Archtitect's rendering of addition to Peconic Bay Medical Center that would house cardiac care facility and future emergency department expansion.

The hospitals in Riverhead and Southampton are competing to win state approval of crucial cardiac care facilities the East End desperately needs — and only one of them will get it.

“We are in a race to get a cardiac cath lab in the Town of Riverhead,” Supervisor Sean Walter said last week. The state health department will approve only one cardiac cath lab on the East End, he said, but both PBMC and Southampton Hospital have applications pending for cardiac catheterization facilities.

Riverhead Town is looking to do everything possible to enhance PBMC’s position in the competitive review now underway, Walter said — including the adoption of new zoning code provisions that would allow the hospital to construct the tallest building in Riverhead to accommodate the new cardiac care facilities. The town board is also reviewing code changes that will allow it to expedite approval of the new construction.

The state will only approve one cardiac cath facility because the region does not produce enough demand for more than one facility. Though the geography of the twin forks can make quick travel from one fork to the other difficult, the demand for services in a given area is the controlling factor in the state’s decision. Providers need to perform enough procedures to maintain quality and safety, experts say.

Department staff will make a recommendation to the state Public Health and Health Planning Council, which makes the final decision. The review is ongoing, a spokesperson for the state health department said today.

State Senator Ken LaValle said in an interview he believes the state should not rule out having two cardiac cath facilities on the East End.

“Things change. The population is growing,” LaValle said.

“I remember MRIs and how the health department doled them out like they were golden nuggets,” LaValle said, “until everyone said the hospital has the responsibility to have that kind of equipment and now the MRI is part of every hospital.” That’s analogous to lifesaving interventional cardiology, where doctors open clogged arteries and insert stents to keep them open.

“Not having a cath lab puts the patient who needs that procedure in harm’s way,” LaValle said.

“The health department, for whatever reason, has been very tough on these things but at some point in time — soon — the logjam’s going to break,” LaValle said.

The facility in Riverhead, with an estimated price tag of more than $42.6 million, would be a three-story addition near the existing emergency department, complete with a rooftop helipad. The new construction would accommodate a future emergency department expansion as well as a catheterization/electrophysiology suite with two catheterization labs and a nine-bay prep and recovery area.

Top cardiologists and administrators in the Northwell Health System, which brought Peconic Bay Medical Center into its health system in January, said the need for an interventional cardiac cath lab on the East End is urgent.

“When you come off the street having a heart attack, what you need is to get to a cath lab as quickly as possible,” Northwell’s chief of cardiovascular and thoracic surgery Dr. Alan Hartman said in an April 2015 interview. Patients who need this life-saving procedure should have it done within 120 minutes of first contact with EMS, according to the American Heart Association.

PBMC filed its application for approval of the new facility in December 2015. Southampton Hospital filed an application for a cardiac cath/electrophysiology suite in March of this year.

Southampton is in the final stages of a partnership deal, announced in October 2012, that will formally affiliate it with Stony Brook University Hospital, a deal that spokespersons for both hospitals said last week they expected to be completed soon after the new year. Eastern Long Island Hospital in Greenport has also decided to affiliate with Stony Brook. ELIH announced its intention to do so in July 2015.

Riverhead Town officials believe Riverhead is geographically best situated for a cardiac care center to serve the entire East End region and are committed to adopting zoning to help the PBMC’s prospects for approval, the town supervisor said.

Proposed new zoning for the hospital site would allow a maximum building height of 70 feet — double the height allowed by the hospital site’s current zoning and 10 feet taller than the five-story buildings allowed in the DC-1 zoning use district downtown. All other zoning districts in the town allow a maximum height of 35 feet.

Town officials said the 70-foot height limit will not allow for buildings taller than five stories, but would allow for greater per-story interior height, which is needed for the construction of certain types of surgical suites.

The town board will also amend the town zoning map to apply the new hospital zoning district to the PBMC site. The site is currently within the shopping center zoning district, but the current zoning code allows hospitals to be built in all zoning districts in the town.

Another amendment being considered would give the town board authority over site plan review and approval for applications in the hospital zoning district.

Hospitals are the only as-of-right permitted use in the proposed hospital zoning district, which would be applied, at least right now, only on the PBMC’s current site. Accessory uses include hospital staff and medical offices, diagnostic clinics and labs and parking garages (which can be no taller than 50 feet high).

The town board held a public hearing on the proposed zoning code changes on Oct. 18. The record was left open for written comment until Oct. 28.

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