MEDICAL VILLAGE PLAN
MEDICAL VILLAGE PLAN
DRAFT City of Fayetteville
The City of Fayetteville is poised to capitalize on one of the most significant economic development opportunities in its history—the creation of a medical village that will become a regional destination as well as an economic catalyst for the City.
MEDICAL VILLAGE PLAN ACKNOWLEDGEMENTS
City Council Mayor Nat Robertson City Staff Mayor Pro Tem Mitch Colvin (District 3) CITY MANAGEMENT Kathy Jensen (District 1) City Manager- Doug Hewett Kirk deViere (District 2) Deputy City Manager- Kristoff Bauer Chalmers McDougald (District 4) City Attorney- Karen M. McDonald Bobby Hurst (District 5) William Joseph Leon Crisp (District 6) PLANNING & ZONING Larry Wright (District 7) Scott Shuford- Planning & Code Enforcement Services Director Theodore W. Mohn (District 8) Karen Hilton- Planning & Zoning Manager James William Arp, Jr. (District 9) Will Deaton- Comprehensive Planner Eloise Sahlstrom- Urban Designer City Planning Commission CORPORATE COMMUNICATIONS Daniel J. Culliton, Chair Kevin Arata- Corporate Communications Director David Carter, Vice Chair Sherri Kropp George “Mike” Dudley Gavin MacRoberts Perry Massey Kenneth Mayner Marshall isler Nathan Walls Clabon Lowe Teddy Warner Michael Clark Cleatus (Jack) Cox Christopher Davis
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CONTENTS
ACKNOWLEDGEMENTS ...... 2 City Council ...... 2 City Planning Commission ...... 2 City Staff ...... 2 EXECUTIVE SUMMARY ...... 6 INTRODUCTION ...... 8 Project Purpose and Description ...... 8 A VISION FOR THE FUTURE ...... 9 GOALS AND OBJECTIVES ...... 10 EXISTING CONDITIONS ...... 10 General ...... 10 Land Use and Zoning ...... 10 Economic Development ...... 11 Transportation and Circulation ...... 11 Infrastructure and Utilities ...... 12 Vacant Lands Analysis ...... 12 Medical Village Identity ...... 12 GUIDING PRINCIPLES ...... 13 Create a Distinctive Destination ...... 13 Create a Mixed-Use District ...... 13 Integrate “Health-Consciousness” into all Development ...... 13 Design Complete Streets ...... 14 Design Engaging Street Walls ...... 14 Design Parking to Support Urban Design Goals ...... 15 Build Upon Authenticity ...... 15 Design for Visual Richness ...... 15 Design for Sustainability ...... 15 Capitalize on Value Creation ...... 15 3 MEDICAL VILLAGE PLAN PLANNING PROCESS ...... 16 Stakeholder Interviews ...... 16 Existing Land Use ...... 17 Parks, Open Space and Natural Areas ...... 18 LAND USE/ZONING ...... 18 Issues and Opportunities ...... 18 Current Zoning Goals ...... 19 MOBILITY ...... 19 Issues and Opportunities ...... 19 Goals ...... 19 HOUSING ...... 19 Issues and Opportunities ...... 19 Goals ...... 20 ECONOMIC ACTIVITY ...... 20 Issues and Opportunities ...... 20 Goals ...... 21 HEALTHCARE TRENDS AND DEMOGRAPHICS ...... 21 Healthcare Drivers...... 21 The Graying of America ...... 21 More than Healthcare – Lifestyle ...... 22 Increase in Health Related Jobs ...... 23 Real Estate Development Outlook ...... 24 MEDICAL DSITRICTS AND URBAN DEVELOPMENT ...... 25 COMMON TRAITS FOR HIGHLY SUCCESSFUL DOWNTOWNS AND VIBRANT URBAN DISTRICTS ...... 25 LAND USE PLAN ...... 30 Land Use Plan Mixed-Use District and Neighborhood ...... 30 District Expansion ...... 30 Flexible Growth ...... 30
4 MEDICAL VILLAGE PLAN Land Use Categories ...... 31 DEVELOPMENT PROGRAM ...... 33 Successful Programs are Market Driven ...... 34 Development Identity and Character ...... 34 A Special Place and Destination ...... 35 Great Neighborhoods ...... 35 Medical and Supporting Uses ...... 35 Supporting Uses: Senior Housing ...... 38 Latent Demand ...... 38 Supporting Uses: Single-Family and Multifamily Housing ...... 38 IMPLEMENTATION OF THE PLAN ...... 40 Land Use and Zoning ...... 40 Economic Development ...... 42 Scenario One: Establish Medical Village Planning and Zoning Requirements ...... 43 Scenario Two: Establish a partnership between the City of Fayetteville and a Non-Profit Development corporation (501(c) 4 corporation) ...... 44 Scenario Three: Establish a Business Improvement District for the Medical Village ...... 44 Transportation and Circulation ...... 45 Site Improvements ...... 48 Public Services and Facilities ...... 51 Infrastructure and Utilities ...... 51
5 MEDICAL VILLAGE PLAN MEDICAL VILLAGE PLAN CITY OF FAYETTEVILLE
EXECUTIVE SUMMARY The City of Fayetteville is poised to capitalize on one of the most significant economic development opportunities in its history – the creation of a medical village that will become a regional destination as well as an economic catalyst for the City. The effort is supported by the fact that, nationally, healthcare is among the most promising industries for job growth and real estate development in the coming decades. Demand for healthcare services, jobs and development is driven by a number of factors, particularly the tremendous growth of Americans over the age of 65 who require the most medical services. The number of Americans aged 65 and over is expected to double between 2010 and 2040. The demographic conditions driving healthcare growth in the rest of the country also exist in Fayetteville. The private market in Fayetteville is already showing that medical uses are feasible, along with the strong population of veterans and the new VA Health Center; so the question revolves around not if something like a medical village will happen, but how and at what scale and quality. The Medical Village Plan supports the City’s goal by establishing a master plan for a high quality, mixed-use, pedestrian-friendly district that will complement and enhance the emerging concentration of medical and health care uses in the vicinity of the I-295 Outer Loop and Raeford Road. With a vision of community-wide health and wellness, the plan integrates health-consciousness and lifestyle into all aspects of development. It focuses on creating a distinct “place” rather than a random collection of businesses and neighborhoods by providing a mixed-use collaboration of medical, commercial and residential uses; an emphasis on walkability; and high- quality, sustainable development that will provide an uplifting experience for employees, patrons, visitors, and residents. Such “places” are suitable and desirable for people of all ages- younger professionals, families with children, empty nesters and seniors. ECONOMIC BENEFITS The mixture of uses, facilities and activities that may be offered in the Healthcare, Medical Office, Biotech, Research and Development, district will provide a health-centered “lifestyle” environment with activity Housing, Retail and Public Spaces
6 MEDICAL VILLAGE PLAN during the days, evenings, and weekends that help energize, populate and animate the district. Located adjacent to the VA Health Care Center and future FTCC West Campus, and in close proximity to residential neighborhoods, the district will be filled with shops, restaurants, and “third places” such as coffee shops, cafes and unique shops, that provide interactive community meeting places and a pedestrian-engaging environment. The district will also include a mixture of offices, hotels and a dense, urban-style residential component. A key component of the plan is the wide array of medical and supporting services and activities concentrated in the medical village. The density of services and adjacency to the district, residential neighborhoods and open spaces will encourage walkability. Medical-related uses include hospitals,
medical offices, laboratories, pharmacies, rehabilitation assisted living centers, hotels and education. Siting of the buildings within the medical village should frame the streetscape, capitalize on the amenities, encourage pedestrian movement, make efficient use of the land and create a density that can support local transit service. Housing options will offer variety for people of different age groups with varying needs, including lofts, live- work units, townhouses and single-family homes. Preservation and enhancement of the existing parks, open spaces and natural areas is key in attracting residents and businesses to the district and improving the overall quality of the area. The plan for the medical village defines a design philosophy and implementation strategy for attracting high quality healthcare, housing and services into a setting and lifestyle concept unique to Fayetteville. If successfully implemented, the medical village will stimulate new development opportunities, create jobs, expand the City’s tax base and create inviting, engaging, connective experiences for residents, visitors and patrons. Implementation of such a plan will have many components – physical, financial, regulatory, operational and organizational – and will necessitate flexibility as market conditions change over time.
Credit: CLH Design
7 MEDICAL VILLAGE PLAN INTRODUCTION Project Purpose and Description Healthcare is an emerging sector anticipated to play an increasingly significant role in the future economic growth and success of the City of Fayetteville. The Garner Report for Fayetteville and Cumberland County notes that the largest absolute occupational gains have come from the Military Group. Healthcare was one of three other occupational groups that experienced growth in the same time period, and has measures of local specialization. Recognizing the developing concentration of medical uses in the vicinity of the I-295 Outer Loop and Raeford Road, the area is a primary gateway with a future goal of linking current and future medical facilities into a cohesive, mixed-used, walkable district. The purpose of the Medical Village Plan is to support the City’s goal of designating a special area that will establish identity, promote continuity, and invite significant new investment to fulfill the demand for medical and healthcare related uses. The focus area of the plan encompasses a contiguous area of land generally located around the intersection of the future I-295 Outer Loop and Raeford Road. This plan evaluates the market feasibility of such a district, establishes a framework and guidelines for the development of improvements, and recommends implementation strategies for the district center. Implementation of the plan should stimulate new development opportunities and create experiences for citizens and visitors beyond what is now possible. The plan reflects input from the citizens of Fayetteville, the U.S. Department of Veterans Affairs, Fayetteville Technical Community College, Fayetteville Metropolitan Planning Organization, City of Fayetteville Planning Commission, City staff and City Council members. It will be used by City staff, decision-makers, district business owners and property owners in the creation of a mixed-use area that focuses on medical care, health and wellness by creating a distinct “place” rather than typical strip commercialization and a random collection of neighborhoods.
8 MEDICAL VILLAGE PLAN The plan cannot anticipate or detail every feature that will ultimately make up the medical village; however, it does define the design philosophy underlying the district enhancements, and illustrates real world examples of its application to help facilitate and translate the different components of a medical village into a distinct identity. To be successful, the plan must focus on defining a distinct image for the district, populating the district with pedestrians, providing green spaces for exercise and relaxation through the preservation of valuable environmental features, and stimulating economic growth by providing an atmosphere for attracting businesses.
A VISION FOR THE FUTURE The vision for the area is one of mutual compatibility and support among differing uses with people living and working in the community. The community also envisions a neighborhood with a perception of safety that encourages people to live and work within the area and promote development that is consistent with, and transitions to, the established neighborhood scale. A walkable, multi-modal community with a variety of transportation options enhances connections and safe pedestrian and bicycle routes and crossings is envisioned to achieve the following:
Support the expansion and growth of medical facilities and associated businesses.
Recognize, foster and enhance the interdependency and compatibility of the healthcare, residential and retail uses in the area.
Support and accommodate growth and redevelopment.
Support development of medical village as a mixed-use community integrated into the surrounding area.
9 MEDICAL VILLAGE PLAN GOALS AND OBJECTIVES The preliminary planning process identified the following goals and objectives as a means to accomplish the mission of the Medical Village Plan.
Develop a plan to facilitate the physical growth, development, redevelopment and renovation of the study area and its adjoining neighbors. Develop a plan to produce a functional, attractive interrelated and growth friendly Medical Village. Enhance Fayetteville’s economic competitiveness in attracting both individuals and businesses to locate in the Medical Village. Identify alternative financing approaches, capital strategies, and organizational models to support implementation of the Medical Village Plan.
EXISTING CONDITIONS General Planning Staff researched existing conditions early in the master planning process. Many site visits to the Medical Village were done to assess current land use, circulation, infrastructure and utilities, and built projects or facilities. Economic issues in Fayetteville were compared to those in other areas of with similar medically focused plans and in similar communities throughout North Carolina. Staff and stakeholders met together on many occasions, discussing ideas for improvements to the medical core as well as adjacent properties. The team visited the area during different times and seasons of the year. The team was able to observe the Medical Village during rush hours, changes in shifts, construction with delays, and other times in order to observe traffic patterns, visitation levels and pedestrian-vehicular interactions. Staff also conducted interviews with stakeholders, residents, members of community groups, local business and property owners and city staff. These interviews and meetings were paired with research of existing city zoning ordinances, regulations and policies to ascertain what growth patterns the city and the public desired. Existing conditions were explored for the following items, including land use and zoning, economic development, transportation and circulation, public services and facilities, and infrastructure and utilities.
Land Use and Zoning Land uses within the Medical Village vary as much as the types of businesses within it. Because some of the properties within the Medical Village were a part of a larger annexation, the different zoning or lack of city zoning has affected the overall compliance of many projects built in the area over the last 30 years. Within the City Limits, projects are subject to the review and approval process dictated by regulations adopted to protect the community from issues such as detrimental zoning, lack of zoning, and lack of appropriate infrastructure or services.
10 MEDICAL VILLAGE PLAN The land use plan takes into consideration existing and historical land uses, as well as the future land use needs for the area to be designated as a medical district. The proposed land use and zoning regulations should help foster smart growth and orderly development within the Medical Village, which is experiencing growth.
Economic Development The health care delivery system and its related industries are a major economic force in Fayetteville. In addition to the direct economic impact of dollars spent by the health care industry and its employees in the community, there are many related and spin-off businesses and services impacted by a strong and vibrant health care delivery system. Examples of complementary functions include technology and research, education, medical supply, laboratory testing and diagnostic services, lodging, and restaurants. Many of these companies sell products and services required by the health care providers, employees, and visitors that come to the area. Therefore, ancillary but associated and important uses in the Medical Village include related commercial and retail uses for employees and visitors. The Medical Village currently contains a large number of residential living units that have little or no connection to the more compact medical core. Continued growth and expansion of the health care industry and its related businesses in Fayetteville requires the ability to recruit and retain highly qualified personnel to the community. Although the educational system in Fayetteville provides education and training for selected health-related personnel, the growing demand for highly skilled professionals will need to be met by attracting new residents to the community. In fact, the demand for skilled workers in a variety of businesses in Fayetteville requires the ability to attract and retain professional personnel to the area. Creating a medical village coupled with a strong and vibrant community will support Fayetteville’s ability to compete effectively on a national platform, enabling the city to attract the skilled workforce required to deliver high quality health care. As Fayetteville looks to the future and its options for attracting and retaining businesses and residents to the area, it will need to base its strategies on the changing demographics of the region. An aging population will continue to support the demand for and growth in health care services. Supporting the delivery of high quality health care in the community through the Medical Village can become an important step in positioning Fayetteville as “A Healthy Place to Be.”
