The Missing Piece: Cherokee Indian Hospital, Phase II – Addition of the Behavioral Health and Crisis Stabilization Unit

The Cherokee Indian Hospital Authority (CIHA) in Cherokee, North Carolina, has sought to provide simpler care to members of the Eastern Division of Cherokee Indians (EBCI) who require mental, behavioral, emotional health or substance abuse services. To help achieve this goal, the organization built an alternative facility to Cherokee Indian Hospital in 2015, where emergency department (ED) crisis care is provided, followed in 2018 by Kanvwotiyi, a 20-bed residential treatment center in Graham County, NC, which It features inpatient treatment and adult programs. But there was a void left: a safe and secure environment in which these patients could be stabilized before being transferred from hospital to residential care. The solution will help mitigate prolonged use of emergency beds to meet inpatient behavioral health needs and provide a dedicated space for mental health care services. “It was decided that if we really wanted to help and provide treatment to this community, we needed a whole gamut of services,” says Casey Cooper, CEO of CIHA.

CIHA decided to build an addition on the campus, but a former 1970s hospital is standing in the way, with part of the vacated building still being used as administrative and storage space. Working with an architecture firm Macmillan Bazdan Smith ArchitectsE (Charlotte, NC) and Construction Management Inc. Robins and Morton (Birmingham, Ala.), Leadership then considered demolishing the 77,000 square foot hospital, but soon realized it would be too expensive. Instead, says Josh Farr, a supervisor at Robins & Morton, the team ultimately opted to demolish only part of the building, salvage and renovate 34,000 square feet for ongoing administrative use and add 43,000 square feet to create an outpatient clinic and crisis unit that connects to the main hospital — a move that It saved nearly a million dollars.

The first floor of the addition opened in June 2020, and houses a behavioral health outpatient clinic with 13 counseling rooms, an exam room, small and large group rooms, and two large classrooms. The second floor crisis stabilization unit includes 18 behavioral health inpatient rooms, four acute care patient rooms equipped to support someone in a health crisis, and two large group therapy rooms.

To ensure that the building fit within the campus and reflects the culture of EBCI, the project team met regularly with a panel of tribal members and elders for input. “The symbols, materials, and outdoor cultural elements seamlessly fit into the Cherokee Indian Hospital to convey the message that the programs inside are just as important to the mission and vision of the facility,” says Kristi Adams, Healthcare Sector Leader and Project Director at Macmillan Bazdan Smith Architecture. For example, the design of the terrazzo floors in the hospital’s entry area and main corridor illustrates a local legend – a detail carried over to the new addition with the legend of a magical lake represented in the floor. From the outside, a unique design depicting the symbol of the wind matches the exterior of the new hospital. “The addition seems to have always been part of the campus,” Farr says.

Project details:

Project Name: Cherokee Indian Hospital, Phase II – Addition of Behavioral Health and Crisis Stabilization Unit

Location: Cherokee, North Carolina

Project completion date: June 2020

Owner: Cherokee Indian Hospital Authority

Total building area: 80,000 square feet.

Total construction cost: $36 million

Cost / square meter. Feet: $469

Architecture: Macmillan Bazdan Smith

Interior Design: Macmillan Bazdan Smith

General Contractor: Robins & Morton

Engineering: RN&M (Mechanical), 4D Engineering (Civil), SKA Consulting Engineers (Structural)