going to close. They could push it off or prolong it, but inevitably they wouldn’t have the votes to keep it,” Kirkpatrick said.

“At some point we realized we were going to lose it,” Commissioner Bill Upton said.

It’s not clear exactly what the state will do with the prison it abandons. Haywood County has an idea, however, that’s still in its infancy and might not come to fruition, but county commissioners are giving a hard look.

Commissioners are contemplating leasing the prison from the state and going in to the inmate business. For $40 a night, the county would house prisoners from other places — from other counties that don’t have enough space in their own jail or from the state itself.

Commissioners say they won’t plunge headlong toward owning a prison yard unless it makes sense.

“You don’t just necessarily want to take it because you can,” Swanger said. “You want to make sure what you are taking. We have to make a wise decision.”

They asked County Manager Marty Stamey to put together a feasibility study and hope to hear back in another week.

The fact-finding mission would include estimated utility costs, staffing and upkeep.

With the county jail next door, the prison wouldn’t need its own cooks or medical officer or canteen. It could piggyback on the jail’s support staff and really only need the guards. The number of guards could be adjusted depending on how many prisoners materialized.

The county could also operate just half the facility, cutting down on utilities.

The beauty of the deal may be the rate the state will lease it for. Commissioners are hoping for the bargain rate of a $1 a year.

Why such a good deal? It’s doubtful the state would find a buyer for a 128-bed prison on the open real estate market, and at least leasing it to the county would keep it from being a maintenance headache and liability for the state.

No matter how cheap the lease is, the county doesn’t want to be saddled with a deteriorating facility that becomes more work than it’s worth. But based on an inspection of the prison by the County Maintenance Director Dale Burris, it is in surprisingly good shape.

“The buildings are old but very well maintained,” said Commissioner Kevin Ensley

The big kicker, however, is whether there are actually inmates out there who need to be housed somewhere.

When someone is first charged with a crime, counties bear the burden of housing them in their local jails. Only after they go to trial and get sentenced by a judge are they shipped off to a state prison.

The state doesn’t seem terribly pressed for space: the existing population at the Haywood prison is easily being absorbed into the state’s other prisons. So demand for bed space, if it exists, would likely come from other counties who have maxed out their own jails.

But there’s the rub.

“A lot of the counties have built new jails,” Haywood Sheriff Bobby Suttles said.

Over half the counties bordering Haywood have recently built new jails of their own and have room to spare: Swain, Jackson and Madison counties all have new jails, and the Eastern Band of Cherokee Indians is about to build one.

Cherokee County also has built a large new jail, capturing overflow inmates from other far western counties.

With so few jails at capacity, there might be little overflow for Haywood to capitalize on — if not for a new state law that would keep inmates serving minor sentences in county custody. (see related article.)

The new law would pay counties to house inmates convicted of misdemeanors and serving less than 180 days. In the past, they would have entered the state’s prison system.

It will give Haywood another 14 prisoners a year, not enough to make leasing the shut-down state prison viable. But Haywood could volunteer to keep some of those convicted misdemeanor prisoners on behalf of other counties, who have enough room for their own inmates but not enough room to take on the extra load.

“We are trying to determine how many of those there actually are in the state,” Swanger said, adding however that there probably won’t be that many

And that may sideline the whole idea.

“I am skeptical about short-term profitability,” Swanger said.

Suttles is more inclined to strike while the iron is hot, assuming that the inmate population is bound to grow in the future.

“Eventually, I think there will be a need for it, to hold inmates. It would be real handy,” Suttles said.

The fences around the perimeters of the state prison and county jail are practically touching already.

Commissioners are contemplating a worst-case scenario where the county essentially mothballs the site for now to see if more demand materializes. And in the meantime, the county looks out for its interests by keeping something else from moving in there, something that may not be compatible with the county’s neighboring jail or public dumpster station.

“If we don’t lease it and the state sells it, who is going to be our neighbor?” Swanger said.

Western North Carolina is losing one of its strongest municipal work forces. And a quick look at their record of projects shows that, in towns and counties around the region, they will be sorely missed.

