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HomeMy WebLinkAboutBANNER HEALTH MEDICAL CAMPUS - PDP ..... NEIGHBORHOOD MEETING #1 - PDP130003 - CORRESPONDENCE - CORRESPONDENCE-NEIGHBORHOOD MEETINGk • Alp Exhibit 2 Helistop Aircraft Final Approach and Takeoff Primary Flight Path IT (-" 45",wO)I MAFOON :T J—E CT KENC=NA CT n KE 4Rh SYeAASra s� n qq� 04 r-- g NITE CT k I v IF n v hL -fT7N 7L \ �rH AVE ' I iG a AKA MAKIAM LN I r',rnn GRAND TE70H aL ++++r ��` sth � I� CMINKOk IN �r♦ I 2RD AV I ♦.I t orI� i I_ i S ^ yE-+TRL a O ' i r ♦ _9I ` P^ 0 E, PO EERpE �y radiusofsed LHalfmile helistop on sMe Proposed FATO� x; \` routes shown in RED and GREEN a 9 a 3 8 SHALLOW PO Dk - F� TRILOY PD..,: ra aAnDLEa CT $ _ z 0;CR4 cr c� P Y �4 E �S34SCge- e— J N 1 Data use subject t3 license t © DeLorme ❑eLornx StreetAtias USAC 2011 0 800 1600 2ACO 3200 4000 Exhibit I - From the American College of Surgeons website Trauma Center Levels: • Level The Level I facility is a regional resource trauma center that is a tertiary care facility central to the trauma care system. Ultimately, all patients who require the resources of the Level I center should have access to it. This facility must have the capability of providing leadership and total care for every aspect of injury, from prevention through rehabilitation. In its central role, the Level I center must have adequate depth of resources and personnel. Banner Health note: Level 1 trauma centers are required to have orthopedic surgeons, neurosurgeons and anesthesiologists on -site 24/7. • Level II The Level II trauma center is a hospital that is also expected to provide initial definitive trauma care, regardless of the severity of injury. Depending on geographic location, patient volume, personnel, and resources, however, the Level II trauma center may not be able to provide the same comprehensive care as a Level I trauma center. Therefore, patients with more complex injuries may have to be transferred to a Level I center (for example, patients requiring advanced and extended surgical critical care). Level II trauma centers may be the most prevalent facility in a community, managing the majority of trauma patients. Banner Health note: Level 2 trauma centers are required to be able to have orthopedic surgeons, neurosurgeons and anesthesiologist on -site within 20 minutes. Level III The Level III trauma center serves communities that do not have immediate access to a Level I or II institution. Level III trauma centers can provide prompt assessment, resuscitation, emergency operations, and stabilization and also arrange for possible transfer to a facility that can provide definitive trauma care. General surgeons are required in a Level III facility. Planning for care of injured patients in these hospitals requires transfer agreements and standardized treatment protocols. Level III trauma centers are generally not appropriate in an urban or suburb an area with adequate Level I and/or Level II resources. Banner Health note: Level 3 trauma centers are required to have general surgeons on - site 24/7. • Level IV Level IV trauma facilities provide advanced trauma life-support prior to patient transfer in remote areas where no higher level of care is available. Such a facility may be a clinic rather than a hospital and may or may not have a physician available. Because of geographic isolation, however, the Level IV trauma facility is the de facto primary care provider. If willing to make the commitment to provide optimal care, given its resources, the Level IV trauma facility should be an integral part of the inclusive trauma care system. As at Level III trauma centers, treatment protocols for resuscitation, transfer protocols, data reporting, and participation in system performance improvement are essential. the helicopter from the prescribed flight pattern and keeps the helicopter as faraway from the neighborhoods and schools as possible. 3. Toxic Waste What are Banner's procedures regarding the storage and disposal of any toxic waste? There are two major types of regulated waste materials generated in hospitals: regulated medical waste (RMW) and Hazardous Waste (HW). RMW is "bio-hazardous" waste that includes used bandages, dressings, sharps (needles), blood, lab cultures, and tissue from pathology. By State of Colorado regulation [25-15-401 CRS], the hospital (as a generator) is held accountable for the proper destruction/disposal of all RMW. The disposal of RMW is regulated and enforced by the State of Colorado. Banner Health complies with all State regulations related to the internal facility collection and storage of RMW and the external disposal of RMW generated materials through the use of licensed RMW disposal vendors. There are no federal regulations or enforcement. Per the Facilities Guidelines Institute (FGI), Soiled Utility Rooms are required in every patient wing, clinic and other appropriate departments (surgery, lab, etc). At Banner Health, all Soiled Utility Rooms are locked and accessible to staff only with appropriate security clearance via card access security system. Banner Health staff picks up RMW from Soiled Utility Rooms throughout the hospital and transfers RMW containers to a central, secure holding room where it is picked up by a licensed RMW disposal company. Banner Health uses Stericycle, a licensed RMW disposal company, to pick up and autoclave our RMW at their facility in Dacono. HW in hospitals comes from the Lab (histology/staining chemicals, like alcohol and xylene), Pharmacy (used/outdated pharmaceuticals and trace chemotherapeutic drug waste, like gloves, IV bags and tubing). The HW regulations come from the federal Environmental Protection