Broadlands Hospital

I'm not in favor of or opposed to the hospital. I'm still deciding. I've just heard a lot of misinformation being circulated. I'm just pointing out the proper place for citizens to voice their opinions. As far as the site selection goes, if it weren't the most profitable, viable site, why in the world would HCA select it?

 

Can someone enlighten me about the history behind the Loudoun Hospital Center's inability to expand? Since I first moved to Loudoun in 1989, it seems that LHC has always begged for more beds to better serve the citizens of Loudoun County. Each request seems to have been answered with a flat-out "no" or LHC was granted permission to add significantly fewer beds than requested. (I'm sorry, I never found it important before to commit to memory which organization had the authority to grant LHC's requests.)

LHC does not have enough beds or staff at this time to serve the citizens of Loudoun. But I fear another hospital so close would provide too many beds in the area, and I'm not sure that both hospitals could survive.

Yes, I am concerned about ambulance sirens, helicopters, traffic patterns, transportation of hazardous materials, security, and property values. But I am most troubled by the ability of a new organization to add so many new hospital beds in one shot while LHC has to pull teeth to add just a few at a time. To be blunt, this is one of those intangible things that makes me wonder who got paid and who got [slept with -- rhymes with "paid"]. I have a nagging suspicion that something bad is going to happen in the future because of something we don't yet know about or understand.

LKWL

 

The hospital beds are are granted by the HSA of Northern Virginia. LHC cannot juts add beds because beds are apportioned on a regional basis (all of Northern Va). HCA can add the beds because thay already own the beds at the Arlington hospital and the psych facility. They are not adding beds, just relocating them.

 

Hi everyone, as most of you know I have been sending out emails to update you on the goings on concerning the hospital. I have presented to the BOS, spoke with the planning commission, HCA, Domioin Hospital, county officials, etc. This hospital is not a good thing for our neighborhood. For our community yes, not our neighborhood.. I would like to clear up a few misconceptions that I have read on this board. When Loudoun hospital was expanding they asked the state to keep the Cormwall location open. The state said no that 2 hospitals were not needed in Loudoun County. That was less than 3 years ago. To understand a little better read through the Proffers yourself and the zoning ordinance. Secondly, I have called on hospitals for over 10 years. On any given day you can find syringes, used tubing, used gloves, clamps, masks, ekg pads, needles, bloodied towels, etc. It is not good to live within walking distance of a hospital. That is why Loudoun hospital is placed where it is...away from homes. I could go on and on about why this is not a good thing, but that will be discussed once the HOA sets up our homeowners meeting. Don't fool yourself into thinking property value and quality of care will increase...It wont. Look at HCA as a company and their past history and then tell me if you would want to do business with them, and place your life or your loved ones lives in the hands of HCA. I wouldn't. Where you also aware that 45% of the patients being transferred to Domioin hospital from only one county hospital arrived in schackles and under police escort. Did you know that Dominion hospital used to be a nursing home...then they changed their charter...do you think it's possible that they could once again change their charter to include violent mentally disturbed patients. Also have you read the Mayors task force report that was presented to the BOS... Donna Fortier

Donna Fortier

 

They have to rezone the land to be used for the hospital? How do we stop this from happening? I heard the HOA/terrabrook board is in favor of the hospital so who do you voice your opinions to?

 

First of all, Loudoun is just a close to homes as the Hospital in Broadlands would be. The last time I checked they aren't having problems selling houses in Lansdowne. In fact we would be lucky to have our houses in the same price range. Second, Loudoun was not allowed to keep the Cornwall location open because the HSA did not feel that additional beds were needed in the region. The new hospital is not adding beds just moving them. Loudoun was free as anyone else to buy the hospital in Arlington but they didn't. HCA did. Third, where in the world have you seen medical waste just lying around a hospital? Outside of the designated trash areas I haven't seen what you claim to see at either Loudoun, Fairfax, or Fair Oaks. If you are going to argue against the hospital at least use facts and not scare tactics.

Hospitals don't drive down property values and people don't stay away from developments because hospitals are near by. Otherwise there wouldn't be million dollar homes near Loudoun, Fairfax, or Fair Oaks.

 

We are strongly opposed to the hospital being built in the Broadlands Community. We spent 18 Months Building a House with Van Metre based on a "Planned Community" - That was available for public display at our community Center. I feel we have been misled on the plans for the space marked as "office buildings". There was a Proffet which included a 5-Acre Psych/Library...We all signed up for this..We did not sign up for a 52+ Acre 140+ Room Hospital/Psysch Ward right down the street.

In all the other locations that I have lived, Hospitals have been built and Communities grow up around them...not the other way around. I agree that Eastern Loudoun County will be growing significantly over the next 10 years..and will need more Public facilities to support the residents. Why Can't this Hospital be planned along with a new community that has not already been built?
We already have Loudoun Hospital in Landsdowne which is close to the Braodlands.

