ANCRON Medical Clinic ~ Rezoning Public Open House March 19", 2015 ANCRON MEDICAL CLINIC PROJECT OVERVIEW ‘The ANCRON Medical Centre has outgrown their current location and sees an opportunity to serve their patients, the citizens and the medical community by creating a significant new ‘medical facility adjacent to the Kootenay Lake Hospital. The site is unsuitable for single family or multi-family residential development because of its adjacency to the emergency entrance ‘and ambulance drop off; the impact of the proposed project on the neighboring residences should be minimized by the building design and the natural site characteristics. We believe that the OCP amendment and rezoning that has been requested is a valid and supportable submission, The proposed building presents an aesthetically pleasing built-form, integrating residential and commercial zones, and providing local employment and medical services for the City's residents. COMMUNITY BENEFITS * The City of Nelson OCP supports Medical facilities near the Kootenay Lake Hospital and that preserve the quality of health care available to residents and adjacent regional areas. © Relocating the ANCRON Clinic near to the Kootenay Lake Hospital improves access and availability for medical services at KLH, + The Kootenay Lake Hospital supports the proposed project as it offers collaborative medical services and possible office space for specialists. © Relocating the ANCRON Clinic will make their current space available to more compatible downtown retail businesses. * Locating the ANCRON Clinic near the KLH expands the potential services and office space for medical specialists, and for specialists to attend the clinic for consultation, and relieving the need for clients to leave Nelson for medical consultation and services. + Createsa significant tax base for the City of Nelson. + Creates sustainable skilled workforce jobs. * Creates of significant short-term employment for construction industry workforces. * Coffee Shop with food is a much needed amenity that is needed for KLH hospital guests. © Walk-in Clinic offers additional medical services to City of Nelson residents who may not have a family doctor, while also offering a continuity of care. + Pharmacy operations will be offered to an existing pharmacy in the City of Nelson and will offer an opportunity for expanded business models to current pharmacy owners. Proponent Representative: Steven Kaup Architect AIBC Studio 9 Architecture + Planning Ltd. e: steven @studio9architecture.com p: 250.254.3959ANCRON Medical Clinic ~ Rezoning Public Open House March 19", 2015 * The Proponent continues to support the idea of a pedestrian path that utilizes the ANCRON site, but this will depend on cooperation of adjacent owners, which is unknown at this, time. * Clinic is on a bus route and is easily accessible to people traveling on foot or by bike. In this regard the proposal is consistent with the City's sustainability objectives. * Creates a new opportunity to utilize important land that is not ideal for residential development due to the property fronting the KLH Emergency Room entrance. + The Proponent will contribute to the Public Art Fund for Nelson. + The Proponent is open to pursuing a pedestrian access from Trevor Street to View Street, and is willing to work with the City of Nelson to initiate required discussions with adjacent property owners as required. BUILDING OPERATIONS & LAND USE + Medical Clinic Hours of Operation: 8:30 am to 4:30 pm, Monday thru Friday * Walk-in Clinic Hours of Operation: 8:30 am to 4:30 pm, Monday thru Friday * Aesthetics Clinic Hours of Operation: 9:00 am to 7:00 pm, Monday thru Friday * Coffee Shop Hours of Operation: 8:00am to 4:30 pm, Monday thru Friday * 6-8 doctors will practice at the Medical Clinic; the building, parking and traffic engineering have been based on this parameter to industry standards. SITE DETAILS = View Street will be widened to municipal standard dimensions and a pedestrian sidewalk is proposed along the front of the ANCRON Medical Clinic to improve pedestrian walk- ability and safety. * [tis important to note that widening of View Street, a much needed effort to decrease the existing ‘bottle neck’ for traffic, would likely not occur in the foreseeable future if this project does not proceed. © Across-walk will be provided by the Proponent that safely enables connection across View Street and the ANCRON Clinic. + Green space/park between View Street buffers commercial building on View Street facade. Proponent Representative: Steven Kaup Architect AIBC Studio 9 Architecture + Planning Ltd. @: steven@studiogarchitectANCRON Medical Clinic ~ Rezoning Public Open House March 