Planning Commission - Special Meeting

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All right, good evening everyone. Thank you for all your patience. Uh, it's wonderful to see you guys again. I think I see you guys more often than I see my wife, but all right, it's currently 6:02. We'll go ahead and start tonight's meeting. Let's please take row. Commissioner Leay here. Commissioner Kandra. Commissioner Diaz present. Commissioner Kryer here. Commissioner Shill, present. Vice Chair Bray, Chair Vain

here. Thank you. Uh we'll go ahead and do the pledge of allegiance. Everyone, please stand to the flag of the United States of America and the stand.

All right. All right. For everyone's convenience, I'll go ahead and read the procedures for tonight's meeting. This meeting is being conducted in person and electronically. For each matter considered by the commission, there will first be a staff presentation followed by presentation for the project applicant. Testimony from the supporters of the project would then be taken followed by testimony from those in opposition. The applicant will have the right to a final rebuttal presentation prior to closing the public hearing. In accordance with section 13 of article two of the planning commission rules and regulations governing the length of public debate, all public testimony from those in support and opposition of the project will be limited to three minutes per person. The three lights on the podium next to the microphone will indicate the amount of time remaining for the speaker. The green light will be turned on when the speaker begins. The yellow light will come on with the soft bell ring when one minute is remaining. The speaker should be completing the testimony by the time the red light comes on with the final bill indicating time at all. In person public testimony must be presented to the commission at the podium. Any testimony that references race, religion, ethnicity, economic status, national origin, or any other classification protected under state or federal law and a derogatory matter shall be deemed irrelevant and will not be considered by the commission in making it land use determinations. If you challenge these land use matters in court, you may be limited to raising only those issues you or someone else raising oral or written testimony or before the close of the hearing. We have the agenda. Do we have any changes to the agenda?

Good evening, Chair Bay and Commissioners. Philip Seuis with the Planning and Development Department. Staff has no changes to tonight's agenda. Awesome. Thank you, sir. Commissioners, do um does do you guys have any comments, questions, any motions to approve the agenda? Second. Okay. So, we have a motion by Commissioner Shogio, a second by Commissioner Diaz. All in favor say I. I. All oppose say no. Agenda's approved. We'll go ahead and move forward to reports from commissioners. Do we have any? Go ahead, sir.

Yeah. So uh I would like to request our Fresno community uh Beautify Fresno is a great program, great project by Mayor Dyer. So u I think uh Fresno belongs to all of us. So please um wherever it is, let's volunteer. Let's keep our parks clean. Let's let's keep the streets clean, our neighborhoods clean because that does add value to our to our properties. Um so so please do uh uh support uh beautify Fresno and also I would like to add if anyone is if anyone is having any graffiti problem anything that has to do with city of Fresno please utilize Fresco app or 311 as a community we're making city of Fresno a city of choice so please utilize all of these um you know apps Fresno app 311 and beautify Fresno because Fresno belongs to all of us. Thank you very much.

Awesome. Thank you sir. Do we have any other comments? I see none. Uh let's please note too that we have vice chair in attendance. We'll move to continue matters. Uh this is continue from January 21st consideration of reszone application number P2501778. Oh, I just turned off. Uh, good evening, uh, chair and members of the planning commission. I'm Valeria Ramirez with planning and development, and tonight staff brings forth consideration of reszone application number P25-1778 and development permit application number P25-1774, of which was submitted by Galloway. And uh staff would also just like to note that all representatives for the project are present tonight as well. So here is an aerial image of our project site. It is located on the southeast corner of North Cedar Avenue and East Hampton Way. It's approximately 3.96 acres in size and it is a partially developed site with two um buildings and a parking lot. The two buildings are currently occupied by a physical therapist office and a law firm. And our proposed project uh will be developing across three paths. The proposed project site is designated for office land uses with properties to the north and to the west designated for residential single-unit development and properties to the south and to the east designated for commercial recreation land uses. Development permit application number P25-1774 proposes to construct a senior healthcare facility that um will offer