No matter how much HCA want to sugar coat this deal...it still smells the same after you peal back the fluff. We will be an active part of the oppositon to fight against this Hospital being placed in our community.

 

We are strongly opposed to the hospital being built in the Broadlands Community. We spent 18 Months Building a House with Van Metre based on a "Planned Community" - That was available for public display at our community Center. I feel we have been misled on the plans for the space marked as "office buildings". There was a Proffet which included a 5-Acre Psych/Library...We all signed up for this..We did not sign up for a 52+ Acre 140+ Room Hospital/Psysch Ward right down the street.

In all the other locations that I have lived, Hospitals have been built and Communities grow up around them...not the other way around. I agree that Eastern Loudoun County will be growing significantly over the next 10 years..and will need more Public facilities to support the residents. Why Can't this Hospital be planned along with a new community that has not already been built?
We already have Loudoun Hospital in Landsdowne which is close to the Braodlands.

No matter how much HCA want to sugar coat this deal...it still smells the same after you peal back the fluff. We will be an active part of the oppositon to fight against this Hospital being placed in our community.

 

The people in greatest need of mental counseling are ones that think its a fantastic idea to have a hospital built next to your new home.

Hospitals are obviously needed by the community, but having one next door will lower your property value. All the arguments against have been presented on this board already, I agree with them and oppose the idea. It is not pleasant to hear that neighbors don't want mentally disturbed people in their midst - but it is a fact.

You can criticize this thinking as NIMBY - you're right. Add hospitals to the list along with sewage treatment plants, landfills, prisons, crack houses, nuclear storage facilities, oil refineries, Al-Quaeda terrorist training centers, child molester day camps, clown colleges -and anybody else the developer can unload this land to after we have already bought here.

Already watching for syringes,

Concerned Homeowner

 

I'm not overly thrilled with having a hospital built directly across the street from my house, but I'm not totally against it at this point and would like to hear more facts instead of hype to make up my own mind.

What really amazes me is the hype that we will have pedophiles running around our neighborhoods because of the hospital. Based on what facts? Have the neighborhoods around the current Dominion facility had such problems or other problems with Dominion patients? That factual information would be more useful than hype.

As for the new hospital COPN not including OB capabilities, I didn't have any problem understanding this when it was explained to us this past Thursday evening (7/25). If the lack of OB capabilities concerns you, work with them to get OB added if their application is approved -- that's not a reason for opposing the hospital.

Where was all the neighborhood concern when Clyde's announced their restaurant? Based strictly on hype, won't Clyde's be a late night and weekend facility that will contribute to traffic and parking problems (e.g., weekend events, wedding receptions, office parties) and noise pollution (e.g., music, car horns)? Isn't Clyde's a favorite afterwork/weekend drinking place? How about drunk drivers leaving Clyde's, some of whom will be driving past the playground? Why did we need such a facility in our development? After all, there's one just down the road in Reston.

If someone can tell me what would be built in the commercial area instead of the hospital and guarantee that it wouldn't be as bad as having a hospital, I'll make up my mind. I know this area was zoned commercial, but what is the exact zoning -- does anyone know?

According to the county zoning regs, PD-CC Planned Development - Commercial Center (if that were the zoning) allows such things as (depending on what type of zoning it is):

Office, medical and dental
Office, administrative, business, and professional
Business service establishment
Utility substation, dedicated
Water pumping station
Sewage pumping station
Motor vehicle sales and accessory service
Motor vehicle service and repair, light
Automotive service station
Mass transit facilities and stations
Water treatment plant
Sewage treatment plant


Building Height. No building in any commercial center shall exceed 35 feet; except that in [small regional] and regional centers a building may be erected to a maximum of (50 feet in a [Small Regional Center] and (100) feet in a Regional Center district if it is set back from public streets or from lot lines that do not constitute boundaries of districts with lower maximum height restrictions, in addition to each of the required minimum yard dimensions, a distance of not less than two (2) feet for each one (1) foot of height that it exceeds the thirty five (35) foot limit.

So, the bottom line is, although the jury is still out on having a hospital across the street, how do I know the alternative won't be as bad or worse (e.g., sewage pumping or treatment plant)? Yes, the alternative could also be much better than the hospital or the possibilities I mentioned, but how can we be assured of this since we can't dictate what gets built there?

 

As I read these posts, having not decided one way or the other, the folks who support the hospital sound the most rational to me.

If you are all so concerned about mental health facilities, why haven't you complained about the live-in mental health facility for mentally challenged people located at Claiborne and Ashburn Farm Parkway? Are you aware that some of your Broadlands neighbors are practicing mental health specialists, and have patients visiting their home offices? I really don't want folks suffering from depression driving themselves to the hospital if their treatment fails, so the police escorts are fine with me. Why the phobia about mental patients, when the majority of the people we are talking about in this demographic are suffering from things like attention defecit disorder, anxiety, depression, or anorexia? This is not zoned for a facility for the criminally insane, like you all make it sound.

If there are some realtors out there who agree that hospitals drive down property values, I haven't heard from them. The realtors I've spoken to say EMPHATICALLY that it is much easier to sell a home close to a hospital vs. close to an office park. In our case, the hospital would not be visible from the residential area. The office park that was slated for Broadlands Blvd. would. If I lived on Broadlands Blvd., I'd rather look at trees than parking lots and office buildings.

Ambulances typically turn their sirens off a mile away from hospitals. I know because I was a patient in one after a childbirth complication, and this is what the driver told me. (Also, I have friends who live in Reston Center and vouch for this.) I was a patient in Reston hospital for the better part of that week and never heard or saw a helicopter land. I have been to Landsdowne Resort, the restaurant, the medical offices and the emergency room there quite a bit. I've never seen a helicopter there, either. (I DID hear the police helicopter circling Broadlands in the middle of the night when those homes in our neighborhood were broken into.) The planes from Dulles would be more of a deterent for me, personally.

As I said, I have not made up my mind yet, but all of you naysayers have not come up with any logical arguments for me. You sound more emotional, as if you don't want ANYthing built on Broadlands Blvd., or as if you bought into this soon to be 3,500 home community expecting it to remain a country setting.

I welcome the competition between the hospitals, and many of the people at the meetings held so far seem to be affiliated with Loudoun Hospital in some way. I can understand why Loudoun Hospital would not want another hospital in the region. They'll have to work harder. And, my experience with Reston has been much better than with Loudoun Hospital. I know several people who would echo that sentiment. But who can argue against bringing healthcare jobs into the community, and competition that will bring better doctors, shorter waits in the emergency room, and shorter waits to get appointments with specialists?

Much of what I have read against HCA seems inflammatory and it sounds like it's been sensationalized. I know I won't be sending my children across a divided highway to Broadlands Blvd. to play, so I'm not impressed with threats that there might be dangerous stuff in the hospital's garbage. I'm sure you could poke around Clydes and find dangerous kitchen utensils. The kids could get into some trouble on the grounds of the gas station if they tried.

My main concerns about a hospital in Broadlands would be:

1. Show me how this benefits our neighborhood. Show me how this project will compare to an office park, with regard to traffic, esthetics, the quality of jobs being offered, crime statistics.

2. Show me why this location makes sense. I understand that the population center of Loudoun County is here, but I would like to see a map of where the HCA officials expect their patients to be traveling from.

3. I think there needs to be some more detail on what types of services the hospital will provide. I know this has been laid out, but it seems there is still some confusion over how much of the hospital staff would be devoted to pediatric vs. adult care, psychiatric care, trauma and emergency room services, etc. Is it possible that this hospital will complement (vs. compete with) Loudoun Hospital's expertise?

4. Since some folks seem afraid that it would become a hospital devoted 100% to the psychotic humans in the tri-state area, how realistic is this scenario?

5. If D.C. wins the bid for the 2012 Olympics, and 10-story high rises in the "Reston Town Center style" are built on the property adjacent to Broadlands, would this proposed hospital be a good thing for our community? Or, will planners be wishing they had built something different in a new location? Likewise, if Loudoun County's economy takes a turn for the worst, would the HCA hospital be a good thing to build in a recession?

Sorry to be so long-winded, but it's hard to search through all the rhetoric for facts, and I get frustrated by the appearance that two distinct groups have already formed that have made up their minds - regardless of whatever the data that is eventually presented shows. I have to wonder whether there would be this much discussion if an office park were proposed on Broadlands Blvd. Would we be deciding things like whether to allow neon signs, how the hazardous waste from dry cleaners would be dealt with, where to put the curb cuts for the patrons of businesses like hair salons, dentists, and banks that have customers coming and going all day long?

Based on the information that has been presented so far, I guess I'm waiting for someone who sounds rational, is not affiliated with Loudoun Hospital in any way, has more than biased opinions to offer, and who has a vested interest in this community to step up to the podium.

 

I agree there has been a lot of misinformation being spread around about this hospital. If you are only listening to one side and taking that information as truth then you are not fully informed. If you are not listening to your neighbors valid concerns and why they are against this then you have made a decision based only on emotion. If you live far enough away that you personally will not be affected, but your neighbors who live close enough to be affected day in and day out by the noise, traffic and safety and don't consider their concerns valid then you are not listening with an open mind. If you think you know the whole story because you have attended a few HCA or Terrabrook meetings and have not researched the information yourself...shame on you. I have asked several times for those people who are for it to give 5 valid reasons for that decision, but like HCA/Terrabrook saying they will provide documentation that our homes values will increase...I'm still waiting.

