ST. ALBANS — The Northwestern Medical Center’s (NMC) $32 million expansion plan went under state review by the District 6 Environmental Commission at a hearing Friday morning.
A number of topics, including storm water management, traffic, and sidewalks were raised during the session.
The hospital’s Act 250 application includes plans to make the following improvements: remodel and expand the existing medical surgical/intensive care (ICU) unit wing, expand the hospital for new medical clinics, construct a new two story office building and a connector road and reconfigure and relocate loading docks, driveway and parking areas.
“A great deal of thought has gone into this plan,” Jonathan Billings, vice president of planning and community relations for NMC, said. “It aligns with our community needs and the future of the hospital.”
“There are a number of factors that are driving this project,” Billings said. “Hospitals need to be more efficient than ever.”
Billings cited the decentralized registration areas that are disconnected from the main entrance and lobby as an example of inefficiency in the hospital’s current layout.
“Our aging population is requiring more care,” he added.
According to Billings, Franklin County is growing faster than Vermont, but it is the senior population that is doubling over a 20-year period. “So the demands for care in our area are rising,” he said.
“We have inadequate space for medical clinics,” Billings said. “We don’t have a sustainable way for specialty physicians who need to be in town for one day a week or three days a month to be in town and have an office space in an affordable and sustainable way to bring the care to the people rather than people go to Burlington.”
All of the updates would move toward resolving these issues. The hospital plans on paying for the construction improvements with $1.6 million already raised by local employers and the hospital family. This is in advance of announcing a public capital campaign.
According to Dereck Woolridge, the project’s civil engineer, the ICU unit would expand 15,200 square feet, the medical clinics about 14,000 square feet and the new two story medical office would take up 42,000 square feet
Parking would expand near the front entrance, at the Cobblestone building area at the back of the property, along Crest Road, as well as south of the Northwestern Counseling & Support Services (NCSS) building.
Construction of the 56 parking space lot in front of NCSS would occur in the first phase of the project so that people could be diverted there while construction in the front of the hospital occurred, according to Woolridge.
The expansion will only add 10 to 12 new spots because of the parking that will be eaten up by the two-story building and other additions. However, during last year’s construction, the hospital added more than 100 new parking spaces.
Along with the expansion of Crest Road [the main driveway off of Fairfield Street and running adjacent to the Doctor’s Commons], there is the plan to add trees and lighting to run alongside it. There are also plans to plant shrubbery in the back of the property to provide better screening for neighbors.
Multiple topics concerning NMC’s plans were raised during the hearing by the environmental commission as well as those offered party status including NMC representatives, Vermont Agency of Transportation (VTrans), Northwest Regional Planning Commission (NRPC) and the project architects and engineer.
Storm water was one of the first issue to be addressed.
Woolridge said NMC plans to expand the existing storm water pond at the southeast corner of the property next to Stevens Brook.
“Last year we had the opportunity to expand the pond, plan for the future and bring it up to the current standards,” Woolridge said.
“We did a small little tweak at the outlet structure to meet the current regulations,” he said. “As you are probably aware, they just included phosphorus reduction in the storm water permitting.”
With the small changes, they were able to treat the entire property for phosphorus, which hadn’t been done before.
“We actually qualified for an onsite offset to mitigate loading into Stevens Brook,” Woolridge said, adding that was due to the fact they were able to treat all 28 acres.
The result will be the removal of 5,800 pounds of sediment a year from the property.
“We are not taking capacity from the Stevens Brook diversion offsite project, which should allow other community property owners to use some of that offset as well,” he said.
They also are utilizing a small underground filter system near the second access point for drainage near the parking lot at the front of the property as well as a grid separator, said Woolridge.
“Our commissioners were hoping for more dispersed L.I.D. (Low Impact Development) structures onsite, but understand that if the state provides the permit to the applicant, that’s enough,” Taylor Newton of NRPC said.
“We have a high groundwater table,” Woolridge explained. “We have poor permeability in our soils and that kind of prevented us from doing anything more.”
