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The list of environmental requirements that Sutter Health must meet to open its $284 million hospital north of Santa Rosa is set to grow longer — again.

The additions are to include a free shuttle linking the 82-bed hospital, under construction next to the Wells Fargo Center for the Arts, to the nearest SMART train station.

Sutter also will be required to provide incentives to employees who carpool or use alternative transportation.

The hospital itself and an adjacent medical office building also will have to meet some of the strictest energy efficiency and sustainability requirements for buildings. Those LEED Silver standards will make the facility, set to open in October 2014, one of the greenest hospitals in the state.

The additional measures are meant to help Sutter and Sonoma County comply with a third court decision calling for stronger measures to offset the hospital's environmental footprint.

The moves appear to have satisfied project critics, who say they are likely to drop the rest of their legal challenge given likely approval today of the new measures by the county Board of Supervisors.

"The county has done a good thing," said Steve Birdlebough, a Sierra Club representative.

The group joined hospitals in Healdsburg and Sebastopol, the California Nurses Association and a San Rafael environmental group, Transportation Solutions Defense and Education Fund, in suing the county over its 2010 approval of the Sutter facility.

Sonoma County Superior Court Judge Rene Chouteau rejected most of their case in his initial ruling last June but faulted the county on two issues, the more significant of which ordered supervisors to strengthen offsetting measures for greenhouse gas emissions connected to the new hospital and a next-door medical office building.

The county's first attempt to comply with that order, a package advanced by the Board of Supervisors in August, fell short, Chouteau ruled. The proposal included a one-time Sutter payment of $185,000 toward a bike lane or pathway, plus another agreement to work with the county on development of a SMART shuttle.

The expanded proposal keeps the bikeway payment in place; Sutter officials say it already has been made. It requires Sutter provide the shuttle service linking the hospital to the nearest Sonoma-Marin Area Rail Transit District station once the commuter line reaches Santa Rosa. That station likely is to be the one proposed at Guerneville Road near Coddingtown.

The other new measures require efforts that either were already planned or were being explored, Sutter officials said.

"We're pleased to be putting the bow on the final pieces here and moving forward," said Mike Purvis, chief administrative officer of Sutter Medical Center Santa Rosa.

He said the project remains on schedule and within its projected budget.

Purvis did not have an estimate for what Sutter would have to pay to establish and run the SMART shuttle.

Another requirement — a natural gas-powered fuel cell that will provide more than half of the hospital's electricity — is set to add $80,000 in costs, Purvis said.

The developer and tenants of the associated medical office building will share the estimated $500,000 in costs to make the building LEED Silver certified, he said.

After the board's vote today, Chouteau will review the county's proposal to determine whether it satisfies his order.

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Other measures required of Sutter when the hospital was approved include:

- More than $2 million in road improvements in the area and a net payment of about $300,000 in traffic impact fees.

- Work on coordinating and expanding bus service to the area.

- More than $600,000 for water-saving home retrofits, an offset equivalent to covering nearly 800 single-family houses.

In 2010, Sutter officials estimated environmental mitigation costs for the project were $5.6 million. Combined with environmental studies and work on a health care access agreement, total costs in the approval process were pegged at the time at nearly $12 million.

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