Buffalo is on the verge of getting an extreme makeover in health care.
The $40 million gift to the University at Buffalo announced Wednesday represents a turning point in a plan to relocate the medical school to the Buffalo Niagara Medical Campus.
The move is part of a coordinated effort with two other projects eyed for a block at Main and High streets downtown: construction of a new Women & Children's Hospital and a large medical office building by Ciminelli Real Estate Corp. that will include the pediatric hospital's outpatient surgery program.
The cost: $375 million for the first phase of the medical school, $80 million for the medical office building and a yet-to-be-determined price for a new hospital for women and children. The impact on the city will be profound, with a surge of students, medical staff and patients numbering in the thousands steered to the medical campus.
The construction schedule is as ambitious as the plan -- build most of it in the next five years.
"This is for real. We're at a remarkable moment for the medical school to take advantage of, and it can serve as an economic engine for the city," said Dr. Michael E. Cain, dean of the School of Medicine and Biomedical Sciences.
The newest projects started separately but are moving forward with an eye toward coordinating the effort, Cain said.
They coincide with construction under way on a center for vascular care and medical research, a 10-story, $291 million facility that will abut Buffalo General Hospital at Ellicott and Goodrich streets.
That center represents a collaboration between Kaleida Health and UB, with half for Kaleida's heart, stroke and vascular care, and the other half for UB medical research.
Completion of the vascular center and a new $64 million nursing home nearby will allow Kaleida to close Millard Fillmore Hospital and shift its services to the medical campus next year.
Women & Children's Hospital, after lengthy study by its physicians, announced last year it intended to locate an outpatient surgery center on the medical campus.
The surgery center, which will fill about 25 percent of the Ciminelli building, was seen as the first step toward the eventual move of the rest of the Kaleida Health pediatric hospital from the Elmwood Village.
At the time, Kaleida Health considered relocation of the entire hospital too costly to do anytime soon. But officials concluded that splitting the pediatric facility between two locations for many years wasn't a good idea.
"The philosophy of consolidating on the medical campus is unchanged, but we began to discuss a strategy for having a more aggressive timeline," said Dr. Teresa Quattrin, the hospital's pediatrician in chief.
So, planning has begun to move the rest of Women & Children's -- probably into two buildings next to the Ciminelli building on the block bounded by Main, High, Ellicott and Goodrich streets -- by 2017 at the latest.
>Looking at trends
Kaleida Health on Friday submitted a subdivision application to the city Planning Board to begin required zoning and state environmental reviews, a process that is expected to take six to nine months.
Kaleida Health also has issued a request for proposals to find a financial or development partner. Kaleida currently is unable to finance such a large project itself, and working with a partner, although potentially more expensive, is expected to shorten the completion time.
Sg2, a Skokie, Ill., health care consultant, was hired to look at trends in the pediatric health care market to help size the new hospital and identify trends in medical care. For instance, fewer inpatient beds are needed because of advances in medicine and the region's smaller population of childbearing women.
Work also includes an examination of what programs are essential to place in an inpatient tower, which is the most expensive space to build and operate because of the high-tech requirements, and what programs make more sense in a second less-expensive building. The new structures also may rely on certain existing services at Buffalo General, such as a power plant and food service.
Officials said they will have a firmer idea in several months of how big the hospital should be and how services should be organized, leading to the design, regulatory approval and financial arrangement of the facilities. A public fundraising campaign is planned that could include naming rights.
"It's a complicated project, like a jigsaw puzzle," said James Kaskie, chief executive of Kaleida Health. "But we have an opportunity to change the health care delivery system in Buffalo, to give it a community asset that it never had but needs."
Kaleida Health in 2002 committed to keeping Women & Children's a free-standing facility. That decision followed opposition to a plan to relocate the hospital into Buffalo General.
Kaleida Health promised to build a new ambulatory care center and to expand parking. But residents opposed a physician proposal to build the ambulatory center on Hodge Street across from the hospital.
>Reviving an old idea
Neighborhood reaction played a part in influencing the doctors to change direction, but it wasn't the only reason. The medical campus, once only a vision of a centralized core of medical and research facilities, is taking shape. Doctors at Women & Children's increasingly saw it as a place where they wanted to work, especially with the planned move of the UB medical school.
The projects are fueled by an old idea that never progressed until now: integrate the medical school and major teaching hospitals to improve care, research, doctor-training and recruitment of specialists. The argument is that this is essential in a shrinking community that should pool its resources to compete nationally for medical and scientific talent.
In addition, while some parts of Women & Children's are state of the art, other parts are outdated and inefficient. An example: outpatient surgery patients get evaluated on the ninth floor, sent to the second floor for the procedure, recover back on the ninth floor and then go to the first floor to be discharged.
"We have a place that doesn't satisfy patients or physicians," said Dr. Michael Caty, surgeon in chief and chairman of the physician committee that has studied the issue.
Quattrin and Caty said a new hospital, if designed well and integrated with the medical school, Buffalo General, Roswell Park Cancer Institute and other researchers on the medical campus, will make itself more of a destination for doctors, scientists and patients.
"To be among the best children's hospitals, you need an environment that combines outstanding clinical care with research and education," Quattrin said.
>Ready to forge ahead
The Ciminelli building is closest to construction.
The company cleared a hurdle recently with an agreement on a process to remove contaminated soil from a petroleum leak at a former gas station at Main and High streets.
Plans include leasing other parts of the 350,000-square-foot building to doctors affiliated with UB -- their group is called UBMD -- and those displaced by the anticipated closure of Millard Fillmore Hospital.
Because Ciminelli must excavate 40 feet below grade to remove contaminated soil, the building can accommodate four levels of underground parking and, possibly, a connection to the Allen Street Metro Rail platform, which ends at High Street.
Other potential elements in the building, which will connect to the new Women & Children's Hospital, include limited retail business and an extended-stay hotel, said Timothy Vaeth, vice president for development at Ciminelli Real Estate.
Site preparation is expected to begin later this year, with an opening projected for the end of 2013, he said.
Meanwhile, UB, thanks to the anonymous donation and recent legislation that included $35 million in seed money, appears ready to forge ahead with its long-sought goal to consolidate doctor-training.
The move from the South Campus comprises students in medical school and master's and biomedical science programs, as well as a majority of staff and faculty. It does not include, for now, undergraduate biomedical science majors. Officials envision a two-phase project near the new Women & Children's Hospital, with the first 500,000-square-foot building opening in 2016 and containing educational programs and research space.
A second 350,000-square-foot building of mostly research space is planned for 2018.
Why do it?
A long-standing criticism of doctor-training here is that UB lacks a teaching hospital. Instead, more than two dozen specialty training departments are fragmented among the area's larger community hospitals.
Officials also want more modern facilities that include flexible lecture halls, consolidated administrative offices and research space closer to hospitals.
The new campus would be built to accommodate an increase in first-year medical students, from 140 to 180.
"We can take a very good medical school and make it excellent, and all of this will help us recruit and fill gaps in our training program," Cain said.
Other sources of funding sought for the first building include $50 million from private partnerships, $40 million in research grants, $100 million from a medical school program fee, and $100 million from funds previously earmarked for South Campus renovations.
Cain said the school expects to choose a building site in the next few months and, after designs are complete, it's hoped construction can begin in the fall of 2012.
A medical campus grows
UB, hospital projects could bring thousands more patients, students and staff downtown
Buffalo General Hospital
Millard Fillmore Hospital
Women & Children's Hospital
University at Buffalo
Source: UB and Kaleida Health
Note: UB numbers comprise medical school individuals who would shift downtown