Transportation and Circulation Preliminary discussions with the stakeholders and subsequent site visits made the City Staff aware of vehicular and pedestrian circulation issues that were potentially unsafe. It was determined that a major necessary component of the plan was to improve pedestrian access to and from the medical core area. The VA Health Care Center serves a wide variety of clients and patients from throughout the region. It is critical that the safety and comfort of these clients and patients are addressed for current and future uses at these facilities and those adjacent or related to them. Vehicular circulation was observed to be heavy at most times of the day, especially during evening shift and the traditional rush-hour.
11 MEDICAL VILLAGE PLAN Employee, resident, and visitor traffic are heaviest on Raeford Road, South Reilly Road and Old Raeford Road. The Raeford Road corridor is especially busy during normal rush hour. This street collects traffic from those that live in the western part of the City and those that commute from and through Hoke County.
There was consensus that the pedestrian experience in the medical village and outside the study area must be improved so that it is a safer and more enjoyable experience as additional development occurs. It was also determined that creating improved street sections and circulation was of utmost importance in creating a safer experience for drivers within the Medical Village. With the pedestrian and vehicular circulation systems both getting attention, it should assure that each will in turn function better alone and together. The only east-west through-street of Raeford Road can be utilized to pass through the Medical Village. With the Outer Loop completion Old Raeford will be closed off. South Reilly Road and the finished Outer Loop will be the main north-south connector into and through the Medical Village. The Fayetteville Area System of Transit provides a major east-west connection linking the VA Health Care Center, the Sykes Call Center and retail nodes along Raeford Road with route 32.
Infrastructure and Utilities As the Medical Village Plan is implemented, services can be improved and adjusted according to the master plan but also to the individual needs of existing property owners who may wish to make their own improvements. Private property and development projects should evaluate their existing systems to determine if immediate or eventual improvements are warranted. There may be the possibility of coordinating private improvements with public improvements so as to minimize costs and impacts on adjacent properties, and to create more efficient systems for infrastructure and utilities.
Vacant Lands Analysis There is a great deal of vacant land in the Medical Village. In addition, many of these vacant lands are surrounded by properties that have seen redevelopment during the last five to ten years. As the VA Health Care Center continues to see growth and expansion to vacant lands within the Medical Village, the underlying uses will become predominantly related to medical and health related functions. Vacant land also takes the form of undeveloped parcels on the outskirts of the Medical Village. These have slowly been transformed from empty lots into viable commercial and institutional projects. There are also large acreages of land held in ownership for future development and expansion of existing commercial and retail facilities.
Medical Village Identity
12 MEDICAL VILLAGE PLAN During the early planning discussions of the Medical Village, it was clear that an interest for the Medical Village was to establish a common identity based on the consideration that it should have a cohesive appearance. A common, unifying set of elements would enhance the overall working and living experience within the Medical Village as well as make it more appealing to visitors and new residents.
GUIDING PRINCIPLES The plan for the Medical Village is based on a series of guiding principles. These principles shape the plan, and provide a solid foundation on which to base planning decisions. They act as a compass to guide new projects and policies, as well as a measure against which to evaluate the appropriateness of future development proposals and designs. They are intended to provide decision-makers with common direction; facilitate understanding of the plan, and inspire and nurture basic planning attitudes that will enable future City leaders, staff, developers and consultants to bring the vision of the medical village plan to fruition.
Create a Distinctive Destination The medical village provides an opportunity to establish a special and unique community within the City, the region and the state. It can become an identifiable magnet for medical facilities, distinguished professionals, health and wellness services and activities. These activities will be heightened by a living, working, shopping, dining and recreational environment.
Create a Mixed-Use District The medical village should include a mixture of medical, wellness, and recreational activities and facilities, as well as retail, personal service, residential and office land uses. This will provide a “life- style” environment with activity during days, evenings and weekends that help energize and animate the district. Retail space should be focused on the district centers and include windows and entries directly from the sidewalk. These spaces can be populated with stores, restaurants and “third places” such as coffee shops; internet cafes and bookstores that will provide an engaging community meeting place and pedestrian environment. A diversity of housing types should also be encouraged in order to fill a variety of needs and markets, such as: • Lofts. • Live-work units. • Townhomes. • Single-family lot homes.
Integrate “Health-Consciousness” into all Development
13 MEDICAL VILLAGE PLAN Provide many ways to access and circulate within the medical village, with an emphasis on convenient, shaded pedestrian and bike connections, which encourage exercise and a healthy life style.
• Trails should connect to parks, open space and other areas of the district. Certain areas should include exercise stations. • Provide shade for walking, parking and other hard surfaces in order to lower ambient temperature and make outdoor activity more comfortable. • Employ LEED and “green building” techniques to reduce energy consumption and improve air quality. • Utilize storm-water management techniques that create amenities and assist in recharging ground water. • Provide transit, such as a local trolley or shuttle that would connect medical facilities with professional offices and retail/restaurant areas to minimize the need for driving and to facilitate handicapped access.
Design Complete Streets Complete streets are those that comfortably accommodate multiple users, such as transit, cars, pedestrians and bicycles, and are designed to function as both vehicular ways and civic space.
When local streets are designed for traffic to move between 20 and 25 mph, all users can share the street. Drivers move slowly enough to watch for pedestrians and see signs and signals. Pedestrians feel safe crossing the roadway; and cyclists can blend in with vehicular movement. Medical village patrons could happily “park once” and enjoy walking to multiple destinations.
Other street improvements that help achieve this goal include: • Bulb-outs at pedestrian crossings. • Minimal turn radii at corners. • Special paving at pedestrian crosswalks. • On-street parking and street trees. • Street furniture, such as pedestrian level lighting, seating and trash bins. • Pedestrian-oriented signage.
Design Engaging Street Walls
14 MEDICAL VILLAGE PLAN New and redeveloped buildings in the medical village should generally be placed at the sidewalk to give streets and blocks a comfortable “outdoor room” feeling. Continuity of windows and doors should create a permeable relationship between the buildings and the sidewalk, creating a flow between inside and outside. A consistent “visual texture” for the street wall, created by complementary arrangements of floor lines, window and doors openings, and other features, is more important to a cohesive image than a consistent architectural period or style.
Design Parking to Support Urban Design Goals Parking should be maximized on non-arterial streets to provide easy customer access to businesses and to aid in traffic calming. Additional parking should be placed in the center of blocks and lined with buildings.
Build Upon Authenticity Respect and build upon historic and cultural precedents and traditions in site design and architecture. Solid, enduring materials should be used. Buildings should be articulated in a way that establishes a rhythm of bays, and windows should be “punched” and have shadow lines rather than be flush with the building wall surface. Recruit locally owned businesses when possible.
Design for Visual Richness Great streets have “a thousand points of detail,” including diverse and detailed architectural facades, engaging signage, attractive furnishings, colorful plantings, sidewalk commerce and public art. The City’s regulatory framework should be flexible enough to allow the unfolding of a diverse and stimulus-rich environment over time.
Design for Sustainability New projects should reflect best practices for “green” urban design strategies and building techniques, “light imprint” site design and greener transportation. Design for new buildings and the public realm must respond to local climate extremes, especially in the provision of shade to enhance walkability and reduce ambient temperature.
Capitalize on Value Creation There are proven techniques to capture value in developments. These should be utilized throughout in order to ensure ongoing reinvestment in the district.
• Proximity and access to public open space, including buildings that directly face the public amenity.
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• Easy and convenient access (walking, biking, transit and auto) to retail, restaurant and recreational uses.
PLANNING PROCESS The development of the Medical Village Plan began with the initiation of the Comprehensive Plan update and a desire from the City Council to address current and future development in emerging and redeveloping areas of the City. The first such area plan, The Cape Fear River Plan, was adopted in May of 2016. Project initiation of the Medical Village started in the late summer of 2016 with due diligence and analysis of the study area. From there, a kickoff meeting was held in October at the Lake Rim Recreation Center to gather information and provide early concepts. A follow-up meeting was held at the beginning of December to report back initial findings based on community feedback, existing conditions, density, opportunities and a draft land use map.
SUMMER 2016 FALL 2016 WINTER 2016 SPRING 2016 Project Initiation Public Meetings Due Diligence & Analysis Draft Land Use Plan Draft Master Plan Final Plan
Stakeholder Interviews The stakeholder interviews were another important part of the planning process. The small group format and confidential nature of the stakeholder interviews often provides critical information to the project team that may not be revealed in a public meeting or large group setting. Comments made during the interviews are not attributed to individuals in order to respect participant privacy and encourage candor. The stakeholder interviews allow the project team to make sure that stakeholder aspirations, concerns and
16 MEDICAL VILLAGE PLAN knowledge of the project area were heard by staff and integrated into the Plan. While staff reviewed extensive information and documents about the Medical Village and the City of Fayetteville, these documents can never be a substitute for small group conversations or local knowledge about the area and its history. Further, stakeholders often continue to be involved in the master planning process throughout its duration and later in implementing the plan. Therefore, it is critical that their perspectives be documented and considered early and addressed in the final plan.
Existing Land Use According to the City’s 2010 Land Use Plan, the existing land uses in the project area generally include industrial, commercial, large lot residential, public and semi-public uses. A large portion of the study area is currently unimproved or vacant within the medical village study area, and potentially available for future development. This appears to be the largest concentration of available land within the City limits. On the west side of Raeford Road, existing development includes a heavy concentration of retail, office and commercial from Gillis Hill Road to Cliffdale Road with a mixture of medium to low density residential surrounding the commercial node. Most of the medical facilities in the area are in the major commercial area or the east of the VA Health Care Center between Old Raeford Road and 71st School Road. With the completion of the Outer Loop that will overpass Raeford Road with on and off ramps, these areas will essentially be separated from each other. There are significant
17 MEDICAL VILLAGE PLAN scattered large vacant tracts of land along Raeford Road that are available for future development. The area surrounding the VA Health Center should stimulate additional growth and development that will connect the existing commercial node stretching from Cliffdale Road to Gillis Hill Road with existing development toward Strickland Bridge Road. It is imagined that a concentration of supporting uses to the VA and future FTCC campus could create a significant mixed-use center bordered by Lake Rim Park, Rim Road, S. Reilly and Raeford Roads.
Parks, Open Space and Natural Areas Within the study area, there are parks, open space and natural areas that are valuable for their beauty and vulnerable to development impacts, including Lake Rim and its tributaries and drainage ways, floodplain land and City parkland. Preservation, enhancement and restoration of these areas will promote the vision of wellness within the district, while improving the overall beauty and visual quality of the district as well. When fully completed, the Lake Rim Regional Park will provide more than 230 acres of open space and amenities. As part of the development of the Outer Loop, Old Raeford Road will be closed to traffic for those that travel southbound on S. Reilly Road and travel west on Old Raeford to eventually reconnect with Raeford Road. This will hinder vehicular access to the park and create a significant detour for those wishing to access the facility. ROAD CLOSING OF OLD RAEFORD ROAD (BLACK HATCH LINE HIGHLIGHTED WITH PURPLE BRACE) LAND USE/ZONING Issues and Opportunities The future land use and zoning regulations should help foster smart growth and orderly development within the Medical Village study area, which is experiencing growth. Healthcare is a vital and important part of the district and the City. There is a need to provide appropriate zoning to accommodate continued growth within a cohesive healthcare district in a manner that promotes the health, welfare and livability of the surrounding residential community. There is a desire to balance the needs of businesses and residents to create an active and successful mixed-use community. Requests for rezoning should support the vision and goals of the district.
18 MEDICAL VILLAGE PLAN Zoning Goals Support rezoning that achieves a mixed-use community. Provide a mix of uses and greater density in the focus area. Retain single-family homes as part of a mix of diverse housing types. Allow for expansion and changing models of healthcare. Development should be reviewed to ensure impacts on users adjacent to the hospitals are effectively minimized. Promote rezoning if a site is no longer suitable for its current use.
MOBILITY Issues and Opportunities Auto traffic into and through the area is a major concern. A multi-modal approach to transportation, which supports transit, bicycles and pedestrians, is the best way to accommodate increased travel. Increasing transit opportunities is the most effective way to reduce traffic and parking demands. Current cross-city traffic on arterial streets within the district produces speeds and traffic volumes that will make pedestrian and bicycle mobility difficult. Pedestrian safety is a major concern along pedestrian routes, and transit stops. Continued improvement is still needed to accommodate cross- town, hospital and residential traffic and parking. Increased public transit may reduce the need for additional parking as well as reduce growth in traffic volumes.
Goals
Develop multi-modal access to and through the district. Establish direct, pedestrian friendly circulation and crossing patterns that connect uses with transit stops and bicycle and pedestrian routes. Provide pedestrian friendly crossings. Develop traffic calming strategies within the residential neighborhoods and where necessary to support these goals. Enhance pedestrian and bicycle connections to parks and recreational facilities. Establish clearly defined circulation routes into and through the proposed development that promote safety and do not negatively impact residential neighborhoods. Support uniform and collaborative parking strategies for all healthcare institutions.
HOUSING Issues and Opportunities
19 MEDICAL VILLAGE PLAN The community values its diversity and seeks to retain the broad mix of housing types and prices currently found within the district. They fear that rising property values and redevelopment will limit opportunity for lower and moderate income families. However, they also see growth and redevelopment as an opportunity to strengthen the community. Relatively few healthcare workers currently live within the community. This plan promotes the attraction of healthcare workers to the neighborhood by creating a mixed-use community where people live, work, shop and recreate.
Goals Support the growth, stability and diversity of the residential communities by ensuring a continued mix of housing types and prices, racial and economic diversity. Retain and promote affordable housing. Protect the historic housing stock as a value to the neighborhood.