But this loss isn’t exactly the result of layoffs or furloughs. It’s what will happen when the Haywood Correctional Center closes at the end of this year, and its 125 inmates — who serve as a nearly free labor force for the region — are shipped off to larger prisons in the state system.

It’s been a good ride while it lasted for communities benefiting from the prison work crews.

They’ve painted public pools in Haywood and Jackson counties, pulled weeds from the dam at the Waynesville watershed, assembled playgrounds, painted schools, done landscaping on municipal buildings, cleaned up the grounds of state parks, assembled school equipment. One crew built an entire boat ramp by hand on Lake Fontana. They shoveled snow from sidewalks in downtown Waynesville one particularly rough winter.

“At one time we had three crews,” said Donnie Watkins, the prison’s superintendent.

SEE ALSO: A new life in the cards for Haywood's prison?

And that’s just in the community work program, which offered up inmates to local governments, schools and the like to add free manpower to a whole range of projects.

Inmates also staff litter pickup crews, and assist the N.C. Department of Transportation with projects on almost a daily basis. This week inmates labored along the roadsides in a Maggie Valley subdivision, repairing old landslide damage.

In the transportation department program alone, inmates logged 122,656 hours between 2006 and the end of July. Worked out to minimum wage, that’s $889,256 of work that’s been almost donated to communities from the state line all the way to Buncombe County. The cost of inmate labor is 70 cents per person each day. It’s a service, said Watkins, that will be noticeable when it’s gone.

The state-run prison is being shuttered, along with three other small-scale minimum security prisons, to save money. It’s cheaper for the state to run fewer big prisons rather than more smaller ones. But the cost to the local community will be immense.

The community work program has been in business for eight-and-a-half years, and tracking the exact projects inmates have helped with over that time is a little difficult. There are so many that to go through the whole record would probably be a box or two of papers to sift through.

But sitting around in the prison’s front office one Thursday afternoon, a gathered group of officers are able to rattle off a laundry list of maintenance and beautification projects, from the offbeat to the mundane.

Haywood Correctional has, until now, supplied more man hours for community projects than any other prison in the region by far. Part of that is because it’s a minimum security place, so by definition, a good deal more of the inmates are eligible to work in the community with less intense supervision.

Plus, say the officers, they’re pretty hard workers. A common problem with the program was recipients of the inmates’ help overestimating how long a project would take. Sometimes, said one officer, you’d take out an eight-man crew and they’d finish the work scheduled for a week in one day.

That kind of efficiency — and the unbeatable price — will be noticeable in its absence in places like Waynesville.

“There’s no question it will definitely leave a dent in the town’s workforce,” said Waynesville Town Manager Lee Galloway. “We’ve depended on the inmate crews. I‘ve been here 17 years, and we’ve used work crews to do that work continually almost during that time.”

The place where their efforts will be most noticeably missed, said Galloway, is in litter pickup. Crews pick up trash all over the city, and there won’t be anyone left to do it when they’re gone.

“We certainly don’t have the money to hire people,” said Galloway. “We’ve been dropping jobs the last several years, most of which have been in public works, so we don’t have the work force to do that kind of work. Unless it’s volunteers, it’s probably not going to get done unless we put different priorities in our work and not do something else to pick up litter.”

The litter pickup is where prison staff foresee the most impact, too. As one officer noted, the counties will be filthy come January 1. The litter crews pick up trash from Canton to Murphy, and local dumpsters are quite a bit fuller thanks to their efforts.

On one recent trip down the stretch of N.C. 107 that runs in front of Western Carolina University, inmate crews collected 181 bags of trash, and it had only been a few weeks since their last pass over the road.

Loss of jobs

Of course it’s not just local governments that are losing in the prison’s closure. The entire prison workforce — 42 employees — will be out of a job when the place is shut down by the end of the year.

They can apply for other jobs within the N.C. Department of Corrections, but most would have to leave the area if offered a position, and there just aren’t that many jobs to give in the department, said Keith Acree, public affairs director for the department of corrections.

