St. Luke’s Expansion Plan

I am truly torn over the St. Luke’s master plan. I would like to see the hospital expand in its present location in a conscientious manner. I do not think that I, personally, would be affected by the closure of Jefferson, but I don’t think closing Jefferson is necessary for St. Luke’s to meet its objectives.

A bit of background: I have lived in the St. Luke’s neighborhood since 1982, first renting on 2nd St. a few blocks away. In 1986, we bought our home in Aldape Heights, overlooking St. Luke’s about a mile away. One of the reasons I decided to locate there permanently is the proximity to St. Luke’s, where my primary care provider, a couple of my specialists, as well as the hospital and its ancillary services—labs, radiology, ER, etc.—are within a 15-minute walk or a five-minute bike or car ride.

That said, unless I am headed for the St. Luke’s “campus” itself or south on Broadway, I avoid the Avenue B-Jefferson-Fort-Reserve streets intersection whether walking, cycling or driving. I prefer, for safety, to weave through the Fort Boise recreational complex if headed west or downtown, or through the East End if headed east or southeast. The proposal for a properly designed, modern roundabout at the Fort-Reserve intersection is one aspect of this plan I wholeheartedly endorse.

What troubles me most about St. Luke’s proposal is the high-handed way they have approached it. Apparently their administration and public-affairs folks haven’t heard of strategic development of informed consent. It entails identifying all of the affected stakeholders at early planning stages of a proposed action and involving them deeply enough in the decision process that they have all the information upon which the ultimate decisions are based. While they may not agree with the ultimate outcome, they are much more likely to assent, having been heard and understanding how the various costs and benefits were weighed. Additionally, the stakeholders actually may contribute to a better decision if they are truly heard. St. Luke’s initial “my way or the highway” is a two-way street, as they have learned. It has brought out a sentiment that truly surprised me, with many of my friends and neighbors suggesting that perhaps St. Luke’s should move their expansion to the population center of the Valley: Meridian.

When I saw the footprint of the addition for which Jefferson St. would be vacated, it seemed obvious that a southward expansion by removing or building over the existing parking garage would meet the same horizontal-service-connectivity/continuum-of-care objectives as a northward expansion and would obviate the need for losing two more blocks of public right of way in addition to that already vacated on Bannock and Avenue A.

The rationale for rejecting the “Expansion South” alternative toward Warms Springs and over Avenue B is misleading, unconvincing and somewhat disingenuous. Objections to the Expansion South alternative stated in the plan documents are attached as an end note.* Almost every objection to expanding southward relates not to the main building expansion but to the (unnecessary) placement of ancillary buildings—the medical office building and the parking garage—to the east, across Ave. B on land much of which St. Luke’s does not own.

Below is an illustration of a southward expansion plan that connects the main expansion to the existing hospital floors and corridors as desired but keeps the new parking garage and medical office building north of Jefferson. Logistically, relegating the parking, central plant, shipping and receiving facilities to the Front/First/Jefferson “island” gets them away from the residential areas yet accessible to thoroughfares and immediately across Jefferson from the hospital building. The new MBO is across Jefferson from the existing medical “plaza,” which also can expand to the west or provide additional parking. These facilities can easily be connected across Jefferson—underground, overhead or both—to the main buildings.

South-improved

The other objections to a southward expansion stated in the plan relate to location of the main entrance and the emergency department. Here is where another bit of ingenuousness creeps into the objections: Expansion to the south causes redevelopment of the entire front of the existing hospital. Patient and visitor access to front door is problematic. Of course, St. Luke’s preferred, northward expansion envisions just that: redevelopment of the entire front of the hospital by moving it to the northeast corner of the expanded building and closing or converting the existing entrance.

For a southward expansion, several options for locating the new entrance and the emergency department are workable. A couple are shown on the illustration above. A grand entrance at the corner of Jefferson and Ave. B, or further up Jefferson, is possible, as is one on Ave. B across from East Bannock. I don’t pretend to be an architect or planner; I just want to illustrate that solutions are possible without vacating Jefferson.

I have heard a couple objections to the southward expansion that were not stated in the plan. The obvious one is the additional cost of removing or building over the (relatively small) existing parking structure. My response to that is, perhaps that location for expansion should have been considered prior to building the garage. The public should not have to pay for the hospital’s short-sighted planning.

The other objection I’ve heard relates to the inconvenience caused during construction when the existing entrance would be blocked by the southward expansion. That inconvenience can be engineered around with an alternate entrance during construction—a temporary inconvenience, which should be weighed against the permanent inconvenience to the public of disregarding the connectivity already built into the city’s comprehensive plan.

 

* Below, the objections to a southward expansion stated in the plan documents that are not related to the main building expansion are highlighted:

Reasons for rejecting the “South Solution” presented in the October, 2014, Appendix:

The new Patient Tower would be located between Avenues A and B in place of the existing parking garage and expand through Bannock Street to the current emergency room entrance. The new parking garage would be located across Avenue B between Avenues B and C south of Bannock Street. The Children’s Pavilion and the new Medical Office Building would be combined in the block north of the garage. This expansion would require the relocation of the emergency department entrance to Jefferson Street, and cause a significant impact to the traffic load on Jefferson Street. Access on Bannock between Avenues A and B would be eliminated to accommodate the expansion of the hospital. Congestion on Bannock Street between Avenues B and C would be increased due to lobby and parking garage entrances, increasing the potential for vehicular-pedestrian conflict on this block. The location of the parking and lobby entrances on Bannock Street between Avenues B and C would likely increase the use of Avenue C as an access route, increasing the encroachment on the neighborhood. Skybridges over Avenue B would provide the conduit from the parking garage to the new hospital and between the new hospital and the Children’s Pavilion/Medical Office Building.

With the parking and lobby entrances on Bannock Street, queue lengths could extend back to Avenues B and C during peak hours. Increased congestion is correlated to increased emissions and decreased air quality. The increased traffic exiting the hospital lobby or parking garage left onto Avenue B from Bannock Street would likely require a signal to get onto Avenue B. Proximity to the Warm Springs signal would be a challenge for signal timing. Additionally, as noted with the expansion to the east, St. Luke’s does not currently own all of the property between Avenues B and C from Warm Springs north to Jefferson Street. Acquiring these properties requires time and resources.

Reasons for rejecting the “South Solution” presented in the original plan as revised December, 2014:

  • With some exceptions, St. Luke’s does not currently own the property required to accommodate the South Solution.
  • Development to the east across Avenue B straddles Zoning Districts H-S and R-3, and a Minor Arterial. Rezoning to allow the new use involves risk and decreases possibility of success.
  • Internal connectivity and circulation becomes inefficient and problematic between the medical office building (MOB) and the expansion.
  • Bannock Street MOB drop-off and garage access would require closure of Bannock Street to through traffic.
  • Additional access points would be necessary on Avenue C, increasing congestion deeper into the East End.
  • Insufficient floor area for the anticipated building program would cause the height of the proposed expansion to increase.
  • Expansion to the south causes redevelopment of the entire front of the existing hospital. Patient and visitor access to front door is problematic.
  • Access to the Emergency Department becomes challenging.
  • Parking is potentially eliminated at the main hospital entrance. All parking would be located across Avenue B from the main hospital.
  • All new traffic volume is concentrated at Warm Springs/Avenue B/Main/Idaho Street intersection, further congesting an already congested area.
  • Street level connectivity between new construction and existing presents safety challenges to pedestrians crossing Avenue B.

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