Agency (EPA) but are enforced by the State of Colorado - Colorado Dept. of Public Health & Environment (CDPHE). The storage and transport of HW is similar to the storage and transport of RMW. Holding rooms are located in areas as required by the FGI (in labs and pharmacies). These rooms are locked and accessible via card access only by staff with the appropriate security clearance. Banner Health staff transports containers to a secure, central holding room where it is picked up by a licensed HW contractor. Banner Health uses Clean Harbors to remove and recycle or incinerate all of our HW at their facility. Clean Harbors is an EPA approved HW hauler with a licensed Treatment, Storage and Disposal (TDS) facility in Kimball, Nebraska. The transport of HW and RMW is regulated by the City of Fort Collins on city streets and State of Colorado on state highways and interstates. All regulations require transport of waste in the most direct and safe route possible between the origin and destination. At the proposed Harmony Road medical center, the City of Fort Collins will require that the licensed transporters exit the loading dock, go north directly to Harmony Road then east to 1-25. Once on 1-25, State Regulations will require the transporters to stay on 1-25 until necessary in order to reach their destination. City and State regulations prohibit transport through residential neighborhoods unless absolutely necessary. At the Harmony Road location, Harmony Road will be easily accessible from the loading dock via the north end of Cinquefoil Lane. Therefore, transport through residential neighborhoods is not necessary and will likely not be permitted. See attached for the location of the loading dock and access to Harmony Road (Exhibit 3). The FATO for the Harmony Road Medical Center will generally involve the following: ■ Helicopters will fly into the wind. In Fort Collins, the prevailing winds come from the northwest direction. ■ During Take Off, the helicopter will travel northwest from the helistop towards Harmony Road and Lady Moon Drive. After reaching a ground level above 500'the helicopter will turn to fly over Harmony Road. ■ During Final Approach, the helicopter will fly over Harmony Road and then when the helicopter reaches 500' above ground level, approach the helistop from the southeast. ■ See the following map showing the approximate approach and departure routes for this facility (Exhibit 2). When the helicopter is 500 or more feet above ground level, it must follow a prescribed flight pattern. In populated areas like Fort Collins, the prescribed flight pattern is to fly over industrial corridors. In this area, helicopters will fly over 1-25, Harmony Road and HWY 287. They avoid flying over high -density areas like residential developments, schools, churches, commercial areas, sensitive ecological areas, etc. What FAA approvals are required? A Notice of Landing Area Proposal is required to be filed with the FAA for approval of the hospital helistop flight path, FATO and the Touchdown and Lift -Off area. A primary and secondary FATO will be filed with the FAA. The secondary FATO is required if wind direction shifts dramatically. The FATO will be aligned with the predominant wind direction to avoid downwind operations and minimize crosswind operations. To accomplish this, the helistop will have more than one approach/departure path. Based on the approach/departure paths on the assessment of the prevailing winds, a secondary FATO will be provided at least 135 degrees from the primary FATO. Banner Health medical centers helistops are developed to FAA hospital design guidelines and standards to provide the maximum safety to all patients, air emergency transport service providers and emergency medical service personnel. Any distance requirements from neighborhoods, schools, etc.? There are no required distances away from neighborhoods or schools. However, all helicopter operators realize that air traffic can be disruptive and undesirable in high -density areas. Therefore, the Banner Health Med-Evac program, as well as most other emergency air transport providers in the State of Colorado, voluntarily participates in the "Fly Neighborly" program. As participants in this program, Med-Evac will develop flight patterns and FATO routes that are published and distributed to all other helicopter operators. All helicopters must follow the published flight pattern and FATOs when landing at the proposed Harmony Road medical center. Banner Health has not yet filed with the FAA or submitted plans to Fly Neighborly. But, when these documents are filed, helicopters will be directed to approach the hospital from Harmony Road and, as stated previously, fly clear of the high -density areas, including the residential developments and schools in the area. Frequency of helicopters? This is difficult to estimate. However, at Banner North Colorado Emergency Care in Greeley, we have had two helicopter transports out of the facility from August 1, 2012 to December 1, 2012. At McKee Medical Center and Banner Ironwood Medical Center an average of 1-2 patients per week is helicopter transported from each of those medical centers to other medical centers. Based on this data, our best estimate would be that the Harmony Road medical center would helicopter transport 0-1 patient per week to other medical centers. We do not anticipate any helicopter transport of patients in to this medical center. Also include any other information from Banner to explain the operations and impacts from helicopters to the surrounding neighborhoods. The helistop at the proposed Harmony Road medical center facility has been intentionally located