Process Moves Forward Without Telluride
TELLURIDE – A site in the Town of Telluride remains out of the picture for a new regional medical center, at least for the time being, as the Telluride Hospital District reviewed three proposed sites, including two in Lawson Hill and one in Mountain Village, at a forum on Tuesday.
The three potential sites reviewed during Telluride Hospital District Board President Larry Mallard’s presentation were the Town of Mountain Village’s Town Hall site, located next to the Market in Mountain Village; Lots H and I, near the Mountain School in Lawson Hill, submitted by the Lawson Hill Property Owners Association; and a lot near the Conoco Station in Lawson Hill, submitted by Big Dog Holdings, LLC. Those three sites were the only ones discussed during the forum.
Although the issue of keeping the medical center in Telluride was a common theme in public comments at the forum, as it has also been in past negotiations and discussions, consideration of the RV lot on Mahoney Drive in Telluride (a site that won a crucial rezoning by voters in November 2013 so that a public facility could be allowed there) was conspicuously absent from Mallard’s formal presentation.
“We don’t even have an offer from Telluride on the RV Lot,” Mallard said. “So we don’t even really have the ability to discuss it here tonight.”
He added, however, that to date, discussions with Telluride have not been contentious, and that, “We do have open dialogue with the Town of Telluride.
“If Telluride gives us the RV lot for consideration, it would be evaluated against other sites based on the information that has already been provided,” Mallard said.
Mallard went on to announce that the Telluride Town Council will be having a work session on Friday, Aug. 15, regarding the RV lot, but cautioned that “even if Telluride gives us the RV lot for consideration, there is no guarantee it’s going to be selected as final site. The only agenda item for the work session is to determine the highest and best use for the RV lot, and there is no guarantee that use will be as the site for the new Medical Center.”
Mallard emphasized the need for a new medical center, which he attributed in large part to a significant growth in patient visits, and the inability to keep the current building up to code and to ensure that a medical facility could even legally remain there once the lease is up in 19 years.
“There has been a 20 percent increase in patients since the Affordable Health Care Act was passed, which makes our timeline even more critical. We have spent $3.2 million on expanding the current facility and we are out of space,” he explained.
“Recently, at the current medical center, it was necessary to give a patient a transfusion in an administrative office because there was no space to do it in a proper exam room,” he continued. “When we are having to do transfusions in an office, that’s when it’s really bad.”
Mallard explained that a new medical center would not only expand and add space for existing services, ER and Primary Care, but that through outside providers other services for patients could be offered such as mental health, detox, county nursing and even hospice care. An all night observation room might also be possible.
Of the three sites Mallard’s presentation focused on as current options for the new Medical Center, none stood out in particular as having any clear advantages or disadvantages with respect to the other two.
All three of the sites were suitable for building, although according to the research Mallard presented, the Mountain Village site had rockier soil. All three sites would also require retaining walls to be built. The sites in Lawson Hill were more expensive with regard to land cost, but all three sites had total costs ranging from $17 million to $23.8 million, and would be funded through philanthropy, bonds, and in the case of the Mountain Village site, potentially also through public financing.
According to Mallard, total cost calculations were based on a 25,000 s.f. facility, and included hard construction, soft construction, equipment, furnishings, fixtures and operating supplies. “The prices we have come up with as total costs for these facilities are fairly realistic,” he said, “And when we include everything the costs usually start at $17 million.”
Access to the three potential sites was also discussed in Mallard’s presentation, and did not pose a significant challenge beyond needing vehicle access or Gondola access to get to the site. However, parking and building a helicopter landing pad were both noted as important considerations for all three of the sites.
Commenting on the timeline for completion of the Medical Center, regardless of what site is chosen, Mallard joked about the futility of setting deadlines for projects like this but did state that, “We are deep into this process, and are in the phase now of picking a site. Once we pick a site, we will need to address fundraising, design and financing, and only after that can we put a shovel in the ground. We had set a date of 60 months for completion, and we have set a timeline backwards of that, and we are still on that plan.”
A number of questions were raised and addressed during the public discussion portion of the forum, many of which had to do with keeping the medical center in Telluride, accessibility issues, feasibility issues and whether there is an actual need to keep medical services in one building or campus.
Ray Levy was given a round of applause after summarizing many of the views in attendance, stating that public access is an essential component to good medical care, and asking, “What agenda are we not seeing that is taking the medical care away from where it is easiest to get to (Telluride) and putting it somewhere that it will be harder to get to?”
A young woman countered this point and the seemingly more popular viewpoint that keeping the medical center in Telluride would make it easier for residents to seek care, in wondering why, with such a lack of affordable housing and the need of many residents to live in cheaper outlying areas such as Mountain Village or Ski Ranches, people were placing so much emphasis on the ability of Telluride residents and visitors to walk to the medical center.
“We are a resourceful community,” she said, “And I know we can find a way around any transportation issues if the medical center moves out of town.”
Jenny Ward agreed, “If you already live in Mountain Village or any of these outlying areas Telluride is simply not the most convenient or accessible location.”
In responding to questions and comments about keeping the medical center in Telluride, Mallard often had to cite the numbers and remind the public that 60 percent of regular patients seen at TMC are not Telluride residents, and that 80 percent of ER patients at TMC are tourists.
“It may make more sense to have it in Telluride but also may make sense to have it in Mountain Village or Lawson due to the size it will have to be. The gondola goes both ways,” he said, continuing, “The 60 percent of patients we see in the medical center now that are not from Telluride or living in Telluride already have to drive or take the gondola to the medical center. They can’t walk.”
“Facility is the first and foremost concern, the site is secondary,” he added.
In response to questions about keeping one facility in Telluride, such as ER and adding others elsewhere, or to outsourcing non-medical aspects of care, such as the administrative offices, to other facilities and devoting that space to exam rooms, he cited lack of efficiency, lack of cost-effectiveness and potential legal issues as reasons this type of approach was not feasible.
“Under one roof you get better medical care, period,” he declared. “We can’t have people going to three different buildings for the same medical issue and having to pay the exact same price tag.”
Other issues, such as altitude, the cost of putting a helipad on the ground versus building one on the roof, impact on the community and traffic, disaster preparedness and adding more bus service were brought up and Mallard was able to adequately assure the public that these issues had all been addressed satisfactorily and that they would be among any challenges posed would be need to be overcome.
The last public comment, also met with applause, urged people to focus on the Lawson Hill and Mountain Village sites only.
“It’s too late for Telluride to propose anything because they didn’t play by the rules and they had plenty of time to do so,” said a man who did not identify himself. “The three lots proposed here are better, make more sense, and are the only ones that should be considered.”
Whether Telluride can jump back into contention, or wishes to, is sure to be a topic of discussion at the town council’s work session on Aug. 15.