HomeMy WebLinkAboutNCH-August 6 2014 BOS Meeting - FAQs_201408120915283791NANTUCKET COTTAGE HOSPITAL
AUGUST 6, 2014
Prospect Street Nantucket, MA
Frequently Asked Questions
Why is a new hospital needed?
Inefficient infrastructure requires NCH to spend more than $1 million per year in repairs and maintenance and accounts for most of its operating deficit; these funds should be going towards investing in patient care and services
Only one operating room, which restricts scheduling of routine and emergency surgeries as it must be reserved when women go into labor due to potential for emergency C-sections
The size of NCH’s departments and clinical areas do not meet state Department of Public Health standards with the exception of one function, CT scans
Lack of space impacts patient privacy, restricts specialty care offerings
Hospital walls are lined with asbestos, making any maintenance/improvement project a complicated and expensive endeavor
Critical services are separated in different areas of the hospital, an inefficient layout that results in the duplication of services and facilities, and prevents the efficient use of staffing
The building was constructed in 1957 with a medical inpatient model no longer in use
Why doesn’t the existing site meet
future needs?
Construction of a new hospital on the 5.7-acre site would impose significant constraints on the design of the new facility, and would take 18 months to two years to complete.
This would cause an interruption in patient services, the temporary off-site relocation of medical offices and staff parking, and disruptive construction noise and dust (the new hospital building would come within two feet of the existing structure which would then be razed after new construction was complete). No space available on site for staging of construction equipment or materials.
Given a lack of site space, the hospital’s helipad would have to be relocated to top of the new building at an estimated additional cost of $2-3 million: a fire suppression system and elevator shaft would be needed, as well as a flat roof to accommodate the helipad, requiring HDC approval for a building not in character for Nantucket.
If a new facility were built on site, the hospital would be at capacity from the day it opened, prohibiting any future expansion or the development of ancillary structures and/or housing for staff.
Current site is directly adjacent to one of the most congested intersections on Nantucket, and thus problematic for emergency ambulances and other emergency vehicle runs.
Site Plan for Existing Site
Rendering for Existing Site
What other sites did you look at?
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; and
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
Comparison of Alternative
Development Sites
Comparison of Alternative
Development Sites
Comparison of Alternative
Development Sites
Why is Wyer’s Valley the preferred
site?
Centrally located near the majority of the Island’s population
Located near the existing hospital site
Total site area accommodates all anticipated hospital services 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 and architecture 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 nine 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
What are transportation advantages of
the Wyer’s Valley site?
Located within 1 mile of the existing hospital site
Centrally located from island villages and major population centers
Safe and convenient emergency vehicle access from major roadways
Direct access from Old South Road and Milestone Road
Does not require primary travel through residential areas
Primary access routes provide adequate width and separate accompanying facilities for pedestrians and bicyclists for safety
Emergency response times are similar to or improved over current hospital site
Accessible from all 7 NRTA bus routes
None of the other sites provide this level of transportation benefits
Site Access
Why don’t you pursue a site that is
already commercially zoned?
Even though some alternative development sites are within the Commercial Neighborhood zoning district, this zoning does not address the critical needs of a 21st century medical campus.
A zoning amendment would be required for all of the potential development sites to create a Hospital Sub-District.
Wyer’s Valley is an appropriate location for the Commercial Neighborhood zoning because it is mid-island, abutting many already commercially (CN) zoned properties.
The proposed Hospital Sub-District would include special protections pertaining to such issues as stormwater, drainage and similar site issues unique to a medical hospital campus.
What initial site investigations have
you done?
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.
Will the new hospital impact the
aquifer?
No, it won’t. Both the existing and proposed sites are in the groundwater Zone 2 “zone of influence,” so as it applies to the aquifer, there is absolutely no difference between building the new hospital at the water company property or building it at the current NCH site.
The potential for any issue is highly unlikely, given the measures included in the design, but the benefits to the community from a centrally located hospital with excellent transportation links to most portions of the island are significant.
The Best Management Practices (BMPs) that will be part of the project design will provide better protection from and better response actions than is available anywhere else on the island or that currently exist on the Wyer’s Valley site.
Wannacomet Water Company general manager Bob Gardner said “The (water) commission felt this was an opportunity for tomorrow, to make a partnership to protect public health, increase public health, and create the services we need on Nantucket. The commission is, bottom-line, committed to protecting the drinking water supply. We feel there’s an opportunity to get a new hospital, increase health care and the way it’s delivered, but also to improve and protect the water supply.“
The proposed hospital will be farther away from the wells than existing commercial buildings. (See attached)
Why do you need a larger building
on a larger site?
The main hospital building will be located on approximately 7 acres; the 20 acre site allows for adequate stormwater systems, treed buffer areas, access, landscaped areas and parking and the opportunity for expansion as part of a medical campus.
The new facility would be slightly larger than the combined square footage of the existing hospital and auxiliary buildings.
The size of the new hospital is dictated by several factors, including Department of Public Health requirements, maintaining key services in the new building, and the topography of the site.
We have designed the “right sized” building that will serve the community and operate sustainably
The properly sized building allows NCH to better serve the community, including providing:
All doctors’ offices in one building;
Greater opportunity for specialists (e.g, dermatologists, neurologists and oncologists) to see patients;
Space for infusion services;
Adequate space for doctor exams and consults; and
Ability for testing services to be adjacent to both the emergency department and doctors’ offices.