“There is a reduction in force process that we will try to place people in other agencies, but we’re kind of limited in that part of the state,” said Acree.

The inmates themselves will be scattered across the rest of the state’s prisons, housed wherever there’s a bed in the right kind of facility.

That, said Watkins, is likely to put a strain on a lot of the local inmates who have family visitors or are allowed out occasionally on home leave.

SEE ALSO: State prisons, county jails play musical chairs with inmates

“They’ll be housed from Buncombe County, across the state, still in minimum custody,” said Watkins. “They’ll be housed much further east, which will put a burden on family members. You’re going to have a lot of families out here who are not going to be able to see their family members who are incarcerated.”

For the facility itself, its fate still stands undecided.

The state has the option to repurpose it, or it could be declared surplus property and sold or leased to someone else.

That’s an option that Haywood County commissioners are keeping their eye on, considering the possibility of leasing it from the state should the department of corrections offer it up.

If the state decides it doesn’t need the prison, said Acree, priority will be given to anyone who wants to continue using the place for criminal justice purposes.

And until the doors officially close in coming months, inmates will still go out on work detail nearly every day, giving the region a few more months of clean streets before the workforce is gone for good.

After hours of scouring the ground for renegade marijuana plants from the air last Thursday, the pilot of a Highway Patrol helicopter was ready to call it day. But as he crested the Balsams, in the homestretch of his flight back to Asheville, he looked down and hit the jackpot: 664 pot plants clustered in more than two-dozen small plots.

“This pilot is pretty alert. He was just looking out and saw what he knew as marijuana,” said Detective Mark Mease, a narcotics investigator with the Haywood County Sheriff’s Office. “When you know what you are looking for it kind of stands out.”

The cultivator of all that pot had done his best to disguise it, though. The plots were a scant 6 feet across, tucked in to an overgrown pasture awash in all manners of briars and brush.

But once on the ground, it wasn’t hard to figure out who was responsible, Mease said. Narrow but distinct paths led from plot to plot, and eventually back to a nearby trailer on the property.

“It is kind of hard to hide when the trails lead back to your house,” Mease said.

Daniel Keith Messer, 51, was home at the time. He answered the door when Mease knocked, and in short order had confessed. Messer has been charged for now with manufacturing marijuana, but more charges are likely.

Officers worked well into the night chopping down the pot and hauling it off. The pilot, meanwhile, flew back to Asheville to refuel then returned to run air support, both for security and to lend a spotlight as officers dragged armloads of the tall pot stalks down the mountain.

It was a big bust, one of the biggest Haywood has seen in years. Mease said there isn’t as much pot grown today as there used to be. Pot cultivation in the mountains has been tapering off since the 1980s.

“It is a lot of labor. If you have it planted out somewhere on a mountain you have to hike in, and they aren’t willing to do that for the reward,” Mease said.

Plus, searches from the air like this one and the ensuing busts have become an annual ritual this time of year. More pot is being grown indoors in hydroponic operations these days.

Mease doubts this was Messer’s first foray into growing marijuana, not with that many plants under his wing. It’s a lot to maintain.

Had Messer gotten to harvest all that pot, he could have made half a million dollars on the wholesale market, Mease estimates. All that for some seeds, potting soil, a little fertilizer and sweat equity.

“It is a huge profit. There is nothing else you can grow that makes money like that. Of course, there is nothing else you can grow that gets you arrested either,” Mease said.

Since 1917, the Red Cross has flown its archetypal white flag in Haywood County. In the 94 years that have since passed, the charity’s presence in the county has been steadily dwindling. First, the Waynesville chapter disappeared. Then the Canton chapter fell by the wayside.

The weight fell on what became the Haywood County chapter of the Red Cross, but now that last holdout is looking at closing its doors as well.

“Our chapter has been struggling financially for several years,” said Kim Czaja, the chapter’s financial director, who will be out of a job in September.

They’ve made some pretty hefty strides in the last few years — cutting the yearly debt from $28,000 down to just around $2,000 — but it just wasn’t enough.

