Authors Posts by Barry Stringfellow

Barry Stringfellow

Barry Stringfellow
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Veteran Island dentist Garrett Orazem said Oak Bluffs benefits from municipal fluoridation.

Updated Sept. 26, Friday: The Board of Health took no action Thursday night.

This Thursday night the Oak Bluffs board of health (BOH) is scheduled to hold a public hearing and possible vote on the continued fluoridation of the town water supply. Oak Bluffs is the only one of the three Island towns with municipal water service that adds fluoride to its water, but for the most part, the significant public health debate has attracted little attention.

Chiropractor John Campbell, a member of the board and a staunch opponent of fluoridation, is the driving force behind the effort. Dr. Campbell cites health risks that include cancer.

Veteran Island dentist Garrett Orazem, a proponent of fluoridation, said any move to end fluoridation would be a “huge mistake.” Public health experts are in agreement on the benefits.

This will be the second public hearing on fluoridation elimination. The first hearing was held in the early afternoon on June 10, and attracted only three people, two of whom were ardent fluoridation opponents. The board said it scheduled the Thursday hearing at 7 pm in the library meeting room hoping to draw a larger audience. The meeting is open to all Islanders. “We’d like as many dentists to weigh in as possible,” health agent Shirley Fauteux told The Times.

Vineyard Haven dentist Dr. Helene Shaeffer questioned the scheduling of the two public hearings and how much input the board really wants from Island dentists. “The first hearing was during the day when we were all working, and this hearing is on the second night of Rosh Hashanah,” she said, referencing one of the Jewish high holidays. “I think their choices have been misappropriated.”

The practice, which began in April 1991, costs the town $15,290 per year. Currently, sodium fluoride is added to town water at all four pumping stations at 0.7 parts per million, according to Water District superintendent Kevin Johnson. The Massachusetts department of public health supports the Centers for Disease Control fluoridation range of 0.7 to 1.2 parts per million, according to a department spokesperson.

A big mistake
Dr. Garrett Orazem, a dentist on the Island for 33 years and staunch fluoride proponent, changed his off-Island plans to attend the Thursday-night hearing.

“I found out about this last Friday night when I came back from off-Island,” Dr. Orazem told The Times. “I called patients from Oak Bluffs on Saturday and Sunday and I’ll keep calling other dentists when my schedule allows. I hope the good people of Oak Bluffs will show up in substantial numbers and let the board know that discontinuing fluoride is a huge mistake. A lot of people aren’t aware that if they take it out, it can’t go back in without great difficulty. When a board votes to fluoridate, and enough people object, it goes to a public vote, and then outside agitators show up from all over the country and use scare tactics. It happened before on the Island in 1962 when Edgartown attempted to add fluoride to their water, and people were wrongly convinced that fluoride causes arthritis.”

Dr. Orazem said he has seen the benefits of fluoridation in his practice. “I know of a family in Oak Bluffs where a father and mother have a great deal of decay and have lost some teeth, while their two children grew up with fluoridated water and have shown barely any tooth decay between them,” he said.

Dr. Orazem discounts the notion that individuals who want the benefits of fluoride can apply the chemical ion with rinses and toothpaste. “I raised a family in Edgartown and I had to give fluoride to my kids every day,” he said, adding that his children, now grown, have had minimal tooth decay. “I’m a dentist, and it was difficult for me. I can’t imagine what it would be like for families with challenges. With fluoridated water, you can reach the entire community, not just a few.”

Junk science
Dr. Orazem studied at the Harvard School of Dental Medicine under Dr. Myron Allukian, Jr., past president of the American Public Health Association and former dental director of the city of Boston for 34 years. In an email to The Times on Tuesday, Dr. Allukian said, “Fluoridation is a sound, safe, public health measure with almost 70 years of positive benefits. Who are you going to believe, every U.S. Surgeon General since the 1950s and just about every reputable state and national health agency and organization in our country, or some junk science from the Internet?”

Dr. Allukian plans to participate in the hearing via speakerphone. In an email to The Times late Wednesday, Dr. Allukian confirmed that health agent Shirley Fauteux had contacted him and will dial him in to the proceedings at 7:30 pm.

Sarah Kuh, Vineyard Health Care access coordinator and director of Vineyard Smiles, a county-sponsored dental health program, also stressed the benefits of fluoridation. “Fluoride in drinking water was cited by the CDC as one of the greatest advances in public health in the 20th century,” she said. “There’s practically no downside to it.”

Ms. Kuh said a recent Vineyard Smiles visit to Tisbury School showed a “shocking” amount of tooth decay, with more than one student needing treatment for 7 cavities. “The science is on our side,” she said. “You can always find one outlier study to support a different point of view. What I would really like to see is fluoride in all towns, rather that taking it away. It doesn’t just benefit children, it also helps prevent caries in adults.”

No fluoride
Dr. Campbell chaired the June BOH hearing. Mr. Campbell did not return calls or emails from The Times seeking comment prior to tonight’s hearing.

At the June meeting, Dr. Campbell read from a two-page sheet that listed various objections to fluoridation, and he discussed the injurious effects of fluoridated water cited in various studies. One study asserted that fluoride increased levels of bone cancer in young males. Dr. Campbell also cited studies that he said show that tooth decay does not go up when fluoridation is stopped. In addition, Dr. Campbell asserted that there has never been a single randomized clinical trial to demonstrate the effectiveness of fluoridation.

Water district superintendent Kevin Johnson said he will not attend the hearing, citing previous plans to be off-Island. At the June meeting, he went on record as favoring the removal of fluoride from the town water supply. Mr. Johnson said he thinks the chemical is potentially toxic and that the money could be better spent elsewhere in the water district. He repeated that stance last week in a phone call with The Times.

Correction: Dr. John Campbell was previously misidentified as Dr. Bruce Campbell

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Dredging at Little Bridge will take place as soon as newly awarded FEMA funds are transferred to the town treasurer.

Citing reduced deficits, increased reserves, and a stable outlook, bond rating agency Standard and Poor’s (S&P) has upped Oak Bluffs’ town bond rating two grades, from AA- to AA+.

“It’s a direct result of the town’s effort and this board’s effort to get a handle on the town’s finances and to put the town on a stronger financial footing,” Town administrator Robert Whritenour told selectmen at their regular meeting on Tuesday night. ”It’s not surprising to see our bond rating going up; what is startling is to see it jump two notches in one review.”

Mr. Whritenour added that the improved rating will make upcoming bond issues more appealing to investors, which will help finance town infrastructure improvements like the new fire station. Selectman Michael Santoro gave kudos to Financial Advisory Committee (Fincom) chairman Steve Auerbach. Mr. Auerbach deflected the approbation to Mr. Whritenour.

“It’s been a team effort, starting with the strategic plan,” Mr. Whritenour said. “We’re clearly on the right track.”

Oak Bluffs had a AA- rating with a negative outlook, meaning future downgrades were likely, when Mr. Whritenour came on as interim town administrator in 2011. The new AA+ rating is one level below AAA, the highest in the S&P grading system.