community- based services and medical services to um individuals aged 55 years and older. Development will occur on approximately 1.17 acres of the property and it will serve approximately 100 to 200 patients per day. are the patients will not be lodged overnight and the proposed use adult daycare facilities is a permitted use in the office zone district. So here is a snippet of the site plan for the proposed development. Aside from construction of the building, a development will also consist of parking lot modifications and um installation of new landscaping. And here is a rendering of the north and south elevations of the proposed building. and the east and west elevations of the proposed building. And the proposed building is consistent with the development standards of the office zone district. As previously mentioned, our property is zoned office with some conditions of zoning that were put into place by previously approved reszone application number R 0648, which prohibits adult daycare facilities among other uses and the related parcel map uh parcel map number 2006-43 subdivided our subject property into 10 lots and the related site plan review application number S-06-254 or 264 if my apologies. Approved the development of nine singlestory office buildings and reszone application number P25-0778 uh proposes to remove one of the three conditions of zoning on the overall property. And here you could see the reszone boundary in comparison to the project boundary. So the first condition of zoning uh has it specifies certain uses as provided that are currently prohibited on the

subject property um which includes adult daycare facilities. The second condition of zoning requires that the applicant record an evagation easement recognizing the Fresno International Airport. And the third condition of zoning um limits future office buildings um to singlestory construction. And to uh conclude, staff recommends to the city council adoption of the environmental assessment and approval to of the reszone application and the development permit application. And with that, I open the floor to any questions that you may have. Right. Thank you. Appreciate it. Do we have any questions from or comments from the commission?

Go ahead, sir. Uh has there been u any public comments on this project? Any public comment? Yes. Uh staff did not receive any public comment. I see. So nothing negative or positive. Correct. Okay. Thank you. Thank you. All right. Any other questions or comments? Thank you. Appreciate it. Do we have the applicant?

Hi there. Kate Hirs on behalf of the applicant. And we do have a applicant presentation. Perfect. Okay. All right. Hopefully I can figure this out. Um I first just want to say thank you to the planning commissioners for coming back again this week. We were excited to be here last week and with the power outage. Um really appreciate the flexibility that you guys have shown for us and for this project. It's been a yearslong project for us in the making and we are um at a critical juncture for our timeline. So really really appreciate you guys coming back tonight um to hear our our our case and also just want to start off by saying thank you to Valyriia and Rob for all the hard work that they've done to date to get us to where we are tonight. Um so I'm here on behalf of the applicant. I am from Turner Impact Capital. We are a social impact investment firm that partners with highquality health care operators to help them realize their real estate and facilities needs. Um, and we are proposing to build an up to 25 20,000 square foot building um, at this location. Um, today I am joined by Nicole Butler who is the executive director of Wellby Health who is the proposed operator at the site um, at their existing Fresno facility. um joined by current property owners Guy Stoppridge and Adam Wong. Um Tara Mortonson from Galloway who is managing our entitlements. Um and if approved, this would be the second location for Wellby Health in Fresno that we are uh building for them. So really excited about the opportunity here. Um and uh hopeful that I can answer any questions that you guys might have. Um I wanted to just give you a little bit of the history on the project. So as I mentioned, it's been years long. We identified this this site in 2022 um and had to get through some state regulations um and were able to finally

