RPB Zoners Reject Free-Standing Emergency Room

By Briana D’Andrea

The application for a free-standing emergency medical facility near Wellington Regional Medical Center was denied by the Royal Palm Beach Planning & Zoning Commission on Tuesday after dozens of medical professionals filled the room opposing it.

Initially, the applicants requested a 30-day postponement, explaining that the proposed operator of the facility — St. Mary’s Medical Center — was no longer interested in the project.

Commission Vice Chair Joseph Boyle made a motion to postpone the item, but it failed. The commissioners voted 3-2 to move forward after hearing from a number of people who showed up to speak about the project.

Development Review Coordinator Kevin Erwin said that the applicant, Legacy Shoppes LLC, was proposing what amounted to an emergency room facility on the west side of State Road 7, just north of WRMC.

Erwin added that the applicant wanted to add a new definition of a “freestanding emergency department” to the village code. It was defined as an extension of a hospital that is physically separate from it, but providing comprehensive emergency services.

“It must be under the same direction and comply with the same regulations and must be permitted by the Agency for Healthcare Administration,” Erwin said.

It would also be subject to the same signage requirements as at hospital ERs. “These types of facility are more appropriate in rural regions,” he said.

That statement weighed heavily on both the commissioners and the wide array of healthcare workers who came out in droves to oppose the idea.

“We’re changing this to incorporate all general commercial, and that worries me because we’re at 47 percent non-residential,” Commissioner Felicia Matula said. “I don’t feel like Royal Palm Beach is rural and underserved. I don’t think it is the right thing for Royal Palm Beach.”

“Any change of this magnitude needs to be taken very seriously,” Commissioner Jackie Larson added.

Planner Donaldson Hearing spoke on behalf of Wellington Regional Medical Center, requesting that the commissioners deny the application.

“Free-standing emergency departments are really something new that were put in place for underserved regions that didn’t have access to care,” he said. “It’s clearly a duplication of effort. It will result in adverse patient outcomes. It won’t decrease wait times.”

Hearing noted that many medical professionals had shown up to object. “These are medical professionals here who are concerned with what it will do to not only local institutions, but their neighbors,” he said.

Dr. Richard Hays, a 45-year resident who serves patients as a primary care physician, said ambulance and emergency medical transport services are going to be required by law to stop at the free-standing emergency room.

“Then they will have to be transferred to St. Mary’s or any other hospital. That is not in the best interest of public safety. This is not needed for the western communities. We have what we need,” Hays said.

Attorney Matthew Scott with the Tripp Scott Law Firm, representing WRMC, urged the commissioners to keep in mind that the application is requesting a policy change to actual zoning codes, allowing more free-standing ERs to pop up.

“What they’re requesting is more far-reaching in the community than one free-standing ER,” he said. “Communities are opposed because hospitals are already providing for needs, and it causes issues with care.”

Scott called the change unnecessary. “It’s important to think about why there are no free-standing ERs,” he said. “It’s because there are already two hospitals serving the area.”

WRMC CEO Robbin Lee said that the doctors and physicians in the community work extremely well with her ER and hospital, built in 1986 to serve the western communities.

“This was quite a surprise that someone thought we needed a free-standing medical facility,” Lee said. “The Village of Royal Palm has about 2,000 patients a year that get admitted to Wellington Regional. About 3,000 patients get admitted via ambulance… that will be stopped by a free-standing ER. The requirements are that the free-standing ER is equipped the exact same way as our ER. Therefore, EMS will be required to stop there. The problem is once they stop, the rest of the hospital services are not there.”

Lee cited cardiac cath labs, operating rooms, advanced imaging, board-certified emergency-room doctors and critical care nurses as facilities that wouldn’t be available.

“The patient would then have to be transported to another hospital, which in turn would add to their medical bills and stress,” she said.

Sharonda Brown, director of emergency services at WRMC, said her hospital is perfectly capable of caring for the community.

“Right now, we see about 48,000 patients a year, and we have the capacity to see at least 70,000. We do have a 38-bed emergency department,” she said. “We practice daily on making sure our processes are in place so patients don’t have to wait, which further proves we do not need an additional free-standing clinic to confuse our community.”

Boyle did not feel that the need existed for more emergency rooms to serve the community.

“You have to show a need for a third ER. We have to look at whether or not this improves quality of life,” he said. “Because this was withdrawn, and you didn’t have the people here, we have no demonstrated need to our community. All we have is the rebuttal. Unfortunately, that’s the circumstance. The technical thing was so bad that I would vote against it for that reason.”

Commissioner Michael Axelberd said the proposal could be detrimental to healthcare. “I can’t ever imagine a scenario now where I would ever approve this in our community,” he said.

After hearing the overwhelming opposition to such a facility, Chairman Richard Belcher agreed.

“To be honest with you guys, I was going to vote for this,” he said. “A special exemption is basically what it is. We have a lot of businesses that get special exemptions.”

A motion to deny the application carried 5-0. The matter was slated to go before the Royal Palm Beach Village Council at its next meeting, on Thursday, Nov. 6.