The Riverhead Zoning Board of Appeals held a lengthy and contentious public hearing Thursday night on Stony Brook Medicine’s proposal to locate an ambulance storage and service facility in the rear portion of the former Big Lots space at Staples Plaza. The hearing ended without a decision by the board, which kept the record open for written comments until April 23.
The owner of the shopping center is seeking a zoning code interpretation on whether the proposed use is permitted in the Shopping Center zoning district, or, in the alternative, a variance from the code to allow the proposed use.
The ZBA originally held the hearing on Jan. 8 and reserved its decision to a later date. Before it made a decision, however, Peconic Bay Medical Center, which did not attend the January hearing, asked the ZBA to reopen the hearing. The request was granted.
The application seeks permission to use about 14,236 square feet of the former Big Lots store for storage space for up to eight ambulances and one mobile stroke unit, along with office, training, break room and supply space.
The proposal drew opposition Thursday from Northwell Health/Peconic Bay Medical Center, whose Riverhead hospital is located close to the shopping center and is preparing to open a thrombectomy-capable stroke center. PBMC and Stony Brook are competitors in the regional health care market.
The unusual decision to reopen the hearing followed a Feb. 4 letter from PBMC president Amy Loeb challenging claims made during the January hearing about stroke treatment and patient transport.
A large portion of the hearing was devoted to testimony from Dr. David Fiorella, a Stony Brook neurointerventional surgeon, who described the mobile stroke unit as a specialized ambulance equipped with a CT scanner, tele-neurology capability and medications that allow clinicians to determine in the field whether a patient is suffering a hemorrhagic or ischemic stroke and begin treatment immediately.
Fiorella said the unit improves outcomes by allowing diagnosis and treatment before a patient reaches a hospital and by routing patients to the hospital that can provide the needed care most quickly.
He said the unit is intended to complement, not replace, local hospitals.
“This is a rare situation where we’re all rowing oars in the same direction trying to get better outcomes for patients with this new and amazing technology that we have,” Fiorella said.
Speaking on behalf of PBMC, Loeb said the hospital supports advanced stroke care but questioned the need to base a mobile stroke unit a short distance from a hospital that is about to open a thrombectomy-capable stroke center.
She called the mobile stroke unit “a really, really cool unit,” but said it is better suited to rural areas or health care deserts than to a location directly across from a hospital investing in comparable stroke capabilities.
“To put a mobile stroke unit a couple hundred yards from a hospital that will be thrombectomy-capable in a matter of weeks, frankly, seems wasteful,” Loeb said.
Dr. Jeffrey Katz, a Northwell physician who testified that he previously ran the stroke program at South Shore University Hospital, said the mobile stroke unit can diagnose stroke and administer IV thrombolytic medication but cannot perform thrombectomy, the procedure needed for patients with certain large-vessel occlusions.
He said there was no good medical reason, in his view, to place the unit a so close to a hospital that can provide definitive stroke intervention.
Former PBMC president Andrew Mitchell told the board the issue before it was not whether mobile stroke units are beneficial, but whether an ambulance garage belongs in a shopping center.
“I thought this was the Zoning Board of Appeals, not the Medical Board of Appeals,” Mitchell said.
Mitchell also argued that granting the application would set a precedent for similar uses along Route 58 and elsewhere in town.
That was a concern for more than 100 people who signed a petition against the proposal because approving it would open the door to similar proposals in other shopping centers.
Attorneys for Stony Brook Medicine and Northwell Health debated whether the proposed use should be considered an allowed use under the zoning and, if not, whether the applicant can demonstrate that it meets the legal requirements for a use variance.
The facility would function primarily as an overnight storage, restocking and staff-support location, according to Stony Brook representatives, not as a traditional emergency dispatch center, according to Eric Nigelberg, assistant vice president of operations for Stony Brook Medicine. He testified that the site would house eight ambulances and one mobile stroke unit, but only five ambulances would regularly come and go from the facility, with those vehicles assigned to posts in Greenport, Southampton and East Hampton.
He said those ambulances would not be responding to emergency calls from Staples Plaza. Instead, crews would report to the facility, pick up vehicles and drive them to assigned locations, then return them for storage and restocking at the end of their shifts.
The mobile stroke unit, he said, would be stationed there from 8 a.m. to 8 p.m. daily and would average about three calls per day.
Nigelberg testified that no fueling, washing or vehicle repair would occur on site.
Traffic engineer Ian Cody testified that the proposed use would have an insignificant impact on traffic and parking compared with a retail use occupying the same amount of space.
He said the operation would generate about 44 daily trips and require about 14 employee parking spaces, substantially less than a conventional retail use of similar size.
Deputy Town Attorney Annmarie Prudenti, who serves as counsel to the ZBA, pressed Stony Brook’s attorney, Philip Butler, on whether the proposed use is consistent with the town’s comprehensive plan. Prudenti also raised questions about outstanding code and site plan compliance issues at the shopping center, including missing stop signs and other alleged violations referenced in a pending Supreme Court matter involving the property.
Butler responded that those issues were not relevant to the legal questions before the board, though he said he would relay the concerns to his client.
Several members of the public spoke in opposition to the application, saying they were not opposed to ambulance or stroke-care services but questioned the suitability of Staples Plaza for the use.
At the end of the hearing, Butler objected to the board’s decision to close the hearing, saying the applicant had been accused of making material misstatements and should be given an opportunity to respond before the record closed.
Prudenti said the record would remain open for written comment until April 23, after which the board would consider the matter for reserved decision on May 14.
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