19", 2015 im Proposed clinic is on the Public Bus Route and Bike Route and is easily accessible to Nelson residents, and visitors. In this regard, the project is aligned to ‘the City’s sustainability goals. ‘TRANSPORTATION, TRAFFIC & PARKING © Proposed clinic is on the public bus route, pedestrian links, and a secondary bicycle route * 68 parking spaces along View Street will be created for parking at Kootenay Lake Hospital. + Detailed Traffic Engineering analysis has been completed and indicates ‘no negative impact’ to View Street and KLH hospital traffic cycles, with room for growth «The Proponent is currently investigating site design that will allow up to 50 parking spaces, Redesign of the general building scheme will be required to the Concept Drawings currently presented CITY OF NELSON AND COMMUNITY CONCERNS BUILDING HVAC EQUIPMENT NOISE: + The Proponent has consulted with 2 professional mechanical engineering consultant and has been advised that there are multiple options for mitigating noise for the mechanical equipment located exterior of the building envelope such as; ground mounted equipment with landscape noise mitigating screening and locating the equipment within a sound mitigating room within the building. + The Proponent is committed to executing a sound mitigation strategy when the final equipment type and size are defined, is open to endeavoring to meet parameters that meet residential neighborhood standards. BUILDING SCALE: +The scale of the proposed project has been raised by neighbors. The design strategy to mitigate the perceived scale of that building is as follows: © The building height is lower than the existing Residential Zoning requirements. Propenent Representative’ Steven Kaup Architect AIBC Studio 9 Architecture + Planning Ltd. €: steven@studiodarchitecture.com pp; 250.354.3959,ANCRON Medical Clinic — Rezoning Public Open House March 19", 2015 . The significant portion of the building is underground and “buried” in the site; the project height varies from 2 storeys on the “front” along View Street (which is opposite the 4 storey facade of the hospital) to 1 storey on the “back” (which is adjacent to 1 and 2 storey single family residences). + The project has a gracious green space buffering View Street to the building's facade, resulting in a perceive decrease in height and scale even though a 0 (zero) setback is allowed in the proposed zone. ° The building’s View Street facade varied texture patterns that balances the materials of typical residential neighborhoods (cedar siding & timber structure), while referencing the new KLH Emergency facility in an effort to tie these institutional buildings together. TRAFFIC & PARKING CONCERNS: * Concerns regarding volume of traffic and parking over-flows for high use periods on View Street were raised by an adjacent neighbor. The Proponent had the Traffic Engineer analyze the situation with the following response: * Traffic Volumes and Parking: Based on the design volume of 6-8 doctors, the Traffic Engineer utilized recognized industry standards to develop the design parameters and the summary of this work are supportable ‘facts’ which address and should mitigate the speculative opinions that have been raised PARKING CONCERNS: + The proposed clinic is providing the required parking per the City of Nelson by-laws. Furthermore, the proposed project is providing an additional 6-8 parking spaces at View Street to assist the over-subscribed parking of the KLH parking. * The City of Nelson has proposed a covenant that limits the minimum percentage of parking to be required at the underground parking. The Proponent is open to discussions regarding this topic. . Access to these reports may be provided by contacting the Proponent's Representative at steven@studio9architecture.com. OCP CONCERNS REGARDING BUSINESSES LEAVING DOWNTOWN: Proponent Representative: Steven Kaup Architect AIBC Studio 9 Architecture + Planning Ltd €: steven@studioSarchitecture.com p: 250.354.3959[ANCRON Medical Clinic ~ Rezoning Public Open House March 19", 2015 SUMMARY OF MARKET STUDY: No negative impacts expected: RE: ANCRON Medical Centre and Walk-in Clinic, Oct 2014. + Available through the City of Nelson website, or by contacting the Proponent Representative at steven@studio9architecture.com, Proponent Representative: Steven Kaup Architect AIBC Studio 9 Architecture + Planning Ltd, e: steven @studioarchitecture.com p: 250.354.3959Dr Andre Kirsten P.O.Box 854 Nelson, BC VIL 6AS Dear Mayor Kozak and Council members February 3, 2015 There has been much discussion in town regarding our plan to build a clinic across the street from the Kootenay Lake Hospital. We understand that people may not be