ECONOMIC ACTIVITY Issues and Opportunities The VA Health Care Center is an important economic anchor and community asset providing a diverse employment base critical to the overall stability and continued growth of the community. Ensuring the continued vitality of healthcare uses within the district is a key component of this plan. The community recognizes the businesses and healthcare services as part of the energy of the community and seeks to foster a stronger connection between those who live and work in the district. Currently, there is a lack of connection between the healthcare uses, local business and residences whereby workers live, shop and/or recreate in the community. Increased residential growth and density creates new demands for existing shops and services. There is concern that the growth could out-pace the available services. The community sees an opportunity for economic growth
20 MEDICAL VILLAGE PLAN to support the increase in population while reinforcing the established commercial corridors.
Goals Maintain existing care clinic as an economic anchor for the community and the City and support the future growth of healthcare and healthcare related businesses. Encourage supplemental uses that provide services compatible and supportive of the VA Health Center. Encourage commercial growth to support the increased residential density by balancing the needs of established businesses with the creation of new ones. Support the established commercial corridors. Create opportunities that encourage employees to support future business development. Encourage mixed-use development rather than single use businesses areas that are empty at night.
HEALTHCARE TRENDS AND DEMOGRAPHICS Healthcare Drivers Both in Fayetteville and nationwide, healthcare is a large, strong and growing industry – in sharp contrast to most other sectors for the nation’s economy. The fundamental drivers of this growth are:
The growing number of Americans who are over 65 years of age. General population growth Affluent demographic groups around the globe that will travel if necessary to seek out the best healthcare and wellness facilities. National policy has expanded the number of citizens covered by insurance. Strong continues growth potential for biosciences, America’s Population pharmaceutical, medical devices and related industries. Source: US Bureau of Census The growing awareness of the need and benefits for health and wellness programs.
The Graying of America
21 MEDICAL VILLAGE PLAN Throughout their lives, as America’s largest generation, baby boomers have made headlines. This continues today, as economists, demographers and forecasters attempt to discern the impacts that aging baby boomers will have on America in the 21st Century. The impact will be broad and will include impacts to the workplace, public policy, retail and other facets of life. The figure to the right shows the dramatically changing shape of America’s population over the past half-century. Between 2010 and 2040, the US Census projects that that number of Americans over the age of 65 will double – from approximately 40 million today, to 80 million in 2040. Beginning in January 2017, and over the next 13 years, at least 10,000 baby boomers per day will turn 65. The figure to the left underscores the scale of the growth in older households nationwide, while also illustrating some additional elements of the nation’s changing demographics. This data also foreshadows a growing need for smaller dwelling units with a richer variety. As references above, the greatest amount of overall household growth during the coming decade will come from the baby boomer generation. Younger households, with heads of households younger than 40 years of age, will also grow – though at a lesser pace. In particular, households ages 25 to 34 – a key demographic that drives apartment demand and development – will experience strong growth. The number of middle-age households, however, will decrease, because of the relatively small number of “Generation X” (born between the early mid- 1960s and the early 1980s) households compared to baby boomers. The decrease in this age group – which has the largest percentage of families and children- suggests that the single-family housing market will continue to stagnate for some time. However, there will be a growth in the number of minority-headed middle-age households.
More than Healthcare – Lifestyle Baby boomers are unlikely to want to register at a retirement community and live out the rest of their days apart from the outside world. They will be seeking more from their communities than simply reliable healthcare. According to a survey, the following are some of the key features that baby boomers will look for in their future housing choices and communities (Source: “Who are you calling a senior?” Urban Land Magazine) :
• Working will continue to be an important part of the boomer lifestyle. Fifty-five percent of boomers plan to continue to work at least part-time, making urban areas close to job opportunities and transportation more desirable. Urban workforces are better plugged into the new economy, a trend that only stands to strengthen as the U.S. information economy expands.
22 MEDICAL VILLAGE PLAN • Arts and culture. Boomers overwhelmingly seek locations that offer travel, arts, hobbies, fitness, entertainment, dining, culture, shopping and gardening—raising the question, what are boomers not interested in? Surprisingly, they agree on their lack of interest in golf, tennis or a move to a warmer climate. • Of the boomers who are anticipating a move, only 20 percent are very interested in golf and/or warm locales, and plan to include those factors as part of their moving decision. • Eighty-six percent of baby boomers want to live in a typical community setting where people of all ages live; diversity of age and experience is critical to boomers.
Information suggests that our definition of “senior housing” will change. Rather than seclusion and exclusivity, many boomers will want activity and connection – with their children, grandchildren, friends and communities. Along with outdoor pursuits, seniors will be looking for arts, culture, food, continuing education and lifelong learning and other pastimes. Further, while high quality healthcare is very important to senior citizens, they are looking for communities in which it is part of an overall puzzle, not the entire picture.
Increase in Health Related Jobs Job growth in the United States has stagnated over the past several years. In the coming decades, job growth is expected to come from several well-defined industry segments, led overwhelmingly by healthcare and professional services. The Bureau of Labor Services (BLS) predicts that the healthcare industry will generate 3.2 million new jobs in a 10-year period. Therefore, there is an opportunity to accelerate the development of a medical village or cluster of institutions as a major economic development opportunity, since this industry is expected to be among the fastest growing in the country.
National Employment Growth by Industry Source: Bureau of Labor Services
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Net New Employment by Facility Type Net New Employment by Facility Type Source: BLS Guide to Healthcare Industry Source: BLS Guide to Healthcare Industry
Figures above show both the types and locations (by development type) of jobs expected to be created nationally in the healthcare fields. This information is relevant because it is indicative of the types of development likely to take place, and because it shows the breadth of jobs that could be created within the City and region. The greatest demand will be for those trained as nurses, physicians and surgeons, followed by many other professionals including social workers, lab technicians and physician assistants. These job types in general offer relatively high wages and security compared with national averages.
Real Estate Development Outlook Real estate development was a major source of the national recession, and an industry that continues to suffer in its aftermath. Nationwide, most types of real estate development continue to be out-of-favor with investors due to dramatic overbuilding in the early part of the last decade, increased unemployment and stagnating wages, more caution on the part of consumers, increased scrutiny by lending managers, ratings agencies, and regulators and other related factors. These conditions are reflected in real estate development prospects figures
Real Estate Development Prospects Source: Urban Land Institute
24 MEDICAL VILLAGE PLAN which show some of the key findings from the Urban Land Institute’s (ULI) Emerging Trends in Real Estate, a leading annual real estate industry publication. While industry leaders are extremely pessimistic about most types of development – most development types are seen as nearly “abysmal” – development within several land uses is “fair”, that is, financeable and profitable under the right conditions. These include apartments, medical offices, senior housing and other types of affordable and infill housing. All of these are development types with strong long-term demand drivers that did not suffer from the same scale of dramatic overbuilding as single-family housing and other types did in the early 2000s. While these trends are important for the medical village, there are a number of qualifications to this information that should be recognized. The Emerging Trends analysis is nationwide and intended for the short term. In fact, we know that every real estate market is highly localized, with its own demand drivers (economy, demographics, etc.) and players (existing development, developers, property owners, etc.). Many North Carolina cities and metropolitan areas have continued to create jobs and enjoy strong real estate markets through much of the last several years, thus avoiding the worst of the national real estate downturn. In addition, the medical village is intended to be a long-term vision with a long-term build-out, and thus, the trends in effect in 2030 and beyond will be nearly as important as those for next year. However, with these caveats in mind, the land uses anticipated to be strong opportunities should continue to maintain their top positions for much of the coming decade. Nationally, the medical office sector has outperformed most other commercial property types through the recession.
MEDICAL DSITRICTS AND URBAN DEVELOPMENT Major healthcare institutions and related uses have clustered together in medical villages across the country. These districts are a result of deliberate and assertive action by healthcare providers, the public sector, and other stakeholders, who seek to provide their patients with more complete offerings for care, proximity to other experts, suppliers and complimentary uses, and increased economic outcomes such as growth in jobs and tax bases. The following case studies summarize some of the key characteristics of medical corridors and districts nationwide. Research across the nation indicates successful medical villages tend to be located in larger communities with populations in excess of 500,000. However, one well established and notable example is Winston-Salem, NC. With a population of nearly 230,000, Winston-Salem is comparable to and only slightly larger than Fayetteville.
COMMON TRAITS FOR HIGHLY SUCCESSFUL DOWNTOWNS AND VIBRANT URBAN DISTRICTS No single organizational model exists. While Fayetteville can and should learn from other medical village models, the approach adopted in Fayetteville will ultimately be distinctive to Fayetteville. Great urban districts are beloved by their citizenry. Pride in the medical village must be promoted and instilled internally to the residents. The district could be useful in establishing a distinct gathering place for meetings focused on medical issues and for patients and their friends and families in the course of access to comprehensive health care solutions.
25 MEDICAL VILLAGE PLAN Great urban districts are able to overcome obstacles. This requires partnerships, shared resources, vision and patience. The premise of the medical village itself is the product of a shared vision and shared resources. The lesson needs to be extended throughout the district and the community. In the context of current and predicted economic reality, there is no viable alternative to a robust public-private partnership to get things done. Great districts are walkable and have pedestrian scale. There must be interesting features that capture the attention of pedestrians while assuring personal safety. The variety of patrons and residents of medical village institutions will help to attract a variety of businesses, public art, aesthetically pleasing streetscapes and visual diversity. Great urban districts have a commitment to mixed-use development. Developers and investors are urged to build for and attract a range of occupants, business types and institutional services. The medical village can and must demonstrate that public/private investments can achieve significant results, and should include a variety of private interests (developers, etc.), public leadership and non-profits. Entertainment is the driving market segment. Revitalized downtowns increasingly serve as places for dining and recreation rather than simply centers for retail merchandise. The medical village can be a leader in attracting and sponsoring public events (fairs, concerts, art walks, “healthy foods” farmers market, etc.) that instill interest in the medical village, eventually leading to a wide range of investments. There are typically a number of strong, adjacent residential neighborhoods that will be within walking distance of the medical village. Respecting the existing neighborhoods while also establishing new residential neighborhoods is essential for the success of the area. Access to and from housing in the neighborhoods must be redesigned to encourage pedestrians into the medical village. Housing is either existing or underway. The medical village must have a substantial amount of housing in addition to improvements in transportation and pedestrian routes. Such housing should appeal to the workforce in the medical village as well as seniors, include affordable options, and be developed as walkable neighborhoods. Colleges and universities help, but are not the sole answer. Many of the medical districts studied are in university towns, but the research found that universities are not automatic keys to district vitality. However, research indicates that a strategic partnership with institutions of higher education is vital to medical villages, is an attraction for regional visitors and a source of well-trained labor for the entire area. With these metrics in mind, a strategic model for establishment of a medical village in Fayetteville and the broader community that leverages the characteristic of its existing strengths can be designed. Such a model, however, must be unique to Fayetteville and must be supported by those who use or would use the medical village more actively. Successful medical corridors and districts have been established in a wide spectrum of urban areas. Some summaries of case studies of Medical Villages are provided on the following pages.
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Wake Forest Baptist Medical Center . VA Health Center Vidant Medical Center Winston-Salem, North Carolina Fayetteville, North Carolina Greenville, North Carolina
Largest employer in Forsyth County. 1,700 employees. Largest employer in Greenville, NC. 14,440 employees. 1,000 patient visits daily. 7,868 full time workers. 198 buildings. 250,000+ square feet. 1,439 beds. 428 acres. Relocates outpatient health care services from Serves 1.4 million in 29 Counties. Wake Forest Baptist Health. VA Medical Center and Village Green and East Carolina University School of Medicine. Wake Forest School of Medicine. Breezewood Primary Care Clinics. Robotic heart surgery training center. Wake Forest Innovations. 66,000 + Veterans receive care at Fayetteville VA and its community-based clinics with 45,000+ receiving care in Fayetteville. Primary Care, Day Surgery, Imaging Services, Medical and Surgical Specialties.
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Texas Medical Center Stemmons Corridor Texas Research Park Houston, Texas Southwest Medical Village Study Area San Antonio, Texas Dallas, Texas World’s largest medical center. UT – Institute for Biotechnology. 93,500 employees. 100,000 employees. UT – Institute for Longevity and Aging. 1,000 acres. 5,000 businesses. Bio manufacturing firms. 14 hospitals and two specialized patient Biotechnology and medical services – key TEXSA Innovations Corporation. facilities. targeted industries. 160,000 daily visitors. Key healthcare providers and tenants: 69,000 students, 5,000 of whom are international students. o UT Southwestern Medical Center. 5.6 million annual patient visits. o Parkland Health & Hospital System. 50-year Master Plan completed in 2006. o Children’s Medical Center. $7.1 billion in building and infrastructure o Texas Woman’s University School of investments approved between 2010-2014. Nursing. Annual Economic Impact - $14 billion. o 40 Hotels (Stemmons Corridor). o Planned expansion of clinical care and Annual Research Expenditures $1.2. billion. new research buildings. o Planned 350,000 SF biotech and life science research park.
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10th Street Medical Business Village Five Points Medical Village Sugarland, Texas Oklahoma City, Oklahoma Birmingham, Alabama Key Healthcare Providers: Recommended development program: Key healthcare providers: Memorial Herman Sugar Land Hospital – 77 Office: 450,000 to 800,000 SF. University of Alabama Hospital – 908 beds. beds. Retail: 130,000 to 175,000 SF, groceries, Health South Medical Center – 73 beds. Triumph Hospital southwest – 170 beds. restaurants, bars, drug stores, household goods, HealthSouth Lakeshore – 100 beds. Sugar Land Surgical Hospital – 6 beds. gas stations, apparel, day care. Callahan Eye Foundation Hospital – 20 beds. Methodist Sugar Land Hospital – 127 beds. Mid-size hotel: 200-250 rooms. Children’s Hospital of Alabama – 310 beds.
Residential: 1,500 to 2,000 units (average of Cooper Green Mercy Hosp – 141 beds. 1,200 SF per unit). Veterans Affairs Medical Center – 122 beds. St. Vincent’s Hospital – 372 beds. Brockwood Medical Center – 602 beds. Princeton Baptist Medical Center – 368. Birmingham Baptist Medical Center -375 beds. Select Specialty Hospital – 38 beds. Hill Crest Behavioral – 80 beds.
