Montgomery County, City negotiate MOU for new Premise medical center; commission seeks clearer terms

Montgomery County commissioners and county staff discussed a draft memorandum of understanding with the City of Montgomery on plans for a new downtown Premise medical facility, with the city to lead construction and the county to share project costs.

County staff said the project "is not expected to exceed 5 and a half million dollars total," and that the county's share would be about $2.7 million, to be paid as construction progresses rather than in a single lump sum.

The proposed facility would sit on city-owned land in a Patterson Field parking area near Louisville Tun…kett Road and is intended to expand services now provided at the county's Hull Street Premise site, staff said. The draft calls for the city to be primarily in charge of construction and design, and would add services such as occupational medicine and a drive-through pharmacy that staff said could reduce appointment backlog.

The MOU is the result of more than a year of discussions, county staff told the commission. "The city is going to take a parcel of land that they own downtown ... and they are going to have the architect as well as they're going to possibly be the lead in the construction of a brand new state-of-the-art Premise facility," a county staff member said. "It is not expected to exceed 5 and a half million dollars total." The staff member also said the county match would be roughly $2.7 million and that those payments would be disbursed through the construction process.

Commissioners pressed staff to provide more detail in writing before taking formal action. Several members asked why existing vacant office space downtown or repurposed school buildings were not considered. "We're going to spend $5,500,000 on new construction when we continue to have existing office spaces throughout the city," one commissioner said, asking whether alternatives had been evaluated. Staff responded that the city had reviewed some office buildings but found either insufficient space or inadequate parking to meet the program requirements.

Commissioners also questioned how ongoing operations would be handled if the city owns and maintains the new building. Staff said that maintenance and utilities were matters for negotiation and that the city currently handles certain outside repairs while the county has handled interior maintenance and utilities on the current Hull Street site; staff promised a fully scoped MOU for commissioners to review before the next meeting.

Several commissioners stressed that the MOU is negotiable and said they wanted a revised draft. "We'll have a brand-new, fully scoped out MOU by the next meeting, and we'll put it back on the information session so you all will have time to look at it, review it, and consider it," county staff said.

County officials also clarified how the existing Premise arrangement operates: Premise functions as a contractor that provides staffing, medications and supplies, while the county and other participating entities are charged based on utilization. "They are all Premise employees ... basically we are charged on utilization," a county representative said.

The commission did not vote on the MOU; staff said the document will return to the information session after edits and negotiation with the city.

If adopted, the project would create additional capacity for county and city employees and include features staff described as reducing wait times, such as a drive-through pharmacy.

The commission directed staff to negotiate outstanding details and return with a clarified MOU for review; there was no formal approval at the session.