Donna Fortier

 

Donna,

I'm listening to both sides and I'm trying to be fully informed. And, as I mentioned, I haven't made up my mind for or against the hospital. However, there's some misinformation being presented by both sides, so it's sometimes difficult to extract the truth from the hype and half-truths. I'm not directing this at you or suggesting that you're not putting out good information -- it's directed at both points of view in general.

I wonder how many people believed everything LHC presented at their meeting because LHC is on "our" side. Just as HCA put a positive spin on their presentation, you better believe LHC did the same to theirs. Since my wife has been working for LHC as an RN for over 18 years, I know better than to believe everything they presented.

As for my location to the proposed hospital, I live directly across Broadlands Blvd from the hospital location, so I'll be directly affected by it. I'll also be directly affected by whatever gets built in place of the hospital if the hospital isn't built. So, where as some people are against the hospital because it'll affect them from a few blocks away, I'm concerned because whatever gets built is directly across the street from me.

I certainly don't know the whole story but I'm still doing researching to make up my own mind. Just because someone is for the hospital doesn't mean they don't know the whole story -- they just don't share your point of view and/or interpreted the data differently.

You mentioned that you've asked people who are for the hospital to give you 5 valid reasons for that decision. How about directing me to sources for the following 5 areas of concern:

1. Where is the data substantiating claims that our home values will decrease because of the hospital?

2. Where is the data substantiating concerns that we will have pedophiles and mental patients walking around our neighborhoods because of the hospital?

3. What problems has Dominion Hospital and its neighborhoods had with the above problems (see #2)?

4. Where is the data substantiating claims that not-for-profit hospitals are better, or make better neighbors, than for-profit hosptials? What percentage of profits do each put back into the community?

5. Why should we be concerned about on-going HCA law suits or other problems? Does LHC have similar problems? If HCA built the hospital and closed it later because of financial problems (and they didn't sell it as I believe you mentioned), wouldn't we be left with an unused building and no traffic or noise problems? If they did sell the building, at least the building foot prints might be better than something else another builder proposes.

I don't expect you to answer my questions -- just direct me to sources where I can do my own research.

Thank you,
GCyr

 

First, let me say that I agree 100% with the 7/26 post by Jimnel.

I am very opposed to the hospital. I am not obsessing over property values, ambulance sirens, toxic waste, or free roaming mental patients. But, I am concerned that as I understand it (from attending the HCA meeting on 7/29), this hospital *will* have a larger number of beds dedicated to mental health than the other No. VA hospitals discussed. It also will *not* have a maternity ward. It sounds logically like this hospital will draw more mental health professionals and patients than other hospitals in our area.

My opposition is really much more basic though. A major hospital will bring many, many people into our neighborhood that would not otherwise have reason to be there. These people will be different people every day of the year. They will come and go all hours of the day and night. Not all of them will come and go on Broadlands Blvd. Some will cut thru our neighborhood, others will simply get lost on our streets. I have small children. I don't need any extra strangers in our area. We hear of too many tradgedies these days. If office buildings were to go into that space, there would obviously be increased traffic, but it would presumably be limited to business hours and it would not be different people everyday.

Broadlands is a beautiful family oriented community. We have nice homes, trees, pools, bike paths, and our own schools. I just don't see how a major hospital in neighborhood would be a good thing for anyone but HCA.



Edited by - ctgc on 08/01/2002 14:10:03

 

Donna,

When I find and send you information that either supports the for or against hospital folks, do you intend to make the info available on your web site or are you just posting what supports your point of view? It's your web site, so you can post what you want but it would be nice if both points of view were available for all to read and make their own decision based on the information.

Also, could you tell us what your affiliation or association is with Loudoun Hospital Center, if any?

Greg

 

All,

Since there are two opposing points of view about the new hospital, but only the information supporting the anti-hospital group seems to get posted elsewhere, I'll provide what I have here with a link so you can read it and make your own decision about what it says.

I found an interesting study that addresses some of the NIMBY concerns. The study was commissioned to assist developers address development concerns within communities, but it does address many of the concerns/issues expressed at hospital/HOA meetings. I do realize the guide's primary purpose is to assist developers, but studies were conducted to support this report and the results deserve consideration. The entire report can be viewed at:

http://www.bettercommunities.org/index.cfm?method=resourceguide1


Of special interest is Part One in the report which addresses property and market values, crime and safety, and people with mental disabilities. Here are some quotes from Part One:

Market Values

Market value studies typically involve a quantitative analysis of real estate transactions for several years before and after the establishment of a facility. Almost all of these studies indicate that there is no significant impact on surrounding property values.

Other investigations suggest that community-based facilities may in some cases exert a positive influence upon adjacent properties. Explanations for a positive impact often appeal to the well-maintained nature of many facilities and their grounds. The ability to offer neighbors a well-designed and aesthetically-pleasing facility may be an important bargaining chip when striving for community acceptance.

Some analyses have reported inconclusive evidence concerning property value impacts. Finally, a handful of studies have recorded negative impacts on property values, but these are rare. A study in Oakland, California, was unusual in that it segmented the housing market by race, and noted that facilities for adults negatively impacted the non-­white housing market, while facilities for juveniles had a negative impact on the white submarket.

Turnover of Properties

A second commonly-used indicator of facility impact is the rate of property turnover. Opponents argue that community-based facilities will induce a spate of property sales, leading to a weakening of community stability. To investigate the validity of such claims, researchers monitored property market activity for several months or years before and after the opening of a variety of community-based facilities in many different locations.

The evidence points strongly towards the absence of any impact of community-based facilities. A vast majority of studies report no evidence of increased turnover. A small number of studies found some evidence of accelerated turnover following the siting of facilities, but the results in each case were inconclusive.

A study of twelve Philadelphia community mental health facilities, for example, found that while the prices of surrounding properties did not decline, there was some increase in sales. However, the increase may have been more a function of general market trends than the specific impact of the facilities. A Toronto-based study found that sales volumes increased in one of five metropolitan neighborhoods which experienced the opening of community mental health facilities, but the overall findings of the survey indicate minimal negative impact. A recent study of five community residences for mentally disabled people in Long Island noted that although one neighbor complained about a nearby facility, none of the seventy-five neighbors interviewed were able to demonstrate a problem selling homes in the vicinity of the residences.

Length of Time on the Market

An undesirable facility might make it harder for current residents or businesses to sell their properties, and even though this impact might not be borne out by market price fluctuations or turnover rates, it still might show up in the extra length of time that properties remain on the market before being sold. To test the validity of this claim, several studies have compared the time taken to sell properties placed on the market before and after the opening of a new facility.

Here again, the majority of studies found no evidence that the presence of a facility increases the time needed to sell adjacent properties. One study noting a negative impact examined a small number of property transactions around nine group homes for the mentally retarded or emotionally disturbed in a medium-size Southern town. It found that properties in the high-end submarket did remain on the market a little longer after the opening of a group residences. The author regarded this as a “small price to pay, especially for these wealthier individuals, when providing normalized settings for retarded and emotionally disturbed persons.”

Distance-decay

The "distance-decay" effect suggests that properties immediately adjacent to a given facility are likely to suffer the greatest loss of value (or other impacts), and that this negative impact will decline with increasing distance from the facility. Being able to record a gradient of this kind is essential to support the argument that the facility actually caused the observed market fluctuations. The absence of such a gradient would suggest that fluctuations in price (turnover rates, etc.) is the result of more general market trends, e.g the opening of a nearby supermarket or freeway interchange.

Most of the studies that have bothered to examine a distance-decay effect have found little evidence for its existence. Therefore, we conclude that any observed market fluctuations cannot properly be attributed to the introduction of the facilities under review. A study in Green Bay, Wisconsin (during the early 1970s) is unusual in that it recorded both resident attitudes to facilities, as well as data on housing market transactions. The analysis revealed an attitudinal distance-decay effect -- people nearer the facilities were more likely to express negative opinions about it. But no evidence of property value impacts or a distance-decay effect were found.

Some other studies have recorded changes in impact with distance from the facility, but once again, findings are inconclusive...

Resident Awareness

Qualitative methods have also been used to examine the impact of facility siting. As in the Wisconsin study just mentioned, researchers have sought to elicit residents' perceptions about the impact of a nearby facility. These studies report that the initial negative concerns of residents tended to dissipate once the facility had opened and the anticipated negative effects failed to appear.

An additional way of demonstrating facility impact focuses on the neighborhood's awareness of a facility's existence. The level of awareness and concern expressed by neighbors after a facility's opening may be a useful indicator of its "true" impact. Since opposition arguments often anticipate a wide variety of enormous problems relating to the facility's opening, we might expect the community to be alert should any of these problems materialize.

Analyses of resident awareness and concerns following the opening of a community-based facility suggest that most individuals surveyed were unaware that they were living in close proximity to a human service facility. In addition, all but one of the studies indicate that for those individuals who were aware of the facility's presence, a marked improvement in attitudes was common once the facility became operational. (Note, however, that a successful opening is no guarantee of successful later integration of the facility and its clients into a neighborhood; this is one reason why good community relations is an ongoing commitment.)

Facility Design and Appearance

Where community-based facilities or subsidized housing projects are well-designed and beautifully maintained, they rapidly dispel concerns about their negative impact upon the neighborhood. Instead, they frequently draw praise for the way in which they help to augment the community's image. The ability to improve your chances of acceptance through manipulation of a facility's design and appearance should not be overlooked.

Almost without exception, studies have shown that the appearances of facilities equal or exceed those of adjacent properties, further weakening arguments suggesting the detrimental impact of such projects. Discussions of facility design have been extended to consider ways in which facility design and location might be used as an opportunity to encourage interaction between clients and neighborhood residents.

