Hall, Render, Killian, Heath & Lyman, P.C.
111 East Kilbourn Avenue
Suite 1300
Milwaukee, Wisconsin 53202
www.hallrender.com

Timothy W. Feeley
(414) 721-0461
TFeeley@hallrender.com

January 15, 2016
City of Marshfield Plan Commission
630 S. Central Avenue
Marshfield, WI 54449
Re:

Marshfield Application for CUP for New Hospital

Dear Plan Commission Members:
We represent Ministry Health Care, Inc., and Ministry Saint Joseph's Hospital (collectively
"Saint Joseph's Hospital"). This letter serves as Saint Joseph's Hospital's objections to the
Marshfield Clinic's ("MC") December 22, 2015, application for approval to construct a 615,000
square foot, 202 bed hospital northeast of its East Wing building.
Saint Joseph's Hospital objects to MC's proposed development on the grounds that the
Marshfield community cannot support two hospitals, and the proposed construction is
inconsistent with the public need of the area. As the Plan Commission already understands,
health care is a serious matter. Saint Joseph's Hospital is the most significant neighbor to this
proposed project, and is the only other party in the community with knowledge of the current state of
healthcare in the area and on the campus on which the construction is proposed by MC. As such, it has a
responsibility to bring these issues to the Plan Commission so that it can perform a meaningful review at
its meeting on January 19.

At the outset, we would like to point out to the members of the Plan Commission that certain
statements in MC's application are incorrect. In its Executive Summary attached to its
application, MC represents as follows:
Executive Summary:
Marshfield Clinic has embarked on an effort to create a new “Hospital of the
Future” to serve and support the healthcare needs of the City of Marshfield,
Marshfield Clinic’s service area and Central Wisconsin. Marshfield Clinic
physicians are nearing the end of their lease agreements for use of space within
the existing Ministry Saint Joseph’s Hospital. Since space within the Saint
Joseph’s Hospital facility is no longer available to Marshfield Clinic physicians,
the need to create dedicated, physician owned space has been created. The
following is a description of the site, building and program response to creating a
new Marshfield Clinic Hospital.

 City of Marshfield Plan Commission
January 15, 2016
Page 2
Contrary to the above statements, no public need exists to construct a second hospital in
Marshfield on the grounds that existing lease agreements between MC and Saint Joseph's
Hospital are "nearing the end." In fact, very few space leases exist between MC and Saint
Joseph's Hospital, and none are in jeopardy of ending. For 30 years, MC physicians have
comprised almost 100% of the medical staff at Saint Joseph's Hospital. Any representation by
MC that MC physicians will no longer have the ability to treat patients in the Hospital, or that
lease agreements for space are nearing their term, is incorrect. The Plan Commission should
therefore disregard this basis as support for any argument by MC that a public need exists to
build a second hospital in the Marshfield community.
Applicable Law
The property on which the new MC hospital is proposed is directly adjacent to Saint Joseph's
Hospital, and is located with the city's Campus Development District. Marshfield Ordinance §
18-42 defines the purpose of this district as follows:
(1) Intent. This district is intended to recognize the presence and importance of
large-scale governmental, office, educational, medical, and research and
development facilities in the City; to facilitate their development; and to
coordinate their futures with those of their neighbors and the community as a
whole. This district is also intended to:
(a) Permit appropriate campus growth, while minimizing adverse
impacts associated with modifications, infill development, and/or expansion;
(b) Recognize the sharing of parking, green space, and other efficiencies
that come with integrated campus planning and development;
(c) Balance the ability of a campus to evolve and the public benefits
associated with such development, with the need to protect the livability and
vitality of nearby properties and neighborhoods; and,
(d) Encourage the preparation of campus master plans that establish full
conforming zoning status, facilitate predictable campus development, and enable
nearby property owners, residents and the community to understand short-term
development proposals, impacts and mitigation strategies within the context of
long-term development possibilities.
Because MC does not have an approved Campus Master Plan in place covering its property, the
construction must be approved pursuant to the Conditional Use Permit process identified in
Marshfield Ord. § 18-161(6)(c), and Wisconsin Statute § 62.23(7)(am) & (c), which state,
respectively, as follows:
Marshfield Ordinance § 18-161: Conditional Use Permit Procedures

(c) The Zoning Administrator shall review the complete application and evaluate
whether the proposed amendment:

