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Alta Bates Summit Medical Center, the only hospital that provides emergency services in Berkeley, may finally get to work on renovating its emergency department, if the Zoning Adjustments Board approves its plan at tonight’s meeting.  

It’s a project 10 years in the making that keeps changing all along the way. The proposal now on the table – which dates back to 1999 – asks for a use permit to renovate the inside of the hospital’s emergency department and reconfigure its parking area and driveways. 

The largest external change would be to create a second door and driveway for ambulances. Currently, one door serves as the gateway for ambulances and private cars so that gurneys compete for space with people who have less serious injuries. 

“We’re not changing the footprint,” said Debbie Pitts, an Alta Bates spokesperson. 

The ZAB decides today whether to approve the plan as is, approve with conditions, deny or continue the process. The public hearing closed March 14, so tonight’s meeting will only consist of board member discussion and questions directed to staff. 

Alta Bates neighbors, who have had a rocky 20-year relationship with the hospital, are generally pleased with the proposal. 

Debbie Leveen, co-chair of the Interneighborhood Hospital Review Committee, said that the only major point of contention is the circulation pattern on Colby Street. 

The new driveway for ambulances is too close to a tot park and residences, she said. Currently, vehicles only travel halfway down the block. But the new plan routes vehicles down to the cul-de-sac to turn around and pull into the hospital. 

“We need just a bit more of a buffer between the hospital traffic and the neighborhood,” she said. IHRC would like the cul-de-sac to be moved 30 to 50 feet northward and the space between the new cul-de-sac and the park to be landscaped. 

She said the cost could be paid by the hospital in exchange for the city’s sale of the sidewalk on the east side of the driveway that they need to widen the space for ambulances. 

“We say moving the cul-de-sac could be part of buying the sidewalk because they have to provide some benefit to the city for getting it,” said Leveen. 

She said the city may also pitch in if the cost is too high for the hospital. 

But Leveen acknowledged that the IHRC proposal may not be practical because it is already very late in the game. Although the group met with hospitals officials a week ago Friday, she does not think their plan can be incorporated, reviewed and approved by April 25. The Permit Streamlining Act requires the ZAB take final action on this project on or before that date. 

She said that if the plan were approved as is, the neighbors would probably appeal the decision to the City Council. They will not be able to speak, but they will probably carry signs that say “Continue the progress,” asking the ZAB to extend the permit review so that their suggestion can be incorporated. 

Public Relations Director Carolyn Kemp emphasized the urgency of the renovation project. “The emergency department was built in the 60s for 12,000 patients. Today, we see over 45,000 patients a year in space that it’s not designed for,” said Kemp. 

Without expanding beyond the current walls, the hospital plans to create wider, more efficient spaces. 

“We’ve got issues of confidentiality and dignity when there are people going through triage and being asked personal questions in front of the security guard and the person behind them,” said Kemp. 

Warren White, a dialysis patient who came to the emergency department on Friday after his head started swelling from a kidney failure, confirmed the uncomfortable conditions. 

“I didn’t have too much privacy,” he said Monday while he was taking a break in front of the hospital. 

“There were lots of people standing around when I was talking to the triage nurse.” 

Although he said he saw a sign that said “If you don’t have enough privacy, tell the nurse,” he said he did not pipe up about it because he was too sick to say much of anything. 

Leveen said that the neighbors have tried to be sensitive to the hospital’s concerns and put behind them past grievances. “We’ve had an unfortunate history with Alta Bates. They’ve been less than forthright with us in the past. But we know people are suffering and we know there are tremendous financial problems. We’re willing to be reasonable,” she said. 

But they have wanted to be extra watchful because of the hospital’s recent mergers and takeover. 

“We wanted to make sure there was a careful public review because now it’s part of Sutter Hospital,” said Leveen. Sutter Health took over Alta Bates after Alta Bates merged with Summit Hospital in 1999. Sutter oversees 33 hospitals in Northern California. 

“We kind of imagine that the decisions here might be made by an outside entity that would do what it wants and not what Berkeley wants,” she said.  

But IHRC also recognizes that Alta Bates supplies the only emergency services in Berkeley. 

“We’re very concerned that there still be an emergency department in Berkeley,” Leveen said.  

But if the city stymies the needed renovation, Kemp cautioned, the hospital would have to think about moving its emergency department elsewhere.  

“If it grows increasingly difficult to do what we feel we have to do, then we will have to consider alternatives,” she said. 

Leveen wishes the city could make the emergency department a condition of approval, but knows that it cannot because of a 1997 court settlement between Alta Bates and the city. 

The judge in 1997 gave the hospital an unusual use permit that allowed the hospital itself to determine how its space would be used because a city might not know how best to design a hospital. Most use permits specify the kinds of units a developer can build and to what use they will be put.  

A condition of this special use permit, however, was that the hospital abide by city-ordained regulations for minimizing traffic and parking impacts. 

“It’s as if there’s a wall around the Ashby campus and the city is monitoring from the outside,” said Margaret Kavanaugh-Lynch, the city’s senior planner in charge of the project. 

The hospital would be subject to January reviews. If it is found to be creating impacts of over five percent, the city has developed a schedule of remedy and review. The ZAB is authorized to impose remediation strategies, including “decanting,” which means that the hospital would have to shift services to another campus. 

Leveen said that the neighborhood is especially pleased that the ZAB has some teeth in enforcing violations. She thinks it is one area in which neighborhood participation has really made a difference. 

Indeed, Alta Bates wants to work with residents, said Pitts. Although it has the right to build a six-story building to be called the “East Building” because of a 1983 permit, she said, the hospital scrapped plans for the new building. 

“We want to be good neighbors,” said Pitts.