on the north side of the campus in proximity to Harmony Road. This placement will result in the most direct flight path for At Banner North Colorado Medical Center in Greeley, there are private residences directly across the street from the hospital. Being a Level 2 trauma center, ambulances bring patients to the emergency department several hundred times a week throughout the year. Quite often, ambulances will access the emergency department by driving down 151h Street where there are numerous private residences, Heath Middle School and Greeley Central High School. To be good stewards of our neighborhood and to provide a safe and quiet environment for our neighbors, ambulances turn off their lights and sirens approximately 1/2 mile from the hospital. Should ambulances have to drive through the neighborhoods south of the proposed Harmony Road medical center, Banner Health will designate a zone where ambulance operators will be required to turn off lights and sirens and obey all traffic laws. We are sensitive to this issue and strive to be a good neighbor at all times. All Banner Health ambulances have forward- and rear -facing cameras. Should an ambulance be involved in an accident or receive a complaint, the Directors and Administrators will review recordings and act accordingly. Any employee who operates the ambulance with disregard for safety or is found to be in violation of State of Colorado Model Traffic Code and/or departmental policy will be subjected to applicable fines from law enforcement including disciplinary action up to and including their termination. 2. Helicopters Will there be a permanent helicopter station with helicopter at the proposed facility? There will be a permanent "helistop" built at the Harmony Road medical center along the Harmony Road frontage. This helistop will be an 80' x 80' concrete pad surrounded by approximately 40' of landscaping built at grade level. There will not be a heliport, hangar or any other building or facilities to support the helicopter at this medical center. Helicopter medical transport aircraft are permitted only to land at helistops for limited periods of time to pick up or drop off patients. Refueling, parking and maintenance is not permitted at helistops. Will helicopter service be picking -up and/or delivering patients? We anticipate that the helicopters will be used exclusively to transfer patients to higher level trauma centers or other regional medical facilities as required. What is Banner's "trauma care" classification, and what does this mean? In Colorado, trauma centers are rated by levels ranging from Level 1 through Level 4, with Level 1 providing the highest level of emergency care and Level 4 being the lowest level of emergency care. These designation levels are earned by meeting specific requirements defined by The American College of Surgeons. A quick description of each level as defined by The American College of Surgeons is attached to this document (Exhibit 1). The Harmony Road Fort Collins facility is anticipated to be a Level 3 or Level 4 trauma Center. Because of this trauma level, it is anticipated that most ambulances responding to emergencies will not bring patients to this facility. Emergency cases will likely go to Medical Center of the Rockies or North Colorado Medical Center. And, all patients picked up at an emergency by helicopter will be taken to Level 1 or 2 trauma centers instead of the Banner Health Fort Collins facility. How is the helicopter route determined? There are two different "zones" where helicopter routes are prescribed. First, the route that helicopters follow as they approach or depart from a landing is called Final Approach and Take Off (FATO). Second, when the helicopter is 500' above ground level and higher where helicopters are in FAA regulated airspace and restricted to designated flight paths as approved per the FAA AC No. 150/5390-2C Section 4, Ground -Level Hospital Heliport Notice of Landing Area Proposal submitted flight path. I- The goal of the ambulance is to get to the patient or hospital as fast and safely as possible. Neighborhoods generally have slower speed limits than arterial streets and contain school zones, speed bumps and pedestrians, all of which will slow down response times to and from the calls for service. In southeast Fort Collins, ambulances will drive primarily on 1-25, Harmony Road, Zeigler Road, HWY 287 and Frontage Road. 2- Ambulances are equipped with Opticom transmitters that change traffic lights on arterial streets in their favor. This provides for a safe, smooth and rapid transport that can only be provided on arterial streets. What is the expected frequency of ambulance arrivals and anticipated approach distribution? Assuming that this question is in reference to the number of ambulances coming in from Harmony Road vs. from Cinquefoil Lane or Lady Moon Drive from the south, unless an ambulance is responding to an emergency in the neighborhoods to the south of Harmony Road and east of Ziegler Road, we do not anticipate any ambulances approaching the hospital from the area directly to the south of the medical center. Therefore, practically all ambulance traffic is anticipated to come from Harmony Road. A response to the question below regarding trauma center level designations states that ambulances will likely take patients to other medical centers with higher level trauma center designations. It is difficult to estimate the number of ambulances that will transport patients to the Harmony Road medical center. We anticipate that it will be minimal due to the trauma level designation. However, Banner Ironwood Medical Center (BIMC) in San Tan Valley, AZ is a 