REPORT TO THE CITY COUNCIL
FROM: JENNIFER K. CLARK, Director
Planning & Development Department
THROUGH: PHILLIP SIEGRIST, Planning Manager
Planning & Development Department
BY: RALPH KACHADOURIAN, Supervising Planner
Planning & Development Department
SUBJECT
Title
***BILL B-9 (Introduced March 27, 2025) (For Adoption) amending Section 15-6703 and Article 68 of the FMC to define a Sub-Acute Care Facility and to include Sub-Acute Care Facilities in the description for Hospitals (Subject to Mayor’s Veto)
Body
RECOMMENDATION
Staff is recommending approval of Text Amendment Application No. P23-03472 amending Section 15-6703 and Article 68 of the Fresno Municipal Code (FMC) relating to Hospitals and Sub-Acute Care Facilities and Terms and Definitions and adoption of the related environmental determination dated January 15, 2025.
EXECUTIVE SUMMARY
Text Amendment Application No. P23-03472 proposes to add Sub-Acute Care Facility as a new term and definition under Article 68 of the FMC and identify a Sub-Acute Care Facility as an ancillary facility to be included in the sub-classification of Hospital under Section 15-6703 FMC. The Text Amendment application is proposed to allow medically related long-term care in a facility meeting the definition of a Sub-Acute Care Facility. A Sub-Acute Care Facility does not include treatment facilities for alcoholism, drug abuse, sexual or psychological disorders. A Sub-Acute Care Facility would be permitted only within zone districts where Hospitals are permitted.
BACKGROUND
Dr. Justice Otchere, MD, of North Pointe Surgery Center, filed Text Amendment Application No. P23-03472 for the purpose of allowing medically related long-term care in a facility meeting the definition of a Sub-Acute Care Facility.
Article 67 of the FMC includes use classifications that describe one or more uses of land having similar characteristics (e.g. residential, commercial, industrial), but does not list every use or activity that may be appropriate within the classification. Additionally, Article 68 of the FMC includes terms and definitions.
Per FMC Section 15-6703 (Public and Semi-Public Use Classifications), the use classification of Hospitals and Clinics is defined as “State-licensed facilities providing medical, surgical, psychiatric, or emergency medical services to sick or injured persons. This classification includes facilities for inpatient or outpatient treatment, including substance-abuse programs as well as training, research, and administrative services for patients and employees. This classification excludes veterinaries and animal hospitals (see Animal Care, Sales, and Services).”
There are three (3) sub-classifications under the use classification of Hospitals and Clinics identified as Hospital, Clinic, and Substance Abuse Treatment Clinic. These more specific uses are described as follows:
Hospital. A facility providing medical, psychiatric, or surgical services for sick or injured persons primarily on an in-patient basis, and including ancillary facilities for outpatient and emergency treatment, diagnostic services, training, research, administration, and services to patients, employees, or visitors.
Clinic. A facility providing medical, psychiatric, or surgical service for sick or injured persons exclusively on an out-patient basis including emergency treatment, diagnostic services, administration, and related services to patients who are not lodged overnight. Services may be available without a prior appointment. This classification includes licensed facilities such as blood banks and plasma centers, and emergency medical services offered exclusively on an out-patient basis. This classification does not include private medical and dental offices that typically require appointments and are usually smaller scale. This classification includes substance abuse treatment and recovery programs which are not residential in nature, and which exclusively administer counseling services.
Substance Abuse Treatment Clinic. A facility that administers medication, or supervises the self-administration of medication, for substance abuse treatment.
Under the current Code, a Sub-Acute Care Facility is not defined, described, or included in a particular use classification. Text Amendment Application No. P23-03472 proposes to add Sub-Acute Care Facility as a term and definition to Article 68 under Sections 15-6801 (List of Terms) of the FMC (Exhibit A). The proposed definition for Sub-Acute Care Facility is as follows:
Sub-Acute Care Facility. A facility providing a level of care needed by a patient who does not require hospital acute care but who requires more intensive licensed skilled nursing care than is typically provided to patients in a skilled nursing facility. Sub-acute care facilities are licensed by the California Department of Public Health, and are focused on in-patient care, including medical supervision, 24-hour skilled nursing and supportive care, pharmaceutical, dietary, social, and physical activities. Patients are referred by a medical doctor for medical procedures requiring rehabilitative and therapeutic care following a surgical procedure. This use is different from other similar uses which are classified as residential uses (e.g. Elderly and Long-Term Care, Residential Care Facilities) in that patient stays shall not exceed 30 days and facilities have a more institution-like environment. This use does not include treatment facilities for alcoholism, drug abuse, sexual or psychological disorders.
Text Amendment Application No. P23-03472 also proposes to amend the description for the Hospital use classification under FMC Section 15-6703 to include Sub-Acute Care Facility as an ancillary facility (Exhibit A).
This type of facility is more intense than a Clinic, but does not meet the definition of Substance Abuse Treatment Clinic because the use does not include treatment facilities for alcoholism, drug abuse, sexual or psychological disorders. Further, this type of facility is different from the residential uses contained in FMC Section 15-6702 (Residential Use Classifications) in that it is not residential in nature, patient care is temporary, and care occurs in an institutional environment.
