Primary Care Hub Wins Key City Sign Off

Yale New Haven Hospital received its final needed city sign-offs Monday night for two major planned renovation projects, including for the Long Wharf building it has proposed to fit out as a new primary care hub.

The hospital now needs only a final approval from state regulators before it can start making that centralized primary care vision a reality.

Those local administrative approvals came Monday night during a special meeting of the City Plan Commission, held in the City Plan department’s fifth- floor library at City Hall.

The commissioners unanimously approved the hospital’s site plan and coastal site plan for 150 Sargent Dr., a current two-story medical office building on Long Wharf that YNHH plans to convert into the home for the proposed New Haven Primary Care Consortium (NHPCC) in partnership with Fair Haven Community Health Care and Cornell Scott Hill Health Center.

They also unanimously signed off on proposed interior renovations to the former Plymouth Congregational Church at 175 Sherman Ave., which the hospital has used as a medical office building since 1983.

The hospital is still waiting for a final ruling from the state Office of Health Strategy (OHS) on whether or not it can relocate its three current primary care services from their downtown and Hamden locations over to Long Wharf. Monday’s approvals apply only to the hospital’s planned improvements to the 150 Sargent Dr. building, which include 52,074 square feet of interior renovations, floodproofing, landscaping, and the repaving and restriping of the existing parking lot.

“The FQHC sites [i.e. Fair Haven Community Health and Cornell Scott Hill], none are closing down as part of this 150 Sargent Dr. project,” YNHH Ambulatory Care Vice President Michael Schaffer clarified at the meeting. ​“No services. No sites. This project doesn’t aim to relocate existing FQHC patients. This project aims to relocate Yale New Haven Hospital primary care services and enhance those services, enhance access, provide more care, and better space and more coordinated care.”

Local attorney David Monz (pictured), local engineer Erik Lindquist, and Burlington, Vermont.-based architect William Brothers explained that the hospital plans to renovate interior offices to retain 150 Sargent’s current phlebotomy and radiology services while also creating room for relocated YNHH adult medicine, women’s health, and pediatrics services.

It plans to grind up and repave the existing parking lot to create 255 spaces, including 26 handicapped-accessible spaces; to replace the lot’s current three-foot-by-three-foot curb plantings with large islands and numerous trees to provide shading and green space and cut down on impervious space; and to install a new subsurface water detention system to help ease the burden placed on the city’s drainage system during heavy downpours and floods.

“We’re not proposing to change any of the footprint,” Brothers said. ​“We are proposing a full interior renovation of the first and second floors.”

City Plan Commission alternate Elias Estabrook (pictured) asked YNHH’s site plan team to explain in greater detail how it plans to floodproof the site, which sits in one of the neighborhoods most vulnerable to sea level rise and increased flooding that will come with climate change.

“We’re proposing to locate our dry floodproofing to an elevation of 13.86 feet,” Brothers said, ​“so what that gives you is almost three feet above the base flood elevation” of 11 NAVD88.

He said the hospital plans to put a waterproofing membrane around the exterior to protect the joint where the slab intersects the foundation wall and the concrete masonry wall of the building.

And on the inside, he said, all of the doors except for the sliding groundfloor entry will be special ​“flood barrier doors.”

“It looks like a regular man door,” he said, ​“but it’s gasketed and sealed, and it has a heavy duty closer. So it still provides egress out of the building. It still does all the normal functions of a door. But the benefit is, when it floods and people leave the facility, it’s closed. It’s contained. And it meets the requirements for the insurers in terms of waterproofing the facility.” The interior stairwells will have those special doors too, he said, as well as insulated flood vents that will allow the stairwells to drain if they are filled with water.

What about pick up and drop off spaces? asked commissioners Adam Marchand and Leslie Radcliffe. YNHH has already contracted with several ride share companies to provide free transit for patients who live over a 40-minute bus ride away from 150 Sargent,. Where will those drivers drop off carless patients and where will those patients be able to wait comfortably and safely for their rides to arrive?

With the relocation of YNHH’s 25,000 annual primary care patients to Long Wharf, how will the current site accommodate those who are dropped off rather than drive themselves?

Lindquist said that the main entrance will retain its covered canopy. The canopy is roughly 50 or 60 feet long, enough to accommodate a queue of a handful of cars. Each of the clinics will have its own indoor waiting area, Brothers said. The vestibule will have benches to accommodate roughly 10 people.

Schaffer noted that, based on a hospital survey of 2,500 current primary care patients, roughly two-thirds drive themselves. On average, he said, the hospital expects to receive 200 patient visits per day at the relocated YNHH primary care facilities at Long Wharf.

“We’re talking about 60 or 70 rides per day that patients could be eligible for,” he said. ​“We think that over the course of an eight to 10-hour day, that’s not an overwhelming number of patients and rides that will need to be accommodated in this space. We don’t think there’s going to be queues of so many people in front waiting for a ride home.”

As for 175 Sherman, a different trio of YNHH-hired lawyers, engineers, and architects explained that the hospital plans to conduct 40,536 square feet of interior renovations to the existing church-turned-medical building. It will add a new handicap accessible ramp to the building, as well as new stairs, a canopy, and landscaping and stormwater management improvements.

The hospital plans to renovate space to accommodate 10 physicians who currently work out of the St. Raphael’s campus across the street, Milford attorney John Knuff said.

“To be clear no expansion of the building itself is proposed,” he said. ​“It’s only the expansion of the uses within the building.” Knuff said the proposed renovations should begin immediately, and should be finished in a year.