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Home My WebLink AboutNCH July 23rd Selectmen Presentation_201407240905505482NANTUCKET COTTAGE HOSPITAL JULY 23, 2014 Prospect Street Nantucket, MA Introduction Margot Hartmann, MD, PhD President and CEO, Nantucket Cottage Hospital Stephen R. Karp Board of Trustees, Nantucket Cottage Hospital John E. Twohig Goulston & Storrs, Development Counsel Purpose of Tonight’s Meeting Discuss our preliminary findings with respect to the need for a new hospital in Nantucket Long-term public health needs Sustainability of operations Need to expand existing services Continue a public process and discussion about a new hospital The Topics We Would Like to Discuss The need for a new hospital What we have done to address the need Why we can’t build a new hospital on-site Review of alternative development sites The preferred alternative site Initial site investigations Anticipated permitting path Timeline/Next Steps The Need For a New Hospital Why do we need a new hospital? The existing building is too small; insufficient operating rooms; challenges to patient privacy Market research and experience indicate the hospital needs to expand services, which cannot be accommodated in the existing building Need to control costs; existing building is very inefficient and outdated (approximately $1 million in annual costs) Existing building can’t satisfy Department of Public Health (DPH) code requirements for operational standards Significant operational limitations Insufficient parking to accommodate expanding services – a condition that exists today What We Have Done to Address the Need What have we done to address the need for a new hospital? Undertaken an extensive 18 month review to analyze the potential development of a new hospital on the existing site Conducted a detailed patient survey and market analysis of what is needed to best serve the public health needs of the Island Developed a sustainable program of health care services based on community feedback and introduced some new services, such as expanded pharmacy care, a walk-in care service, oncology, to address patient needs – all of which strains available space Identified community health care needs Worked with state agencies to identify requirements Developed a building layout Determined, after all of that effort, that a new hospital could not be constructed on the existing site due to increased patient services Why We Can’t Build a New Hospital On-site Why can’t we build a new hospital on the existing site? Severe operational limitations impacting patients and staff associated with constructing a new hospital on the existing site while trying to operate the existing facility (construction noise, parking and inability to provide services) Many of the hospital functions would need to temporarily move off-site to accommodate construction activities Existing medical office buildings would be demolished to accommodate construction The construction sequencing would be very difficult and result in a large expense for the hospital New building would be constructed within 2 feet of existing facility which jeopardizes existing hospital operations The hospital design would be inefficient as a result of site constraints Flat roof would be required to accommodate helicopter landing pad; building design would be out of character for the Island Certain key services could not be provided during the construction period such as our walk-in care service Construction would be highly disruptive to the outpatient services Site Plan for Existing Site Hammond Pond City of Newton Town of Brookline Rendering for Existing Site Hammond Pond City of Newton Town of Brookline Review of Alternative Development Sites Which alternative development sites have been reviewed? After rejecting the existing hospital site, we identified certain key alternative sites The following sites were initially reviewed in 2013 and then subsequently refined in response to input from the Planning Department: Existing site combined with 47 Prospect Street Existing site combined with Gouin Village/Sevrens property Valero site (64 Old South Road) Glowacki site (63 , 67 & 73 Old South Road and 4,6,8,10,12,14 Nancy Anne Lane) 0, 20 Davkim Lane, 24, 26, 28, 30 Evergreen Road Airport Parcel site from 10 Sun Island Road We also reviewed additional sites, including the Fairgrounds property next to the police station, the Town owned property next to Sherburne Commons and the Boy Scout Property on the corner of Fairgrounds and Surfside, which were rejected for a variety of reasons, including size, topography, cost, shape and location. Plan of Alternative Development Sites Hammond Pond City of Newton Town of Brookline Comparison of Alternative Development Sites Hammond Pond City of Newton Town of Brookline Comparison of Alternative Development Sites Hammond Pond City of Newton Town of Brookline Comparison of Alternative Development Sites Hammond Pond City of Newton Town of Brookline The Preferred Alternative Site Why is the Water Company site the preferred alternative? Centrally located near the majority of the Island’s population Located near the existing hospital site Total site area accommodates the anticipated program as well as future expansion areas to adapt to changing technology Topography allows the hospital to construct a new building that is consistent with the design of other island buildings and to utilize multiple levels (e.g., emergency services to enter on lower level) Superior access from multiple locations on the island with proximity to five roadways while other sites have only one or two access points Traffic report indicates the existing roadway network can support proposed project Close to public transportation and retail/restaurants Limits development to the edge of the Town Overlay Area without extending too far into the Country Overlay Supported by the Water Company Site Plan for Existing Site Hammond Pond City of Newton Town of Brookline Preliminary Site Plan for Preferred Alternative Site Rendering for Existing Site Hammond Pond City of Newton Town of Brookline Preliminary Rendering for Preferred Alternative Site Initial Site Investigations What initial investigations have been completed for the preferred site? Environmental No hazardous waste/environmental concerns Land Area Sufficient area to accommodate anticipated development and future expansion potential Topography Allows the hospital to construct a new building that is consistent with the design of other Island buildings and to utilize multiple levels (e.g., emergency services to enter on lower level) Geotechnical Sufficient soils Wetlands No wetlands impacts Utilities Adequate sewer, water and electric service Transportation Location along major roadways with multiple access points to accommodate anticipated vehicle trips Site Access Anticipated Permitting Path What is the permitting path? Local Approvals Rezoning to the Commercial Neighborhood zoning district, consistent with recent zoning efforts Creation of a hospital sub-district that focuses on the unique needs of a hospital, including the potential for expansion and related health care services Land restriction to ensure healthcare use as well as preservation of existing vegetation/buffers State Approvals Environmental Notification Form Coordination with the state Coordination with DEP on well relocation Timeline/Next Steps Timeline/Next Steps Coordinate with the Selectmen on the process and the collective goals of the Hospital and the Town Coordinate with the Water Company on well relocation and related issues Coordinate with the Planning Department and Planning Board on potential zoning issues Coordinate with the Historic District Commission and Finance Committee Continue public outreach and dialogue on the need for a new hospital and site Coordinate with the state on permits and due diligence Identify timeline for Town Meeting