City official hears criticisms of possible three-laning of Charlotte Street 

From Staff Reports 

Ambitious development plans for Mission Hospital were unveiled by a hospital official during the Sept. 6 issues meeting of the Council of Independent Business Owners following breakfast in the food court at Biltmore Square Mall in Asheville.

In addition, the proposed narrowing of Asheville’s Charlotte Street from four to three lanes to allow for sidewalks and bicycle lanes was presented by city Transportation Director Ken Putnam, assisted by Vice Mayor Esther Manheimer.

In addressing Mission’s development plans, Brian Moore put much of his focus on the building plans and space needs for the hospital. Moore, who has been with Missionsince 1985, is director of the hospital’s public policy and regulatory affairs

Moore began by noting that nearly $350 million in (cost) cuts” will be necessary as the result of “changes resulting from” the Affordable Care Act, which is more commonly called Obamacare.

“We’ve had to make some tough decisions, including letting some employees go,” Moore asserted. “That’s a tough issue to go through.

He said Mission’s “mission” is to serve this community. “The only reason we’re here is to do it safely, without waste and with an exceptional experience,” Moore said.

“So we’ve got the whole changing environment.... On both the Mission and St. Joseph sides of the street — we’ve got a whole lot of buildings that are hitting 50 years old or more....

“So those are some tough issues that are colliding... Having to modernize and at the same time facing cuts in reimbursements. Each year, Mission Hospital faces $50 million in buildings needing modernization.”

Moore spoke glowingly of Dr. Ron Paulus, Mission’s president and chief executive officer, and “I’ve never had more confidence in our leadership team..”

Moore then asked, rhetorically, the CIBO members, “How many of you been involved in — at  any point in time — and studied manufacturing?”

He added that, “about two years ago, we began updating our processes.... How many have you been in our emergency department in last year?”

For Mission, “it’s a tough environment. We have to deal with issues of behaviorial health,” particularly in its emergency room areas.

“The emergency room is like the front door (at Mission), so you start there.” To that end, Moore said anyone who has visited the ER area lately will see the major changes.

“One of the main issues we’re facing are ancient facilities. Two hospitals that used to be competitors are across the street from each other,” he said in reference to Mission and St. Joseph’s that are now merged into Mission.  

Last year, Moore said, 12,000 trips were made with patients by nurses, doctors and other staff between the buildings. “That’s wasteful. You can’t fix that.”

“Another issue is room size,” he noted. “When hospitals were constructed in ‘60s and ‘70s, rooms were smaller. Now with medical equipment and patient expectations,” the rooms are too small.

“The punchline is we consolidate our facilities on the Mission side of the street,” Moore said.

He noted the growth of “that Medical Mile” between the hospital and downtown Asheville.

“At the earliest, around 2015, we could begin this construction. There are lots of processes we have to go through first.

“Areas that are suboptimal... the towers, both have room sizes that just won’t make it for the future.

“I’m very confident the building can stay on our existing campus....It looks like it wants to be a tower.

“It’s easy to get lost at Mission and St. Joseph’s ... We’re seeing over 105,000 patients per year in our emergency department. With three or four people” accompanying each patient, “it’s easy for us to see a half a million people in our emergency department.”

During a question-and-answer period that followed, CIBO member Mac Swicegood asked, “Is there anything that’s going to happen to the street system — the way you’ve got it outlined?”

“The answer, I think, is no — if it’s designed properly,” Moore replied.

To another question, he said Mission’s urgent care centers are proliferating, but still its ER is seeing an “unusually high number of patients.”

Also, Moore added, “We have a problem in Western North Carolina … We’re 140 positions shy of primary care doctors — and as we look forward to the retirement situation with baby boomers (who are doctors),” the situation is likely to get worse

To a question about whether Mission will remain independent or merge with a larger health system, Moore said, “I think our board of directors have made it very clear that we should stay independent. I think we will increasingly see ourselves (in the U.S.) with coalitions of systems. The systems that are being created across the state do provide important critical mass. It’s a tough issue.... We like our independence in Western North Carolina.”