29 MEDICAL VILLAGE PLAN LAND USE PLAN Land Use Plan Mixed-Use District and Neighborhood The Medical Village will be a fully functioning mixed-use district and neighborhood with emphasis on multimodal transportation options. It will encourage a healthy lifestyle and place amenities within a short walk or bicycle ride, as well as within an easy transit trip. It will also be a place that will be suitable, and in fact very desirable, for people of all ages – young professionals, families with children, empty nesters and seniors. This type of neighborhood meets the demands of the highest growth demographic market over the next 40 years. It also happens to embody the timeless principles of successful neighborhoods.
District Expansion It is anticipated that the Medical Village may grow over time as properties within and surrounding the area develop. Appropriate land uses for these areas will need to be determined at the time of development and should be based on the guiding principles in the plan, existing surrounding uses, availability of infrastructure, and the marketability of the proposed land uses.
Flexible Growth The key to achieving the goal of flexibility in development is to establish the framework of roadways, trails and open space; and to establish core land use areas, such as:
VA Health Care Center. FTCC West Campus. Raeford/Gillis Hill/Rim Commercial Node. Repurposing of South Reilly Road. Existing and planned residential areas. Possible additional specialized medical facilities
30 MEDICAL VILLAGE PLAN Land Use Categories The Land Use diagram indicates several land uses, some of them unique to this plan:
Medical-Related: A pedestrian-friendly area intended to provide a concentration of medical-related uses, including labs, professional offices, pharmacies and others that will provide a full range of support uses for medical activities. Uses include: All medical services, rehabilitation, sports medicine, psychiatric, laboratories, pharmacies, senior housing, assisted living, hotels and education.
Medical Village: Intended to provide a mixture of retail and residential uses, possibly with supporting offices in a pedestrian and bicycle-friendly environment. Uses include: Retail, office, urban residential, restaurants, medical-related and hotels.
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Commercial: Intended to provide more professional office space and services, primarily targeted for sites along the major corridors. Uses include: Professional office, retail, personal service, medical related, hotels and other similar uses. Suburban Commercial: Intended to provide low intensity professional office space and services, primarily targeted for sites along the secondary corridors. Uses include: Professional office, retail, personal service, medical related and other similar uses.
Urban Residential: This is a neighborhood adjacent to medical-related facilities and the medical village which is fairly high density and very pedestrian and bicycle-friendly. It should contain a variety of residential types and sizes. Uses include: Townhome, live-work, loft, apartment, independent living, and assisted living.
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Low-Density Residential: This is an area of low-density single-family lots that will provide a buffer and transition to existing single-family neighborhoods. Uses include: Minimum 6,000 square foot single-family lot, cottages, and patio homes.
DEVELOPMENT PROGRAM The program serves as a guide for the physical planners (land planners, landscape architects, architects and engineers) who are responsible for translating the narrative program into a physical development pattern. The development program describes an overall identity for the project including theme, image and “brand” attributes to be merchandised. The overall objective is to capture target markets, maintain economically viable conditions, and create a positive, long-term identity for the project.
Product and amenity opportunities are based on the research and analysis of markets for the project—all of which should be simultaneously pursued for the purpose of accelerating project sales and mitigating absorption risk. Programming includes identifying and formulating alternative concepts for the master plan, including: • Development theme and character. • Timing and phasing. This development program is intended for an approximately 10- to 20-year period. However, some uses will develop before others. • Land uses by type, including a wide range of medical and non- medical components. • Land use mix. • Number, type and land (acreage) needs of the various land uses.
33 MEDICAL VILLAGE PLAN • Likely amounts of medical and commercial uses (measured in square feet) and housing (measured in dwelling units). • Recommended amenities.
Making accurate long-term development projections has never been easy. But it is arguably more difficult now than ever before, given the dramatic changes to the nation’s economy and real estate markets that have taken place, and the ripple effect this has had on consumer preferences and demand for housing, retail space and other components of the built landscape.
Successful Programs are Market Driven The master plan must address, to the extent possible, the goals of the City. The additional and equally rigorous layer of considerations that impact the program consists of: • Market willingness to seek out medical services, housing, shopping or leisure activities, or other products and experiences in the physical environment to be developed. • Market capacity to pay either through equity, debt service, rents, home ownership or commercial rents. • Lending and loan underwriting policy and criteria. • Achieving reasonable levels of profitability commensurate with risk to attract private development capital to the study area. • Establishing an arrangement of land uses which can be successfully introduced in the marketplace with sufficient velocity (rate of sales) to generate revenues adequate to cover or partially cover the cost of infrastructure both on-site and off-site.
Hence, all development strategies must thoughtfully consider the needs of the potential employers, residents, and shoppers who will come to the district. These considerations include price, size, quality levels, image, quality of life and other factors.
Development Identity and Character Preparing a development program for the medical village begins with establishing a statement of the recommended overall identity and character for the project. This statement of the project should be adopted by the medical village leadership and organization. It is analogous to the mission statement in a business plan. It is the guiding statement against which later program details can be “tested” for compliance in support of the overall theme. The recommended program is for a medical village and mixed-use community, as illustrated in the following graphic.
34 MEDICAL VILLAGE PLAN A Special Place and Destination The medical village will of course have a different look, feel, and identity than the rest of Fayetteville, but it should establish a sense of place and, in doing so, create a means by which it can differentiate itself from its competition. This will help it to attract patients, doctors and residents because of a natural desire to spend time in high-quality environments.
Great Neighborhoods Two key groups—senior citizens and medical professionals—will have a distinct interest in living close to the medical village. Seniors have a demonstrated propensity for living in close proximity to quality medical care, and people tend to seek housing that is within easy access to their jobs. This suggests strong demand within the medical village for both senior housing—which includes a “continuum of care” that ranges from independent living, to assisted living, to skilled nursing facilities—and a wide range of housing for medical professionals. The types of housing sought by medical professionals will also be very broad, and may range from large-lot, single-family homes, to urban-style condominiums within walking distance of the hospitals. Making these housing options available will enhance the value proposition of the medical village and its potential for long-term success. The medical facilities will benefit from a consistent base of patients, and find it easier to attract the best doctors, nurses and technicians if great neighborhoods are located nearby. Finally, this population will also help the district center retail component to thrive.
Medical and Supporting Uses As shown in the figure below, the medical village can generally be divided into major use areas: an existing and expanding medical core and a large are of supporting uses. However, these areas will include a mix of medical and non-medical uses. The types and locations of these uses are summarized on the following pages. Medical and Healthcare Uses Supporting Uses Located Supporting Uses Located in in the Medical Village the Surrounding Areas
Existing Hospitals and Retail/Village Center Senior Housing Expansions General Office o Independent Medical Office Buildings Hotel and Living Specialty Clinics Conference space o Assisted Living Research and Plazas, Pathways, o Skilled Nursing Development Parks, and Other Facility University/Educational Public Spaces Single-Family Detached Facilities and Attached Housing Neighborhood Retail
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Manageable competitive environment. Most retailers will avoid an area if competitors are already there. Demographic match. Retailers choose sites located near their “target market” customers. Anchor tenants. Retail developments are often “anchored” by one tenant who then attracts other tenants. Sense of place, safety, cleanliness. Contiguity. Urban retail must be continuous, or many shoppers will stop and turn back.
Parking capacity.
Retail / Village Center A village center with a strong retail Office component could thrive within the medical Office uses would be an excellent addition to village. Retail provides activity and amenities the medical village as they would provide to the residents, employees and visitors of the daytime activity and are compatible with the medical village. Retail creates a sense of other uses being proposed for development. place, making the medical village more desirable for residents, visitors and employees Requirements for success: of the area. Easy access to and from clients. Requirements for success: Accessibility to workforce and executive Hotel Experience from other medical corridors residences; Offices need to be sited near Visibility. Thousands of customers must shows that additional hotels and conference metro regions or at major transportation pass and see the site on a daily basis; space will be needed in the medical village hubs. Daily traffic volumes of approximately to accommodate visiting families, patients, Proximity to support services - banking, 20,000 are desirable for most national and doctors. food, hotels and other services. retailers. Access to intra – and inter-regional Accessibility. Must be very easy to get to; Requirements for success: transportation connections such as daily-shopping or convenience retail freeways, high capacity transit and should be on the “way home” (right) side Visitor amenities and attractions. airports. of the street. Easy access to major thoroughfares. Central location. For example, grocery Co-location with other hotels. anchored centers should be within Visibility. approximately one mile of 10,000 Parking capacity. residents.
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Medical Office Building Specialty Healthcare Research and Development Medical office buildings (MOBs) typically include Specialty healthcare includes specialists in Research and Development (R&D) facilities can be routine and preventative care facilities such as cardiology, oncology, OBGYN, mental health and comparable to office buildings, flexible physician’s offices, dentists, ophthalmologists and other fields that cannot be completely addressed warehouses, or industrial properties depending various other providers. MOBs have many of the within a single general-care hospital. These upon the type of research being conducted. Often same locational requirements and typical office special services can be offered in multi-tenant or they need both types of facilities - an office in buildings such as easy access for clients; proximity single-tenant clinics, or on a contract basis within which to develop and market concepts and a lab to support services such as food, hotel, labs and the existing hospitals. In addition, medical or production room to conduct experiments and medical supplier; ample parking; and access to hardware suppliers and other support facilities fabricate prototypes. Like MOBs they require a intra- and inter-regional transportation connections are likely to locate in the medical village in the greater level of technology and often have higher such as freeways, high capacity transit and future. energy and water consumption. They also require airports. However, MOBs usually require a higher a greater level of security, as products may be in degree of technology and services such as a highly secretive phase of development. R&D advanced computer systems and a higher standard facilities benefit from proximity to universities and of air quality and purification than typical office large research hospitals for prospective employees buildings. as ideas spin off from research conducted at these institutions.
37 MEDICAL VILLAGE PLAN Supporting Uses: Senior Housing
Stakeholder interviews and research indicate strong recognition of the need for more senior housing and Long Term Care (LTC) facilities in Fayetteville. The facilities listed below show the typical range of senior housing, all of which are appropriate in varying quantities for the medical village. In addition to the categories shown below, continuing care facilities offer the full range of senior housing types within a single large development. This allows residents to “age in place” and move easily from one housing type to another as their medical needs or preferences change. Continuing care facilities typically require a long-term contract from residents with an initial down payment, whereas the stand-alone facilities are often contracted on a monthly basis. Senior housing differs from other housing types in that it is not only a real estate investment, but also involves a hospitality and healthcare component that must be considered when operating the facility. The following sections evaluate the amount of senior housing likely to be in demand within the medical village. Demand for senior housing will come from two primary sources: latent demand and the net new senior population moving to the area.
Independent Living Assisted Living Skilled Nursing Multi-unit complex marketed to seniors. Support services include laundry, food service, Facilities designed to provide 24-hour care and arranged activities, limited medical oversight and intensive medical attention. Staff assists residents assistance to those with physical impediments such as with daily tasks such as bathing, dressing and other blindness or decreased mobility. needs.
Latent Demand Interviews with Fayetteville residents and those in the healthcare industry strongly indicate that while there are thousands of senior residents of the City and surrounding areas, there is very little senior housing within the City itself. Many seniors reported having to move out of the City in order to find a senior community that met their expectations. Thus, there is expected to be latent demand for senior housing in the market.
Supporting Uses: Single-Family and Multifamily Housing As previously stated, the housing market in Fayetteville and other locales in the state have changed significantly over the past several years. In
38 MEDICAL VILLAGE PLAN contrast to the middle of the last decade, the best-selling houses are smaller (1,500 to 1,800 square feet) and considerably less expensive ($150,000 to $300,000 maximum). The core of the short-term housing market is seen as those seeking affordable homes and downsizing retirees who have moved out of large homes and are now looking for comparatively smaller and lower-maintenance homes, including “cluster” or “cottage” communities. Both trends are well suited for the medical village.
Requirements for Success • Critical mass: adjacent residential neighborhoods and urban amenities (schools, parks, retail, and services). • Safety. • Large share of one and two person households within market area. • Easy access to employment centers.
Single-Family Housing Mixed Use Mid-Rise Wood Frame Condos or Apartments 5 to 10 du/acre, 1 or 2 stories 40 to 60 du/acre, 4 to 6 stories 20 to 35 d/acre, 2 to 3 stories Surface parking Structured parking Surface, garage or tuck under parking
Town Houses or Row Houses Cluster or Cottage Housing 15 to 25 du/acre, 2 to 3 stories 10 to 25 du/acre, 1 or 2 stories Surface parking or parking within each unit Surface parking
39 MEDICAL VILLAGE PLAN IMPLEMENTATION OF THE PLAN The Plan is intended to be implemented on a project-by-project basis, based on the overall vision for the entire Medical Village. With this type of implementation, it may require more time to see the ultimate long-term results than if an area wide implementation program were initiated; however, it also allows property owners of smaller parcels or of limited financial resources to make improvements over time. City Staff has recommended the most relevant and realistic implementation initiatives below. These will provide the most progressive and useful solutions to ensure the success of the Plan. Many of the initiatives recommended in this section are intended to implement the features, ideas and concepts that came as a product of a series of public meetings and brainstorming sessions. The vision of the future in the Medical Village Area Plan is only the first part of a successful plan. Identifying ways to achieve that vision is of critical importance. The Implementation Plan contains specific actions necessary to reach the vision. Actions in the implementation plan are short, medium, or long-term and work together to achieve the overall vision for the area. This chapter recommends a series of principles and tools intended to help the City of Fayetteville and its partners implement the plan. Just like the planning process, the implementation of the plan will have many components, including physical, financial, regulatory, operational and organizational. A wide range of actions is required to transform a paper plan into a vibrant built place. This chapter primarily focuses on financial or funding tools, while also making recommendations regarding other elements of implementation. In order to recommend the proper set of tools for the plan, it is important to recognize the content of the plan— what it is that will be implemented.
Land Use and Zoning The development of the Medical Village and in Fayetteville has historically been piecemeal. Most development or construction in the area has taken place without an overall “big picture” or master plan. With future changes in land use maps, amended regulations, and other controls, future revitalizations or changes in properties would be easier to accomplish since they would be more compatible with the overall purpose and intent of the Plan. Land use patterns were researched and evaluated as they relate to developed and undeveloped lands within the Medical Village. Developed lands fell into three major categories: commercial, residential and institutional. The undeveloped lands within the Medical Village have good potential for development given their proximity to existing infrastructure and services. The Master Plan should work hand in hand with zoning districts in the Medical Village. A unique “Medical Village” zoning designation should be created to encourage a wide variety of land uses and development, as well as redevelopment opportunities. This zoning district should allow complementary uses to exist in and near the medical core area. Land uses include residential, commercial, retail, technology, research, institutional, and education.
40 MEDICAL VILLAGE PLAN The City of Fayetteville should adopt amendments to the Zoning Regulations to allow the new Plan to work seamlessly with the adopted land development code, growth policy and other relevant documents. The following initiatives should effectively enable redevelopment and revitalization to occur more easily throughout the Medical Village. City staff recommends the following initiatives: 1. Create a “Medical Village” zoning classification within the Land Development Code. a. A “Medical District” zoning classification should be adopted in the Code. The new zoning classification would accommodate medical, clinical, hospital, pharmaceutical, physician, and related business services and activities.
2. Create a “Medical Village Overlay” within the Code. a. A “Medical Village Overlay” should be created that includes the Primary Study Area boundary of the Medical Village. This overlay district would facilitate the implementation of the concepts, visions and proposals presented in the Plan in order to produce a functional, attractive, inviting, interrelated and growth friendly medical area with its own unique identity 3. Identify permitted and prohibited land uses within the Code for the created “Medical Village” zoning district. a. Land uses within the “Medical Village” zoning district should be a mixture of uses and should encourage in fill, redevelopment and revitalization. The uses should not detract from each other, but rather provide a symbiotic relationship with a mixture of commercial, residential, institutional, and public uses.
4. Encourage mixed use development throughout the Medical Village. a. Through planning and zoning controls, mixed use development can be encouraged. The City should encourage development or redevelopment that promotes the combination of residential living opportunities with office, small-scale commercial or complementary land uses.
5. Pursue and encourage redevelopment of vacant or properties into complementary businesses or services. a. The City should promote the development of gray sites by offering incentives including expedited review procedures and/or tax incentives. Individual property owners can pursue and receive funds or other incentives to develop or redevelop their site (including tax credits). 6. Develop land close to the medical core in the most financially sound way, including complementary businesses or services.
41 MEDICAL VILLAGE PLAN Economic Development The economic vitality of the City of Fayetteville can benefit from a successful and vital medical village. There is much evidence that suggests the future of the area included in the Medical Village Plan will be successful and will foster expansion, smarter growth and the revitalization of properties within. The economic component of the Plan is important in that it provides for the process of creating the wealth or means by which to mobilize community, physical, capital, and natural resources to produce marketable goods, services or development opportunities. Several communities across the country have developed medical districts with the goal of enhancing the physical design and economic impact of their local health care delivery system. Research was conducted on several medical districts located in various parts of the country. Examples of alternative models for the medical districts included (1) medical district overlay zones established to develop and enforce the city’s planning and zoning codes; (2) creation of nonprofit entities using developer incentives, public-private partnerships, and tax-exempt funding mechanisms to revitalize blighted areas; and (3) to special taxing districts that combine a multitude of public/private funding sources to re-invest in the area and benefit the community as a whole. Depending on the vision and ultimate goals for the Medical Village, governance, structure, and leadership issues will need to be addressed in order to best position the plans and resources required for success. The economic component of the Plan is an important one. It recognizes that growth in the community with enhanced access to new sources of capital will translate into a stronger base to support infrastructure needs and other investments required for strong and vibrant communities. The desired benefits that can accrue from a well-developed and successfully implemented Plan will require a commitment to the vision with allocation of sufficient resources. Rather than a specific recommendation to address the proposed structure and implementation model, the Plan identifies alternative means by which to mobilize and leverage community and additional capital resources to achieve the desired outcomes. City staff recommends the following economic development-based initiatives: 1. Establish a mix of businesses in the Medical Village including housing, retail, business and commercial services. This may be achieved by: a. Identifying partners to develop housing projects, with particular attention to affordable housing, student housing, senior independent housing, and assisted living to meet the needs of workers and residents that choose to live proximate to the Medical Village. b. Identifying a lodging/hotel partner to develop convenient access to lodging for guests and patients coming from outside the City for health care services and access to conference space. c. Exploring the feasibility of locating child care programs within or near the Medical Village to meet the needs of health care and other employees in the community. d. Coordinating with Police Department resources to assure that the Medical Village area is well patrolled and viewed by the community as a safe place to work and live.
42 MEDICAL VILLAGE PLAN e. Coordinating with City/County Health Department to co-locate services in the Medical Village that are convenient to other health care providers and ancillary support services. f. Coordinating with Fayetteville Technical Community College, Fayetteville State University and Methodist University to identify future facility needs and opportunities to expand clinical and translational research programs in the Medical VIllage as well as shared conference space.
g. Utilizing various local, state and national funding mechanisms to attract additional capital partners and encourage development within the Medical Village.
h. Implementing, on a per case basis, the use of special incentives such as waiving of City charges and utility hook-up fees, and cost-sharing models to reduce infrastructure costs required for project development. i. Meeting routinely with representatives from community partners and others to learn about the successes and challenges in recruiting and retaining employees and identifying ways to assist in addressing their needs. 2. Develop a marketing plan to highlight and communicate the various functions within the Medical Village and to create a “buzz” or excitement around the growth and development happening in the area. a. Create a Fact Sheet regarding the Medical Village and its plans to be used when communicating with interested parties. b. Create a method for routinely communicating information to the community regarding progress and new initiatives within the Medical Village. c. Coordinate with the Chamber to help position the Medical Village, in regional and national venues, as an asset in the community in support of the broader economic development agenda for the community. d. Coordinate with local schools and universities to identify ways to support future development of the Health Sciences programs through co- branded communications and expansion of activities located within the Medical Village 3. Identify the desired alternative organizational and governance models. Select them to implement the Plan. Three alternative scenarios are outlined below for consideration. With each scenario, the level of resources and infrastructure devoted to the Medical Village Plan implementation intensifies and represents a more aggressive role in spurring future development.
Scenario One: Establish Medical Village Planning and Zoning Requirements Under this scenario, the medical village is a geographically defined, planning overlay zone controlled by a municipal government entity. Specific zoning ordinances are adopted to create a desired look and feel to the designated area. Future facility investments may be made within the district
43 MEDICAL VILLAGE PLAN by independent parties subject to the long-term planning agendas and regulatory codes. Changes to or variances from the ordinances require adherence to a defined process for approval. This approach is primarily design-oriented and controlled by a municipal government entity. There is limited expectation of generating a significant economic impact through the medical district function other than creating a sense of place and consistency in the design parameters. This approach is more reactive to development proposals and would not be considered a proactive strategy for soliciting or developing improvement initiatives.
Scenario Two: Establish a partnership between the City of Fayetteville and a Non -Profit Development corporation (501(c) 4 corporation) This scenario represents a collaborative model designed to (1) coordinate development activities among its members, (2) attract new businesses and capital to the area, and (3) generate economic benefits for the broader community. By establishing a non-profit entity to initiate and develop specific strategies for development in the Medical Village, the needed leadership and infrastructure can be put into place to advance the development agenda for the area and garner new resources to support its goals. This model would require either formation of a new corporate entity or partnership with an existing development corporation. This entity would be responsible for building alliances among its members, identifying priority projects, and soliciting resources (at a local, state, and national level) to accomplish the development agenda. The City of Fayetteville would interface with the non-profit board through representation and would continue to control the zoning aspects of the District. In addition to funding mechanisms, it would be expected that the funding sources such as Federal Block Grants, Federal Housing Grants, Community Development Funds, Economic Revolving Funds, Grant Programs, philanthropic funding, and other loan programs would be explored as a means to bring additional resources to support future development. The development corporation is typically funded from membership dues, development fees, tax increment financing fees, other assessments, and philanthropic contributions.
Scenario Three: Establish a Business Improvement District for the Medical Village A “Commission” or advisory board would be appointed by the City of Fayetteville to coordinate the activities of the business improvement district and manage the development of the Medical Village. Key functions of the Commission and its staff would include: • Serve as public-interest developer • Encourage redevelopment through adaptive reuse and new project construction • Offer financial incentives and assistance to encourage development • Initiate plans and studies to develop strategies for revitalization • Provide research data to prospective developers and tenants
44 MEDICAL VILLAGE PLAN • Advise the city on redevelopment issues • Recommend and coordinate needed public improvements • Monitor maintenance and safety of public and private spaces • Serve as an information clearinghouse for Medical Village activities • Inform the media and general public of Medical Village issues and activities • Produce marketing and promotional materials • Coordinate community programs with businesses in the District This model would need to be further evaluated within the context of North Carolina State law. Funding of the Commission activities would typically come from several sources: a portion of property or special tax revenues from the District, developer fees, and contributions from public and private entities in support of the redevelopment effort. This model would:
Encourage and foster development opportunities that include a diverse combination of medical, support, ancillary services, neighborhood commercial, and residential land uses for cooperative function and enjoyment of the medical district.
Require amendment of City zoning regulations to allow for more diverse land uses in appropriate areas of the medical district.
Encourage developers and/or property owners to pursue projects that create a dynamic mixed-use approach where suggested by the Master Plan.
Transportation and Circulation The transportation and circulation network consists of streets, walkways, sidewalks, trails, parking lots and garages, and other related facilities and structures. These all contribute to the function and experience of the visitor, employee, resident, or community member within and adjacent to the Medical Village. A major component to implementing the master plan is to improve the existing transportation and circulation situation as well as plan for future growth and facilities. Because some of the vehicular connections are either weak or unsafe, it is imperative that the overall organization of vehicular travel be improved throughout the Medical Village. Staff recommends that the following transportation and circulation initiatives be implemented:
1. Streets and Roads
45 MEDICAL VILLAGE PLAN Provide improved pedestrian crossings and amenities at key entrances to the Medical Village Improve awareness of the Medical Village by providing cohesive signage at key entrances to the Provide traffic calming measures to slow through traffic along this corridor Implement better signage to direct traffic to parking areas and building entrances. Create visible and safe pedestrian crossings 2. Pedestrian Facilities It was determined that a major component in the Plan was to improve pedestrian access to and from the medical core area. The upgrade of existing pedestrian facilities such as sidewalks, handicap ramps and crossings should be improved immediately, especially near the medical core new development Pedestrian facility initiatives should involve the following: a. Conduct a detailed inventory of existing sidewalks, handicap ramps, and street crossings within the Medical Village. -This initiative will outline existing pedestrian facilities most likely in need of replacement or removal as well as which features should remain. In addition, missing sections of sidewalk should be noted and improved to City standards. -It is critical in a Medical Village, and especially in the medical core, that access be provided to pedestrian facilities via handicap ramps or other devices. In addition, safe crossings would benefit both impaired users and others by providing delineated and obvious crossing locations. This Medical Village experiences a high volume of traffic on busy streets during most hours of the day. Incorporating more “safety” features is necessary and beneficial. b. Implement a plan for replacement of existing sidewalks, ramps and crossings that are in need of repair or replacement. Implement a plan for construction of new sidewalks, ramps and crossings. -This type of implementation plan could be funded through a Medical Village capital improvements plan, special improvement district or other means. c. Create a design standard for pedestrian crosswalks in key areas of the medical core. -Creating unique and consistent crosswalk patterns and treatments establishes a sense of place for pedestrians and enhances motorist awareness of pedestrian crossings. d. Strengthen physical connections between the major health care providers and developments. -Provide pedestrian connections between the two major developments with intermediate public plazas or spaces.
46 MEDICAL VILLAGE PLAN -Improve signage so that facilities are clearly identified from all major vehicular access routes. -Implement common “themes” for site amenities, such as signage, pavement treatment, street tree plantings, furnishings, etc. e. Strengthen physical connections between the core medical area and the adjacent land uses as well as the entire community. -Provide pedestrian connections between the two with crosswalks, seating areas, public plazas, and other pedestrian amenities. -Improve existing or construct new sidewalks and trails between these areas, especially between the academic campus to the west and the medical core and between the residential areas and the medical core. -Utilize common “themes” for site amenities such as signage, pavement treatments, street tree plantings, furnishings, etc.
3. Trail Facilities In addition to providing improved sidewalks and pedestrian facilities in the Medical Village, it was determined that informal pedestrian linkages were just as important as formalized ones. Footpaths and trails are an ideal method of providing informal pedestrian facilities on the outskirts of the core medical area. Much of this land is undeveloped and would benefit from a network of trails and pedestrian amenities, connections to nearby parks and open space, and connections to residential neighborhoods on the east and west sides of the core medical area. Trails encourage informal and casual enjoyment of open space during many hours of the day. Employees of the Medical Village and surrounding area could enjoy a lunch time run or walk. Residents of surrounding neighborhoods could enjoy a weekend bike or hike with the dog. Trails offer many opportunities for many different types of recreational enjoyment. Trails are also inexpensive to build and maintain compared to more formal pedestrian facilities. Trail facility initiatives should involve the following: a. Conduct a trail inventory of the Medical Village. -This inventory should include connections, trailheads and parking associated with trail facilities. This inventory should also include a viability study for each trail. b. Create a trail specific plan for the Medical Village. - A more comprehensive trail plan should illustrate proposed trails, trailheads and parking areas. d. Construct bike lanes in order to provide room on major streets for bicycle traffic.
47 MEDICAL VILLAGE PLAN -Key north-south and east-west streets should include bike lanes, which could link to off-road trail facilities. 4. Public Transit a. Perform an evaluation of the existing public transit routes to determine if adequate opportunities exist in connecting residents throughout the City to the Medical Village. -This evaluation should take into consideration the current stops along the route, proximity to major facilities and residential nodes, number of user trips, and frequency of stops along the route. b. Based on evaluation of current route schedule, if need exists for additional routes or stops along a route, implement these to increase public transit service to the Medical Village. -An increase in public transit service to the Medical Village will greatly benefit the employees at the major facilities. It will also reduce the amount of employees requiring parking, which will reduce trips per day into the Medical Village.