Really, though, said Czaja, what’s happening to Haywood is just a snapshot of a very turbulent climate in the Red Cross around the country.

Chapters in Cincinnati are merging to save money, Buffalo is slashing 50 jobs in their blood division and the agency said it’s cutting administrative jobs, consolidating things like payroll and accounting, which are currently done by each chapter.

“There are layoffs going on throughout the Red Cross as a whole,” said Czaja. “It’s just a change right now, and I’ll be honest with you, it’s like any change, it can be painful but it is a very good thing because it’s definitely going to make the Red Cross stronger.”

Some of the services the local chapter offers will also go through an evolution, probably being administered out of the regional office in Asheville.

The western region of the state has seven Red Cross chapters. Haywood County was the only one west of Asheville, and it’s been that way for years, said Czaja.

“We want to continue to be strong in the community, but it is going to be different,” said Czaja.

She estimates that they serve around 7,000 to 8,000 people every year. That includes all the classes — CPR, first aid, swim and lifeguard courses — blood drives, water safety classes in schools, helping businesses craft emergency plans and local versions of the disaster assistance the Red Cross is known for globally.

They also offer financial help to military families and get them in touch with service members overseas when there’s an emergency at home.

The restructuring is a new proposition; Czaja, who is only part-time and the chapter’s only paid employee, just learned of the changes last week. So that means she’s not yet sure how or when the fallout will actually fall.

“There’s a lot of fear because the doors may be closing,” said said. But she’s hopeful that the group’s role in the community won’t diminish and that they can continue serving the county through volunteers. She started as a volunteer herself.

“I understand decisions like this have to be made,” said Czaja. “The most important thing is that the services continue.”

A new $9.3 million surgery center in Haywood County is being financed with equity put up by 20 doctors in the community who invested capital in exchange for a real estate interest in the project.

The hospital will lease the space, outfit it with equipment and manage its operation, but won’t pay for any of the construction costs.

MedWest CEO Mike Poore said the hospital could have afforded to build the surgery center on its own if it had to, but prefers the business structure.

“We could have taken on the debt, but what’s more important is it has our physicians invested even more in the health care of our community,” Poore said.

Poore said the hospital-physician partnership makes the outpatient surgery center all the more unique.

The business arrangement marries the hospital and physician community. Now more than ever, their success is contingent on the other.

The doctors will profit from the lease paid by the hospital. The hospital profits from the patients the doctors will rake in.

Also involved in the project is Meadows and Ohly, a development company out of Charlotte that builds medical offices and outpatient centers. The firm will act as the general partner and orchestrate the construction.

The 20 physicians who bought shares in the project as limited partners fronted nearly one third of the building’s cost, accounting for all the equity.

At first blush, the number of doctors who bought in to the outpatient center is impressive — more than 20 percent of the doctors practicing in Haywood.

But it is a fairly fool-proof and risk-free venture. As long as the hospital keeps leasing the space, they’ll get a return on their investment.

Dr. Luis Munoz, a pathologist, said for some doctors who put up money, it may have seemed like an attractive real estate investment. But for most it was out of their conviction to support health care in the community they serve.

The project didn’t exactly hinge on the financial backing of physicians.

“I could always do it with my own equity,” said Jay Bowling, vice president of Meadows and Ohly.

And the firm could have kept all the profits for itself.

“Are we leaving money on the table? Probably,” Ohly said.

But, the project is much stronger thanks to doctors’ involvement, Bowling said. And certainly less risky.

Its success is nearly guaranteed since the doctors are doubly vested: not only in their own practices but also as a real estate investor. The more business they bring in, the better surgery center does, and the more they get back on their lease.

Storied history

An outpatient surgery center has been in the works for more than a decade, but at one time was a controversial undertaking, one that looked much different than the end result today.

Five years ago, the hospital was poised to break ground on a $16.5 million expansion, financed and funded solely by the hospital. In late 2007, hospital leadership held a reception to unveil the blueprints, and even showed off upholstery samples for new waiting room sofas.

