Permitting Process For OCHS Clinic Under Town Microscope

By: William F. Galvin

Topics: Health , Development

Outer Cape Health Services, Inc. has filed plans with the town for renovations to the Kennedy Building at 710 Route 28 for their 18-room health center. WILLIAM F. GALVIN PHOTO

HARWICH — Outer Cape Health Services, Inc. has applied for necessary town permits to move forward with its proposal to establish a medical clinic on the first floor of the Kennedy Building across Route 28 from Saquatucket Harbor.

OCHS was scheduled to go before the conservation commission last night for a request for determination of applicability for the project, which is located in the FEMA flood hazard zone. The health care agency is seeking to install flood-proofing measures; while not within the wave action zone, the building has an existing floor slab below the flood elevation.

The building code allows commercial buildings with ground floors located below the design flood elevation of 12 feet to be flood proofed. The proposal calls for removal of the windows on the front of the building, removal of the wood knee wall and reconstruction of the wall with concrete block.

OCHS has also filed an application with the planning board seeking a site plan special permit and a special permit for a medical clinic with a gross floor area more than 7,500 square feet. Waivers will also be needed from parking and landscape requirements.

A determination has been issued by Cape Cod Commission Chief Regulatory Officer Jon Idman that the project does not require Development of Regional Impact review. Idman determined the project does not constitute a “change of use” as defined in the regulations. The planning board hearing has been scheduled for Tuesday, Feb. 13.

Representatives of OCHS last week made an informal presentation to the planning board. The nonprofit health care organization has a lease with owner Building Down the Road, LLC, for a 10-year period with an option to extend the terms for two additional 10-year terms.

OCHS CEO Patricia Nadle called the proposal an “incredibly important project” for the community. The smaller medical office the agency has on Chatham Road has five rooms and handled 13,000 patient visits last year; the new facility will be significantly larger.

Nadle said there is need for additional health care facilities in the community; some health care providers in the area are leaving, others are not taking new patients and some are not taking certain insurance programs, she said.

Attorney Eliza Cox of Nutter McClennen and Fish of Hyannis went over the plans for the 32,000-square-foot, two-story building that sits on 1.92 acres across from Saquatucket Harbor. She provided the board with a history of permitting for the building that was constructed in 1989, noting that a couple of special permits and a variance for parking reconfiguration were granted in the early 1990s.

Architect Virginia Branch of DBVW Architects, Inc. of Providence, R.I., explained plans for the interior retrofit of the existing building, which will establish two pods for health care – each containing eight examination rooms and one behavioral health care room – on the first floor.

Stair and elevator improvements will provide access to the second floor, where OCHS administrative offices are now located. The existing docking bay will be converted for ambulance use.

It was made clear there is no urgent care service planned at the clinic and ambulance service will not include drop-offs, only pick-ups for patients who need to be transported to the hospital. The entrance location on the west side of the building will be transformed into a waiting and reception area, Branch said.

The plan is to utilize the existing septic system and parking lot, which will be re-striped, and the same curb cut. About 3,200 square feet of space on the first floor will not be used in the first phase of the project; the organization will return to the board if that space is used in the future.

Cox said the planning board will be asked to use its discretion in waiving the parking regulations, as is allowed under the zoning bylaw. She pointed out zoning regulations require 162 parking spaces and there are 94 now. The parking space numbers were based on “professional or administrative office, bank or other financial institution and general business office.” She said the numbers were based on the number of employees, space and additional clients visiting the office.

Cox said OCHS will not be seeing clients and customers in the administration offices and she does not think 48 of the spaces should be required. Cox said OCHS has done its own survey of parking lot use and found a need for the high 20s or low 30s in spaces required for administration. She requested the board remove 48 of the 84 spaces identified for administration, bringing the requirement number of spaces to 114. The proposed number of spaces for the project is 96, leaving a difference of 18 spaces, Cox said. Parking can further be controlled through scheduling of patients. It was also pointed out there will be times when not all the examination rooms are in use.

Interim Town Planner Charleen Greenhalgh said she has been involved in several of the staff meetings and the analysis done relative to the parking was good, adding the number far exceeds what is needed for the second floor. It was also pointed out in the busy summer months there would be off-site parking and car-pooling would be encouraged.

“When you come in be prepared to say how you will make up the absence of the 18 spaces,” Planning board member James Atkinson said.

Planning board member Joseph McParland said there is a large town parking space that will be located across Route 28. “I don't think there is any rule that says you can't park there. Employees can park there and your issues are resolved.”

“There are a lot of changes going on across the street and we have to consider that before we can address that use for part of the waiver,” Atkinson said.

OCHS has a little less than a month to make any adjustments to the plan before making pitches for special permits on Feb. 13.