A vacant lot on Hercules Drive in Colchester is poised to become the site of an ambulatory surgical center, recently approved by the state’s Green Mountain Care Board after years of debate. (File photo)

The state’s Green Mountain Care Board approved the application for a for-profit, multi-specialty ambulatory surgical center in Colchester this week, two years after it was first proposed.

In a 4-1 written decision posted online Monday, board members said their verdict was guided by “input from many Vermonters,” and underscored the need for affordable health care.

“Vermont’s health care landscape is in transition,” the decision reads. “Our success at bending the cost curve will depend on taking an integrated, statewide approach to payment and delivery reforms.”

Called the Green Mountain Surgery Center, the facility will provide “elective, non-emergent” services in gastroenterology, obstetrics and gynecology, orthopedics and more, all while improving patient experience and lowering costs, advocates say.

Amy Cooper, executive director of HealthFirst and a primary planner of the project, told the Sun in June it will likely take up to 10 months to build the 13,000-square foot center on Hercules Drive.

The facility will feature two operating rooms, four procedure rooms and 14 pre- and post-operation beds and will cost more than $11.6 million, according to the decision. Applicants plan to employ 22 full-time staffers, including 15 registered nurses, four surgical technologists and a medical director, among others.

Cooper formed the applicant, ACTD LLC, in 2014 with Dr. Thomas Dowhan and “in consultation with local physicians.” Most members of the latter group intend to perform surgery at the proposed center, Cooper said.

All new health care projects in Vermont must obtain a certificate of need from the GMCB, according to the state website, a measure “intended to prevent unnecessary duplication” and promote cost containment, among other aims.

Because Vermont does not currently license or directly regulate ambulatory surgical centers, the GMCB will not have oversight of this facility’s budget as it does for hospitals, the decision said.

The Vermont Association of Hospitals and Health Systems and the Northwestern Medical Center opposed the surgical center during its review.

According to a citation in the board’s decision, VAHHS said the proposed services were “duplicative” and would drive up health care costs by adding capacity to a “well-served region of the state.”

Major commercial health insurers MVP, BlueCross BlueShield of Vermont and Cigna all expressed support for the project, according to the decision.

The lengthy approval process for the surgical center stalled when two of the five board members left their posts, leaving Cornelius Hogan, Jessica Holmes and Robin Lunge to hold the public meetings.

On May 12, a notice posted on the board site said the remaining trio could not come to the required consensus on the proposed center and would hold off on issuing a decision until the vacant seats were again filled.

Weeks later, Gov. Phil Scott announced two appointments to the board: Kevin Mullin, a longtime Republican senator from Rutland, and Maureen Usifer, a Colchester resident and former CIO of Seventh Generation Inc.

Both Usifer and Mullin joined Holmes and Lunge in the majority, voting in favor of the center.

Hogan cast the lone opposing vote, writing in his dissent that the center would “contribute to the fragmentation of Vermont’s health care system,” while increasing costs.

“At the end of the day, this case presented a major test for the survival of an integrated health care system in Vermont, and I fear the board has not risen to the challenge,” Hogan wrote.