To retain its priced-out workers, Martha’s Vineyard Hospital is spending $38 million to build apartments

“This,” she says, “is the highlight of my career.”

The structure Schepici is standing in will not be a new emergency department or state-of-the-art cancer center. It’s a 48-unit apartment building, less than a mile from the Atlantic Ocean, that will house hospital employees being priced out of the island community they serve by housing costs that have risen to near-unfathomable heights.

For Martha’s Vineyard Hospital, this project — six years in the making — is a critical investment in its ability to retain a large enough staff to sustain essential functions. The need is so great that the hospital leapt over enormous logistical and financial hurdles to make it reality: The units were built in a factory in western Pennsylvania, transported by truck and then boat to the island, and then stacked on a sloping, 28-acre parcel. The cost? $38 million so far.

This is the reality of operating a hospital in one of the most housing-starved places on the planet. Housing is in such short supply here — the Martha’s Vineyard Commission estimates the rent for a typical one-bedroom is around $3,000 — that many employers can’t keep workers, even for essential health care jobs, unless they help pay for, or build, housing.

“Every time a house goes up for sale on the Vineyard, one of our employees becomes housing insecure,” Schepici said. “It is one of our greatest challenges — keeping people housed.”

Schepici has had a vision for a hospital-financed housing development since she was hired as chief executive in 2018. The nonprofit hospital, which is part of Mass General Brigham, has been steadily losing staff who either move off the island because their year-round rental was converted into a vacation property, or because they have grown sick of commuting by ferry from the mainland (where costs on Cape Cod are high, too) every day for work. Several times a week, chief administrative officer Michael Cosgrave said, hospital executives hear from an employee who is losing their apartment or struggling to find an affordable rental.

The erosion of housing affordability on Martha’s Vineyard, according to the commission, has become a full-blown crisis. Few homes sell for under $1 million these days, and only one in four properties on the island is a rental, many of which are offered mainly to vacationers. Some 40 percent of year-round households on the island are considered housing cost-burdened. That means much of the island’s workforce commutes from the mainland, making the 45-minute sojourn from Woods Hole each day, or from other ports.

The hospital has responded by acquiring a portfolio of homes they own or lease, enough to house a small portion of its employees, though they have to compete for properties with other big employers that are grappling with the same staffing issues, like Stop and Shop.

But that is a Band-Aid on a much larger problem, Cosgrave said.

The idea of a hospital-built housing project was more hope than reality until 2019, when Martha’s Vineyard Hospital struck an initial agreement with the prominent Norton family, who have owned property on the island for generations, to purchase 28 acres on Edgartown-Vineyard Haven Road for $3.6 million.

To put a building on that land, they had another ambitious idea: Construction on the Vineyard is a challenge because many commonly used building materials must be shipped by barge, adding time and expense to most larger-scale projects. Could the hospital build modular units in a factory and have them shipped to the Vineyard prefabricated?

Indeed, each of the 48 units was built in a factory near Pittsburgh complete with appliances, countertops, and finishes. They were then loaded onto trucks and driven to New Bedford, where they were taken by barge, one at a time, to the Vineyard, then loaded onto another truck and placed into foundations by crane at the site. Altogether, each unit traveled roughly 600 miles.

“There is a tremendous amount of work that goes into building a project like this on the Vineyard,” said Neil Lemieux, the director of preconstruction at Columbia Construction, the project’s general contractor. “Where are you getting your materials and your workers from? Believe it or not, it’s easier to build these units off-site and ship them here.”

At the site, the “boxes” transported to the island were fit together to create duplex units, townhomes, and an apartment building, and stacked and clamped together with 10-inch screws that are still visible in the hallways of the buildings.

“It’s like a giant jigsaw puzzle,” Lemieux said.

On a breezy day earlier this month, each of the boxes were in place, with crews busily applying finishing touches, assembling decks, and laying concrete sidewalks. The units are modern — like you’d see in an expensive building in Greater Boston — complete with new appliances, in-unit laundry, and personal decks. In the middle of the site, an elder care facility, which will have 70 skilled nursing beds, was in the late stages of construction.

The project was initially estimated to cost around $25 million, but the rise in construction costs during and since the pandemic added roughly $13 million. While much of that cost will be covered by donors, the hospital is not expecting the project to be a “money-maker,” Cosgrave said.

The building is on track to open in June, when the first new residents will move in. But even 48 new units won’t meet the demand. The units will be awarded to hospital employees through a lottery conducted by the local housing authority, and selected residents will have their rents subsidized based on their income. No employee, the hospital says, will pay more than 30 percent of their income toward rent.

The hope, Cosgrave said, is that by opening the development, they’ll spark something of a chain reaction, freeing up some year-round rentals that are occupied by staff members, and getting more employees into stable homes. Any sort of dent in the problem will help, even if it’s a relatively small one for a big cost.

“Of course we’re extremely proud of this project, and feel like we’re doing it because it’s the right thing to do for our employees,” Schepici said. “But it’s also true that, as a hospital, we have to do this for our operations. Our doctors and nurses need homes.”

Andrew Brinker can be reached at andrew.brinker@globe.com. Follow him @andrewnbrinker.