CaseStudy:New medical center and the replacement of Charity Hospital in New Orleans

The Louisiana state-owned Charity Hospital and the U.S. Department of Veterans Affairs (VA) Medical Center sustained extensive damage during Hurricane Katrina on August 29, 2005, and have been closed to the public since that time. Both the VA and the Federal Emergency Management Agency (FEMA), through its public assistance program, are working to meet the need to restore health care for uninsured, indigent, and veterans in New Orleans. The selected locations for the replacement hospitals are adjoining sites in the National Register-listed Mid-City Historic District. VA and FEMA consulted with local and state government, neighborhood organizations, and historic preservation groups to reach an agreement that was executed on November 14, 2008.

The urgent need to replace these vital medical facilities damaged by Hurricane Katrina necessitated an expedited consultation process. In addition, the selected alternatives will cause substantial adverse effects on the Mid-City Historic District and various individual historic properties including the locally iconic Charity Hospital. The National Trust identified Charity Hospital and the adjacent neighborhood (Mid- City Historic District) on its 11 Most Endangered Places List in 2008. The level of public controversy regarding these undertakings continues to be high. The federal agencies and the consulting parties struggled to identify and resolve the full range of adverse effects of the project alternatives for these separate but adjacent undertakings.

The agreement reached among the VA, FEMA, the Louisiana State Historic Preservation Officer (SHPO), the state of Louisiana, the city of New Orleans, and the Advisory Council on Historic Preservation (ACHP) provides a $24 million package of treatment measures targeted to address issues raised by the public and consulting parties. The stipulations regarding the selected sites include the following:
 * The SHPO will establish a program to promote the preservation and rehabilitation of the Mid-City Historic District. VA, the city, and the state will contribute up to $1.4 million to support the costs of this program. The Louisiana SHPO will have the discretion to work with stakeholders to develop the criteria for program expenditures. Similar SHPO programs indicate it may be appropriate to limit expenditures to $20,000 projects with a 50/50 matched investment by the property owner in kind or cash.
 * The SHPO will also establish a program so that the city will pay for homeowners to move their buildings from within the selected site for the new VA Medical Center to another location within the Mid-City Historic District. VA and the city will contribute up to $800,000 to support the costs of this program. With eligible costs to move each building limited to $40,000, this program may fund as many as 20 individual house moves.
 * VA plans to re-use and rehabilitate the Dixie Brewery and the Pan-Am Building in its new medical center. The state will, if feasible, avoid acquiring, and thereby preserve, the Deutches Haus and Orleans House on the outside edges of its selected site. Louisiana will develop and implement a marketing strategy for Charity Hospital if the state cannot re-use the historic building. This marketing strategy will seek to identify appropriate adaptive re-uses and incentives for its preservation (including state and local tax incentives). Through this stipulation, the state has provided a framework for preservation of Charity Hospital.
 * Buildings and structures contributing to the Mid-City Historic District will be demolished for construction. Selected sites will be documented, and architectural elements will be salvaged and donated to a local nonprofit that will recycle them back to the community. This salvage effort is acknowledged to address, in part, environmental responsibility issues raised by the consulting parties.

Since Congress has already appropriated funds for this undertaking, VA is acquiring the property within its selected site and beginning design of the approximately 1 million-square-foot, state-of-the-art medical center. VA is coordinating with the SHPO to establish the Mid-City Historic District rehabilitation program and the house moving program. The urgency to complete the project and restore health care for veterans as soon as possible indicates that monitoring and assistance from the ACHP will continue so that potential disputes among the parties do not lead to delays in project planning and delivery. Louisiana and FEMA continue to work to determine the amount of FEMA’s assistance for the new public hospital. Such discussions and current financial market constraints could potentially delay progress toward property acquisition and design of the new hospital. If such delays are protracted, the ACHP may work with the parties to amend the agreement to adjust timeframes for relevant stipulations.