For two years, Horst and Luisa Ferrero have been on a mission to create a dedicated children’s hospital. It’s a personal cause for them, but the hospital could also bring hundreds of jobs and millions of dollars in revenue to the region.
October 10, 2007.
It’s a date Horst and Luisa Ferrero can’t forget. It’s the date their son Sebastian died as a result of a series of preventable medical errors that occurred at a pedeatric outpatient clinic at Shands at the University of Florida.
Since then, the Ferreros have focused on a plan to build a hospital specifically for children in Gainesville. In the process, they’ve started a movement that could revolutionize health care for the area’s youngest residents and create a huge economic engine for the city and Alachua County at large.

Sebastian was three years old when he died. His parents had taken him to the clinic for a test because he seemed small for his age. But because of failures in communication and errors in labeling, the child received more than 10 times the required dosage of a drug named arginine during a growth rate stimulation test.
During the procedure, the boy became sick. A doctor told Horst the dosage noted on Sebastian’s chart was correct, but no staff member examined the child or checked the bottles of arginine, which would have revealed the overdose. Sebastian’s brain swelled and he was dead within days.
Six months later—following a settlement that amounted to nearly $1 million—the Ferreros pledged to partner with the very institution responsible for their son’s death and to work together to develop a nationally recognized, comprehensive patient safety program.
“Sebastian Ferrero changed the College of Medicine forever,” said Dean Michael Good, who was the college’s senior associate dean for clinical affairs at the time of Sebastian’s overdose. “It’s unfortunate that it takes an event like this to affect cultural change.”
But, if the Ferreros are successful, Sebastian’s death won’t only result in better safety standards; it will lead to a state-of-the-art, dedicated children’s hospital that will help patients and the community at large.

The Benefits for Health Care
A dedicated children’s hospital would be a health-care bonus for north Florida and south Georgia, says Richard Bucciarelli, MD, chairman of the Department of Pediatrics at UF/Shands and a member of the board of directors of the Sebastian Ferrero Foundation.
Bucciarelli broadens the focus, however, suggesting a new facility should serve children and mothers, providing such services as special maternal/fetal medical care for high-risk pregnancies, private labor and delivery suites promoting family-centered care, and a mother/baby unit with private rooms for the newly delivered baby.
Bucciarelli says there are numerous reasons to build such a facility here, including the fact that specialized care is safer for children. For instance, one of the top ten causes of death among children is errors administering medication.
When it comes to medication errors, children are the most vulnerable because most medications are made and packaged for adults, because children are less able to tolerate a medication error, and because young children can’t communicate as well about adverse effects they experience.
Beyond medication errors, there are some other areas where children could be better served by specialized care. Children are not just mini-adults. Not only do they require smaller doses for treatment, they often need different medicines altogether.
Today’s dedicated children’s hospitals are designed with larger private rooms and have a kid- and family-friendly environment with bathroom appliances sized and positioned for kids. Dedicated children’s hospitals typically have 100-percent pediatric trained staff, not staff who must shuttle between various disciplines. This allows doctors and nurses to concentrate full-time on the needs of children.
Children’s hospitals often have pediatric-specific equipment, but in affiliation with a larger hospital such as Shands, they can share expenses, an important budgeting factor when an MRI machine alone costs as much as $3 million.
Dedicated children’s hospitals help recruit and retain pediatric specialists.

The Financial Benefits
The Sebastian Ferrero Foundation has signed an agreement with Shands Healthcare to conduct a Needs Assessment Survey that will determine such things as whether there is a justified need for a children’s hospital in this area, the size of such a facility and the services it could provide. Until that assessment is completed in May, it’s difficult to say specifically how a new children’s hospital could impact the area. However, it is possible to get a general idea by looking at other facilities.
When Shands built the new 254-bed cancer and critical care center in Gainesville, it provided construction jobs over a 30-month period, employed as many as 1,200 workers at its peak, and generated $120 million in expenditures. So clearly, a new children’s hospital could have a positive, immediate impact on the area’s economy from the moment construction started. But the long-term jobs would be even more significant, if the Dell Children’s Medical Center of Central Texas and other hospitals like it are any indication.
With 1,100 full-time employees, the new Dell children’s hospital in Austin, Texas, employs about 500 nurses and 313 physicians. Another 800 physicians have privileges at the hospital. It has an annual payroll of around $55 million and serves a 46-county area as the premier health care provider for children and adolescents.
Dell has 169 private rooms plus 10 in a recently expanded emergency department, says communications specialist Matilda Sanchez. “We are the only dedicated freestanding pediatric facility in the region and it is all digital, all wireless.”
Yet another children’s hospital is rising, floor-by-floor, in Orlando. Projected to open in the third quarter 2012, Nemours Children’s Hospital is certified for 95 beds.
“We are initially building around 630,000 square feet,” says Nemours communications specialist Jerrod Cady, “and will expand to 1.4 million square feet in Phase 2.”
How many jobs will that hospital generate? A 2007 study by the Milken Institute estimated that 5,000 area jobs would be created during the construction phase, followed by 2,600 permanent jobs once the hospital opens.
Perry Wong, senior managing economist at Milken, said the hospital should add $50 million to Orlando’s economy in its first year and an additional $81 million each year after five years.
But a dedicated children’s hospital also indirectly benefits a community as the people employed there or visiting there spend money in the community and generate jobs obliquely. “The impact of a new hospital goes way beyond children’s services alone,” says Ferrero Foundation treasurer Gil Levy. “There are home construction jobs—remodeling or new building—landscaping, and hundreds of permanent skilled jobs.”
For example, a recent study in central Kentucky suggested that for every one hospital job created at the Rockcastle Hospital and Respiratory Care Center, an additional 0.48 jobs was created in the community; in Rockcastle’s case, 138.6 jobs.
Income rose similarly, according to the study. For every $1 generated by Rockcastle Hospital, 38 cents of additional income is being generated in the community.
Closer to home, a report funded by the Florida Hospital Association suggested that every $1 spent at a Florida hospital generated $2.47 of additional income. “Florida hospitals,” the report noted, “provide high-skill, high-wage jobs, with annual earnings averaging $52,661 in 2006.” (The latest year for which complete data was available.)
Says Levy, “A new hospital will have a fairly sizable economic impact as well as enhance the ability of UF/Shands to recruit and retain the finest practitioners. Medical professionals are well compensated and highly skilled people who will have a tremendous impact. Doctors and nurses will need homes and schooling for children; eat pizzas and buy cars … A multiplying factor is at work for everyone who comes into the community.
“If the Sebastian Ferrero Foundation can lead the way to a new children’s and women’s hospital here, it will be a great, great thing,” Levy says.