On the separate issue of possible Charlotte Street road changes, Putnam told the CIBO members that there are pluses and minuses with remaining at four lanes or narrowing to three lanes. 

He then noted that the possibility of narrowing Charlotte Street — to make it more friendly to pedestrian and bicycle traffic —is still being studied and no definitive action has been taken on the matter.

“There are 11 intersections along that corridor from I-240 to Edwin Place, Putnam said.”There’s a lot of traffic congestion.”

Also, he said, “There are a lot of driveway cuts. We also have ways along the corridor where driveway cuts exist, but they don’t go anywhere. That deteriorates the sidewalk and makes them ... not customer-friendly.”

Charlotte Street carries 14,000-20,000 motor vehicles per day, Putnam noted, adding, “The afternoon hours are the most critical ones.

“If the road stays at four-lanes, we can expect minor delays by 2015 and, a few years after that, “moderate” problems. “We’ll start seeing the congestion spreading out.”

On the other hand, “If we go to three lanes, we’d see delays increase on side streets... Some of the results that the study found is that queu lanes – the southbound approach.... So the queus would be longer on the side streets. The potential for speeding will likely increase simply because we’ll have wider lanes...

“Even if we did all of this, we’d still have the problem with driveways. … So the biggest problem is how we can make this more pedestrian-friendly? And not at the expense of businesses.

Putnam introduced Manheimer,, who is running for mayor. “I think Ken nicely summarized where we are with this.” she said, 

“I’m chairing the Planning and Economic  Development Committee... The process is going to include more public input opportunities. We may bring this to our annual retreat (in January)... If we do something, it’s going to require capital expenditures.

“We’d like input and feedback on any ideas by city officials.” Manheimer said, adding, “I probably get more emails about Charlotte Street than Hendersonville Road.... on pedestrian safety.”

She noted, “I’m talking to business-owners. We’d like to enhance, ultimately, the business opportunities on this corridor.”

In a question-and-answer period after the city duo’s presentation, Swicegood asked about the impact of any plans on Chestnut and Hillside streets.

“Yes, they were added into the equations,” Putnam replied. “The right of way on Charlotte Street varies.... 46 to 53 feet.... It is true that space is the issue. We’d like to think (about that) as we explore these other options. There’s more opportunity on one side than on the other (side of the road) because of existing retaining walls.”

Mayoral candidate John Miall said he saw no purpose in still planing the project after paying for five consultant reports — to date — regarding the reducing of the lanes on Charlotte Street — and all five recommended against it.

Miall suggested adopting a plan for the I-26 connector, as recommended by former mayor Ken Michalove, “then see what, if anything, needs to be done on Charlotte Street.” 

Manheimer sprang to Putnam’s defense, noting that,“Ken comes to us originally from the Department of Transportation — and he’s an expert road engineer. “

She added, “Because we are dealing with a finite width and finite amount of dirt,” the proposal is complex. “We’re asked about bike lanes,” too.

“I think the primary consideration would be cars and sidewalks,” Manheimer said. “You may have to give up on-street parking and bike lanes because of the finite space.”

Putman interjected, “Just to add to that, hopefully, there are some short-term things we can do.... Right now, if congestion is around the I-240 ramps, we can work with the Department of Transportation. We’ve already started that conversation. They don’t want traffic backing up into interestate.”

A CIBO member asked for a comparison of Merrimon Avenue and roughly parallel Charlotte Street traffic.

Charlotte Street averages 14,000 to 20,000 motor vehicles daily between I-240 to Chestnut Street, while Merrimon averages 18,000 to 20,000 vehicles daily from I-240 to Chestnut Street, Putman said.

“Charlotte Street, Edwin Place and Kimberly Avenue are the three optional routes,” Putnam noted. “Merrrimon has been in that traffic-volume range. The uinque thing about Merrimon being four lanes is the outside lanes tend to be left turn lanes.”