get the property under contract in 2024. Um quickly thereafter we realized that even though the underlying land use is office which allows for adult daycare use um there were conditions of zonings recorded on this property that prohibited it. So that's why we're here tonight to have that um uh first step in having that removed so that we can operate this healthcare facility at this location. Um a little bit about the project um and the site. Right now we're showing the site plan. Valaria showed you a more technical plan earlier, but we are proposing to reconfigure the site in order to be able to place our uh building, our singlestory building at the corner of Hampton and Cedar. Um and we are maintaining 167 parking stalls on the site uh for in support of not only our project but the surrounding uh buildings that are there and for future development. Um I do want to highlight that uh we are also installing as part of our project 26 EV charging stations. Um Nicole is going to get a little bit more detailed about the PACE program in case you're not familiar about it um with it, but just high level um a PACE program is a center that offers wraparound whole person services to the elderly and frail seniors in the community um who would otherwise qualify for nursing home care. And this is a program that allows them to stay um at home living and thriving in their homes and in their communities. A little bit about the building program. Um, it's designed to have a large day room where participants can congregate um and have daily activities including meals and that's what's highlighted in the the pink and uh reddish color up there. Um, we also as part of the program it includes a fully functioning clinic that's uh for uh the the participants of the PACE program only.

um that includes eight eight exam rooms and one dental room there. Uh that's in the the green. Um in the light blue is an exercise and rehab space for physical therapy, occupational therapy, and um exercise. And uh in the purple is what we call the spa area. It includes bathrooms, um a salon room with a salon chair and chair and sink, shower areas, and laundry facilities. Um the remainder of the building in the light teal and the yellow is uh back office and administration space. There it takes a lot of uh uh personnel to operate a program like this. So it includes administrative area, break areas, private offices and a transportation office. Um these are uh uh colored elevations of what the building would look like uh if approved to be built. and also wanted to show a rendering of uh what the the building entrance would look like. Um, a lot of times renderings either don't do it justice or look prettier than what it looks like in real life. So, I also wanted to share a a a picture of a Wellby Health that we recently completed with Wellby in San Bernardino um that opened its facility um about seven months ago. So, uh, it's not exactly the same as what this building would look like in Fresno just because of site configuration and constraints, but this is the the type and the quality building that we would build and wanted to also include some interior pictures. Um, uh, I also wanted to touch on some of the neighborhood outreach that we've done to date on this project. So, um, in anticipation of, uh, this public process, we reached out to, uh, through a flyer and community mailer to residents and property owners within a thousand feet of our property back in September to give them notice that we were proposing this project and including a little of some information

about what the project is and then also what a PACE program is. And then we also held a community meeting in October. Um, and then just to wrap up my portion, I want to talk about the our timeline. So, our goal is to complete this facility's construction in March of 2027, which is about a year from now. Um, and if we're cap able to do that, then Wellby would open its doors to members of the community by the end of 2027, so fall 2027. Um, our hope is today that you guys will approve our project so we can move on to the next step, which is to go to city council. um and so that we can maintain our timeline to get our approvals and then our building permits so that we can begin construction at the end of March. So um I will invite Nicole to come up and talk a little bit about the wellbe health programs. Um and we are here for any questions that you guys might have. Thank you.

Hello. My name is Nicole Butler. I'm the executive director of Webby Health here in Fresno and I've been with the organization for over five years. I opened and launched the first building here in Fresno, which was four uh building four for Wellby. Uh today we have 11 buildings throughout the state of California serving over 200 uh senior participants with wraparound care. Um PACE is really designed to uh keep people out of the hospital and keep people out of skilled nursing facilities, keeping thriving in the in the community by providing the wraparound care. Um primary care services is kind of the the hub of everything we do. Our primary care doctors drive um nine different IDT members uh to provide that care throughout throughout their rest of their lives that they're with us. Uh the nine IDT members in addition to the primary care is home care, uh transportation, physical therapy, occupational therapy, um day center, and then a personal care assistant um that would work with them on the day center floor um as well as one of our facilitators as we call them. Um just really trying to drive care. So any care is all coordinated through that IDT team and that includes specialty. So if a pro uh one of our um we call them um participants uh needs to go to a specialist we would coordinate that care, provide transportation to them, coordinate the medical records and get those back to to the to the IDT team to uh effectuate the care that they would need. Um PACE is very unique. It's been around since the 50s, but it's like the best hidden secret. Um we don't classify our care in thousands like you would get from a from a a big um like HMO or um United Health program. We kind of qualify them in the hundreds um because it's very hightouch care that we provide. So we in order to be successful with that it's very small um when I say we have a thousand participants in Fresno that's a ginormous PACE program. Most PACE programs run anywhere from 6 to 800. So,