The S&P report concluded the two-page assessment of town finances with a caveat. “The stable outlook reflects Standard & Poor’s opinion of Oak Bluffs’ strong economic profile and budgetary performance, coupled with very strong liquidity … While we do not expect to change the rating further within the two-year outlook period, we, however, could lower the rating if budgetary performance were to diminish, resulting in lower financial reserves and pressuring liquidity.”

Fuel for thought
More positive financial news came from selectman Michael Santoro, who informed the board that harbormaster Todd Alexander reports the new Oak Bluffs fuel facility has surpassed the 60,000-gallon sales goal, and with the temperate September weather, sales could exceed 70,000 gallons. “There were naysayers who said we’d never sell 30,000 gallons, and we didn’t start until early July,” Mr. Santoro said. Chairman of the selectmen Greg Coogan added that he’s had a great deal of positive feedback from boaters about the competitive pricing at the Oak Bluffs harbor vis-à-vis Falmouth and other Island fuel depots.

FEMA funds Sengie dredging
In other business, Mr. Whritenour informed the board that the Federal Emergency Management Authority (FEMA) has given the final approval on funding for the Sengekontacket “Little Bridge” dredging project. Little Bridge is one of two channels that connect Sengekontacket Pond and Nantucket Sound. FEMA originally estimated the project cost at $596,131, which included moving the dredge spoils to the Inkwell and Pay Beach. However, in reviewing Oak Bluffs projects in a process known as “recapture,” FEMA reclassified the project as a dredge project, in part to expedite the funding process, according to FEMA official Robert Grimley. Under the new conditions, the dredge material will be deposited on Sylvia State Beach.

Mr. Whritenour said the town has bids in place to do the project for $321,750. The town will commit 25 percent, $80,437.50, of the project cost once FEMA funding is in place. Mr. Whritenour said that the town can act immediately once the FEMA money arrives, and that it’s feasible the dredging can be done in October.

Beach malnourishment
In other business, 12 members of a newly formed citizen beach committee attended to voice their concerns and displeasure with the condition of town beaches. The lack of amenities, limited access for the elderly and disabled, and the overall shabby condition were recurring themes.  “I think our beaches are the most-used beaches on the island, and they’re the worst,” seasonal resident Jill Nelson said. “Now when I come back from the beach, I don’t brush sand off my feet; I have to take a shower because they’re caked with dirt. We pay $16,000 a year in taxes, and I can’t even go to the beach. I have friends that come here and say, ‘I heard Martha’s Vineyard is a big deal, but this is a dump.’  I’m sure it hurts tourism. We’re not just ranting summer people, we have a point. It’s really discouraging.”

At one time we had a shower, a toilet, and a lifeguard station, and now we have nothing,” seasonal resident Gus Gaskin said. “Now it’s 1.3 miles to get from the jetty to the nearest restroom.”

“I’m a business owner, and I think you’re right,” Mr. Santoro said. “I think a lot of this comes back to money, and I’m sure you know we hit rock-bottom five years ago, and it’s taken us time to get back on solid financial ground. We have breathing room now, and the beaches are on our radar.  I think you need to go to Conservation Commission meetings and keep telling them what you’re telling us. There’s a lot of permitting involved in these fixes.”

“We’ll be sitting down just about a month from now for our strategic planning session, where we lay out priorities for the coming year,” Mr. Coogan said. “Your coming to us puts this in the forefront of our mind.  When we talk about what we can address this year, this will be at the top of the list.”

Sign up for signs
The Oak Bluffs Downtown Streetscape Master Plan Committee is seeking volunteers to form a wayfaring committee to improve signage in the town. Volunteers can write to Shelly Carter at scarter@oakbluffsma.gov.

Martha’s Vineyard Hospital donated a house that will be used to fill a critical gap in addiction and mental health treatment on the Island.

Community Services executive director Julie Fay and hospital chief executive officer Tim Walsh stand in front of the new home of the community crisis stabilization program.

In what health professionals describe as a major step forward in providing care for Islanders in crisis suffering from substance abuse and mental health issues, Martha’s Vineyard Community Services (MVCS), will establish an on-Island community crisis stabilization program (CCSP) on the grounds of the Martha’s Vineyard Hospital.

Tim Walsh, hospital chief executive officer, confirmed to The Times the hospital will donate  the “red house,” a former residential property located in front of the main hospital building that currently houses the billing department, to Community Services, the Island’s umbrella social services agency.

A CCSP treats patients in acute distress due to addiction or mental health issues for the first 24 to 48 hours of a crisis. It’s a less restrictive and voluntary alternative to inpatient psychiatric hospitalization. The goal of a CCSP is to stabilize the patient, to give clinicians time to chart an appropriate course of action, and to find the resources with which to implement it, according to treatment specialists.

“It’s going to be a huge resource for the Island,” Juliette Fay, Community Services executive director, told The Times. “When somebody is in crisis and needs evaluation, instead of going to the emergency department they’ll come to the red house. There will be individual therapy rooms, a group therapy room, crisis-stabilization beds, clinicians that are tied to emergency services, and also staff from our New Paths program.”
Currently when MVCS gets a call on the 24-hour hotline, a clinician is sent to the hospital emergency room to make an evaluation and determine if the person needs to go off-Island for inpatient care. Ms. Fay said the CCSP will spare people in crisis the cacophony and chaos of a busy emergency room.

“The emergency room staff has been wonderful, but a busy ER is not a good place to try to calm a situation down,” she said. “Consequently we have a very high rate of hospitalization. Right now, on the Island, 60 percent of the people we evaluate in the ER get hospitalized; off-Island it’s somewhere between 12 and 15 percent.”

A CCSP is not a detox facility, but the treatment it provides can potentially help an Islander avoid the onerous ordeal of going to an off-Island clinic.

“We don’t have to do an evaluation right away,” Ms. Fay said. “24 hours or 48 hours of crisis-intervention activity can forestall an evaluation and come up with a plan B, which is not going off-Island. Often when people are in the ER, that’s just the beginning of the ordeal. Our clinicians then have to start calling inpatient facilities, and finding an open bed is not easy. Once they find a bed they have to arrange an ambulance to the ferry, an ambulance on the ferry, and an ambulance to meet the ferry on the mainland to take the patient to the facility, which could be in Springfield or the Cape or Boston, you don’t know.”
A CCSP can also save valuable hospital resources. Currently, it’s not uncommon for a patient who could be treated in a CCSP setting to stay in the hospital ER for several days before a bed is found at an off-Island facility. During this time, patients who could be starting treatment in a CCSP are in a state of limbo, and often the patient requires 24-hour supervision from hospital staff or law enforcement personnel.

Collaboration pays off

Ms. Fay, Community Services staff, and board members began discussing the need for a CCSP about a year ago.

“We thought if we had access to a crisis-intervention program we could probably cut our hospitalization rate in the first year,” she said. “We thought if we could do it at the hospital, that would be ideal. About four months ago, Tim Walsh offered us the red house, and things really came together.”