36 bed Level 3 trauma center in a community of approximately 120,000 people. An average of 8 patients are transported by ambulance to the Emergency Department at BIMC each day. Based on this data, we would estimate that approximately 2-4 patients would be transported to the Harmony Road medical center per day since Poudre Valley Hospital will also receive patients throughout the day. It is also difficult to estimate the number of ambulances that will transport patients to other medical centers. BIMC transports an average of 8 patients per day to other medical centers. Based on this data, we anticipate that ambulances will be transporting 2-4 patients per day to other medical centers. All transports to other medical centers will take Harmony Road to 1-25 then down to Loveland, Greeley or the Denver metro area. Also include any other information from Banner Health to explain the operations and impacts from ambulance service associated with the proposed Banner Medical Center facility. Please remember that the staff members who operate ambulances are healthcare workers whose goal is to safely tend to sick or injured people. They operate the ambulance in a manner to ensure the safety of patients in the ambulance as well as the public around them. They will not endanger the general public when responding to routine or emergency calls or when transporting a patient to a hospital. Despite having an Opticom transmitter that will change traffic lights in the favor of the responding emergency vehicle, Banner Health staff will still slow down at intersections to ensure a safe clearance through the intersection (Slow, Stop and Clear, as stated above). Additional emergency vehicles from police or fire agencies may also be responding to the same emergency, so all emergency vehicles will approach intersections and "Slow, Stop and Clear" to ensure that no other emergency vehicles are crossing the intersection at the same time. Ambulances are not operated in such a manner that will cause discomfort to the patient(s) being transported. A patient in the back of an ambulance may be sensitive to sudden jarring movements due to injuries or illness. Ambulances that aggressively accelerate and/or decelerate could be detrimental to a patient's condition. Therefore, unless a patient's condition is life threatening, rarely will an ambulance respond or transport using their lights and sirens. Instead, an ambulance will be operated no differently from the safe operation of a personal vehicle. k� Jason Holland, City Planner City of Fort Collins Community Development & Neighborhood Services 281 North College Avenue Fort Collins, Colorado The following are the applicant, Banner Health's responses to the three general comment categories discussed during the November 26, 2012 Neighborhood Meeting and subsequent follow up questions submitted to the City of Fort Collins regarding the proposed Banner Health medical center at the southeast corner of Harmony Road and Lady Moon Drive. 1. Ambulance Traffic. Does Banner have its own ambulances or contract this service? Banner Health owns and operates Banner North Colorado Paramedic Service. How will PVH vs. Banner emergency response be determined? Emergency responses to calls for service in Larimer County are routed through the 911 System in Fort Collins to the Public Safety Answering Point (PSAP) closest to the call's origin. The PSAP receiving the call will dispatch the appropriate and closest responders to the emergency. How do ambulance drivers decide their route? Is there a map screen as with fire engines? Banner Health ambulances have computers mounted in the vehicle providing GPS guided routing. Spillman Technologies is our Computer Aided Dispatch (CAD) service provider for computerized mapping that provides the fastest, least obstructed route to emergencies. Can ambulance drivers deviate from prevailing traffic regulations (i.e., stop signs, speed limits)? The Colorado Model Traffic Code applies to the operation of ambulances. Section 108 describes the rules that apply to emergency response. Safe operation is the priority to ambulance response to and from calls for services at all times. However, Banner Health has strict policies for ambulance operations that are often more stringent than State requirements. Our policies require the following: ■ Employees receive driver training during their initial employment training. ■ Employees must pass motor vehicle record checks on an annual basis. ■ Ambulance operators are not permitted to exceed the posted speed limit by more than 10 mph. ■ Ambulance operators are required to approach all controlled intersections and "Slow, Stop and Clear." This means that ambulances will slow down when approaching intersections, stop as necessary to verify that there are no vehicles approaching the intersection and proceed through the intersection only when it is safe. ■ If an ambulance is forced to drive in an on -coming lane of traffic, the maximum speed is 20 mph. ■ When operating in a school zone, ambulances will follow all posted speed limits, stop signs and crossing guards. What would be the circumstances under which an ambulance would be using a neighborhood street? An ambulance will drive through a neighborhood in two cases only. 1- There is an emergency in that neighborhood. 2- There are unusual circumstances where all major arterial streets are closed off, such as an accident, water main break, or some other condition where there is no other option but to drive through a neighborhood. This would be an extremely rare occurrence. Please be aware that ambulances avoid driving through neighborhoods as much as possible. This is due to the following: