RAMONA: PPH moving forward on long-awaited medical clinic

But officials say hurdles remain for project

By DAVID GARRICK - Staff Writer | Tuesday, November 18, 2008 6:08 PM PST ∞

RAMONA ---- Plans to build a modern medical clinic in downtown Ramona got a boost last month when a developer was hired for the long-awaited project, but Palomar Pomerado Health officials said this week that the project still faces some challenges and uncertainty.

Ramona community leaders and hospital district officials say the clinic will dramatically improve the medical care available to residents of the so-called backcountry, which includes Ramona, Julian, Ranchita, Santa Ysabel, Warner Springs and other nearby communities.

But Dr. Marcelo Rivera, a trustee for the public hospital district, said Monday that the project still needs approval from county planning officials and the Ramona Community Planning Group. He said those approvals are expected in the first half of 2009, with construction slated to begin in fall 2009 and conclude some time in 2010.

Rivera said hospital officials also hope to persuade County Supervisor Dianne Jacob to reduce the roughly $1.1 million the hospital would owe the county in controversial "traffic impact fees."

The county charges those fees to developers to mitigate the increase in traffic their projects are expected to generate, but critics have said the fees have stifled development by making projects too expensive.

The fees were adopted in 2005 as an attempt to reduce traffic congestion in rural areas by forcing developers to pay for new roads, but critics have said the fees actually increase congestion in some cases.

One example is Valley Center, where the arrival of the community's first supermarket was delayed by the fees. Oliver Smith, chairman of the Valley Center Community Planning Group, said the lack of a supermarket forced Valley Center residents to travel several miles to Escondido for groceries.

The County Board of Supervisors agreed in January to reduce the fees by up to 40 percent for commercial developments, but Rivera said he is hoping the new Ramona clinic will receive special consideration.

"It's a big hurdle," said Rivera. "We will have to work with the county to make the fee more reasonable."

Rivera said hospital officials believe they deserve a discount because the clinic is different from a typical commercial project or housing tract. The clinic will be a community amenity that will save lives, he said.

Rivera said hospital officials had not yet approached Jacob about the fee reduction. A spokeswoman for Jacob said the supervisor would be willing to discuss the issue.

Marcia Jackson, chief planning officer for the hospital district, said the amount of the mitigation fee would probably affect the lease rates for retail shops slated for the ground floor of the two-story clinic. The higher the mitigation fee, the higher the lease rates, she said.

While plans call for the clinic to be 40,000 square feet, Jackson said the developer might reduce the size of the building if tenants are difficult to find. She said that is one reason hospital officials could not provide an estimate of the clinic's construction costs.

Mike Shanahan, the hospital district's chief architect, said the project also faces environmental concerns, but he said they were relatively minor and that he did not expect them to jeopardize the county's approval of the project.

The clinic will be built on a 2.5-acre site in downtown Ramona that the district bought in 2006 for $2.4 million. The site is on Main Street between 13th and 14th streets.

The project is among those paid for by Proposition BB, a hospital facilities bond voters approved in 2004. The bond authorized the hospital district to sell $496 million worth of bonds to help pay for a $1 billion expansion.

Rivera said hospital officials are upbeat about choosing Pacific Medical Buildings as the clinic's developer. He said the San Diego-based company did a great job on the outpatient services pavilion it completed last year at Poway's Pomerado Hospital.

Rivera, who has lived in Ramona for the last 30 years, said the community is the perfect spot for such a clinic.

"The folks in the backcountry look at Ramona as their hub," Rivera said.

Longtime Ramona resident Arvie Degenfelder said the clinic will make a huge difference in her community.

"This is a longtime dream of mine," said Degenfelder, who has served on a Ramona citizens committee providing feedback on the project.

Degenfelder said residents cannot get X-rays, mammograms or lab tests in town. A community survey conducted a few years ago found that residents ranked health care facilities as Ramona's No. 1 need, she said.

Even though much of Ramona features Old West architecture, Degenfelder said she loves the modern look hospital officials have proposed for the clinic.

"It needs to make the statement that this is a 21st century structure with all the tools of a modern hospital," said Degenfelder.

Contact staff writer David Garrick at (760) 740-5468 or dgarrick@nctimes.com.