The application for the storm water permit went on public notice Thursday and will remain open for 30 days.
According to a study conducted by Woolridge, traffic would increase by 160 trips a day during peak hours. This statistic is for the first year after completion of the improvements.
Five years in, traffic would increase to 240 trips a day during peak hours.
In comparison, there are 5,400 vehicles per day on Route 36 (Fairfield Street in the city), 6,700 on Route 104 north of Fairfield St. and 10,400 on Route 104 south of Fairfield St.
“So technically the hospital gets bigger, the trip generation is based on square footage,” Woolridge said. “But we’re not generating any more rooms or any more traffic because of that.”
“Our traffic study is conservative,” he said. “We’ve assumed that it will generate more traffic.”
“This is probably the worst case that we can reasonably expect to see,” Woolridge concluded.
“No improvements were needed at our site access points,” he said, because they will operate at acceptable levels.
“It would be interesting to verify the amount of traffic that is coming in and out of the hospital,” Joe Segale of VTrans said.
Segale also requested monitoring of traffic at the intersection of Route 36 and 104 and at the intersection of Route 7 and the St. Albans Highway.
However, the intersection of Route 104 and Exit 19 of Interstate 89 is a high crash location, said Segale.
Due to the poor level of service during peak hours already, VTrans is asking NMC to pay an impact fee for the traffic that the hospital improvements will contribute.
Within the next 5 to 15 years, VTrans hopes to replace the stoplight system with a roundabout at that intersection.
“Act 145 of 2014 now allows the district commissions to establish transportation impact fees for projects that then benefit a development,” Segale said. “So the situation is now set up that we can recommend an impact fee for that intersection.”
“I think it will be the first time that it is established here in St. Albans,” he said. “We’ve done it in several locations in Chittenden County.”
“What would happen is the hospital would pay the fee before construction,” Segale said. “If we don’t implement the project, the fee is returned.”
Segale said VTrans cut the fee in half for the hospital, making the total around $40,000.
In the meantime, Segale will work with NMC to see if they can make any short-term improvements to the intersection.
Public Transit & Sidewalks
NMC plans to work with Green Mountain Transit Agency to see if it can add an additional bus shelter on the property, at the recommendation of NRPC.
Billings said the hospital also is working with RiseVT to promote walking to work for employees and to see if there are any areas they can improve bike ability on the campus such as more bike racks or bike lanes.
Newton, the regional planner for NRPC, brought up the issue of sidewalks.
Due to the hospital’s location within the south wing of the regionally designated growth center, NRPC recommends that a sidewalk be installed from NCSS’s main facility to Route 104.
It would be built across from an existing sidewalk that links NCSS’s Family Center to Route 104.
The Environmental Commission asked Segale if VTrans could provide a crosswalk and signage to connect the two if construction got the go ahead.
Segale said he would look into that.
NMC is working with a town resident to connect the existing city and town sidewalks together on the south side of Route 36. The missing link between the two sidewalks consists of one resident’s front lawn.
If connected, there were be a complete sidewalk from the hospital to the park and ride at the corner of the intersection.
Billings said NMC had an excellent relationship with the resident and seemed confident that the hospital could move forward with the construction in due course.
Still up for debate is whether NMC will go forward with construction of a sidewalk parallel to Route 104 within the property limits.
Tyson Moulton, facilities director for NMC, repeatedly mentioned the hospital’s mission for walkability in the town as well as connectivity between sidewalks.
He questioned the necessity of building a sidewalk though that might not connect to another sidewalk in the foreseeable future, if the town’s history of not building sidewalks continues.
Newton suggested that NMC set aside an easement for sidewalks, stipulating that they will build them if they have something to connect to in the future.
After some back and forth, both parties agreed to conversing on the topic further and creating a draft plan for the sidewalk to present in front of the Environmental Commission at a later date.
The hearing was recessed, pending the receival of the additional paperwork.