fully informed about the various issues relating to the clinic. Some have also provided the City with severe misinformation. We would like to provide the City Council with an update of our perspective regarding the proposed new clinic at View Street. First of all, let me address some concerns that have been expressed. + Traffic: There has been concerns that the clinic will generate more traffic to the extent that it will create problems for those visiting the hospital and for through traffic. We have commissioned two traffic studies by a professional consultant group and their conclusion is that the clinic will not generate a significant increase in traffic flow. (Please see the two reports attached). Also, we are committed to the widening and upgrading of the road between the Emergency Department and the clinic and to build a sidewalk and pedestrian crossing to create a safe walkway, which will be a significant improvement on the current situation + Parking: We will provide 37 parking spaces on the property as required by the City. These are 37 new spaces, which currently does not exist across the Hospital. We would like to increase our parking capacity by 13 spots for a total of 50 by creating a parking area behind the new clinic for our staff members , this will be a low traffic flow area as staff will park in the morning and leave in the afternoon. This will allow us to increase parking space and occupy less public parking stalls. The hospital is well served by the City buses and we believe that many patients will rather use the bus than drive to the clinic. We will certainly promote the use of public transport to visit the clinic; it is hardly a minute's walk from the bus stop. + Effect on downtown businesses: Professional consultants found that, without exception, 37 downtown businesses were not concerned that relocation of the Ancron Clinic across the hospital would have a detrimental effect on their businesses (please see attached report).Pharmacy: The pharmacy was never planned to be a commercial pharmacy i.e. a pharmacy that sells products other than pharmaceuticals as alleged. In fact, this pharmacy will only be a dispensing pharmacy and we plan to expand services from one of our local existing pharmacies thus not creating more competition to our local pharmacies merely expanding services of a local pharmacy. Coffee Shop/Cafe: Only light fare will be provided. This will provide a service to our clients waiting for a family member or for anyone utilizing the hospital services across the road. There are currently no such services available at the Hospital. Building Size: The size of the building is 15,133 sq ft, some have alleged that the size is 25,000 sq. ft. or rivals the size of the hospital. Just the Emergency Department is 9946 sq ft (2/3 of the proposed Ancron Clinic). The height of this building will actually be ten feet lower than the maximum height allowed for residential dwellings in this area. Suitability of the land for housing versus medical clinic: It has been suggested that this land is better suited for residences as it is located in a residential area. We do understand the concer of people living in the area. However, these three properties are directly across from a very busy Emergency Department and therefore not really that suitable for families and especially not if they have children + Concern regarding noise from adjacent properties: We have created underground parking to minimize traffic noise and we will ensure that our neighbor's privacy will be respected by creating a sufficient barrier with landscaping to reduce noise from the building itself. (e.g. fans) Number of physicians: Some have worried that the clinic will employ a large number of staff. In fact, the plan allows for a maximum of three 2-physician pods and room for possibly 2 more exam rooms (e.g. for an IH nurse or Family Physician resident or possibly outreach specialist for example: rheumatologist or dermatologist), also 1 physician in the Walk in Clinic. This is a relocation of a 5 physician clinic (4 regular Family Physicians and 1 Walk-in-Clinic physician) with room for expansion for two more physicians. Staffing is about one staff member per physician. Laboratory: A laboratory currently is not part of the planned new Ancron Clinic. Hours of operation: The clinic will be open “regular hours”. Staff arrives at 08:00am and the clinic opens at 08:30am. The clinic closes at 4.30 pm. The Walk-in-Clinic operates Monday to Friday same hours (08:30am - 4.30pm). The Walk-in-Clinic is currently open on weekends from 10:00am to 2.30pm. These hours will likely be extended from 09:00am to 4.00pm. Kootenay Medical Aesthetics/ Integrative Medicine