“Initially, Community Services wanted to set up in the old hospital building, but that was problematic for the Medicare reimbursement process,” Mr. Walsh told The Times.

Mr. Walsh said the question was how to provide a venue that would work but be separate and accessible: “Having the red house where everything is separate, and where we can keep all the expenses separate, is a better solution for us.” Mr. Walsh invited MVCS representatives to inspect the red house at the beginning of the summer. “They thought it was a really good fit. With that, we started trying to accelerate our own renovations in the old hospital so we could get the billing department in there as soon as possible. We have a lot of balls in the air, like renovations to the dialysis unit, but we’re hoping that we can be out of there by December, January, so we can hand it over to Community Services and if they’re ready to start something, they can.”

Getting ready

MVCS will be ready, according to Ms. Fay. “We have a private donor who has made funds available to do the startup,” she said, adding that she has also met with commissioners from the Massachusetts Department of Public Health (DPH) and Department of Mental Health (DMH) to obtain additional funds and to navigate the bureaucratic maze.“We may have a volunteer architect, but we haven’t finalized that yet,” she said.

Estimated renovations will take two to three months, during which time MVCS staff will be trained in crisis-intervention stabilization. “It’s a very different model from what is used in emergency rooms,” Ms. Fay said. “You work proactively with individuals and family members about how to keep somebody safe in the community instead of going off-Island for inpatient care.”

The CCSP will be staffed on an as-needed basis. “We don’t think there will always be someone in the red house, but when someone is, we are committed to provide 24/7 staffing,” Ms. Fay said.

Contrary to the usual ebb and flow on the Island, the winter and spring will be the busiest time for the CCSP. “Our busiest time is January through May; that comports with a seasonal economy, the dark months,” she said.
If all goes as planned, the CCSP will be operational before the dark months on the Island have passed.

“You have to give all the accolades to Julie,” Mr. Walsh said. “I’ve been an advocate for a crisis-intervention center for years, but she really pulled it all together and made it happen.”

Ms. Fay said MVCS still needs funding to keep the momentum going for the CCSP. Donors can contact her at 508-693-7900.

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The yellow pins show the approximate area off Eastville Beach where brothers Dan and Greg Martino plan to farm oysters.

Oak Bluffs selectmen made history Tuesday night when they approved the town’s first aquaculture license with a 4-1 vote. Selectmen granted a three-year license to brothers Dan and Greg Martino for a two-acre farm, located about 100 yards off Eastville Beach on Vineyard Haven harbor.

Selectman Gail Barmakian was the dissenting vote. Ms. Barmakian said she wanted more time to consider the issue.

It has been a long and contentious approval process. Tuesday night was no exception, as the chairman of the selectmen Greg Coogan twice used his gavel to restore order.
Eastville opponents have been regular attendees at shellfish committee meetings and selectmen meetings following a unanimous vote in March by selectmen to grant preliminary approval to the Martinos. The Eastville homeowners have consistently cited concerns about safety for swimmers, boaters, and windsurfers. They also claim that the farm location is vulnerable to nor’easters, which would mar the beach with debris, and that the associated machinery noise and 100 white buoys would damage the aesthetic quality of the shore.
Eastville homeowner Jack Ludwig, along with his sisters Wendy, Amy, and Patricia, have spearheaded opposition to the Martinos’ farm, and retained Boston law firm Sloane and Walsh to represent them. The attorneys submitted a 10-page position statement to the selectmen on Monday detailing their objections. They also asked the selectmen to postpone the vote because they couldn’t attend the meeting, but Mr. Coogan elected to move ahead with a vote.
“We were disappointed,” Mr. Ludwig told The Times on Wednesday morning. “The selectmen decided to take away a public use for a lot of people for a private use for two people. I think the Martino brothers are well-meaning, and aquaculture is almost certainly the future of shellfishing, but we think the location is wrong. The application has a lot of flawed, inaccurate information.”

Mr. Ludwig said he would confer with his family and the 10 other objecting families and decide whether to seek a temporary restraining order by the end of the week.

Adjustments made
The plan the Martinos presented Tuesday night was designed to address earlier concerns.  They reconfigured the layout of their grow cages to allow for a wider path of egress for ease of navigation. They also outlined a plan to reduce susceptibility to storm damage, switched to electric power to mitigate noise, and changed to a smaller, neutral-colored buoy they said will better blend with the surroundings.

The Martinos plan to have 10 cages in operation next summer, and hope to expand to 50 cages by the end of 2015. They will make their first harvest, if all goes to plan, in the summer of 2017. They hope to eventually expand to 100 cages.
Prior to Tuesday’s vote, they received needed approvals from the Division of Marine Fisheries, the Coast Guard, the state Archeological Resources board, Native American tribes, and the Army Corps of Engineers.
Oak Bluffs shellfish constable David Grunden and members of the shellfish committee attended the meeting to show their full support. “We’ve worked with Dan and Greg for several months, and they’ve tried very hard to work with everybody,” Mr. Grunden said. “I think this will be a good thing for the town. It starts a new industry, and it’d be great to see oysters sold in Oak Bluffs that were grown in Oak Bluffs waters.”
Mr. Grunden also said he would be watching the operation closely. “They both know I’m going to hold them to these guidelines. If they don’t do what they proposed, I will shut them down immediately,” he said, to a chorus of groans from skeptical Eastville opponents.

Sailor talk
“I’m not against it. I think you guys have done a great job,” Ms. Barmakian said, addressing the Martinos, “I would just like some more time.” Ms. Barmakian said she was given pause by objections presented by Vineyard Haven Yacht Club member and youth sailing committee member Dan Pesch. “This operation will have a significant impact on our ability to educate Island youth in sailing,” Mr. Pesch said, adding, “It also curtails our ability to run regattas.”
Selectman Kathy Burton, an experienced sailor, contended there was ample space for both activities to coexist.
Mr. Coogan, also an experienced sailor who docks his boat in Vineyard Haven harbor, likewise disagreed with Mr. Pesch. “I sail out there often. It sees like a pretty small area to me. My kids went through that program, and I understand your concerns, but to me they sound more dire than they really are.”
On Wednesday morning, Mr. Coogan told The Times,”I think it might require a little adjustment for the Vineyard Haven Yacht Club, but I don’t see an obstruction in that area. Honestly, I think some of us, kids and adults, will enjoy the obstacles. That’s part of the fun of sailing.”
Mr. Coogan said the bigger issue at hand is creating year-round commerce in Oak Bluffs. “In all of this, we’re trying to promote a sustainable, year-round business. We need more of that in Oak Bluffs.  It’s a struggle for all of us who live here. The Martinos have invested a lot of time and money, and there’s no guarantee they’ll succeed. I think they’ve earned a chance to try. I’ll be sailing by there all the time. If they’re not doing a good job, they’ll hear from me, believe me.”
The 10-page position paper prepared by Sloane and Walsh asserted that the town made it difficult for seasonal residents to be heard. It also implied there was duplicity because Eastville Beach was not on the selectmen’s agenda for the March meeting.  Mr. Coogan dismissed the notion out of hand.