But the entire project came crashing down a few months later when the hospital lost its Medicare and Medicaid status after failing federal inspections in early 2008. Savings squirreled away to pay for the $16.5 million surgery wing were spent instead to keep the hospital afloat until it rebounded from the crisis. The leadership in place at the time has been replaced.

More than $400,000 spent on architects and plans went down the drain.

The project today looks much different than the one pursued by the older hospital leadership — both in scope and cost.

While the old project was billed as a “surgery center,” in reality it was a new wing of the hospital. The old plans simply called for a makeover of existing surgery rooms, while the majority of the project was ancillary: a new lobby and main entrance, new administrative offices and two floors of “shell” space for future expansion, for example.

While that project was shelved, the idea for an outpatient center was not.

Starting over from scratch — and without a nest egg to work with — the hospital administration and more than a dozen doctors split the cost of a $40,000 feasibility study in 2009 to reassess the project.

The result is a far different project: a standalone building on the hospital’s campus with the entire footprint dedicated to outpatient services.

New era of physician involvement

Other than its physical differences, the most marked evolution in the project is the business arrangement, namely the partnership with the doctors.

Under the old leadership, that type of investment and partnership wasn’t welcomed or allowed, Poore said.

Doctors had previously sought a seat at the table, offering to partner with the hospital and help finance the surgery center.

But the former hospital CEO wanted “complete and total control” and shut the doctors out, said Dr. Luis Munoz, a pathologist and a partner in the project.

Munoz, one of the physician investors, is pleased with the new approach under today’s hospital leaders.

“I think this is a preferable scenario, when both parties are involved,” said Munoz. “This is another example of this administration being transparent.”

“This is a really good example of how collaboration should work,” agreed Dr. Al Mina, a general surgeon in Haywood.

Better for the bottom line

The new outpatient center should help Haywood capture more market share, namely those patients who now bypass Haywood and go to doctors in Asheville affiliated with Mission Hospital.

Currently, outpatient services accounts for two-thirds of the hospital’s revenue. Not all of those services and procedures will be relocated to the new center, but it provides a snapshot of just how important outpatient revenue is for a hospital’s bottom line.

The hospital hopes to attract more outpatient services — and thus bring in more revenue — to pay for the new building.

While the hospital won’t bear the upfront construction costs, it still has sizeable expenses to deal with: the annual lease on the space, the overhead, the nurses and other support staff to run it. The cost of the equipment, from waiting room chairs to operating tables, will fall to the hospital as well.

But some of the cost to run the new surgery center will be a wash. Nurses and technicians who currently work in the surgery wing, mammography services, and other departments of the main hospital will simply move to the new outpatient center.

Some services will be duplicated in both the hospital and outpatient center, such as MRIs or blood work, and will require doubling up of staff.

In other areas, the outpatient center will operate more efficiently thanks to a better layout. The hospital will no longer need such an extensive transport crew, a by-product of the cumbersome design of outpatient services inside the hospital.

“It will save on this whole group of people who spend all day transporting people up and down from the sixth floor to the basement,” Markoff said.

Patients using the new building also will be able to stay on the same stretcher during their pre-surgery prep, the actual surgery and the recovery. Again more efficient, and cost cutting since there’s not all the sheets to wash or staff to constantly strip stretchers.

In many urban areas, new outpatient centers aren’t being built alongside hospitals, but instead are free-standing medical office buildings across town, sometimes not even run by the hospital. But it is advantageous to have the surgery center on the same campus as the hospital, Poore said. If there’s an emergency, the full resources of the hospital right next door can be brought to bear.

“If you are a free-standing surgery center and something goes wrong, they call 911. Here, we are the 911,” Poore said.

The project should be completed by spring.

“This project has been in the planning stages for many, many years so it is a great thing to see it come to fruition,” said Mark Clasby, member of the hospital board and Haywood County economic development director.

When asked to paint a picture of a dream vacation she would like to take, 68-year-old Hazel Wells began conjuring her image of an airplane en route to Hawaii. With impressive depth and detail, she incorporated her favorite color, blue, and flowers across the bottom.