Site Improvements 1. Signage Signage will play an important role in the Medical Village, as well as to surrounding uses. Signage directs traffic, both vehicular and pedestrian, to desired destinations. It is important that signage function both efficiently and safely. Signage should not detract from the nearby buildings, architecture or pedestrian experience. Signage need not be obtrusive or unsightly in order to be effective and informative. Directional signage, such as that used in parking lots and private drives, to direct visitors to facilities and areas of interest, should be obvious but not obtrusive. Most importantly, as it relates to function and safety, signage in the Medical Village should be informative so that users can locate key facilities and services, including the Emergency Room, drop-off areas, handicap parking, and parking areas. Signage should also be placed in locations that strategically inform visitors of main entrances to primary buildings within the medical core. Staff recommends the following signage initiatives be implemented: a. Implement a sign inventory for the Medical Village, especially the medical core area. -It is important to determine which signage is effective and is ineffective at describing or illustrating intended messages. Messages should be clear, legible and in locations that adequately advise users of their desired destinations. All signs should be visible and not blocked by parked cars, landscaping or buildings. b. Develop a signage standard for style, materials, font, logo, height, and size.
48 MEDICAL VILLAGE PLAN 2. Site and Landscape Site improvement initiatives should involve the following: a. Improve the presence of the Medical Village. -Implement improvements along this corridor. These improvements should at least include turning lanes, signalization and signage to alert drivers that the medical village is near. -Develop an overall “campus style” arrangement of buildings, facilities, open space, parks, and other amenities. -Utilize an orderly layout between buildings with common open space areas, pedestrian facilities and shared general parking on the perimeter. -Incorporate pedestrian spaces throughout the medical village, especially in the medical core
b. Improve the entrance into the Medical Village -Inside the Medical Village boundaries, install signage and entry features to enhance “way finding” and experience. c. Create a “Sense of Place” within the Medical District. -Design and implement standards and guidelines that assist developers, property owners and residents with the development or redevelopment of their properties. Establish a body to enforce the use of these standards and guidelines. -All new buildings, structures or projects should have plentiful outdoor pedestrian space that is landscaped attractively and is interconnected to other spaces via pedestrian paths. -All new projects should implement professionally designed outdoor spaces that provide space for relaxation, shelter and enjoyment near the buildings or structures adjacent to it. This might include landscaped beds, water features, flower gardens, sculpture, public art, seating, children’s play equipment, and space for concessionaires or outdoor/mobile vendors. The City of Fayetteville is very fortunate to experience an excellent and mild climate that allows plant material to thrive in the spring and summer. Advantage should be taken of these conditions. A medical village is a prime place to showcase excellence in landscape architectural design. It is also a place that desperately needs “green” or “soft” spaces to provide shelter and visual relief from the “hardscape” that covers most parking lots, plazas, streets, and open space. Improved or enhanced landscape features will provide “softer,” quieter and more enjoyable spaces for use by visitors, residents, passersby and medical professionals.
49 MEDICAL VILLAGE PLAN Landscaped buffers can enhance relationships between two different uses or two conflicting uses. Vegetative screens add interest as well as provide a buffer between uses. These vegetative screens should be tall enough to create an adequate screen. The species chosen should be either evergreen or leafed out a good portion of the year. Landscape initiatives should involve the following: a. Conduct a detailed inventory of existing conditions for all major properties, buildings and structures. -This initiative will outline existing landscaping features most likely ready for replacement or removal, as well as which features should remain. A viability rate of 10 to 15 years is adequate for evaluating plant material longevity. b. For all major properties, develop an outline of proposed improvements, including type, phasing, cost, and implementation timeframe. -By actively planning landscape improvements as part of other capital improvements or major projects, it is more likely to be implemented. Planning over a period of five to ten years to implement a certain amount (either in space or finances) of landscape improvements will help to budget funding. Certain key or high impact areas can be planned for immediate improvement or enhancement, while other areas can be improved through replacement of dead or dying material and/or repair of “hardscape” features, as needed. c. Create an organized maintenance plan in order to care properly for plant material and “hardscapes.” -Outline a plan that includes maintenance standards for replanting, pruning, disease prevention, irrigation, and seasonal care. All plant material should be planted and pruned according to accepted industry standards. These activities should be perfomed by qualified personnel. For example, tree pruning should be done yearly or as needed by a certified arborist. -“Hardscape,” such as pavers, edging, seating, and stonework should be maintained in its best condition to remain safe, as well as to maintain its appearance. This maintenance work should be done by qualified contractors, according to industry standards. d. All new buildings, structures or projects should provide plenty of outdoor pedestrian space that is attractively landscaped and is interconnected to other spaces via pedestrian paths. -All new projects should include professionally designed outdoor spaces that provide space for relaxation, shelter and enjoyment. These might include landscaped beds, water features, flower gardens, public art, sculptures, seating, and children’s play equipment, and space for concessionaires or outdoor vendors (i.e. hot dog, ice cream, lemonade). e. Plant materials should include a mixture of native, naturalized, drought tolerant or low maintenance species.
50 MEDICAL VILLAGE PLAN -Representative species should require low to moderate maintenance and watering. Irrigation should be applied to plants more heavily during planting and early establishment periods or when weather requires. As plant material becomes more established irrigation can be decreased, weather permitting. Native and naturalized species of plant materials are encouraged to be used to complement turf grass. f. Create a “healing environment.” -Indoor and outdoor spaces should provide a relaxing, reflective, calming, or safe environment for visitors, patients and staff/employees. -Create a green oasis in the middle and to the edges of the medical area. These spaces may be pedestrian plazas, seating areas, outdoor eating, playgrounds, pedestrian connections, or water features.
Public Services and Facilities Staff recommends that the following public services and facility initiatives be implemented:
1. An inventory of all public lands should be initiated for the Medical Village to determine availability and quality of services and amenities. City parks and open space should be improved to create enjoyable spaces for community gatherings, recreation and use. These parks or open space areas should be linked throughout the medical district via a network of sidewalks and trails. Parking should also be provided.
2. Pavilions should be considered in the parks, in order to provide a place for community gatherings, farmer markets, flea markets, cook-outs, or informal uses. These would also provide shade and cover during inclement weather.
3. Opportunities to further develop the parks in the Medical Village with additional pedestrian amenities and facilities, such as shelters, play equipment, and walkways should be investigated.
Infrastructure and Utilities Staff recommends that the following infrastructure and utility initiatives be implemented: 1. Storm Drainage – As new areas are added, on-site detention will be required to prevent overloading of the detention pond or downstream piping. 2. Private utilities and infrastructure should be upgraded or replaced concurrent with major public upgrades or replacements if the two can be coordinated. This will reduce overall costs and inconvenience associated with projects. In addition, private utilities should be installed, replaced or upgraded according to all applicable regulations and requirements, in order to provide the most up to date services.
51 MEDICAL VILLAGE PLAN APPENDIX
MEDICAL VILLAGE PLAN APPENDIX
IMPLEMENTATION REGIONAL ACTIVITY CE NTER OVERLAY FUNDING TOOLS: OVERV IEW AND KEY RECOMMEN DATIONS DISTRICT FUNDING TOO LS INFRASTRUCTURE FUNDI N G T O O L S ADDITIONAL FUNDING T OOLS DEVELOPMENT AND REDE VELOPMENT INCENTIVES
PROJECT REFERENCE MAPS FLOODPLAIN EXISTING LAND USE CURRENT ZONING PROPOSED LAND USE
I-295 OUTER LOOP OUTER LOOP COMPLETIO N E S T I M A T E FAYETTEVILLE OUTER L OOP (CLIFFDALE ROAD AND S. REILLY R OAD) FAYETTEVILLE OUTER L OOP (S. REILLY ROAD AND RAEFORD ROAD)
REGIONAL ACTIVITY CENTER OVERLAY DISTRICT MEDICAL VILLAGE PLAN APPENDIX This chapter recommends a Regional Activity Center Overlay District to facilitate infill development and redevelopment in key areas along arterial road corridors. The resulting concentrated mixture of uses in a walkable development pattern is intended to achieve a critical mass of predominantly mixed-use development to:
Create centers of activity;
Enhance the viability of existing businesses;
Promote reinvestment and redevelopment;
Implement adopted plans;
Serve as a catalyst for future compatible development and redevelopment in the vicinity of the node;
Ensure reasonable access from flanking development to retail and neighborhood services; and
Increase the efficiency and utilization of transportation facilities and services. Regional Activity Center Overlay The primary objective is to offer a tool that can protect and strengthen existing (or new) activity areas that make a economically significant contribution to the community. Examples in other parts of the City include the Cross Creek Mall, the Crown Coliseum, hospitals and VA centers, or a concentration of restaurants. While existing standards can serve as a springboard, the range of uses and standards should be unique to the character of the center envisioned and facilitate concentration of uses defining the area. Incentives are possible in the overlay in the form of additional densities/intensities and relaxed standards established through the master plan for a proposed overlay. Key to the success of such areas would be the clarity of vision for the proposed activity center and a master framework focused on complementary uses and features that establish and reinforce the economic ‘theme’ or common thread for the various developments concentrated in the overlay. The Regional Activity Center Overlay District is created to promote the continued vitality of areas of the City that demonstrate a common, economically significant contribution to the community by ensuring continued compatibility between existing and future uses in terms of type, scale, and character and by promoting compatibility with other uses proximate to the designated Regional Activity Center. Background MEDICAL VILLAGE PLAN APPENDIX Anticipates opportunities to encourage infill and redevelopment of aging center; supports new centers.
Focuses more on uses with highly compatible and complimentary economic contribution. Purpose
Create centers of activity.
Enhance viability of existing businesses.
Promote reinvestment and redevelopment.
Implement adopted plans.
Serve as catalyst for future compatible development and redevelopment in the vicinity of the node.
Increase the efficiency and utilization of transportation facilities and services. Within the District, all development standards of Section 30-5 apply, unless specifically exempted herein or addressed by a different standard (for example, sidewalk width). Establishment of the overlay district may be initiated by the City or by owners of property in the specified area, in accordance with Sec. 30-2.C.1 Map Amendments. The standards would apply to development that involves the construction of new buildings or the expansion of an existing building equal to or greater than fifty percent of the gross floor area of the original structure. Allowable Uses The following uses shall be allowed as permitted or special uses (S) within the Medical Village. Some uses may be subject to additional requirements as noted below; such requirements may be modified by a positive recommendation from the TRC and approval by the City Manager for good cause, usually in the context of a larger development. Ground floor uses shall not include residential or industrial uses except in outparcels. Medical District Use Table
PERMITTED USES ([S] = Special use permit required) Residential Use Classification Live/work Multi-family Single-family attached Single-family detached MEDICAL VILLAGE PLAN APPENDIX Two-to four-family Upper story Dormitory Therapeutic home Fraternity or sorority house [S] Group home, large (7 or more residents) [S] Group home, small (up to 6 residents) [S] Rooming or boarding house[S] Public and Institutional Use Classification Community center Cultural facility Library Museum Senior center [S] Youth club facility [S] Adult day care center Child care center College or university Elementary school Middle school High school Vocational or trade school Government maintenance, storage, or distribution facility [S] Government office Post office Blood/tissue collection facility [S] Drug or alcohol treatment facility [S] Hospital Medical or dental clinic Medical or dental lab Medical treatment facility Outpatient facility Assisted living facility Auditorium Club or lodge Convention center Halfway house [S] Nursing home Religious institution Arboretum, botanical garden Cemetery, columbaria, mausoleum MEDICAL VILLAGE PLAN APPENDIX Community garden Public golf course Greenway, public square or plaza Park, public or private Fire or EMS facility Police substation Police station Helicopter landing facility [S] Passenger terminal, surface transportation Telecommunication antenna (on existing tower or building) Telecommunications tower, freestanding [S] Major utility [S] Minor Utility
Commercial Use Classification
Animal grooming Indoor kennel [S] Veterinary clinic [S] Conference or training center Dinner theater Restaurant, with indoor or outdoor seating Restaurant, with drive-through service [S] Specialty eating establishment Business services Financial services Professional services Radio and television broadcasting studio [S] Sales (including real estate) Parking lot Parking structure Commercial recreation, indoor Theater Arena, amphitheater, or stadium [S] Private golf course Athletic field/clubhouse Golf driving range [S] Swimming pool, private Swimming pool, nonprofit Tennis court Other commercial recreation, outdoor Bar, nightclub, or cocktail lounge MEDICAL VILLAGE PLAN APPENDIX Entertainment establishment Gasoline sales [S] Financial institution, without drive-through service Financial institution, with drive-through service Funeral home Laundromat Personal services establishment Repair establishment Convenience store, without gas sales Convenience store, with gas sales [S] Drug store or pharmacy, without drive-through service Drug store or pharmacy, with drive-through service Grocery store Liquor store Retail sales establishment, large Other retail sales establishments Mini-warehouse [S] Automobile repair and servicing (without painting/bodywork) [S] Automobile sales or rentals [S] Taxicab service Bed and breakfast inn Hotel or motel Tourist home
Industrial Use Classification
Laundry, dry cleaning, and carpet cleaning plants [S] Repair of scientific or professional instruments Research and development Parcel services Recycling drop-off center Wholesale uses (all uses) [S]
ACCESSORY USES
Accessory dwelling unit Amateur ham radio/tv antenna Canopies Child care, incidental Clothes line Greenhouse Garages MEDICAL VILLAGE PLAN APPENDIX Home occupation Ice house Outdoor display/sales Produce stand Rain water cistern Recycling drop-off stations Satellite dish Small-scale wind turbines Solar energy equipment Swimming pool/hot tub DIMENSIONAL REQUIREMENTS 10,000 square feet (mixed-uses); Lot Area 15,500 square feet (all other principal uses) 20 feet (mixed-use); Lot Width 45 feet (all other principal uses) 20 units/acre (mixed-use); Gross residential density, max. 12 units/acre (all other principal uses) 65% of lot (mixed uses); Max. Lot Coverage 55%of lot (all other principal uses) 75 feet (mixed use); Max. Height 50 feet (all other principal uses) Front Setback 10 feet, max 20 feet Corner Side Setback 10 feet, max 20 feet 5 feet; 10 feet where abutting a single- Side Setback family zoning district or use 5 feet; 10 feet where abutting a single- Rear Setback family zoning district or use *Separate setbacks for certain uses (churches,
etc.)*
District Standards Figures 30-3.H.13.d.1 through 4 illustrates some of the dimensional and form standards of this section. MEDICAL VILLAGE PLAN APPENDIX General Development Form and Orientation - RACO districts shall be designed with new access ways which create a traditional urban “block” pattern with no “block“ dimension less than 400 feet in length or exceeding 800 feet in length unless specifically authorized by the city manager or designee. On at least two sides of each “block”, a minimum of 75% of the linear frontage shall be occupied with structures and/or public open space
meeting the specific standards established below. The other sides of each “block” may be occupied with outparcels and/or parking; parking areas shall be screened from the street as described below. The intent of this section is to ensure that an urban development pattern is established and maintained on at least two sides of each “block”.
