Rochester and Mayo Clinic are a crucial step closer to a $6 billion makeover.

Friday was the first meeting of the eight-member board that will oversee Mayo's massive Destination Medical Center project. The two-decade, multibillion dollar project is intended to double Mayo in size and transform its hometown into a hip, attractive destination in its own right.

Twenty years from now, Rochester "is going to be better, it's going to be newer, it's going to be more attractive, it's going to be more dynamic and it's going to have more people with more jobs," said Gov. Mark Dayton, who traveled to the Mayo Civic Center to kick off the first meeting of the Destination Medical Center board.

The board appointed Dayton's chief of staff, Tina Smith, to head that group. Smith was instrumental in maneuvering the project and the hefty state contribution through the final weeks of the legislative session.

"Not to say there aren't going to be challenges along the way," Dayton said. "The challenges with expansion and further development and growth are far preferable to the ones on the other side. I think it's a fabulous opportunity for Rochester."

The board will oversee the largest economic development project in state history, which will blend Mayo seed money, more than $2 billion in private investment and $585 million in state and local tax subsidies.

Over the next two decades, Mayo hopes to turn its already renowned facility into a global health destination on a par with the best health care centers in the nation. To woo patients and top doctors, it wants that facility to sit in a city with a vibrant and diverse economy and all the charm and appeal of Portland, Ore., Madison, Wis., or Austin, Texas.

Without the project and the tax subsidy, Mayo officials had warned they might have to shift their focus away from the town that Mayo has called home for the past century and a half.

"Health care is at a crossroads," Mayo CEO Dr. John Noseworthy said. "Health care is under attack. It is too expensive, it's too inefficient in this country and Americans spend too much money and struggle with their medical bills. … Mayo Clinic is leading the charge to change that. We've been here for 150 years … we are completely committed to our patients and to our staff and to our community."

It will be a while before those plans the board is making become reality. By the first half of next year, the board hopes to produce a design master plan for the project. Until then, there will be meetings, debates over bylaws and an extended period of asking Mayo staffers, patients and Rochester residents what they'd like to see built with $6 billion.

The governor already has one item on his wish list. Now that his chief of staff will be splitting her time with the Destination Medical Center board, Dayton joked that he has even more reason to push for a high-speed rail line between Rochester and the Twin Cities.

Jennifer Brooks • 651-925-5049