“There were Eastville residents at the first meeting,” he said. “The Martinos sent letters to Eastville residents, and 99 percent were signed for.  There are a lot of other Eastville homeowners who haven’t come forward. Clearly it bothers some people. But at the end of the day, I think we listened to all sides.”

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Circuit Avenue extension, a main thoroughfare for visitors into downtown, has a shortage of signage and sidewalks but no shortage of power lines. —Photo by Michael Cummo

A consultants’ report delivered to Oak Bluffs officials Monday as part of an ongoing planning process described the town as a primary trade area, one that is growing, aging, and becoming less seasonal in its mix of homes. The 29-page study delivered via teleconference to members of the Oak Bluffs Downtown Streetscape Master Plan Committee (DSMPC) and town and Island officials also included recommendations for invigorating the downtown area.

Town officials and attendees were presented with a trove of information in the two-hour meeting hosted by consultants from Horsley Witten Group to share the data from a recent economic study and to discuss results of the initial public outreach survey done by the newly formed DSMPC in late July.

In comments after the meeting, DSMPC member Brian Packish told The Times, “I think it’s a good start. They gave us some solid information and some good suggestions. Now we as a group have to discuss what we like and what we don’t, and keep the process moving. A lot of the big concerns, trash, parking, sidewalks, were also big issues in the 1998 town master plan. That was almost 20 years ago. I think it’s time we make some real progress.”

He said the DSMPC will have an open meeting at 1 pm Monday at town hall to talk about the results.

Good return

The DSMPC held its inaugural outreach event on July 23 and 24, to elicit opinions from visitors, seasonal residents, and Islanders on how to revitalize downtown Oak Bluffs. The survey was also available until Aug. 22 on the DSMPC website.

At Monday’s meeting, Jon Ford of Horsley Witten Group shared the results with palpable excitement. “We had 542 responses to the survey,” he said. “That’s record-breaking, even for Horsley Witten.”

Mr. Ford said 70 percent of the respondents were year-round residents, 23 percent were tourists, and seasonal residents filled out the remaining seven percent.

“There was consistent optimism among seasonal residents, which was a little bit surprising,” he said. “The top priority of respondents, across the board, was that the town had to preserve its historic character and the vibe of downtown.”

“There’s also a need to carve out more in the public realm. By that I mean places to sit down and relax in the downtown area,” Mr. Ford said.

Unsurprisingly, decrepit theaters and town cleanliness were also high on the list of concerns. “Garbage and litter have been a hot topic for many years,” he said.

The town beaches were also frequently mentioned, according to Mr. Ford; however, this survey was focused on the downtown business district.

“Healy Square, or as many know it, Post Office Square, is a valued downtown asset that many respondents cherish, and also feel can be improved. It’s a great space,” Mr. Ford said, likening it to the increasingly popular “pocket parks” of urban-planning argot. “It can be expanded and enhanced.”

The surveys showed other long-standing issues, walkability and parking, remain high on the list. Parking, access to town, and circulation, especially the congested and narrow sidewalks, were repeatedly cited as problematic by respondents.

“There’s also clearly a need to get around by car and for better parking,” he said.

Mr. Ford said that a conversation with Police Chief Erik Blake yielded one possible win-win tactic. “Meters are much simpler parking management. Chief Blake said it’s a lot less man-hours than chalking tires. Assuming half the downtown is metered spaces six days a week, from 9 to 6, the four-month gross revenue is $150,000.”

Big ideas

With regard to the downtown parking issue, Mr. Ford proposed, counterintuitively, to reduce parking spaces on Circuit Avenue. “We can lose 18 spaces on Circuit Ave. and gain 10 on Kennebec,” he said. “This would also make room for more outdoor street space on Circuit Ave., and more room for Healy Square.” He added that there are 600 parking spaces within a five-minute walk of downtown. There was also the suggestion to make parking on Circuit Avenue back-in only, still on a diagonal, to improve traffic flow and safety. “It requires public outreach,” he said. Neither suggestion was received enthusiastically.

The state of Circuit Avenue extension was again often mentioned. The major thoroughfare road from the harbor and from the passenger ferries is an anarchic mix of pedestrians and recently rented mopeds and cars, garlanded by drooping power lines. There are no directional signs and no designated sidewalks.

In what Mr. Ford described as “our biggest idea,” Horsley Witten suggested making Circuit Avenue extension one-way, leading away from the harbor into town, and possibly renaming it “Harbor Avenue.” The current right-turn lane off Oak Bluffs Avenue onto Circuit Avenue extension could be converted to parking. He also pitched the idea of street painting where Circuit Avenue and Circuit Avenue extension meet, and repaving the street with a porous material, as Provincetown did with their main street, since the road is in a floodplain area.

Mr. Ford was upbeat about the survey findings and the future of the downtown district. “We’re not re-envisioning,” he said. “We’re just recalibrating to make a great place greater.The bones are all there as we all know.”

Less seasonal

Horsley Witten contracted Cambridge-based ConsultEcon to conduct an economic analysis of the Oak Bluffs business district to help inform the decisions of the DSMPC. The wide-ranging study included data on trends in the town and Island economy, demographic shifts, consumer-expenditure patterns and trends with seasonal residents and tourists. It defined the town of Oak Bluffs as the primary trade area, and the rest of Dukes County — the other five Island towns and 75 Gosnold residents — as the secondary trade area.

According to the study, the Island population is growing faster than the state as whole, and there will be an estimated 18,000 year-round residents by 2018. The 5.6 percent growth rate “is significantly larger than projected growth in Nantucket and Cape Cod, where population is expected to grow by 1.2 percent and 1.1 percent, respectively,” the report said. The projected population growth for the Commonwealth of Massachusetts for the same time period is 2.4 percent.

Two-thirds of the Oak Bluffs population is over age 35, and the median age is 46.2 years old. The household size in Oak Bluffs is less than the state average, which reflects an aging population and more seasonal residents retiring to the Island — a trend that is also growing on the Cape.

The median household income in Oak Bluffs is $68,405, lower than the median income for the total trade area, $71,083. The numbers also reveal a stark income disparity in Oak Bluffs — one-third of the town population earns more than $100,000 a year, while the second-largest income group is the 20 percent who make between $25,000 and $49,999 a year.

The study estimates that year-round residents spend roughly $52.5 million per year, on and off-Island, spending the most for food, motor-vehicle and parts dealers, and general merchandise, in that order.

In a trend that bucks the rest of the Island, seasonal residences in Oak Bluffs have declined from 56.1 percent in 2000 to 50.8 percent in 2010. “The expectation [is] that more seasonal homes will be converted into year-round residences in the coming years, and the demand for more year-round goods and services will likely rise,” the report says, noting again that the same trend is playing out on the Cape. “General merchandise and home improvement stores are opportunities that would better serve the growing resident market population and support more business activity in Oak Bluffs downtown.”