Wells and other artists who are part of LIFESPAN have become professionals, selling and displaying their work at venues such as the Waynesville Recreation Center and Twigs and Leaves Gallery in downtown Waynesville.

LIFESPAN provides education, employment and enrichment opportunities to children and adults with developmental disabilities. Since 1973, the organization has grown from its roots in Charlotte to 20 locations from Haywood to Alamance counties. LIFESPAN started a creative campus in 2010, introducing clients to art, horticulture, and health and wellness enrichment programs.

Pamela Hjelmeir, the arts assistant of the LIFESPAN Creative Campus in Waynesville, started building the arts program on a local level a year ago. With an art degree from the University of Florida, Hjelmeir had plenty of ideas to inspire the participants.

She has introduced several artistic elements including painting, weaving, drawing and mixed media. Although many participants are non verbal, art allows them to communicate through creativity and illustrate their passions and thoughts.

“Everyone has their own special gifting and their own special talent,” Hjelmeir said. “We all have our weaknesses, but we all have unique contributions to make. You have to look beyond the disability and look at the ability of somebody.”

During the summer of 2010, Hjelmeir worked closely with participants to create art to sell to the community and raise awareness about LIFESPAN’s mission. Their debut appearance was at a booth at the International Festival Day during Folkmoot last July.

Having their work on display is a source of excitement and pride for the participants, who now consider themselves working artists after selling several pieces at various events.

In addition to the gallery showings, LIFESPAN art was used on the Thanksgiving cards for the Haywood County Arts Council. Many participants won blue ribbons for their crafts at the Haywood County Fair and often show their work at state shows in Charlotte and at the Charlotte Douglas International Airport.

Carrie Keith, an owner of Twigs and Leaves, was so impressed with the artworks’ level of professional appeal she purchased one of her own – a vibrant painting of a tractor. She hung it proudly in the room where her grandson sleeps when he comes over.

“I think it has a lot of fun color,” Keith said. “It’s amazing the talent they possess.”  

In March the Waynesville Recreation Center mounted several pieces of their art along the walls facing the new fitness equipment on the second floor. Having LIFESPAN artist’s work at the fitness center has been an effective way to expose the organization to the community and ties into the program’s encouragement of health and wellness.

Each piece of art is priced competitively and fairly in regards to other arts and crafts being sold in the community.

“It’s not as though just because they have a disability we should lower the price,” Hjelmeir said. “It’s very fairly priced, and I have the responsibility to make sure that we protect their interest. They work very hard on these projects.”

In their studio at the LIFESPAN building, Hjelmeir combines group art activities and one-on-one instruction for each of the students involved. While group activities provide a fun atmosphere, one-on-one work allows participants to push their goals and show what they can do individually.

Robert Rogers is also a representational painter with a fascination with farms. His art is full of detailed fences, farm tools, animals and barns, one of which sold at Waynesville’s recent Whole Bloomin Thing Festival. He also admits a love for working with beads and weaving.

Stacey Delancey takes a more abstract approach to her work. She enjoys interactive projects and is drawn to mixed media. During instruction, Hjelmeir sometimes offers suggestions for color mixing and layering and helps them rinse off the paint brush between colors, but otherwise allows the students to create their unique vision.

“We don’t want to box in their creativity and say there is a prescribed formula because there is none,” Hjelmeir said. “It’s individualized just as much as they are.”

Participant Kenneth Grant creates most of his art around political themes and has painted presidential portraits of George Washington and Abraham Lincoln as well as military tanks and war arsenals.

Hjelmeir tries to organize regular field trips for the students to inspire their art. Some of these include swimming at Haywood Regional Health and Fitness Center and the Pisgah Astronomical Research Institute.

LIFESPAN relies on grant money and monetary donations from supporters to purchase art and craft supplies. They are always looking for opportunities to show the work of the artists.

In the annual report for 2010, LIFESPAN reported that it had sold 1,125 pieces of participant’s art from all the communities totaling $21,667 over two years.

Hjelmeir is currently working to create digital portfolios of each student’s work and hopes to create an online store to sell each piece.

— By DeeAnna Haney • SMN Intern