The Hard Steps Ahead
John Barnes is a consultant to the Sebastian Ferrero Foundation and has extensive experience working with Emory University Health Care in Atlanta. He says that once the Needs Assessment Survey is done, the Foundation will enter a critical stage in finding funding for a local children’s hospital.
“The Needs Assessment is going to map out the direction at UF,” Barnes says. “If it says ‘go,’ we’ll recommend using the Foundation money to find a major philanthropy that can make a significant gift, maybe $50 million. Our task will then be to use this commitment to leverage Shands into financing a children’s hospital.”
Even if the Needs Assessment is positive, that won’t necessarily be easy. It isn’t just  “finding money.” It’s a matter of reallocating scarce resources and it would force UF/Shands administrators to make very difficult decisions, Barnes says.
Larry McAndrews, president and CEO of the National Association for Children’s Hospitals and Related Institutions in Alexandria, Virginia, says, “The fund-raising mantra is to find a few people who can make a meaningful difference.”
If the project moves forward, Bucciarelli believes a free-standing hospital within the Shands system and in the Shands/VA neighborhood is the best possible result. He suggests the ground-breaking ought to happen in five years.
“Everything depends on the outcome of your Needs Assessment, though,” says McAndrews, “from state accreditation to further fund-raising to estimating a new hospital’s impact on the community. Until the formal assessment of need is completed, everything is just a guess.”
McAndrews says that the Foundation and its vision for a children’s facility can only take place in cooperation with Shands. “Nobody creates a children’s hospital from scratch. You really cannot do that. To think you can build a quality, independent program—much less a significant building—apart from Shands … that’s just not going to happen.”
So much depends on the results of the 2010 Needs Assessment. But is it possible that the analysis could recommend no children’s hospital be built?
“Not a chance,” Barnes says.

It Takes Money, Money, Money
In 2005, following years of study and preparation, the board of directors of The Children’s Hospital of Austin (Texas) and a committed group of private citizens went to work in earnest to raise money to replace their aging facility. They knew that extensive fundraising would be required. Fortunately, they could call on a major source: the foundation created by the head of Dell Computers, whose company is headquartered in Austin.
The Michael and Susan Dell Foundation provided a $25 million matching grant and other donors contributed an additional $50 million. Seton Family of Hospitals paid the remaining $125 million and the new hospital opened in June 2007.
Local fundraising is wonderful, but the Central Texas hospital might never have gotten off the ground without the initial Dell Foundation grant. And that foundation later made an additional $50 million grant to the University of Texas in Austin, a portion of which helped establish a pediatric research institute that will complement the children’s hospital.
Likewise, the new $380 million Nemours Children’s Hospital in Orlando was fortunate enough to find a major benefactor: its own corporate pockets. The hospital is one of a group of hospitals and clinics financed by the $31.836-billion E. I. du Pont de Nemours chemical company.
To support ongoing operations, the Dell children’s hospital gets funding from the Children’s Medical Center Foundation of Central Texas. Over the last 10 years, that group has raised $2.8 million to aid children’s healthcare in Central Texas, and it regularly runs events to keep the money coming in.
As an example, the Spring issue of the group’s newsletter reported on “an unforgettable evening at the beautiful Bella Collina estate of Julie and Stephen Siegele. The event raised an incredible $810,000.” It was highlighted by a fireside chat with featured guest Henry Kissinger and special guest (former University of Texas football coach) Darrell Royal.
Successful children’s hospitals often have major benefactors and some, such as The Children’s Hospital of Philadelphia, establish endowments to cover ongoing costs. Good children’s health care clearly won’t come cheap.
In Gainesville, the Sebastian Ferrero Foundation already has accomplished much in two years. Nearly $7 million is in the bank or has been pledged. Obviously, that leaves a huge gap in paying the total cost of a new hospital. “The philanthropic community can probably raise 10 to 20 percent of the money,” insists Horst Ferraro. “$20 to $35 million.”
Gil Levy, president of Tioga Town Center and treasurer for the Foundation says, “Our goal is to assemble enough capital within five to seven years that we can sit at a big table and discuss how to finish it.”