Recommendations

The ConsultEcon report stresses the importance of visitors’ arrival to the town because it sets the “tone and tenor for a visitor’s trip.” While the report credits the Steamship Authority for improvements to the terminal and adjoining streetscape, it describes the North Bluff arrival area as “chaotic,” adding, “When arriving at these passenger-only ferries, visitors are immediately presented with an array of opportunities to rent cars, mopeds and bikes, or take a tour or taxi, that signal that Oak Bluffs is a place of departure and not arrival.” The aesthetic and functional shortcomings of Circuit Avenue extension was an oft-mentioned topic in both studies.
“Wayfaring,” signage that helps visitors find their way to town and to specific attractions, was another frequently raised issue. The report suggested that in addition to signage, which should be designed in the Victorian spirit of old Oak Bluffs, “interpretive trails create an attraction for cultural tourists, who tend to spend more money during a trip than the average tourist spends.” It did not define “cultural tourists.”

The oft-trod issue of inadequate sidewalks was again raised. “Overall, the sidewalks in the Oak Bluffs Downtown are too narrow to accommodate all visitors at peak times, leading people to walk in the streets.” Suggestions were made to add more open space and public seating in the downtown area, noting, “Many visitors use the tree planters in the streets, which are in ill repair.”
To draw more visitors to the downtown area during peak season, the ConsultEcon report recommends hosting more midweek events. It also suggests adding under-represented stores like home furnishing and arts and crafts galleries. It concluded that the downtown could benefit with the addition of entertainment attractions, which “may include but are not limited to” nightclubs, amusements, a bowling alley, and a movie theater.

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New unit will increase access to care and decrease costs for patients and for caregivers, hospital officials said.

The new walk-in clinic will provide an alternative to the busy hospital emergency room. (Photos by Michael Cummo)

The Martha’s Vineyard Hospital has begun renovating the no-longer-used emergency room in the old hospital building for use as a walk-in clinic. Hospital leaders said the new clinic is necessary to address a longstanding shortage of access to non-critical health care for Islanders.

Tim Walsh, Martha's Vineyard Hospital CEO (left), and Dr. Jeffrey Zack, chief of emergency medicine, said changes in health care are driving changes at the hospital.
Tim Walsh, Martha’s Vineyard Hospital CEO (left), and Dr. Jeffrey Zack, chief of emergency medicine, said changes in health care are driving changes at the hospital.

In a conversation with The Times on Wednesday, Tim Walsh, hospital CEO, and Dr. Jeffrey Zack, director of emergency medical services, discussed this newest addition to an expanding scope of services that the hospital now offers.

The hospital officials said the addition of a walk-in clinic would provide an alternative to the emergency room and become part of a continuum of care that includes emergency care, primary care and inpatient care overseen by hospitalists, all linked by a system of electronic medical record keeping under the umbrella of the hospital’s parent organisation, Massachusetts General Hospital (MGH), which now provides the Vineyard hospital with radiology, anesthesiology and oncology services.

In March 2007, Martha’s Vineyard Hospital became an affiliate of Massachusetts General Hospital and a member of Partners HealthCare.

“This is part of a system-wide overhaul that we’ve been doing over the last few years to better accommodate the needs of our patients on the medical end and also the financial end,” Dr. Zack said. “The goal here is to design a system that can cover from the very sickest to the non-critical patients, and the walk-in facility has been a big hole in our delivery system.”

Dr. Zack said all too often, patients utilize the emergency room (ER) because they may not have a primary care doctor. “Emergency medicine is here for the sickest of the sick, yet over the last 10, 20 years we’ve started to take care of everybody. We do a lot of primary care, especially here on the Island. It isn’t the most cost-effective way to deliver quality care. This [walk-in clinic] fills that need of ‘not too sick but can’t wait for an office visit in a week.’”

Dr. Zack said that the walk-in clinic will also help manage the surge in patients when there’s an outbreak of the flu or a virus like the one currently spreading in the midwest. “Historically this overflow would go into the ER, which diverts resources and is a costly way to practice medicine. But up until now, there’s been very little options for folks on the Island.”

Staffing and hours

The medical personnel staffing the walk-in clinic will be a mixture of physicians and mid-level providers, such as physician’s assistants and nurse practitioners. Mr. Walsh said the hours of operation will be tailored to demand.

“We’re going to study and figure out the hours as we go along,” he said. “If there’s a need to stay open after hours, we’ll see what we can build around that. We’re hoping to play off the community. If there’s a real need to keep it open, say, until 7pm at night, then that’s what we’ll do. We’re open to figuring that one out.”

Long range benefits

In addition to the benefits in patient care and cost containment, Mr. Walsh said the clinic will help balance the books in the long term as well.

“Looking down the road at the Affordable Care Act, and where they’re trying to go, it’s really about population health management,” he said. “For a given population you’re responsible for everything that happens to them. We’re rethinking how you do it. They want to do global payments in the future, for every person that comes into your system they’ll pay you $25,000 a year — you take care of the health care. Right now, it’s about volume, the more you do, the more you make. That’s going to change to: the more you do, the more your expenses are. So you’re not making more money. That’s where a walk-in clinic can save money. A $300-dollar visit to the ER can be done instead for $100.”

Mr. Walsh said the goal is to make the walk-in clinic operational by next summer at the latest. “I’m hoping we can get it in by next February, but we got sidetracked with repairs to the air handling system in Wing 1 in the beginning of the summer. Replacing a new unit costs over $700,000. The next move will be to install air transfer in the old ER It’s interesting times around here.”

Increased demand
The walk-in clinic is the latest in a series of improvements and upgrades. These include the addition of a new MGH oncology unit, the recently completed $2 million transfer to electronic record keeping, and a $1 million investment in hiring hospitalists, doctors who solely treat hospital inpatients and thus provide consistent care and free up overwhelmed primary care doctors.

The expanding system was put to the test this summer, which according to hospital statistics, was the busiest in the hospital’s history. Patient days in acute care were up 28 percent, and patient days in skilled nursing facilities (SNF) were up 74.4 percent.

“We were busting at the seams,” Mr. Walsh said. “Because of our expanded services like the hospitalists, we were able to hold on to more patients here and not transfer off-Island. The ICU was much busier. It’s stunning how much volume we did. We were boarding in the ER, which is unusual for us. We had it happen in the past but not to this extent. Not even close.”

One goal is to avoid transfers to mainland hospitals when possible. “I don’t think the number of patients went up significantly; it’s the number of people we’re keeping in the system,” Dr. Zack said. “That’s the overall goal here. Our patients don’t want to go to Boston. They want to stay here with their families. So we’re adding more resources one bit at a time so we’re able to do that. Now looking at the big picture, we need to address the lower acuity stuff.”

Doc docs

The recent conversion to electronic records will enable the growing departments within the hospital, and partner hospitals off-Island, to instantly access critical medical information within the Partners Healthcare network.

“It’s an all-in-one system,” Dr. Zack said. “There’s no fishing around at 2 am trying to find information — it’s there. That time can be important, and maybe life-saving.”
“If you go from here to Mass General, they see the primary care records, the ER records, they see everything. And vise versa: when the patient comes back, we see everything they did in Boston,” Mr. Walsh said. If the hospital shows “meaningful use” of the electronic records system, according to an upcoming Medicare evaluation, it will receive a significant rebate to defray the cost of the system.