Key Points: Property Values

The property value "myth" remains a powerful battle cry for communities opposed to the siting of human services facilities.
An overwhelming volume of evidence supports the contention that human service facilities do not significantly impact the property markets around them. They do not diminish market values, do not increase turnover rates, and do not make proximate properties harder to sell.
Such property market fluctuations that have been observed in the vicinity of human service facilities cannot be attributed to the facilities themselves, but tend to be associated with broader fluctuations in the land and property market (e.g. interest rate fluctuations).
Neighbors are very often unaware of the opening of facilities in their midst. Those who were aware often reveal significantly improved attitudes after the facility has been in operation for some time.

Facility design and appearance are important in determining its reception by the host community. Facilities sometimes cause property values to increase in their vicinity.
The studies which informed this discussion cover the time period 1973 - 1993; there is very little fluctuation in the findings during this entire period.

CRIME AND SAFETY

Crime and personal safety are the uppermost concerns of most Americans. People usually place these issues at or near the top of the most important challenges that face our violence-prone nation.

Crime and safety become a NIMBY issue because neighbors believe that the safety and integrity of their communities will be jeopardized because threatening individuals are being introduced into their neighborhoods. Hence, the second most-frequently voiced complaint by opponents of community-based human services is that neighborhood crime rates will increase and their personal security will be compromised as a consequence of a service's opening.

The key motivators in neighbors' perceptions of threat are the unpredictability and potential dangerousness of the client group. Threatening behavior is most frequently attached to people who are psychologically impaired, who are substance abusers, or who are in any way associated with criminal behavior. The three groups who have attracted most attention during the period 1972-94 are: people with mental disabilities (which usually means those described as "mentally ill," but excludes the developmentally disabled, or mentally retarded); homeless people; and substance abusers (especially drug addicts). The frequency of dual- and triple-diagnoses of course means that membership in each of these groups will overlap. The almost exclusive concentration on these groups is undoubtedly related to the recent histories of the deinstitutionalization movement, the explosion of homelessness, and the epidemic of crack cocaine.

Before we examine the specific evidence associated with each of these three populations, some special circumstances surrounding the problem of understanding their "criminal behavior" have to be spelled out:

Almost any behavior associated with illicit drugs is by definition a crime.

Compassion fatigue among the general public has led to increased demands for a crackdown on the activities and even the presence of all three groups.

More and more of the activities of homeless people and people with mental disabilities are being criminalized (i.e. being redefined as law­breaking), including public sleeping, panhandling, and informal
feeding arrangements.

Almost every major city in the U.S. has stories of "rogue cops" (both public and private) who harass, arrest, and otherwise penalize people who are obliged to live on the streets.

Relatively minor misdemeanors and fines, if left unattended, can swiftly turn into bench warrants for the arrest of the individual who cannot afford to pay a fine (for, say, carrying an opened bottle of beer in public).
These conditions mean that the people whose behavior we are considering in this section are, by definition, necessarily, and unavoidably involved with illegal activities, even if such activity involves begging for food. A major part of this behavior is criminal because we have declared it as such; similar behavior in other people would be overlooked, forgiven, or reclassified as within the bounds of acceptable behavior. We point this out not to condone aggressive panhandling or drug addicts who steal, but simply to underscore that for many people survival means stepping beyond the law. This condition has always to be borne in mind when we examine crime statistics and the behaviors of people in need.

Key Points: People with Mental Disabilities

People with mental disability are no more likely to commit crime than members of the general population; indeed, they are generally less likely to engage in criminal behavior.

Harmful individuals constitute only a small minority of the population with mental illness. Media reports focus heavily on isolated negative incidents and therefore create disproportionately negative images of people with mental illness.

More and more of the activities and behavior of people with mental illness are being classified as "criminal."

A lack of proper care and supervision within a community setting may exacerbate psychiatric problems, and thus prompt a greater likelihood of contact with the criminal justice system. Failure to provide adequate support and care may also push people with psychiatric problems onto the streets.

There are relatively few studies examining the level of crime around facilities such as group homes for people with mental disabilities. Those that exist suggest that the impact of such facilities upon local crime rates is negligible.

Where people with mental illness are provided with a suitable living environment, they represent little or no threat to surrounding communities.

For developmentally disabled people (the “mentally retarded”), crime rates are generally substantially below those of the general public.

The prison is rapidly being transformed into the first line of treatment for people with mental disabilities. (In Los Angeles County, for example, the largest population of severely mentally disabled is located within the county jail system.)

....

