Like so much else in Columbia, the taproot of Howard County General Hospital reaches down to James Rouse.
In the late 1960s, the founder of Columbia asked Johns Hopkins Hospital and the Connecticut General Insurance Co., which was financing Columbia, to come up with a plan to provide medical care to the new town's residents.
The result was the Columbia Medical Plan, a prepaid health insurance plan established in October 1969 for Columbia residents. As Columbia and the need for medical services grew, that insurance plan was followed in July 1973 by the opening of the county's first hospital: the 59-bed Columbia Hospital and Clinics Foundation, located at the corner of Little Patuxent Parkway and Cedar Lane and designed to treat members of the CMP.
Forty years later that hospital has changed names, changed management and ballooned into a 249-bed facility that serves the entire county with an array of clinics and specialties, and a host of nearby medical offices. It remains the county's only hospital.
"I think the hospital's worked out very well," said Ed Cochrane, who as a County Council member and county executive in the 1970s helped steer the establishment and growth of the hospital. "It's well-located in the center of the county … and it's a very fine facility — absolutely solid in terms of a medical care facility."
"It's grown to the point where it provides a full range of services," said Lloyd Knowles, also a County Council member in the 1970s who was involved in the hospital's birth. "In many ways, it's considered to be the most outstanding community hospital in Maryland."
"We think we bring a lot to the table," said hospital President and CEO Victor Broccolino, ticking off a list of attributes that included not only the hospital's medical presence but the jobs it creates (with 1,700 full- and part-time employees, it is the fourth-largest employer in the county) and the hospital-funded Horizon Foundation, an independent philanthropy that funds health and wellness in initiatives in Howard.
"We're the number one provider of health care here," said Broccolino, who has been head of the hospital since 1990 and who, along with his wife, Tina, will be honored June 1 at the hospital's 40th Anniversary Gala in Baltimore. "We cast a large shadow on the community — but a positive one."
Howard County General's status as the county's one and only hospital is taken for granted today, but that wasn't always true.
In the early 1970s, even as the future hospital was being built, some county officials decided Howard needed a second hospital, and no fewer than three organizations applied: Lutheran Hospital and Bon Secours, both struggling hospitals in Baltimore, and the Hospital Corporation of America, a national chain.
With suspicion of a Columbia-centric hospital high in some parts of the county, and some county leaders backing a second hospital, the state approved an application from Lutheran Hospital.
That approval sparked a classic Howard County battle. Led by activists that included such future local political figures as state Del. Liz Bobo (later county executive) and former County Councilwoman Angela Beltram, the Citizens Committee for Sensible Hospital Planning was formed to fight the second hospital. Members argued that one large hospital would offer better, more extensive and sophisticated care than two or more smaller hospitals.
The debate raged for a half-dozen years. Lawsuits were filed, meetings and hearings held, and at one point a busload of angry residents visited the office of the Maryland health secretary to lobby for his support.
In 1974, a new County Council, with a majority of members from Columbia, used its zoning authority to block construction of the planned Lutheran hospital in Ellicott City (at the site of the new Miller Branch library).
The controversy burned until August 1978, when state officials denied a renewal of Lutheran Hospital's approval to build — insuring, after six years of doubt, the significance and future growth of Howard County General.
Beltram, a veteran of numerous zoning and planning disputes the past few decades, said her successful fight for one county hospital is one battle she is especially proud of.
"I've told people, the only thing I ever really accomplished was that," she said in a recent interview.
In a history of the hospital that he is writing, professional health planner Harry Glass, a supporter of the one-hospital contingent in the 1970s, writes that future events have confirmed the wisdom of the one-hospital strategy.
"HCGH has gone on to fulfill predictions that allowing it to grow would be the best way to develop quality hospital services in Howard County," writes Glass, 74, a Columbia resident. "It is now a comprehensive medical center with an acute care inpatient capacity of 249 beds — fewer beds than would have existed for nearly 40 years under even the least bad of the multiple hospital scenarios under consideration in the mid-1970s.
"Evidence of the importance to the community of the one-hospital strategy is the fact that, over the years, HCGH was able to develop into the kind of organization that caught the attention of Johns Hopkins as it began to grow its network of hospitals."
Broccolino cited that affiliation with Hopkins, established in 1998 after the county had split from Hopkins in 1974, as pivotal to the hospital's growth.
"It allowed us to expand," he said, explaining that the partnership gave the hospital the financial wherewithal to add medical services — the number has nearly doubled since 1998 — as well as access to clinical and medical expertise from the Baltimore-based health care powerhouse.
Officials say the Hopkins affiliation is only one factor in the hospital's evolution. The county's changing demographics across the years also have driven change.
"The county has grown and changed, and we've had to grow to meet that need," hospital spokeswoman Susan Case said.
As the population aged, for example, the young parents of Columbia and elsewhere became senior citizens. In response, the hospital beefed up its cardiac care, added stroke rehabilitation and cancer programs, and in 2011 opened an Acute Care for Elders Unit, where a team of social workers and others help elderly patients transition back to their homes.
Similarly, as the minority population grew, the hospital bolstered its community outreach. It added, for example, a Latino health fair, and in late 2011, launched Martti, a video translation system that allows medical providers and patients to communicate by computer in more than 170 languages.
The hospital also has developed partnerships with about 100 community organizations, ranging from the public school system to the National Alliance for the Mentally Ill.
In addition, Howard County General has embedded itself in the community with an array of health fairs and sponsored community events, including the Symphony of Lights, held during the Christmas holidays at Columbia's Symphony Woods Park.
Looking to the future
Broccolino sees more changes in store in the coming years, such as an expanded emergency room that leaves more space for patients needing observation, more specialized medical care and another "significant' building project in three to five years.
He also foresees having to trim some services in order to handle the tighter reimbursement polices that will result from federal health care reform.
"We offer the widest range of services among community hospitals in Maryland," Broccolino said. "But it's hard to be all things to all people. … I'm not sure we can sustain it."
Still, he said, that paring is not a certainty. "If anybody's going to find a way (not to trim), I believe my team will do it," he said.