Choice is good

Mr. Walsh and Dr. Zack said the recent sale of Vineyard Medical Services, presently the only walk-in clinic on the Island, had no bearing on today’s announcement. “This has been on my radar for two years,” Dr. Zack said. “For us the hospitalist program was more important to get up and running; so that took precedence.”
“I talked to Dr. Jacobs several times over the years about buying his practice as a satellite facility,” Mr. Walsh said. “I like Dr. Jacobs, he’s a great guy. We’ve always had a really good relationship. The problem is the licensures. When you’re talking about a hospital satellite, you have to meet hospital code, and the standards are brutal, as they should be. The air-exchanges demands are extremely high. I don’t think any house could meet them.”

Mr. Walsh is supportive of the new walk-in venture. “It’s good for people to have choice. It’s on us to deliver a good product,” he said.

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The President of the Friends Group Leo Gagnon, in front of the Council on Aging building. (Photo by Michael Cummo)

The Oak Bluffs Council on Aging (COA) board meeting held August 28 was slightly delayed. The Thursday morning exercise class in the meeting room had gone long, and it took a while for the steady stream of sweating and, for the most part smiling, endorphin-charged seniors to exit.

Council-on-Aging_Robert-Whritenour.JPG
Oak Bluffs town administrator Robert Whritenour, center in pink, joins community members at the monthly luncheon put on by the Council on Aging. (Photo by Michael Cummo)

As the room cleared, Leo Gagnon, president of the Friends of the Council on Aging (FCOA), a nonprofit corporation that is the fundraising arm for the COA, talked about an open house held on August 13 to mark a change in direction for the organization that had been at the center or controversy.

“I introduced it as the new senior center,” he said. “We want to get rid of the old and bring in the new. You should have seen this place. It was packed. Local merchants contributed prizes and every 15 minutes we rang a bell and gave out a door prize.”

Mr. Gagnon said the many contributions from local merchants included a 32-inch flat screen television from Crane Appliance.

“We also had live entertainment from the Princess Poo-Poo-Ly band. They’re an Island band of 16 people playing ukuleles. They were terrific. They played for over 90 minutes. A lot of people were singing along. There were four guys sitting up front, who are barely able to walk, and they were standing and stomping their feet and their canes. Sandra from the Vineyard Haven COA said, ‘This place rocks!,” Mr. Gagnon said, grinning.

Trying times

The picture Mr. Gagnon described is in marked contrast to the COA of a few months ago when the organization was rocking with a different kind of energy. The 2014 winter of discontent involved police and forensic accounting investigations, heated accusations, and divisive infighting, which culminated in the resignation of former director Roger Wey, as of June 30.  While the investigations found no criminal wrongdoing, a history of sloppy accounting and years of rancorous relations among COA staff came to light. In a six page report, town administrator Robert Whritenour wrote that the long-standing rift between associate directorRose Cogliano and Mr. Wey yielded “charges and counter charges of harassment” dating back to 2006, which divided the COA membership into opposing “camps.”

In his June 19 memo to the selectmen, Mr. Whritenour recommended a reorganization of the COA — eliminating the director and assistant director positions and creating a COA administrator and a program director, while making the board the engine that drives COA.

Moving forward

“Roger is moving on and we’re moving on and that’s the way it should be,” Walter Vail, selectman and COA board member told The Times following the August 28 board meeting.

Mr. Vail was chairman of the selectmen when on the advice of town counsel an investigation began into COA accounting practices and procedures. Although the matter could have been handled in closed executive session, Mr. Vail elected to make the proceedings public. He became a lightning rod for criticism by Mr. Wey’s supporters, who were always in full throat at selectmen’s meetings, but he stuck by his decision.

“There are only a few people who are still unhappy,” Mr. Vail said. “We had 135 people show up at the open house. Leo did a great job. Everybody had a good time. I think the message is pretty clear.”

“The board needs to be a managing partner of the COA,” Mr. Blythe said in an earlier conversation with the Times. “If you’re going to be a good board member you have to listen to both sides before you make a judgement.”

At the recent board meeting, some topics the board discussed included a new photography class starting in September, upcoming bus trips, a trip to the Woods Hole Oceanographic Institute without a bus, an October dental clinic, and a generous $1,500 gift from the Cottagers Association.

“They give to a lot of organizations,” Mr. Gagnon said. “The COA received the most. I never expected that kind of check.”

“I already have a call into Arthur to make sure it’s done properly with the town,” Ms. Cogliano said, adding that the money will be put in account for fuel assistance.
“People need to know they can apply,” outreach coordinator Susan Von Steiger said. “I’m sure Arthur will be very discreet.”

In other business, the board discussed the need for a new projector so movie night can become a regular event, recruiting a high school student or technologically savvy person to give computer classes, and how to acquire the new computers on which to be taught.

Although much of the current technology accessible at the COA is relatively ancient, Mr. Gagnon said the Oak Bluffs COA is the only place on Island where seniors can schedule a Skype session with a live person from the Social Security Administration. He then floated the idea for a Karaoke machine for a regular Karaoke night, to widely varying degrees of enthusiasm from the board.

Later, Mr. Gagnon spoke excitedly about a new program beginning in the fall, “A Matter of Balance,” which teaches seniors how to navigate the fear of falling through physical and mental exercise. He also said the board was looking to expand the popular line dancing classes given in the summer to a year-round activity.

Board member Abraham Seiman told the members that the bridge club was considering a move back to the COA from its self imposed exile. The club had separated from the COA in protest over Mr. Wey’s dismissal. “They left because of all the nonsense,” Mr. Gagnon said.

Following the meeting, Mr. Gagnon had high praise for Ms. Cogliano. “Rose turned this place around,” he said. “It’s been difficult, at best, but this place is much better than it used to be.  There’s no more fighting. It’s a happy place to come now.”

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Ralph Packer saved the day after heavy seas snapped the barge anchor lines hours before the show.

President Obama watched the Oak Bluffs fireworks from the North Bluff porch of Valerie Jarrett. (Photo by Max Bossman) — Photo by Max Bossman

The estimated 12,000 spectators at the annual Oak Bluffs Fireman’s Civic Association fireworks show Friday night had no idea how close the show was to being postponed.

“The was by far the most difficult show I’ve had to deal with as chief,” Oak Bluffs fire chief John Rose told The Times. “We had a stiff northeast wind blowing 20 miles an hour and six to eight-foot seas, and two anchor lines on the barge broke. We lost the first anchor around 4 pm. When the second line broke, someone from [R.M.] Packer had to go back to Vineyard Haven for two more anchors.”