Specific Development Form and Orientation Standards. Except as specifically modified or waived in this section, the dimensional and design standards of Article 30-5 shall be met in the development of a RACO district. MEDICAL VILLAGE PLAN APPENDIX Principal RACO development (a minimum of two sides of each block):
1. Façade orientation and design. Facades shall be oriented to the adjoining street or access way and shall comply with the design standards of Article 30-5.I or Article 30-5.J. Any façade in view from a public space, street, or access way shall include at least three of the same design features as the front facade. Other facades shall contain at least two of the three façade features of the front façade. 2. Access way design. Access ways shall be designed to appear as an extension of the public street network and are encouraged to include parallel or angle parking with landscaped bulb-outs at the terminus of each parking area and at corners. Marked crosswalks shall be provided at each corner and may be provided at mid-block locations. Street trees shall be provided approximately every 35 feet in approved tree pits with Silva cells to accommodate tree roots. Low impact development may be part of the access way design as approved by the city manager. Utility placement is not to conflict with street trees. Sidewalks of at least 12 feet in width shall be provided on both sides of each street or access way where there are primary or secondary building frontages and a minimum of five feet elsewhere.
3. Setbacks.
Front. Structures shall be set back a minimum of 12 feet and a maximum of 20 feet from the edge of curb, except courtyards not to exceed 50% of the depth and width of each structure may be provided. Courtyards shall contain landscaping and street furniture designed to complement the pedestrian environment.
Side. None, except 35 feet from adjoining residentially zoned property, and except for additional required setbacks for taller structures as provided in subsection v below.
Rear. None, except 35 feet from adjoining residentially zoned property, and except for additional required setbacks for taller structures as provided in subsection v below. 4. Street yard, buffer yard and landscaping. Street trees shall be provided as required under “Street Design”, above. Site and building landscaping (Article 30-5.B.4 (b)) is waived for principal RACO development. Out parcels are not exempted from this requirement. Vehicular use landscaping (Article 30-5.B.4(c)) and property perimeter landscape buffers (Article 30-5.B.4 (d) shall be provided.
5. Height. Generally, a minimum of two stories and a maximum of four stories. The city manager may allow one-story development for big- box anchor structures, theaters and grocery stores. The city manager may allow mixed-use/residential and tourist accommodation structures up to eight stories provided such structures are located a minimum of 75 feet from adjoining residentially zoned property.
6. Density. A maximum of 45 dwelling units per acre unless a greater density is approved at the time the RACO district is mapped. 7. Parking and other vehicular use areas. Shall be provided in accordance with Article 30-5, except, in order to accommodate a flexible mix of uses, the developer may provide a minimum of one space per 300 square feet of gross floor area and shall not exceed a maximum of MEDICAL VILLAGE PLAN APPENDIX one space per 250 square feet of gross floor area. Parking lots shall be consolidated and circulation systematized to avoid smaller sized parking lots divided by arbitrary lot lines with landscape buffers. 8. Curb cuts. No more than one per each side of a “block” located a minimum of 200 feet from any corner or crosswalk except as specifically authorized by the city manager or his designee. 9. Open Space/Parkland. Open space / parkland shall be as approved in the master plan. See Article 30-5.C for guidance. Outparcel development: Development of outparcels shall comply with the applicable dimensional requirements of the underlying zoning district and the applicable development standards of Article 30-5. Transitional Standards: Transitional standards in Article 30-5.K shall not apply to the RACO district. Parking lots: All parking areas shall comply with the applicable development standards of Article 30-5. Parking Structures: Structured parking facilities shall be designed to encourage and complement pedestrian-scale interest and activity, and shall be designed so that motorized vehicles parked on all levels of the facility inside are screened from public view from the street and/or from adjacent residentially-zoned property. Decorative elements such as grillwork or louvers may be utilized to accomplish this objective.
Openings at the street level are limited to vehicular entrances, pedestrian access to the structure, and ventilation openings. All such openings shall be decorative and be an integral part of the overall building design.
Liner uses are encouraged.
Parking structures shall meet the requirements of the city manager for controlled gate locations.
Parking structures shall be subject to the setback and streetscape requirements of the RACO District where such structures are part of the principal RACO development. Identity Concepts MEDICAL VILLAGE PLAN APPENDIX The medical village envisioned and planned in the previous pages has the potential to occupy a unique position among similar districts in the region and state. Design should underscore the unique qualities of the medical village that will differentiate it from other medical developments—most notably its community-wide focus on health and wellness—and how that focus is expressed in the range of services offered, the convenient and complementary mix of medical, commercial and residential uses, the emphasis on walkability, the extensive greenway and trail system, the high quality of site development, and the uplifting experience envisioned for employees, patrons, visitors and residents. This study is not charged with designing a comprehensive identity program for the new medical village. Rather, it offers examples and recommendations of how to differentiate the medical village and to enhance its visibility through strong identity design for key site elements, such as gateways, roadways and signage. Design Elements Lighting The quality of light can greatly affect the character of the streetscape within the medical village and the perceived sense of whether the area is safe or unsafe. Lighting for pedestrians should be designed to avoid glare and give the pedestrians the ability to see their immediate area as well as their surroundings outside the lighted area. A well-lighted medical village with pedestrian lighting, attention to human scale and appropriate light levels will invite more pedestrian traffic, and help avoid potential nighttime conflicts. Pedestrian lights and streetlights should complement each other and the other site furnishings. Site Furnishings Site furnishings are a major contributor to a pedestrian-friendly environment within the medical village and include items such as benches, shade structures, trash receptacles, bike racks, signs, traffic signals, tree grates and bollards. A pedestrian friendly environment is greatly influenced by one’s perceived level of comfort. A comfortable place to sit and relax enhances the level of comfort for the pedestrian. Street furnishings can also provide a strong unifying element within the medical village, setting it apart with a distinct identity. The color of the site furnishings should match or compliment the other elements in the design vocabulary. MEDICAL VILLAGE PLAN APPENDIX Monuments It is critical for the success of the medical village to have a strong entry statement as it sets the standard and identity for the district as a visual icon. Gateways and landmarks properly located will serve as a visual announcement to let people know they are entering a special district. The Columbus Gateway Foundation completed the structure shown above encompassing 50 acres, 20 flags, 20 fountains, and life-sized statues atop the gateway pillars. The monument’s four statues represent the Armor school and a “Follow Me” Infantryman, all well-known symbols to members of the military and especially important to those attending the base’s Armor and Infantry training facilities. Paving Enhanced paving treatments are one of the key features in a design vocabulary to introduce color and texture into the streetscape environment. It is also an important component in traffic calming that leads to a safer pedestrian realm. Paving materials should be durable for the volume of traffic anticipated with the build-out of the medical village. Specialty pavement materials can be used to establish a pedestrian priority. A change in pavement texture or color signals drivers that the crosswalks are a pedestrian priority area. The use of curb extensions, or “bulb-outs,” at intersections and crosswalks will function as traffic calming devices, as well. Bulb-outs give the illusion of narrowing the lane of travel, alerting the driver to slow down. The rough texture of enhanced paving MEDICAL VILLAGE PLAN APPENDIX and contrasting color will be a second indicator for drivers to reduce their speed. Landscaping Street trees are key components to creating a successful streetscape and traffic calming. A tree-lined street not only helps define the vehicular corridor, it also defines the pedestrian spaces while introducing rhythmic groupings of color and texture. Street trees are also one of the vertical elements in a streetscape that provide comfort and shade for pedestrians in the heat of the summer and can also produce “visual friction.” Visual friction uses vertical and/or horizontal elements within the streetscape, such as street trees, enhanced pavement or bulb-outs, to make drivers more aware of their surroundings. Drivers perceive they are driving within a pedestrian zone, contributing to a greater awareness and slower speeds.
Medical Village Design Capitalizing on the planned improvements to the study area, and the abundance of available land, the plan for the Medical Village proposes the creation of a Medical Village roughly bounded by S. Reilly Road, Old Raeford Road, Raeford Road and existing and future nodes of activity at Gillis Hill Road and Rim Roads, Cliffdale Road, and Hoke Loop Road. This area’s development pattern should predominately consist of commercial, retail, medical (office), mixed residential, and other lifestyle destinations situated in a mixed-use environment that take advantage of its location near the VA Medical Center, existing activity centers, future FTCC West Campus and the Outer Loop. Sites in the Medical Village may be developed for multiple land uses as defined below. It is encouraged that developments be mixed-use in nature, incorporating any of these permitted land uses in either a horizontal or vertical manner.
1. Use Limitations Sites in the Medical Village may be used for the following land uses: medical, office, townhouses, apartments, lofts, live-work units, retail, service and restaurant.
2. Building Placement It is intended that buildings within the Medical Village Corridor create a strong "street wall" in which the urban form and block closure along the street is the definitive characteristic of its environment. Consistency must be maintained along the street edge and around corners. Minimum and maximum setbacks are necessary to create this effect, while allowing flexibility for design variety or certain use types.
3. Site Controls There are a series of site controls affecting how development and streetscape interact. These controls are critical in achieving the desired urban environment.
3.1 Lot Coverage – As the Medical Village Corridor has been envisioned to be more dense in built form than conventional suburban areas, the minimum lot coverage shall be forty (40%) percent to ensure a village-like atmosphere. The maximum lot coverage shall be eighty (80%) MEDICAL VILLAGE PLAN APPENDIX percent to provide for circulation, setbacks and small open spaces. These lot coverage amounts shall be inclusive of parking facilities, except for parking structures.
3.2 Block Requirements – In order to present the village-like environment defined by development within a street grid, the Medical Village Corridor shall be based on development built on blocks. The maximum block length in one direction shall not be more than four hundred (400) feet. The maximum block length in the other direction shall be more than six hundred (600) feet. All streets and streetscapes defining a particular development block shall be completed to correspond with the completion of said development.
3.3 Site Massing and Floor Area Ratio – By prescribing specific site massing strategies in key areas, a consistent and desired urban form is created. For development in the Medical Village, taller development shall occur along Raeford Road and the S. Reilly Road Frontage to reinforce the importance of the Medical Village. The maximum Floor Area Ratio for all blocks adjacent to the Medical corridor shall be 2.5. The maximum Floor Area Ratio for all remaining blocks shall be 2.0. On blocks adjacent to the Medical Village, the tallest buildings (excluding parking garages) shall be placed closest to the Medical Village.
4. BUILDING MASSING AND HEIGHT Restrictions on minimum building height are intended to assure a minimum level of urbanity and building intensity within the Medical Village area.
4.1 Height Limits – In order to ensure a minimum level of vertical consistency and street-wall volume within the Medical Village, all buildings shall have a minimum height of thirty-five (35) feet and a maximum height of one hundred and twenty (120) feet.
4.2 Building Corner Treatments – Buildings shall reinforce a strong and pronounced corner condition at street intersections. All buildings shall be designed to accommodate required visibility triangles without compromising the corner design.
4.3 Maximum Building Length – Buildings shall not be longer than four hundred (400) feet along any one street frontage without an unconnected physical separation of at least thirty (30) feet between buildings.
4.4 Building Articulation – Building facades fronting public and private streets and driveways shall have massing changes and architectural articulation to provide visual interest and texture. Buildings within the Medical Village are intended to avoid oversimplified one-dimensional facades that lack a human scale. Design articulation should not apply evenly across the building facade, but should be grouped for greater visual impact employing changes in volume and plane. Architectural elements including projecting volumes, windows, balconies, loggia, canopies, pediments, and moldings that break up the mass of the building are encouraged. All buildings should be designed to emphasize a “base, mid-section, and top.” The base may be defined through the use of unified storefront heights, running awnings, and the building(s) base construction. The mid-section, for buildings over one-story, may be defined through the use of punched windows, balconies, and awnings. The building’s top may be defined through the use of a strong cornice treatment, articulated parapets, and overhanging eaves.
MEDICAL VILLAGE PLAN APPENDIX Roof Line Articulation – Variations in roof lines shall be used to add interest and reduce the scale of large buildings in the Medical Village. In order to provide such variations, forty (40%) percent of the roofline for each building (measured as forty (40%) percent of the linear dimension along a particular building block) shall utilize at least two of the features below: 1. Parapets concealing flat roofs and rooftop equipment from public view. The average height shall not exceed fifteen (15%) percent of the height of the supporting wall. Parapets shall feature three dimensional cornice treatment. 2. Overhanging eaves, extending no less than three (3) feet past the supporting walls. 3. Supporting roofs that do not exceed the average height of the supporting walls with an average slope no greater than 3:1 slope. 4. Exposed end gable conditions. 5. Roof dormers designed to interrupt the eave line.
FUNDING TOOLS: OVERVIEW AND KEY RECOMMENDATIONS The following table shows an extensive list of the funding tools that can be used to implement the plan. Each of these tools is then explained in detail in the following pages.
