August 26, 2016 (TELLURIDE, CO) — This week the Telluride Hospital District (THD) released the results and answers of questions submitted via their Site Selection Public Survey.
The site-selection survey was issued electronically following the THD Public Forum—which was live-streamed by Telluride TV and broadcasted on KOTO—held to review site proposals for a new regional medical center by three regional stakeholders.
The Public Forum, held August 12 at the Sheridan Opera House, provided the community with an opportunity for public comment and to review site proposals from the town of Mountain Village, Lawson Hill Property Owners Association and Big Dog Holdings, LLC, also in Lawson Hill.
The site selection public survey asked respondents to rate the importance of the criteria each site is being evaluated on by the THD and a third party Community Advisory Committee. It also provided an opportunity for open-ended feedback or questions.
Surveys were sent to 130 people who attended the Public Forum as well as to Telluride Medical Center patients. Responses were received from 410 individuals who identified themselves as full time (73%) or part time residents (23%). The residence location was Telluride (42%), Mountain Village (21%), or outside both towns (36.6%). These numbers mirror the origin of Telluride Medical Center patients as shown on another recent survey measuring how patients access the medical center.
The site selection public survey asked respondents to rate site selection criteria on a scale from “Not Important” to “Extremely Important.”
Four criteria—cost, future expansion space, convenient access to primary care, and availability of funding mechanisms—were rated as important or extremely important by 78% of respondents. Site suitability for building was rated by 75% and carbon footprint 63% as important or extremely important.
Many respondents expressed very positive remarks about TMC’s site selection process and were pleased with how the public was being involved. Complete survey results are available at tellmed.org.
Questions asked via site-selection survey:
1. There were discussions in the meeting [Public Forum] about the current TMC location as a viable option to consider. Has this site been reviewed? Has the Owner approached TMC to consider a sale?
Answer: This site does not meet our criteria for a suitable site. Its lot size, opportunity for future expansion, lack of helicopter landing, etc. are problems. The owner has not indicated any interest and has been approached regarding a sale on multiple occasions.
2. Just wondering what your timeline might be?
Answer: We need to secure a site this fall. We then will begin developing our plan, negotiating terms with landowner, and fund raising. We will develop a specific timetable as we go on, but hope to have a building within 5 years.
3. Would it be feasible to have small emergency treatment centers, with one main facility that would contain the bulk of the equipment? This would hand growth, minimizing distance and time to an emergency facility, and keeping building costs down.
Answer: Having two separate facilities is very costly. Separate staff, radiology, lab facilities, pharmacy, and other services would be necessary to provide quality care. At this time, this does not seem feasible. Perhaps down the line if funding could be obtained a small satellite primary/urgent care might be considered in Telluride.
4. I hope there will be emergency care availability in Telluride. It is where the skiers come down and where some of the densest population is located.
Answer: See previous answer regarding separate facilities. Winter is the ER’s busiest month and over 80% of the skiers taken off the mountain come from Mountain Village and transported to ER via EMS Ambulance or TSG Van
5. There are plenty of private options. Why not explore those? Private enterprise has always been more efficient than government. Consider using a portion of the Peaks Hotel for Medical (ER, acute care rooms, MOB etc.) and using the rest of it as employee housing for both towns. It has been a dismal failure as a hotel and we are in desperate need of both low-cost employee rental housing and improved medical facility space.
Answer: We have explored a number of private options and existing buildings, all to no avail. Remodeling an existing facility always presents more problems than new construction. For example, building code requirements for health care facilities are different. We have not approached the Peaks nor have they indicated any interest.
6. Logically the Big Dog site seems central. Would the site be available for re-zoning to allow for a Multi Story Building, a Parking Structure and room for future expansion? Thank you all for you hard work on this.
Answer: All sites are being evaluated on the 6 criteria — (1) site suitability for construction, (2) cost, (3) future expansion ability, (4) primary and emergency care accessibility, (5) availability of funding mechanisms and (6) carbon footprint. The County would have to approve rezoning for Big Dog. We have to consider what is “Central” based upon both geography and population density. To the degree a “central” location has to do with priority #4 – Primary and Emergency Care Accessibility, it is a very important criterion for members of our district and the THD will factor that into their decision.
7. A. Why is the board not talking about total dollars per square foot at this time? What is the estimate cost for the dream building?
B. Please tell me what the hospital district tax money is supposed to be spent on and the rules for that money?
C. I do not believe letting a 1,700 square foot building that costs 10.00 a year is being financially sound plan to the tax payers like myself. I strongly think that the current ER and other components should be built now on a site that can expand in the future. The government rules will be different in 2032 when the lease runs out. Why not turn the downstairs area that Dr. Hackett used into a visiting docs office. That adds an exam room upstairs. Then the ER area becomes three or so offices. If it is true that the leasee says no separation of uses then the board must go back to Idarado mining company and ask to change that limitation. The board should not just say no we need a huge new facility now.