The new facility must be designed to meet current standards, including a second operating room and a fixed MRI unit and diagnostic center.
The building must be designed to provide adequate and appropriate space that will enhance the patient experience and provide our clinicians with an environment conducive to quality care.
Adequate parking spaces will be constructed to support the hospital along with associated access and circulation drive aisles.
Sidewalks and bikeways will be constructed to enable pedestrians and cyclists to access the hospital safely from bordering roads.
A new building would allow the hospital to continue to add physicians and sub-specialists to its ranks, and provide a home for urgent care and primary care services that would assist in recruiting and retaining new doctors.
What services will be offered?
Cancer care
Obstetrics
Medical/surgical
Emergency medicine
Ambulatory care with inpatient capacity
Walk-in clinic/urgent care
Primary care
Additional sub-specialists
Dialysis
Imaging
Nutrition counseling
Speech therapy
Preliminary Site Plan
for Preferred Alternative Site
Preliminary Rendering for
Preferred Alternative Site
What is your anticipated
process/permitting path?
Local Approvals
Any use of the land by the hospital would have to be approved by the voters of Nantucket at Town Meeting
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
What is your anticipated 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
Are you considering a Special Town
Meeting in the Fall of 2014?
We anticipated seeking voter approval for transfer of the Wyer’s Valley site
and required zoning at the Annual Town Meeting in April.
In the meantime, we plan to work closely with town officials, community
groups and the public to provide the most detailed information possible
and to answer all question regarding relocation of the hospital.
Why shouldn’t Wyer’s Valley be
preserved as open space?
The Wyer’s Valley site proposed for relocation of the hospital is not open space today. It is the headquarters of the Wannacomet Water Company with buildings on site, roads and parking areas. The Wyer’s Valley site is home to 79 shallow vacuum wells with a large wellhead recharge area. If the hospital were relocated to Wyer’s Valley, those 79 shallow wells would be abandoned in favor of one or two deeper wells farther east on the property, at a significant cost to the hospital. This would reduce the wellhead recharge area around the wells, a net benefit for water quality.
Wyer’s Valley in the past has been considered for the relocation of other town facilities, including the Fire Station. The site is best suited for a hospital, and is consistent with the Wannacomet Water Company public health goals. In supporting relocation of the hospital to Wyer’s Valley, Water Company General Manager Bob Gardner said recently, “The commission felt this was an opportunity for tomorrow, to make a partnership to protect public health, increase public health, and create the (medical) services we need on Nantucket.”
What is your relationship with Partners
and does Partners support this effort?
Nantucket Cottage Hospital is an affiliate of Massachusetts General Hospital and a member of the Partners HealthCare system. The affiliation with MGH became official in January 2007, and has since provided island patients and NCH with a host of critical benefits, including financial stability and clinical expertise in areas such as radiology and cancer care.
Nantucket Cottage Hospital remains a private, non-profit hospital with an independent Board of Trustees that is responsible for fiscal policy and strategic decision-making. While MGH is represented on the NCH Board of Trustees, the hospital is led by a dedicated local group of year-round and seasonal island residents.
In the seven years since the affiliation became official, MGH has provided direct support to Nantucket Cottage Hospital in a number of ways, including the forgiveness of millions in debt, providing loans to sustain NCH over the lean winter months, and the payoff of millions in mortgage payments.
Mass General has also made a major commitment to support the capital campaign for a new hospital on Nantucket. In addition to funding $2 to $3 million in development costs for the project, MGH has committed a $10 million challenge grant toward the construction of NCH’s new building, and will offer construction financing at no interest, advancing funds on pledges from donors.
Will the hospital provide consideration for
the Wyer’s Valley site?
Yes
NCH has agreed to provide funding and pre-development support for the replacement of the vacuum well system with two new deeper wells – This replacement program, which has been planned for several years, otherwise, would need to be funded by the Town of Nantucket
NCH has agreed to provide funding to relocate the administration and maintenance facilities from Wyer’s Valley to the main Water Company property
The hospital relocation allows for the existing hospital site to go back on the tax roles, generating needed property tax revenues for the Town
Wyer’s Valley is not currently generating tax revenue so the hospital development will not eliminate existing revenue
The Wyer’s Valley site has significantly limited value because, if approved at Town Meeting, the site could only be used for a hospital
If the hospital is relocated, what are
the plans for the current site?
No decisions have been made about future uses of the site
Discussions and due diligence are still in the preliminary
stages
If the land were sold, proceeds could be invested in the
hospital’s endowment to defray hospital operating
expenses in the future and support core services, and
incorporate new technology and treatments.
NCH officials will be working closely with town officials
and community leaders on these issues
Is Our Island Home included in the
proposed hospital development?
NCH is continuing the dialogue with the Town
about the future of Our Island Home
NCH will continue to provide shared
amenities and laboratory services to Our
Island Home
NCH will continue to evaluate providing
additional shared services
Will the proposed hospital be located in
the vicinity of the old railroad bed?
A portion of the old Nantucket railroad bed is
located on the Wyer’s Valley property
A majority of this railroad bed is located on
the portion of the property that will not be
developed
A small portion of the parking area may be
located adjacent to the end of the old railway
bed