NEIGHBORHOOD AMENITY

Ranked third on the list of complaints that opponents voice against community-based facilities is the claim that "neighborhood amenity" will decline if a facility is allowed to open in their community. Residential and business property owners often suggest that the facility (and, by extension, its clients) will not fit in with the local landscape, or that neighborhood character will be irrevocably altered. Although clearly related to the property values issue, the concern with neighborhood amenity is not solely a matter of potential monetary loss. It is frequently measured as a disturbance of the status quo in the neighborhood, through (for instance) increased pedestrian and vehicle traffic, pressure on parking resources, or the introduction of "outsiders" into the community. Aside from such material concerns, neighborhood amenity also incorporates less tangible aspects of community life, including long-standing traditions and prejudices of (say) religious and ethnic homogeneity. Business owners, on the other hand, customarily translate the decline of local amenity into dollar terms. Those involved in retail trade and the leisure/entertainment industries, in particular, identify many of the same concerns as residents, but tend to translate them into a loss of customers and a downturn in sales.

What is the evidence for declining neighborhood amenity brought about by human service facility siting? In general, the evidence suggests that fears about declining neighborhood character are largely unfounded. As we have already seen, there has been negligible impact on neighboring property values, except, in some instances, to improve neighboring property values. Similarly, studies of crime and safety also suggest that many opposition claims are unfounded.

Human service facilities are often relatively inconspicuous, and tend to be better maintained than neighboring properties. A 1980 report found that only about one quarter of the group homes examined had any type of distinguishing feature, and less than half were even noticeable to the public as a group home. Other studies continue to confirm that significant numbers of neighbors remain unaware that they are living near a facility long after it has opened.

The relatively few studies that focus on the issues of traffic and parking also point to a general lack of impact.

Neighborhood concerns are also expressed about the disruptive effects of client/resident behavior on community stability. Residents and business owners have objected, for instance, to the unusual and disturbing behavior of mentally retarded people, the vandalism caused by residents of a home for troubled adolescents, the dangerousness and unpredictable acts of the mentally disabled, and the public urination and petty thievery of some homeless individuals. Isolated incidents which achieve both local and national prominence do much to influence neighbors’ overall vision of client behaviors. While incidents undoubtedly do occur, they are often rare and do not reflect the uneventful existence in most community-based facilities.

Despite the results of studies that indicate the minimal impact of facilities and their clients, claims about potential damage to neighborhood and business amenity continue to hinder facility siting. The 1992 relocation of a homeless shelter in Yakima, Washington, illustrates the nature of opposition claims, and the ways in which such claims were countered. In Yakima, the Union Gospel Mission wanted to relocate to a larger facility; in response, local business owners and residents formed the "Yakima Gateway Organization" to oppose the relocation. Opponents successfully appealed to have the zoning classification of the mission changed so that relocation would require a public hearing prior to approval.

Three aspects to this case study are of particular interest here. The first is that local opponents successfully stalled the relocation process by appeals to declining neighborhood and business amenity (specifically, fears about loitering pedestrians, property values and declining business). Second, opposition concerns were effectively countered. In addition to presenting expert testimony on the absence of property value impact, Mission operators provided testimony from property owners adjacent to the existing site stating that the presence of the Mission had not adversely affected their business environment. Finally, the Yakima example illustrates the way in which the manipulation of facility design eventually eased the path to community acceptance. The public examiner ultimately supported the relocation of the Mission but with several conditions, including the creation of additional parking spaces, construction of fence, creation of a new bus pull-out, and requirements concerning the entrance to the mission. Although business owners and residents remained in opposition, these concessions facilitated the definition of a reasonable court-based compromise.

In conclusion, it seems worth remembering that the whole question of NIMBYism, and the concern with neighborhood amenity in particular, is another of those human paradoxes that would cause amusement were their consequences not so deleterious. We know that disability, homelessness, and the rest exist, but we are unwilling to commit sufficient resources to meet their needs; yet at the same time, we are offended by the sight of "problem people" in our midst. People urinate in public because they have no access to private rest-rooms; they sleep in public because there are insufficient shelters; they are sick because they cannot access proper health care. Why are we surprised (or worse still offended) when they live and die on the sidewalks around us?

 