it just tells you that the need that we have here in in Fresno County um is just exorbitant. Uh a lot of seniors, a lot of care. Uh this PACE program that we built here in Fresno and that we operate today is the fastest pace um grow the fastest growing pace organization in the state of California, most likely in the country. So, just a very big need here. And so, this this second building could not come fast enough for us. uh we we just want to continue the care and we will have to cap the care that we provide um most likely this year until the new buildings are open. Any questions that you might have about pace or about wellbe questions?

I do.

Can you um describe if you know u what is the difference between PACE and hospice? So the difference is pace is is you're you're at the cuff of really needing the extra help. Like you potentially could need skilled nursing facility, but you're not quite at the end of life. So end of life care would be the hospice piece of it where you have a um an outcome of the rest of your life anywhere from six months to two years. Um people could join PACE and stay with us for six, seven, eight years. Um and and we grow with them. They age with us and we continue to provide the care. So somebody that's coming in at the, you know, say at the the 60, our average um age is 72. Um so somebody coming in in their in their late 60s, early 70s may not need as much care as they would need in their 80s. So they grow into that care and as they grow old with us is like we like to say is we beef up the the care. A good example is that is home care. So, right now, somebody in their um early to mid-60s may not need help in their home, but as they start aging or if they have um something that happens to them health-wise, we would send a home care aid in there to help them with meals, bathing, washing clothes, lighthousekeeping, things like that. Those those things that they need in order to be able to stay in their community and stay in their homes as long as possible. But we do provide hospice care as well. If if you get to that point in your life, we do not disenroll anybody from our program. um they would have to want to leave our program. So we try and keep them as long as possible.

Commissioner Shgo, do you want to ask your question in regards to So my question is uh we have a lot of seniors u you know they live with their children. Uh they may not speak English, they may speak Punjabi, they may speak Mo, they may speak Spanish. I mean those are the three three of our top you know languages after English. uh do you have multilingual uh nurses or doctors or uh people who could easily communicate with them?

We do. We try and build we call our our IDT teams are we call them pods and each of our pods we try and diversify the language in those pods in order to help the participants that are that are part of them. So we have for instance we have a Spanish speaking pod that the entire team well I shouldn't say the entire team the clinical team all speak Spanish. So their core clinical team would be their PCP, their case manager, which is an RN, and their social worker. All three of them would speak Spanish. Now, some of their other team members may not speak or care team may not speak Spanish, but we have interpreting services that that help with that service. We also have um a pod that is not full u Mong population, but it it's probably 75% Mong combined. And then um Punjabi is a is another area. We only have only about 3% of our population um is Punjabi but that's that's definitely an area we have three Punjabi speaking providers today.

The reason I'm asking because a lot of like probably a lot of our communities do not know about this program because I was actually doing some research on your website. I mean it's uh it's covered by Medicare or

Yeah. So how it's work it's a three-way contract between department of healthcare services so medical for the state and then with CMS through through federal. So, it's we call it a three-way contract. That's the contract we need before we can open. Our funding primarily comes from the state. Um but but CMS also does fund it. Uh PACE is driven by CMS but in conjunction with DHCS. It's a very um interesting model how it was built. Uh CMS provides the regs on how we operate on a daily basis and DHCS kind of make sure that we're staying in line with those regs. Um but the somebody that somebody could join the program um with just medical um and somebody could join the program with medical and Medicare Medicare only they would have to supplement the cost of the medical piece of it which is costly so we don't see a lot of that it's less than 1% of our population