Clinic currently is open Mon-Fri from 9:00am to 7.00pm and this will remain the case.Now I would like to list some of the benefits of having such a clinic. + Convenience to our patients: We are physicians to over 6 000 patients. Many of them are elderly. Having parking at the clinic and being directly across the street from hospital services such as the laboratory and diagnostic imaging will certainly be of great benefit to them. + Ahybrid walk-in clinic: This is a Walk-in-Clinic associated with a full service clinic; it is in the interest of our clinic to provide quality care at our own Walk-in-Clinic. Also patients who do not have Family Physicians and who are then seen at our clinic have a greater chance of finding a regular Family Physician. This Walk-in-Clinic system also allows our patients who need to use our Walk-in-Clinic (e.g. on weekends) continuity of care (access to their own records). Furthermore, doctors who work at our Walk-in- Clinic and who plans to stay on in Nelson permanently may be able to build a practice in this way (this actually has happened in other locations) + Closer cooperation with Emergency Department Physicians: When we see a patient who is quite ill and needs to be seen by an Emergency Department physician, we would be easily able to consult the Emergency Department physician and send the patient over. Currently such patients are at times reluctant to go to Emergency Department as they may not have transport up the hill etc. + Kootenay Medical Aesthetics/ Integrative Medicine Clinic: This clinic delivers services which are valued by patients and family physicians. A wide range of services are delivered, from purely disease oriented to cosmetic, about 80% of services are for traditional/complex medical problems. Patients are referred for a variety of reasons by their Family Physicians; there is a waiting list to be seen. Services include treatment of, skin cancers/mole evaluation, varicose veins, facial acne, scars hypertrophic and keloid (a variety of state of the art lasers are used at this clinic). Botox for a variety of medical conditions is used (muscle spasms, migraines, hyperhidrosis /severe underarm sweating, ocular blepharospasms etc ). | also have a Fellowship in Integrative Medicine and is frequently consulted in this regard. Many of the services listed above are not available, elsewhere in the KB. Benefit to KLH and the Nelson Physicians: We continue to believe that having this clinic across the street from the hospital will strengthen the hospital and the local medical / physician situation. We hope that the clinic could potentially be used by outreach specialists who might want to come to Nelson, reducing the need for patients to leave town for medical services and also creating a space where they can work in modem offices. We will have a fairly large room with adjacent kitchen that can be used for meetings (CME, patient conferences, etc). Any development which has the potential to enhance patient care and delivery of patient related services should, we feel, be supported. + With the development of the new residency training program in Family Medicine from UBC, will make this clinics location ideal for the creation of a medical campus for training and accommodating new physicians training in Family Medicine.In conclusion, | feel that the City Council has received information which does not properly reflect what we propose to achieve and there has been serious and gross misrepresentation by some. This has resulted in very negatively affecting perceptions of some physicians, some hospital staff and some City employees of what we would like to achieve. We have worked very hard, and invested substantial resources, to the planning of the development of a facility that we, and Nelson, will be proud of. Judged on its merits our proposal is inarguably very good. It will enhance patient care and provide valuable services not available otherwise. We think it is wise for a town such as Nelson to support upgrades to medical facilities (and every Family Physician clinic is a medical facility in the real sense of the word; to suggest that it is not is playing with words). We have reason to believe that many of Nelson's residents are already supportive of the proposed clinic. We also believe that we have addressed sufficiently, and as far as it is possible for us to do, the concerns that have been expressed, We think that this project is good for Nelson. We feel strongly that the City should support private initiatives that will add much value, on many various levels, to our city. We know that a clinic such as we want to build, will result in improved patient care, Kind regards Dr Andre Kirsten