Greg, First let me say that I don't check this site everyday so my response time to answer you may be a little delayed. Also as I mentioned to you personnally at the HOA meeting I am working on getting your questions answered. Also if you have been to www.broadlandshospital.org you would see that we do post information that has been provided to us from HCA. It is not my job to post HCA or Terrabrook data on our site that is nothing but PR. That is what their site is for. However any relavant information that you or anyone else sends will be posted as soon as time allows. So thank you for submitting it. You asked about my affilliation with LCH. I am not affiliated with Loudoun County hospital as an employee or paid representative. They are a wealth of information for us, they are just one of the many and diverse groups that I have talked to with reagards to getting information. (Just to let you know, I have met with HCA on more occassions than Loudoun Hospital and I can assure you I am not affililated with HCA).If you or anyone else is interested in hearing from them let me know. They have a lot of great and informative information that is important to know. In response to your other posting this is what I can tell you. I am also trying to keep myself fully informed on this issue so I would be very interested in knowing from your wife exactly what she doesn't believe from Loudoun Hospital since she has been employeed there for 18 years. So to answer your comments:
1. I don't believe I said that our property values would decrease because of the hospital, what I said was that our homes values won't increase because of it. I think HCA's claim of property values being 20% higher in Lansdown, for instance, because the hospital is there, strains credulity. How close are the nearest homes. How much do you supposes the builders can charge for a home built in a golfing community.
2. As recently as this past spring some poor soul committed suicide in the woods near Reston near a mental health facilty that denied him entrance. This along with other stories are archived in The washington Post, our local papers, google, physichiatry online, etc.
3. Please check Mason District for statistics.
4. You can check the Wall Street Journal article by Richard Freeman and Linda Everett.
5.I directly asked LCH if they have similar problems like HCA. They assured me that they do not. So far as directing you to sources for your area of concern regarding" why we should be concerned about on-going HCA lawsuits or problems" all I can do is tell you MY concerns. Bottom Line is I don't knowingly do business with or affiliate with companies or businesses that have violated the law in such a big way. And when it comes to my family's health I certainly will not do business with a hospital convicted of so much wrongdoing.
I hope this information is helpful. Please feel free to continue to provide information. I look forward to hearing from your wife. Thanks again Greg.

Donna Fortier

 

All,

There's an on-line book at the following link titled "For-Profit Enterprise" (1986) which reports the results of research comparing for-profit and not-for-profit hospitals:

http://books.nap.edu/books/0309036437/html/index.html

The book is long and a pain to navigate through, but some chapters are especially worth reading, such as Chapter 3 - Quality of Care and Chapter 10 - Summary and Conclusions.

Bottom line, I found a better case toward for-profit hospitals than not-for-profit. At least I didn't find anything that would lead me to state that LHC is better or provides better care because it's a not-for-profit hospital. But please, read it yourself and draw your own conclusions -- not someone elses, including mine.

I managed to capture it, page by page into 3 parts, but the resultant .pdf files total 15.2Mb, so I won't be uploading it anywhere. But if we ever create a repository for all information, pro and con, I can make it available.

 

All,

Here's another report titled "Hospital Ownership and Cost and Quality of Care: Is There a Dime’s Worth of Difference?" (Dec 1998). I lost the link to this report but do have a Word document file of it. The following conclusion is a direct quote form the report:

Conclusion
Adjusting for endogeneity, we found that for-profit hospitals were more expensive to Medicare. The higher cash flow to for-profits plausibly reflects their greater incentive to maximize reimbursements from payers by various means including formal and informal contractual relationships with other suppliers of health care services.

Endogeneity may reflect patient choice of hospital conditional on a choice set and/or endogeneity of the choice set. Since we confined the analysis to first shocks, the former may not be an important influence. However, it is plausible that for-profit firms would have a greater propensity to locate where they could make more money. Empirical evidence from past research supports this view (Norton and Staiger 1994). The fact that we did not find endogeneity in the outcomes analysis also suggests that patient choice of hospital is not the main source of endogeneity.

Above, we explained that nonprofit organizations may exist because they soften incentives to produce easily monitored outputs and to under producing hard-to-measure ones. In other words, such organizations may be less likely to cut corners at the expense of quality that customers cannot observe. Applying this concept to hospitals, a profit-seeking firm might cut corners on care that has beneficial effects downstream. Outcomes analyzed in this study clearly fit in the “hard-to-monitor” category. For example, mortality during the hospital stay may be partly observable, but mortality differences several months after discharge would be very hard for customers to trace. We found that nonprofit hospitals were better than for profits on mortality, but if anything, slightly worse on other outcomes, conditional on living to the next interview. For some persons, the tradeoff seems to be between living shorter or living longer but enjoying life less. On balance, therefore, hospital ownership does not seem to make a difference on quality.

Of course, there may be other hard-to-measure outcomes that may be relevant, but we have studied the major ones. Elsewhere, we assessed the probability of readmission to a hospital for the same diagnosis and found no differences by ownership (Sloan and Taylor forthcoming).

Empirical studies comparing public and private for-profit enterprises have been conducted for a variety of industries, especially electricity generation and distribution, water, and refuse collection. Overall, the evidence on comparative performance has been mixed. Based on their review, Vickers and Yarrow (1988) concluded that competition in the enterprise’s product market may be a more important determinant of performance than ownership per se.

Unfortunately, there is little evidence on comparative performance of private for-profit and nonprofit firms other than for hospitals since the latter are only highly represented in only a few sectors, such as health care and education.

In sum, considering differences by ownership, there is a dime’s worth of difference for Medicare. However, the hypothesis that for-profits engage in cost cutting at the expense of quality does not receive support. Compared to previous studies of hospitals, our analysis represents a major advance in measuring program costs and outcomes longitudinally, with relatively many measures of relevant outcomes.

 

Donna,