The wind direction also created additional complications. “Because the wind was out of the northeast, which is unusual for this time of year, we had to reposition the barge 1,600 feet offshore instead of the usual 600 feet,” Mr. Rose said. “We also had to move the barge 400 feet to the south so the debris wouldn’t fall on spectators or on buildings in town.”
Mr. Rose said that he and state fire marshal Stephen Coan were in constant contact with the National Weather Service station in Taunton, which provided critical data that informed the final fireworks decision. “They told us winds would diminish from sustained 20 miles an hour to sustained 14 miles an hour between six and eight o’clock,” Mr. Rose said. “They called it on the money.”

After a frenetic afternoon of repairing, recalculating, and repositioning, a test shot that was fired shortly after 5:30 pm showed the barge needed to be moved further offshore.

“We were having trouble orienting the barge because of the wind and the strong currents” Warren Pearce, president of American Thunder Fireworks told The Times. “I was pretty panicked. Then I called Ralph Packer and he told me the tide was going to change in an hour and the current will switch and the wind will drop and we’d be all set. He was right. That man knows what he’s doing.”

Mr. Pearce, a 25 year veteran of the fireworks industry, said Mr. Packer makes many unseen contributions to the show every year. “Generally barges are an expensive addition to a show, but not in this case, because Ralph donates it. He also has his guys pitching in doing all kinds of things. They’re an integral part of making this work.”
Mr. Rose also gave kudos to Mr. Packer. “He was generous enough to tell the tugs to stay on the barge during the show,” Mr. Rose said. “As long I can remember, it’s the first time we had tugs holding the barge in place. Without the tugs there wouldn’t have been a show. Mr. Packer stepped up and saved the day.”

Mr. Pearce said Mr. Rose also deserved credit. “Chief Rose called me four days before the show and said he was concerned about the forecast and that wind was going to be a problem,” he said. “That informed what equipment we brought and in the end we had what we needed. We had a plan in place even before we got there and John was an integral part of it.”

Mr. Rose said the annual fireworks show requires a great deal of planning and coordination, even in ideal conditions. “Nobody realizes all the different things that go into the fireworks show,” he said. “We do a ton of pre-planning, starting right after the first of the year. Everything has to fall into place.”

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Funding approval for clearing the little bridge channel appears imminent, but other projects face further scrutiny.

FEMA officials are expected to fund dredging the north channel into Sengekontacket Pond. — Photo by Michael Cummo

Town administrator Robert Whritenour presented Oak Bluffs selectmen with a good news/bad news update on the status of Federal Emergency Management Agency (FEMA) funding for Hurricane Sandy repairs at their regular meeting on Tuesday night.

“We’ve received verbal determination that the Little Bridge dredging project meets the public benefit threshold,” Mr. Whritenour said. “One big change: we can’t use it for beach nourishment at Inkwell and Pay Beach.”

Little Bridge crosses one of two channels that connect Sengekontacket Pond to Nantucket Sound. The two popular public beaches are approximately one mile north of the dredging site.

Mr. Whritenour said that FEMA guidelines for dredging funds require the most cost-effective disposal of the dredge spoils, which in this case means depositing the material on State Beach. He added that when the formal written approval comes through as expected, the dredging contractor can do the work within 30 days.

Selectman Walter Vail noted that FEMA will only cover 75 percent of the project and asked how the town would cover the remaining 25 percent. Mr. Whritenour said the town dredge account would cover the balance. The work will be done in October or November, if all goes as planned.

While things are looking up for Sengie, the funding forecast for another project under FEMA review, the reconstruction of the North Bluff, is not as promising.

In an August 22 letter to Robert Grimley, FEMA region 1 disaster recovery manager, Mr. Whritenour wrote, “The second critically time-sensitive project is the reconstruction of the North Bluff seawall that has been degraded to very poor condition as a result of Hurricane Sandy. In its current condition this seawall is no longer capable of protecting the adjacent coastal bank or the public roadway and we shudder to contemplate the risk of failure we face in the next major coastal storm.”

Mr. Whritenour also provided FEMA with an August 21 memo from CLE engineering consultant Carlos Pena, who wrote that the seawall, which was built in 1940 with inferior cement, “has a strong risk of failure during a major coastal storm” and needs to be completely rebuilt. FEMA officials has so far maintained that the less expensive option of reinforcing the existing wall can adequately protect the town. The North Bluff seawall runs from Oak Bluffs harbor entrance to the Steamship Authority terminal.

Other projects for which the town has applied to FEMA for Hurricane Sandy funding include repairs to Sea View Avenue bulkhead, restoration of beaches and jetties at Pay Beach, Jetty Beach, and the Inkwell, and East Chop bluff restoration. Mr. Whritenour suggested that the town consider appropriating funds for additional engineering studies on East Chop bluff, since they can be used to apply for funding from other state and federal agencies in the event FEMA does not award hurricane Sandy funding, which seems more likely in his estimation.

Cheers and jeers
In other business, the selectmen gave patrons of The Ritz Cafe something to celebrate with a unanimous vote to officially transfer the year-round, all-alcohol liquor license from Janet King, former co-owner of the Ritz for 31 years, to Joseph L. Stallings, president of BB&L management. The bequeathment was presided over by attorney Howard West.

Eastville Beach seasonal residents were again out in force to fight the proposed oyster farm that received preliminary approval from the selectmen in March after the proposal garnered the unanimous support of the shellfish committee and shellfish constable David Grunden. Chairman of the selectmen Greg Coogan told those assembled that the fate of the aquaculture project currently rests with the Massachusetts Department of Marine Fisheries (DMF), and selectmen cannot act until that decision is made. Mr. Coogan assured the concerned residents that the board was taking in both sides of the debate, and he showed a thick stack of letters to that effect.

Selectman Gail Barmakian said a recent site visit to Eastville Beach gave her a better understanding of the group’s concerns. Eastville residents also asked for improved communication from the town during the off-season, including email blasts on upcoming decisions. Mr. Whritenour said that tailoring emails to specific groups is a large undertaking and is not in the town budget. He added that all taxpayers in Oak Bluffs can keep abreast of developments by checking the town website. Selectman Michael Santoro said that improving the town’s Internet infrastructure and social media is a high priority for the capital committee in the coming months.

Mr. Whritenour informed the selectmen that for the town to maximize insurance benefits to cover repairs to the fire damaged transfer station, a declaration of emergency had to be passed. Selectmen endorsed the move unanimously.

Selectmen also unanimously endorsed the appointment of Jennifer Parkinson to the Council on Aging board of directors. “I think she’ll be a great asset to the council,” selectman Kathy Burton said. “I’m sure she’ll bring some great ideas.”

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When Bill Howell hires a recovering addict, he knows their situation first hand.

Bill Howell, owner of Concrete Bill. "Education and treatment is the silver bullet when it comes to overcoming addiction." (Photo by Michael Cummo) — Photo by Michael Cummo

This is the seventh installment in a continuing look at drug abuse and its effect on the Island community by Times reporter Barry Stringfellow. The series began on Jan. 2 “Opiate addiction hits home,” and was followed on Jan. 22 “Martha’s Vineyard police and physicians confront opiate abuse,” on Feb. 12 “Opiates, a love story,” and on May 7 “Battling Addiction on Martha’s Vineyard,” on June 5 “Section 35—when addiction calls for drastic action” and on June 25, Intervention—tackling addiction head on.

