Thomas Breen photo
The proposed new primary care center at 150 Sargent Dr.
Flooding concerns have added nearly a year’s delay to the initial timeline for a proposed new primary care center on Long Wharf.
Yale-New Haven Hospital (YNHH) Director of Strategy & Regulatory Planning Jeryl Topalian delivered that news to state regulators on Thursday afternoon in a new 33-page submission to the state Office of Health Strategy (OHS) regarding the hospital’s proposed relocation of all YNHH primary care services to a single building at 150 Sargent Dr.
The new primary care center, to be run in collaboration with Fair Haven Community Health Care and the Cornell Scott Hill Health Center, is called the New Haven Primary Care Consortium (NHPCC).
The state formally closed the hospital’s application on Jan. 18 in order to review its plans to terminate existing outpatient service locations in anticipation of the Long Wharf move. Then state Hearing Officer Micheala Mitchell reopened the application on March 18. She asked the hospital four new questions about the project’s timeline, transportation plan, billing processes, and the impact of recent changes to Title X regulations.
In the hospital’s response Thursday, Topalian reported that YNHH now plans on transitioning primary care services to the 150 Sargent Dr. building starting in late summer 2020, nearly a year later than its initial estimated transition date of September 2019.
“A significant cause for the delay relates to the extent of the proposed renovations at 150 Sargent Dr.,” Topalian wrote, “which requires a full Site Plan Development Review by the City of New Haven. This review is in addition to the need for the submission of a Flood Plain Certificate/Permit Application, due to the siting of the building in a restricted flood plan, which also requires approval from the City.”
The hospital plans to submit its site plan to the city on April 18, she wrote. The plan should be heard at the May 15 City Plan Commission meeting.
Click here to download a copy of the hospital’s latest response.
Topalian wrote that the hospital’s concerns about the flood vulnerability of this new primary care center date to October 2018, when the hospital’s engineering company, Tighe & Bond, determined that the elevation of the main floor of the site building is around 0.14 feet below the required flood-proofing elevation of 12 feet National American Vertical Datum 1988(NAVD 88). The base flood elevation in the area is 11.0 feet NAVD 88.
In order to move forward with the project, Topalian wrote, the hospital needed to obtain a Floodplain Development Permit from the city, “which would entail either raising the elevation of the main floor or flood-proofing certain parts of the building.”
But after a structural evaluation of the building, the hospital decided that raising the main floor elevation to 12 feet NAVD 88 would not be structurally sound.
“Accordingly,” he said, “flood-proofing was determined to be the only viable compliance option.”
After subsequent conversations with the city’s building department, the state Department of Energy and Environmental Protection (DEEP), and City Plan staff, the hospital nailed down an application schedule for its remaining needed permits.
“To date,” Topalian wrote, “the City has permitted only the Radiology Phase 1 scope of work. That work experienced a two month delay, due to the initial Flood Plain review. The first floor will be completed by March 2020, but the second floor, which is dependent on the relocation of the Yale Medicine IVF program to the West Campus in December/January 2019, will not be complete until July 2020. Upon the IVF relocation, the second floor needs to be abated which will take about eight weeks.
“Construction can not start until end of February/March 2020. Due to the needed abatement and construction, the NHPCC Steering Committee decided not to occupy the building until both floors were complete. Finally, any and all project dates are contingent upon the City Plan review and approval of the project documents.”
Abortion List Limitations
The state also asked the hospital to explain how the proposed primary care center would be affected by President Donald Trump administration’s recent changes to federal Title X regulations.
Specifically, federal qualified health centers (FQHCs) like Fair Haven Community Health Care and Cornell Scott Hill Health Center may no longer “perform, promote, refer for, or support abortion as a method of family planning, nor take any other affirmative action to assist a patient to secure such an abortion.”
When asked about the impact of such a change during a public hearing in November, hospital officials demurred, saying that they couldn’t detail the effects of a rule change before the rule change took place. They said that neither of the two local community health centers partnering on the project currently provide abortion services, nor do any of the primary care services planned to move to Long Wharf.
Now that the Title X rule change has happened, Topalian wrote, the new primary care center will still be able to provide pregnant patients with a “list of licensed, qualified, comprehensive primary care providers (including providers of prenatal care); referral to social services or adoption agencies; and/or information about maintaining the health of the mother and unborn child during pregnancy.”
However, it won’t be able to identify which providers on that list perform abortion.
Below are links to previous articles about the proposed New Haven Primary Care Consortium.
• Primary Care Plan: Shuttle Out, Uber In
• Farwell Questions Primary Care Move’s Impact On Poor
• Primary Plan’s Obstacle: Broken Bus System
• Plan Reimagines Primary Care For Poor
• West River Questions Primary Care Move
• Harp Backs Primary Care Move
Also below are Facebook Live videos of portions of last fall’s public hearing, and of an interview earlier this year with Lagarde and Taylor on WNHH’s “Dateline New Haven.”
Apart from the issue of whether this move should be approved, this case illustrates the impacts of climate change. Sea levels have been rising at an accelerating pace. If the move is to go forward, the building will need to be raised or flood-proofed, either of which will entail serious costs. The costs of dealing with climate change are occurring now.