DHMC presents plan to open a palliative care center

by Zachary Benjamin | 11/8/15 9:04pm

Dartmouth-Hitchcock Medical Center presented a revised plan for its proposed palliative care center to the Lebanon City planning board on Oct. 26. The proposal received generally positive feedback from the planning board, planning board members said.

The plan, which has been in discussion for several months, would call for DHMC to build a freestanding palliative care facility to take care of terminally ill patients, DHMC media relations manager Michael Barwell said.

The proposed center would be located in a wooded area on the DHMC property — away from the critical care units where palliative care patients would normally end up — so as to promote a relaxing atmosphere for patients and their families, Barwell said. At first, it would have 12 beds, and that number could expand to 18 over time, he said.

DHMC has not submitted a formal application to begin construction for the center, Lebanon associate planner Margaret Howard-Heretakis said.

Instead, they have been speaking with the city planning board in a series of “conceptual reviews” — a slate of non-binding discussions designed to garner feedback about the proposed plan before it is submitted officially.

Planning board members said that the main concerns raised related to zoning. Previously, DHMC had planned to build the center in a different location, Howard-Heretakis said. That site, however, was not located in an area previously zoned for the medical center — in order to use it, the hospital would need to gain approval to rezone the site for the medical center’s use. As a result, the hospital chose to relocate the proposed site to an area located on DHMC property.

Noting that she was speaking as an individual and not on behalf of the planning board, Lebanon city council liaison to the city planning board Suzanne Prentiss said that she was glad that DHMC had chosen to relocate the property.

While she supports the center as an individual, Prentiss also said she sees the need to balance her views with concerns about preserving Lebanon’s natural beauty.

Elizabeth Celtrick, Lewis Greenstein, Earl Jette and Carl Porter — four members of the city planning board — declined requests to provide their opinion on the new center, saying that they could not do so before an official application is submitted and a vote is taken. They pointed to audio transcripts of the Oct. 26 meeting, available on the planning board’s website, as publicly available indications of their thoughts on the project.

Four additional planning board members did not return request for comment.

Porter did say that he plans to inspect the proposed building site in person before the winter to ensure construction is feasible on the site.

Palliative care is a practice designed to help patients who are generally in the end stages of their lives. These patients often experience pain from their illnesses or have to undergo rigorous and possibly debilitating treatment, Barwell said.

“The whole point of palliative care is ... helping patients and their families to focus on what is really important to them,” he said. “So how do you help them relate to family and friends, how do you help them make the best use of the time that is available.”

Treatment in palliative care centers can involve care from doctors, nurses and social workers, Barwell said. It can also involve bringing in therapists, playing relaxing music or having massage therapies for patients. The main goal is to help patients be comfortable in their final days, he said.

The next step for DHMC would be to submit an official application to the planning department’s office, Howard-Heretakis said. This would begin the process of staff review, in which various departments — including planning, public works and the fire department — review the proposed application to make sure it complies with regulations.

The planning department would then reach back to the applicants to discuss any potential issues and to allow the applicants the chance to revise and resubmit their application, Howard-Heretakis said.

After that, the planning department would create a memorandum for the planning board to outline what is being proposed and discuss any potential issues the board should be aware of, she said.

The hospital will subsequently hold a public hearing for the planning board to review the application, during which citizens could raise possible objections at this time, Howard-Heretakis said.

Then the planning board would then choose whether or not to approve the potential plan. They can also give a conditional approval if there are outstanding items to be resolved, Howard-Heretakis said. Following approval and resolution of other outstanding issues — for example, at the state-level — DHMC could seek approval for a building permit and begin construction.

It is not unusual for projects to take several years to be completed, Howard-Heretakis said.

There is a deadline each month to submit applications to the planning board. This month’s deadline is Nov. 9, Howard-Heretakis said.

Barbara Olachea contributed reporting.