I see and then u so you so I heard uh this company also provides at home care so for example let's say there are so here's just an example there is two elderly uh probably in their 70s s early 70s husband and wife um you know they want to live like in like they just want to stay at their own house um so you like you'll be able to send someone there to to help them um like cleaning like what what what do you mean by cleaning like

so a typical day in a in a a PACE participant um that is living in their home husband and wife per se um they would maybe come to the day center a couple days a week they'd socialize they'd come in have breakfast maybe see some of their IDT members participate in activities go home. The days that they don't come in, we would offset that care with we call it a home care aid that would go in um help them with their laundry, help them with light light housekeeping, making sure that their meals are prepped. If they have the ability to do meals on their own, they would help prep. Um they would also if for some reason uh they couldn't shower on their own, they would help them with showering, bathing. Um our OT, our rehab team would make sure that their home was safe for them. that they would go in and do home visits, making sure that if they were entering a shower, that they had grabbars, could get in and out. Um, making sure that the home is set up in a safe manner. Um, I don't know about you, but my mom's house is a little cluttered. So, we try and keep um try and educate the participant for highf fall risk or things like that. Uh, making sure that they their home is safe for them to live in. So, I'll give you another good example of something we do. We had a participant um a couple weeks ago where her stove went out and as so that came back to our IDT team and as the care team she could no longer derive nutrition because her stove was not working. So it was a simple fix for us. Let's get her stove fixed. If we can't fix it, we'll buy her a new one. That's the uniqueness about PACE is like our goal is to remove barriers for somebody to stay in their home as much as possible. And since we're the health plan and the provider of the care, we can pretty much um we have a lot of flexibility on what we can can and cannot do. So,

thank you. Any other questions or comments? I do the last one. I'm sorry. No, you guys are good. I can talk about this all day from all the residents around the uh project area. Were there any concerns, any questions, any disapproval with the project with the at the new site? Yes.

It's a beautiful building. I mean that the the drawings don't do it justice. It's going to be a very beautiful building. I think that especially the senior population, we now give them a place to come to. We give them a place to come and socialize and get meals and and get their health care that's in their neighborhood where our existing building right now uh a large population um is very is within probably two to three miles of of our current building. I mean, obviously we have people outside of it, but they they enjoy they enjoy that being in their backyard. So, I I think especially in the area that it's going in, I think it's going to be very uh convenient for a lot of that uh population that lives over there.

And then I I think the one thing that I'll add is we did send mailers to residents within a thousand feet of the property and we didn't receive any concerns. We gave them our emails, our phone numbers. We had a community meeting and there was no opposition to the project. Gota. So, even at the uh October meeting, um did you guys get a lot of positive feedback from the community meeting? Yes, the only feedback we got was positive. Okay. And I think speaking from uh my culture, the Mong culture, I think um there's not a lot of individuals in that facility just because of the cultural norms, right? Or I think my parents would probably disown me if I ended up sticking them in there, too, right? So that's just speaking from my experience, but uh any other questions or comments. Thank you. Appreciate it.

So we'll go ahead and go to the public. Uh do we have any individuals who would like to speak in support? All right. Any individuals who like to speak in opposition?

All right. I see none. We'll bring it back to the commission. Do we have any um additional questions, additional comments, motions from the commission? I'd like to make a motion to um recommend that we uh take this to the city council and accept the staff's recommendations. I'll second it. Okay. So, we have a motion made by Vice Chair Bray. We have a second by Commissioner Shill. All in favor say I. I. All oppose say no. Motion's approved. Thank you. All right. Next, uh we don't have anything under new matters. Any reports from the secretary?

Uh good evening, chair. Um we do not have a new report. I would ask um our next meeting is a week from tonight. So please make sure if you're unavailable, I know I've already heard from one commissioner, but if you're unavailable for next week to please let Carrie know as soon as possible so we can ensure that we have a quorum. Aside from that, um happy end of January. Thank you. Went by pretty quickly, huh? All right. Any unscheduled oral communications? I see none. 6:29. Everyone have a wonderful evening. Meet