The proposed Text Amendment would allow a Sub-Acute Care Facility to be located only within zone districts where Hospitals are permitted and subject to applicable specific limitations and property development standards in accordance with the base zone district. Pursuant to Tables 15-802, 15-902, and 15-1002 of the FMC, Hospitals are not permitted in Buffer, Residential Single-Family, and Residential Multi-Family districts. Pursuant to Table 15-1102 of the FMC, Hospitals are permitted in the CMX (Corridor/Center Mixed-Use) and RMX (Regional Mixed-Use) zone districts with an approved Conditional Use Permit and subject to Specific Limitation No. 11 which provides a maximum building height of 150 feet for hospitals. Pursuant to Table 15-1202 of the FMC, Hospitals are permitted in the CC (Commercial - Community), CR (Commercial - Regional), and CG (Commercial General) zone districts with and approved Conditional Use Permit and subject to Specific Limitation No. 13 which provides a maximum building height of 150 feet for hospitals. Pursuant to Table 15-1302 of the FMC, Hospitals are permitted in the O (Office), BP (Business Park), RBP (Regional Business Park), IL (Light Industrial), and IH (Heavy Industrial) zone districts with an approved Conditional Use Permit and subject to Specific Limitation No. 11 which provides a maximum building height of 150 feet for hospitals. Pursuant to Table 15-1402 of the FMC, Hospitals are permitted in the PI (Public and Institutional) zone district and subject to Specific Limitation No. 5 which provides a maximum building height of 150 feet for hospitals. Pursuant to Table 15-1502 of the FMC, Hospitals are permitted in the DTN (Downtown Neighborhoods), DTG (Downtown General), and DTC (Downtown Core) zone districts along Activity Class B and C streets with an approved Conditional Use Permit.
PUBLIC NOTICE AND COMMENT
A public hearing notice for the City Council hearing was published in the Fresno Bee on March 17, 2025, pursuant to Fresno Municipal Code Section 15-5007(D) (Exhibit E). In addition, the notice was posted on the City Clerk’s website and provided to the City’s distribution list for such notices.
Review by Committees & Commission
Airport Land Use Commission
On August 5, 2024, the Fresno County Airport Land Use Commission considered and approved the proposed text amendment. (Exhibit F)
Council District Project Review Committees
Four of five active Council District Project Review Committees (Districts 1, 3, 4, & 6) reviewed and recommended approval of the text amendment with no additional conditions or recommendations. The Council District 5 Project Review Committee failed to establish a quorum at two (2) consecutive meetings on September 25 and October 23, 2024.
Planning Commission
The Planning Commission considered this item at its regularly scheduled meeting on March 5, 2025, and recommended City Council adoption the environmental determination and approval of the proposed text amendment. See Exhibit B for Planning Commission Resolution No. 13883.
ENVIRONMENTAL FINDINGS
An environmental determination was made for this text amendment in accordance with the requirements of the California Environmental Quality Act (CEQA). It was determined to be exempt from CEQA under the commonsense exemption that CEQA applies only to projects that have the potential for causing a significant effect on the environment pursuant to CEQA Guidelines Section 15061(b)(3). (Exhibit C)
This Text Amendment proposes only minor changes to the language of the text in the Development Code to identify and define a specific use type to be included in the Hospital sub-classification under the current use classification of Hospitals and Clinics. It would clarify that a sub-acute care facility is an ancillary use consistent with the current use classification and description of a Hospital. It can be seen with certainty that there is no possibility that the proposed text amendment may have a significant effect on the environment and therefore is not subject to CEQA.
FRESNO MUNICIPAL CODE
Section 15-5811 (Criteria for Development Code Text Amendment) of the FMC specifies that the Planning Commission shall not recommend, and the City Council shall not approve, an application unless the proposed Text Amendment meets the Text Amendment findings under Criteria A (1 and 2) of Section 15-5811. See Exhibit D for the required FMC Findings.
CONCLUSION
The appropriateness of the proposed Text Amendment has been examined with respect to its consistency with goals and policies of the Fresno General Plan, its compatibility with surrounding existing or proposed uses, and its avoidance or mitigation of potentially significant adverse environmental impacts. These factors have been evaluated as described above and by the accompanying findings, environmental determination, and exhibits. Therefore, based upon this evaluation, it can be concluded that the proposed Text Amendment No. P23-03472 is appropriate.
LOCAL PREFERENCE
Local preference was not considered because the Text Amendment does not include a bid or award of a construction or services contract.
FISCAL IMPACT
There is no fiscal impact to the City’s General Fund as a result of this action.
Attachments:
Exhibit A - Ordinance Amending Sections 15-6703 & 15-6801 of the Citywide Development Code
Exhibit B - Planning Commission Resolution No. 13883
Exhibit C - CEQA Exemption Determination Memo
Exhibit D - Fresno Municipal Code Text Amendment Criteria Findings
Exhibit E - Public Hearing Notice - (Fresno Bee 3/17/25)
Exhibit F - ALUC Consistency Determination Letter (8/8/24)
Exhibit G - PowerPoint Presentation