 City of Marshfield Plan Commission
January 15, 2016
Page 3
1. Is in harmony with the recommendations of the Comprehensive Plan.
2. Will result in a substantial or undue adverse impact on nearby property,
the character of the neighborhood, environmental factors, traffic factors, parking,
public improvements, public property or rights-of-way, or other matters affecting
the public health, safety, or general welfare, either as they now exist or as they
may in the future.
3. Maintains the desired consistency of land uses, land use intensities, and
land use impacts as related to the environs of the subject property.
4. The conditional use is located in an area that will be adequately served
by, and will not impose an undue burden on, any of the improvements, facilities,
utilities or services provided by public agencies serving the subject property.
5. The potential public benefits outweigh any and all potential adverse
impacts of the proposed conditional use, after taking into consideration the
applicant’s proposal and any requirements recommended by the applicant to
ameliorate such impacts.
Wisconsin Statute § 62.23(7) Zoning
(am) Grant of power. For the purpose of promoting health, safety, morals or the
general welfare of the community, the council may regulate and restrict by
ordinance, subject to par. (hm), the height, number of stories and size of buildings
and other structures, the percentage of lot that may be occupied, the size of yards,
courts and other open spaces, the density of population, and the location and use
of buildings, structures and land for trade, industry, mining, residence or other
purposes if there is no discrimination against temporary structures. This
subsection and any ordinance, resolution or regulation enacted or adopted under
this section, shall be liberally construed in favor of the city and as minimum
requirements adopted for the purposes stated. This subsection may not be deemed
a limitation of any power granted elsewhere.
…
(c) Purposes in view. Such regulations shall be made in accordance with a
comprehensive plan and designed to lessen congestion in the streets; to secure
safety from fire, panic and other dangers; to promote health and the general
welfare; to provide adequate light and air, including access to sunlight for solar
collectors and to wind for wind energy systems; to encourage the protection of
groundwater resources; to prevent the overcrowding of land; to avoid undue
concentration of population; to facilitate the adequate provision of transportation,
water, sewerage, schools, parks and other public requirements; and to preserve
burial sites, as defined in s. 157.70 (1) (b). Such regulations shall be made with
reasonable consideration, among other things, of the character of the district and
its peculiar suitability for particular uses, and with a view to conserving the value

 City of Marshfield Plan Commission
January 15, 2016
Page 4
of buildings and encouraging the most appropriate use of land throughout such
city.
Under the above Wisconsin statute and Marshfield ordinances, the power granted to cities to
promote the general health and welfare, prevent overcrowding and weigh the public benefit of a
development with the burden on the community and its resources is broad, and is not tied solely
to regulating the physical characteristics of property. To the contrary, the Plan Commission's
evaluation of MC's application should include the effect and public need of a second hospital in
Marshfield as a significant component of its review.
In Delta Biological Resources, Inc. v. Board of Zoning Appeals of the City of Milwaukee, 150
Wis. 2d 905, 914, 467 N.W.2d 164 (Ct. App. 1991), the Wisconsin Court of Appeals recognized
that the concentration of business services in a limited area and their concomitant effects on the
community are appropriate for consideration. See id. at 914 (rejecting the argument that
consideration of the concentration of services impairs competition and is outside ambit of zoning
review). In other words, review of the impact of an applicant’s business on the community
(unrelated to its physical characteristics) is an integral component of ensuring the health, safety
and general welfare of a community, and any argument that doing so unfairly restricts or
otherwise affects competition is erroneous. See also Lucky Stores, Inc. v. Board of Appeals, 312
A.2d 758, 768 (Md. Ct. App. Md. 1973)(cited with approval by the court of appeals in Delta).
As the Maryland appellate court observed “every denial of a conditional use permit results to
some degree in the prevention of competition,” but that consideration does not render it
unlawful. Id.
With respect to MC's application, the proposed construction is detrimental to the health, general
welfare and safety of the community because the community already has an existing hospital that
has more than adequate capacity. MC has not submitted any data with its application that
demonstrates the area is underserved, and/or that the population can support two hospitals. The
new MC hospital design replicates the existing Saint Joseph's facility in layout, services and
approximate size. Saint Joseph's Hospital already has more than adequate capacity to serve the
community, yet MC seeks to add an additional 200 plus beds. In addition, its plans call for a
second helicopter, and other services, to be added to the current campus. This duplication of
services cannot possibly be justified for a community that is already served and that is not
experiencing significant growth, and is not expected to experience significant growth, in the
future.
The Plan Commission should also consider the impact on the community with regard to MC's
timeline for completion. Since announcing its plans one year ago, Saint Joseph's Hospital has
experienced significant work force losses. Many staff already have chosen to relocate outside of
the community because of perceived uncertainties about future employment by the Hospital and
MC. Reductions in staff have a direct influence on the number of patients that any hospital can
accept, and Saint Joseph's already has had to turn away patients and to direct them to seek care

 City of Marshfield Plan Commission
January 15, 2016
Page 5
elsewhere. These issues will intensify over the course of the next two and one-half years while
MC is constructing its new facility.
Saint Joseph's Hospital requests that the Plan Commission consider these important issues, and
specifically address whether the Marshfield community can support a second hospital and all of
the additional healthcare services, like a helicopter, that go along with such a development. MC
cannot establish that its new facility will lower the cost of health care for the community, and/or
that its new facility will increase the high quality of care already received by patients at Saint
Joseph's Hospital where MC physicians have comprised almost 100% of the medical staff for 30
years. For all these reasons, Saint Joseph's Hospital requests that the Plan Commission deny the
current application or, at a minimum, require MC to submit data which establishes that a public
need for a second such facility exists in this community.  
Very truly yours,
HALL, RENDER, KILLIAN, HEATH & LYMAN, P.C.

Timothy W. Feeley
cc: City Attorney Harold Wolgram

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