This is not looking after the best interests of the tax payers.
D. Stage the development over 15 to 20 years instead of going for the whole deal now. Get the land now!
Answer: Our present facility does not meet current medical building requirements such as wider hallways, additional bathrooms, etc. With an increase in number of patient visits (20% in the past three years), we are very crowded. We have spent $3.25 million as a bridge to a new facility by remodeling a building that we do not own and which was built as a residential facility. Given the growth, we do not feel it is prudent to spend more on remodeling. Our liability insurance carrier has stated that patient care is not permitted in the current IFAM office. Separating primary and emergency care facilities is very costly because of the duplication of staff, services and equipment. We cannot estimate cost until we have a site selected and then have refined the architectural drawings to minimize cost and future operating expenses.
8. I thought the presentation was very informative. Larry’s moderation of questions, concerns, and ideas from the audience was well done as he provided clear answers and information and was open to receiving suggestions. The only concern I have… After all of this discussion about expansion and need for expanded health services, Larry mentioned that there is no intent of expanded services in the new facility. He basically said that the Medical Center will continue to provide Primary Care and ER services only… but with more doctors available to support our increased need for care. What about Urgent Care or Walk-In Care, a Pediatrician, Orthopedic doctors, etc… Will this more specialized care only be an option in a “campus”-like situation where they would need to open separate private practices?
Answer: At the present time we have 10 visiting specialists including orthopedic, ophthalmology, midwives, mental health, and urology. We would like to include pediatrics and are discussing how we can offer urgent care. A procedure room for minimally invasive procedures (without general anesthesia) is planned in new medical center. Our focus will continue to be primary care and emergency service. Any additions, like mental health, detox unit, and home care will be pursued with partners who will shoulder the cost.
9. I would like to know if/when Telluride’s RV lot is being considered for the facility.
Answer: With ample notice, the Town of Telluride chose not submit an RFI (Request for Information)which would have allowed them to be evaluated along with the other sites. Currently, Telluride is considering placing the public use designation of the RV Lot on the November ballot.
10. Why can’t the med center remain where it is and add another floor and/or basement? With 18 years left on the lease that seems to make sense to me.
Answer: (see previous answer #1) There are too many complex problems with the existing facility to correct with remodeling. Continuing to provide care in a building while rebuilding is problematic. Putting more money into remodeling a building that we do not own is not wise. There is no room for future expansion at the current site. We cannot wait until near the end of the lease to secure a site from the dwindling available properties in the region.
11. Why not expand the existing hospital up to a second level, rather than build a whole new facility? A second level would give the hospital almost the total square footage you said (in a flyer I received in the mail) that you want; and I believe it would much less expensive then acquiring the land and building a new facility from scratch.
Answer: (see previous answers #’s 1, 10)
12. Is there still a possibility for locating within the town of Telluride?
Answer: The RV Lot was the only suitable site put forth by Telluride for consideration. The Telluride Town Council chose to not respond to THD’s RFI effectively not making their property available for consideration.
13. Regarding the question above about Carbon Footprint; while I am sensitive to environmental issues, I think it is important to consider the increasingly regional nature of our community. I wonder if Lawson Hill won’t end up being more and more “central” as time goes on.
Answer: Many studies have been conducted to project where the growth will occur in the region. Most of that growth is anticipated in Mountain Village with the remainder outside both the Town of Telluride and Mountain Village. The largest number of people are outside the Town of Telluride.
14. The town voted last year to open up Pearl, with TMC lobbying hard as this being the only way to get a new medical center in town. TMC needs to follow-up with town and not be in a rush to judgment before town gets its act together. Have you sought philanthropists yet, and if so what site(s) do they favor, and how much will this influence you? Will the town “work session” on Friday be open to the public? And will TMC be there? Thanks
Answer: The lobbying was not done by TMC, but a citizens group. We have been discussing this site with the Town since 2006 and feel we must move on to provide quality care for the citizens of THD. We have formed the Telluride Medical Center Foundation to lay the ground work for fund raising in cooperation with the Telluride Foundation. Feedback to date indicates the major donors favor a site where we can build a quality facility with room to expand and one that allows a heliport. Yes, the Aug 15 Telluride Town Council was open to the public and THD attended.
15. Who will make the ultimate decision? The Board or is there a possibility the decision will be made (by vote) by the members of the Hospital District?
Answer: The Community Advisory Committee and a site development consultant will make recommendations to the Telluride Hospital District Board who will make the final decision. That decision will be based on these recommendations plus the public comments from the survey following the Public Forum.