Bill Howell arrived at the Vineyard House construction site off Holmes Hole Road in Vineyard Haven early on a recent sunny Monday morning with his dog, Keeper, kicking up a cloud of dust behind him. Mr. Howell didn’t look like a typical cement contractor in baggy shorts, low-cut Chuck Taylor All-Stars and faded “Keep off grass” tee-shirt. He also bucked the stereotype with his easy-going, soft-spoken manner.

Jamie Kergaravat hauls boards that will make the form for a concrete foundation. (Photo by Michael Cummo)
Jamie Kergaravat hauls boards that will make the form for a concrete foundation. (Photo by Michael Cummo)

He gave instructions to his young and eager five-man crew as they put the finishing touches on an expansive foundation for the men’s dormitory at the new Vineyard House, the Island’s only sober living facility. The job has special significance for Mr. Howell. “I was one of the first residents of Vineyard House; I started living there in 1999,” he said. “I bid low on this job. I really wanted this one.”

Mr. Howell started Concrete Bill, his cement contracting company, in 2001 when he was still a resident at Vineyard House. He’ll have 15 years clean time on November 29 — “5,377 days clean, but who’s counting?” he said.

Mr. Howell has hired many Vineyard House residents and alumni over the years. “A lot of people in recovery won’t hire people in recovery. I don’t get that,” he said. “I did from day one. This is not a not-profit company. But I can’t not hire these guys.”

Four out of five of his crew today are in recovery. “We were five out of six, but we lost one last week,” he said. “He needed to borrow $500 for a new car, that’s the last I’ve seen of him.” Mr. Howell shrugged. “I don’t fire people who are struggling. In the past 10 years, I only had to fire one person.”

Solid reputation

Mr. Howell’s company, Concrete Bill, is well respected in the Island building community. “Bill has been doing foundations for me since he first started out,” Bill Potter, CEO of Squash Meadow Construction, told The Times. Squash Meadow is the general contractor for the new Vineyard House. “Integrity and honesty are core principles that we believe in as a company and we expect from the people we work with. Bill Howell lives up to that in every respect.”

“Bill’s easy to work with and his crews are quality,” project manager Woody Mitchell told The Times. “When you’re doing modular homes like Vineyard House, foundations have to be perfection. It’s not like you’re framing in the field when you can make adjustments on the fly. Bill does a quality job every time.”

Rock bottom

Originally from the Cape, Mr. Howell, 51, came to the Island because he was “basically homeless,” and he hoped the move would lead to the path of recovery.

Initially, it didn’t.

“Pills, cocaine, heroin, I took whatever was there,” he said. “It doesn’t matter to an addict. It has nothing to do with logic. lt’s a form of insanity.”  Mr. Howell began using drugs and alcohol at the tender age of 9. Addiction runs deep on both sides of his family. “My father died of complications from alcoholism, my grandfather was an alcoholic,” he said. “Being around addicts was normal for me, and I just kept doing it.”

In the end, the move to the Island was key to his recovery. In addition to gaining a foothold at Vineyard House, “It felt good to have an ocean between me and the people I was spending time with,” he said.

Pillar of the community

Mr. Howell is active in the Island recovery community. In addition to providing employment, he’s a sponsor, mentor and he helps organize an annual celebration of recovery that the Vineyard community has hosted for the past 26 years.

Per 12-step program protocol, no individual can speak to a particular  recovery program. While the ultimate goals are the same, there are differences in dictum. “The goal for us is not abstinence, it’s recovery,” Mr. Howell said, adding that he relapsed for the last time in the 90’s. “There’s zero hope or expectation when you start in recovery. All you think about, all day, every day, is using again. But if the times a person uses are shorter, and the clean times last longer, that’s a win.”

Mr. Howell said the dark days create a special bond among recovering addicts. “We’re all survivors of the same near-fatal catastrophe,” he said. “We pull for each other. If you need support, go to a meeting. There’s one on this Island every day.”

Mr. Howell also had a suggestion for people who aren’t sure if they need help. “If you’re wondering if you have a problem, ask your family and friends what they think,” he said. “They’ll tell you.”

De-stigmatizing addiction

Mr. Howell was unfailingly forthcoming about his addiction and his recovery and he didn’t hesitate to give his last name. “I think people are more comfortable doing that because the perception of addiction is changing,” he said. “It has to change. Education and treatment is the silver bullet when it comes to overcoming addiction.”

Two of Mr. Howell’s crew also elected to give their full names.

Jamie Kergaravat, 29, has been working for Concrete Bill for three months. He has the build and the close-cropped hair of a Marine who just finished boot camp. “I was homeless three times,” he said, lighting a cigarette. “I lived in halfway houses, homeless shelters, outdoors. I was not into my recovery.”

Like Mr. Howell, he was down to his last stop when he came to the Island. His aunt took him in after yet another rehab stint at the Brockton Addiction Treatment Center. He’d stolen so much from his mother that she had a court order to keep him 50 feet from her house. “Now, I can’t get her off the phone,” he said laughing.

“The best thing I ever did was going to my first meeting here. I raised my hand and asked for help. It was hard to do. It was like putting my tail between my legs. I was scared. I sat at a table afterwards, and there was a line of people who wanted to help.”

Mr. Kergaravat has six months clean time. He’s lived at Vineyard House for the past five months. “It’s a great group of guys — we all click,” he said. “It’s impossible to do this alone. It’s all about surrounding myself with people who are doing the right thing.”

Which is not to say it’s been a smooth ride. “There’s definitely white-knuckle times, especially in the beginning,” he said. “But I’m not going back. I love living here. This Island has so much to offer.” Mr. Kergaravat reached into the back of his pick-up and picked up a brand-new surf rod and reel. “I haven’t caught anything yet, but I figured it’s time to start learning.”

Emmett Cook, 21, went to 12-step meetings with his father when he was a child. “He did work at it,” Mr. Cook said. By the time his father moved the two of them to the Island for a fresh start, Mr. Cook had been a frequent guest of Rhode Island and Connecticut state youth facilities, starting at age 13.

He enrolled at Martha’s Vineyard Regional High School but dropped out after a year. His appetite for drugs grew unabated. “My drug of choice was ‘More,’” he said. “It didn’t matter what it was, just ‘more.’”

Mr. Cook’s father has since moved back to the mainland and is no longer in recovery. Mr. Cook stayed and, after one relapse, has been clean for over a year. “April 17, 2013,” he said.

Mr. Cook had turned 21 the day before he spoke to The Times. He celebrated with a cake and a dip in the ocean, and a meeting. “I usually go to a meeting every day,” he said. “It’s an hour a night: there’s no excuse not to go.”

As the crew packed up, Mr. Kergaravat surveyed the finished job. “It’s very cool that we got to build the foundation for this place,” he said. “If someone wants help, I’d say come to Vineyard House. There’s always a bed. The new place will have tons of beds.”

For more information about Vineyard House, call 508-693-8580 or go to VineyardHouse.org.