APPLICABLE FOR TOOL PUBLIC INFRASTRUCTURE AND OPERATIONS PRIVATE REAL ESTATE DEVELOPMENT
DISTRICT TOOLS
Tax Increment Financing
Business Improvement District
INFRASTRUCTURE FUNDING TOOLS
Capital Improvement Program/Public Works Funds
Municipal Debt/Bonds: General Obligation or Revenue MEDICAL VILLAGE PLAN APPENDIX
Special Purpose Tax
ADDITIONAL FUNDING TOOLS
Regional, State and Federal Grants
Regional Transportation Allocations
Legislative Appropriations
DEVELOPMENT AND REDEVELOPMENT INCENTIVES
Expedited Entitlement / Permitting Soft Costs / Professional Fees
Land Acquisition, Assembly, or Write Down
Public Infrastructure Improvements / Place Making
Fee or Tax Deferral or Abatement
Storefront Improvement Grants/Loans
Brownfields Assessment and Cleanup Funds
Capital Improvement Plan (CIP): The City’s CIP (and potentially the CIPs developed by the County and other agencies) is the first and best place for supporters of the medical village to focus their efforts to fund a variety of needed infrastructure improvements, particularly transportation improvements. CIPs usually list, prioritize, and specify funding strategies for the City’s roadway and other infrastructure projects. Medical village leadership should make sure that the needed improvements receive very strong consideration and ultimately inclusion in the CIP. Like other tools on this list, a high priority from the CIP can help a given project to attract matching funds from other sources. Tax Increment Financing (TIF): TIF is usually the most powerful public financing tool available that can help to spur development and fund public infrastructure projects within a defined district such as the medical village. TIF has been used throughout the country for large scale, mixed-use, urban development projects. TIF essentially captures the net new tax revenues that are generated within a defined district as a result of development and directs them towards projects within the district that will accelerate private sector development and investment. TIF is therefore geared to direct public investments where they have the greatest potential to incentivize private investment and to create a virtuous cycle of investment. Additional TIF information is covered under the Funding Tool Description section below. MEDICAL VILLAGE PLAN APPENDIX District Organization and Funding Tools: Business Improvement District (BID): As described above, it is critical that the medical village have the funding and staff capacity to move this vision forward. BIDs are critical tools for the urban districts, such as a medical village, and are used extensively nationwide to fund ongoing operations: marketing, management, safety and security, event planning, and other programs. As the names suggest, these district based tools direct locally collected dollars to activities within a defined district. They are largely funded by the private sector, but this funding is often complemented or augmented by the public sector. Creative use of incentives and public private partnerships: Plan implementation is never smooth sailing. There are always headwinds, whether in the form of funding challenges, incompatible regulation, external competition or other currents. Therefore, professionals— whether the City, BID or outside consultants— who understand how to build public-private partnerships and work with the private sector and major institutions are essential. The approaches and tools needed to work with private partners vary over time. Sometimes, the key to a major deal may simply be ensuring that the right permit is obtained on time. At other times, a major funding gap may require creative public sector assistance in the form of specific infrastructure improvements, low interest loans or fee deferrals. In order to sustain strong partnerships, experienced staff and elected leaders need to understand the tools at their disposal and keep the focus on the district’s long-term benefits to the community: jobs, investment, economic development and quality of life. Grants and loans from regional, state, and federal government agencies: Various regional, state, and federal government agencies offer a range of grants and loans for deserving projects. For the medical village, grants could come from agencies focused on economic development, public health, transportation, housing, or other issue areas. Medical village leadership and staff should be proactive about pursuing public grants and loans. Creative development of private and philanthropic funding: Private and philanthropic funding have the potential to lift the profile and effectiveness of the medical village, and should be pursued by medical village leadership once the bedrock funding provided by TIF, BID or other sources listed above are established. Private and philanthropic funding can help the district to increase the quality of infrastructure investments, and assist with marketing and event planning. While some funding in this category can be motivated by altruism, it is also often generated by pragmatism. Corporate partners will be interested in contributing through sponsorships, advertising, and promotions if they are able to connect their brand to an iconic place that enhances the health and wellbeing of area residents.
District Funding Tools Tax Increment Financing Tax increment financing (TIF) is a mechanism whereby public projects are financed by debt borrowed against the future growth of property taxes in a district. The assessed value of all properties within the district is set at the time the district is first established (the frozen base). As public and private projects enhance property values within the district, the increase in property taxes over the frozen base (the increment) is set aside. Debt is issued, up to a set maximum amount, to carry out the urban renewal plan and is repaid through the incremental taxes generated within the district. These are usually in effect for 15 to 20 years. When a district is retired, the frozen base is removed and all property taxes in the district return to normal distribution. Business Improvement District (BID) A Business Improvement District (BID) is an independent special assessment district formed to improve the business climate within a designated commercial or industrial area. Independent special districts have characteristics of assessment districts but also have autonomy from local control and authority to issue bonds, enter into contracts for service, and impose user charges. Property owners in the MEDICAL VILLAGE PLAN APPENDIX district pay the assessment to support services and/or capital facilities intended to augment—not replace—services and facilities already provided by the local government. Typically, BIDs are formed by an ordinance or resolution of the local government, but only following explicit statements of support from the affected area. Decisions affecting BID revenues are usually made by a board consisting of private property and business owners. Most BID revenues are used to fund operating expenses in commercial business areas, for services such as sanitation and maintenance, police or marketing and promotion activities. A BID may also pay for capital expenditures supporting the same goals, such as the purchase of a new sanitation vehicle.
Infrastructure Funding Tools Capital Improvement Plan Capital Improvement Plans (CIP) are one of the most reliable sources of local funds. Generally, a CIP identifies capital projects (and some major equipment purchases) during a five-year period, providing a planning schedule and identifying opportunities for financing the projects in the plan. CIPs coordinate community planning, financial capacity and physical development. A CIP typically includes: • A list of capital improvements (projects or major equipment); • Projects ranked by priority; • Project cost estimates and funding sources to demonstrate a balanced funding and expenditure program; and • A schedule for construction or completion of the projects. CIPs are typically updated annually. Each update is created with input from the public, advice from the planning commission and direction from the city council. The adopted CIP then becomes the basis for a city’s annual capital budget. Municipal Debt/Bonds – General Obligation and Revenue A bond is a financing tool that transforms a long-term stream of public-sector income (for example, property taxes) into a near-term source of capital for major capital improvements. In its basic structure, it is not unlike a mortgage: a large asset in the short-term is exchanged for a long-term debt obligation. Bonds, therefore, are not truly sources of funding, but financing tools; there must also be a funding source (property or sales taxes, general fund moneys, utility fees, etc.) that secure the bond. While bonds are not funding sources, they are an important resource in the public funding and implementation toolkit. Capital improvement plans are often financed through bond issuances. One distinction within the category of bonds is between general obligation and revenue bonds. General obligation bonds are often serviced by already existing funding sources and/or the general fund and therefore, must compete with all of a jurisdiction’s other funding priorities. Jurisdictions are usually limited in the amount of general obligation bonds they can issue. Revenue bonds are tied to a specific, dedicated and often new source of revenue. For example, a bond that will be used to construct a new reservoir might be serviced by a surcharge on water rate payers’ bills.
MEDICAL VILLAGE PLAN APPENDIX Additional Funding Tools Regional, State and Federal Grants and Loans Three different federal grant/loan sources, Community Development Block Grants, New Market Tax Credits and Sustainable Communities Initiative Grants and Loans are summarized in the following paragraphs. This is, of course, a representative rather than comprehensive list. Many other regional, state and federal grant and loan programs exist and should be sought on an ongoing basis. Agencies whose mission is to address economic development, healthcare, housing, and “smart growth” communities may all be able to help to implement the master plan. Legislative Appropriations State and federal appropriations (also known as earmarks) are funds set aside for a specific purpose during the legislative process and often included within a larger spending bill. Appropriations can be used to finance a variety of special projects, including planning or construction projects and transportation projects. Like many other sources of state and federal money, decision-makers will want to see significant local commitment to a project before pledging state money.
Development and Redevelopment Incentives Economic Development Staff Assistance / Public- Private Partnerships The most basic and often most important way to incentivize desirable development is by assigning economic development (or other) public staff to help assist with specific sites, projects, initiatives or developers that have been selected based on specific qualifications. One important way that public agency staff can assist is by helping developers to understand and navigate the local, state or federal approval/ entitlement processes. Conditional use permits, zone changes, building permits, and other land use approvals require time and money, and thus public assistance for key projects is valuable. Expedited Entitlement/Permitting In real estate development, time is money. Time spent understanding regulations, completing due diligence, and acquiring permits means expenses accrued through professional fees and debt service on any outstanding loans; this is also time during which revenues from development cannot be realized. Therefore, jurisdictions should make desirable development easy. Development that meets the goals of the community and its design and building standards should be expedited or fast-tracked. Such fast-tracked development processes create a very strong incentive for the development community to build the desired type of development. Soft Costs/Professional Fees Some jurisdictions assist specific development sites or initiatives by hiring architects, real estate analysts, engineers or other professionals to conduct due diligence on specific sites. This makes otherwise marginal projects less risky to developers by reducing upfront fees. This should be undertaken only in the case of specific development sites or initiatives that have been identified as priorities by the community. Public Infrastructure Improvements/Place Making Real estate development responds to transportation infrastructure, the qualities of the adjacent public realm and other inputs. By adjusting the types of infrastructure and place making elements it provides, the City can encourage certain types of development. For example, a great neighborhood park will encourage adjacent residential development; a high-quality urban plaza will help to encourage adjacent employment, lodging, retail or other urban development, though other conditions must also be in place to realize this development. Land Acquisition, Assembly or Write Down Public agencies have the ability to acquire, assemble and “write down” land and then transfer it to developers selected through transparent public processes, which enables public sector agencies to incentivize the redevelopment of specific sites. MEDICAL VILLAGE PLAN APPENDIX Land assemblage simply refers to the aggregation of multiple properties into a single ownership. A land write down is the sale of land at less than its purchase value (but not necessarily its market value) often to reflect high development requirements, site constraints or challenging site conditions such as contamination. For example, the City of San Diego, California sold off a multi-block parcel to a selected developer at less than its purchase price as part a deal that required the developer to build a major new urban shopping center. The resulting Horton Plaza is now at the heart of San Diego’s revitalized downtown. Fee or Tax Deferral or Abatement Local governments can use fee or tax deferral or abatement programs to facilitate a private investment that benefits the public and is consistent with the community vision. Abatement means that a property owner is not responsible for paying a particular tax or fee for a given amount of time (one, five or 10 years, for example). Deferral allows a developer to postpone the payment of a tax or fee, also for a predetermined length of time. Deferral and abatement programs provide developers with an incentive to build projects, including residential developments with an affordable housing component, transit-oriented development and other types of projects that might not otherwise be financially feasible. Building or Façade Improvement Loans or Grants Many cities and redevelopment agencies operate programs in which they offer low interest loans and/ or grants to assist property owners in key districts with improvements to building facades, other cosmetic improvements or the analysis of major capital improvements. This tool enables cities and property owners to work together to create urban districts that are consistently attractive; for example, it is used extensively in historic downtowns where dilapidated buildings can be returned to their former glory through modest improvements. In the medical district, low interest grants or loans could be used to incentive specific improvements for properties at important district entryways or other locations. Brownfields Assessment and Cleanup Funds In some urban locations, the real or perceived contamination caused by previous site users can prevent development of sites for decades. This can take place when redevelopment is attempted at the site of former gas stations, dry cleaners or other types of commercial or industrial operations. In many cases a perception that a “brownfield” site is contaminated may be just as great a deterrent as actual contamination. In order to overcome these barriers and make efficient use of land and infill sites, there are numerous federal, state and private grant and loan sources to help evaluate and address brownfield conditions. The EPA’s Brownfields program is a good starting point for funding investigation. Private Funding/Financing While public investment are critical to most urban redevelopment projects, it is important to recognize that private debt and equity sources are still likely to provide the majority of funds for most real estate development. In almost all cases, public funding sources should be used to close a funding gap or achieve additional outcomes that would not otherwise be possible, not fund an MEDICAL VILLAGE PLAN APPENDIX entire project alone. If the private sector is entirely unwilling to invest in a development project, that is a strong indication of a fundamental problem with its economics or another key component. Debt and equity sources vary from project to project but include banks, developer equity, wealthy individuals, investment funds, pension funds and Real Estate Investment Trusts (REITs). Debt and equity investors usually work directly with developers— the recipient of funds—rather than with public agencies. Over the past decade, numerous funds and investment groups have been established specifically with the goal of investing in urban or smart-growth communities. Naturally, these are the groups most predisposed to invest in urban districts such as medical villages. MEDICAL VILLAGE PLAN APPENDIX
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MEDICAL VILLAGE PLAN APPENDIX Project Overview and Purpose Work is underway to complete the western portion of the Fayetteville Outer Loop (I-295) from U.S. 401 Business/Ramsey Street – north of Fayetteville – to I-95 just across the Cumberland-Robeson county line. The 39-mile outer loop will provide unprecedented interstate connectivity for the region and provide Fort Bragg direct connections to I-95. The Fayetteville Outer Loop is critical for the region in that it will help support the military, promote continued economic growth and strengthen North Carolina's ability to attract and retain business and industry. Other benefits include:
. Reducing the volume of traffic on portions of the local street network
. Connecting major routes in the south, west and north portions of Fayetteville
. Providing an additional crossing of the Cape Fear River
Project Highlights The project, as shown in the chart below, is divided into five sections and includes segments of roadway that are complete, under construction or in the planning stages.
Location Section STIP Number Status
U.S. 401 Business/Ramsey Street to All American Freeway Section DA U-2519DA Complete
All American Freeway to Cliffdale Road Section CB U-2519CB Under construction
Cliffdale Road to U.S. 401/Raeford Road Section CA U-2519CA Design-build contract underway
U-2519BA U.S. 401/Raeford Road to Camden Road Section B In development U-2519BB
U-2519AA Camden Road to I-95 Section A In development U-2519AB
MEDICAL VILLAGE PLAN APPENDIX All American Freeway to Cliffdale Road
Referred to as Section CB, I-295 from All American Freeway to Cliffdale Road is under construction and expected to open to traffic in October 2018. Cliffdale Road to U.S. 401/Raeford Road
NCDOT awarded an $85.2 million design-build contract in June 2016 to the project team of Barnhill Contracting Co., Sanford Construction and HDR Engineering for work on Section CA, a 3.1-mile stretch from Cliffdale Road to U.S. 401/Raeford Road.
Design-build allows all aspects of a project from design through construction to be completed under a single contract.
Work also includes replacing the Lake Rim Runoff bridge on Old Raeford Road over Bones Creek.
Construction is underway on the Lake Rim Runoff bridge, and construction for the Outer Loop section is scheduled to begin as early as July 2017. It is expected to be completed by May 2021. MEDICAL VILLAGE PLAN APPENDIX
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