department of public health facilities plan may 2011 15/department of... · past & recent...

Department of Public Health Facilities Plan-update Report to the Health Commission January 15, 2013

JANUARY 2013

Prepared by Mark A. Primeau, AIA, Capital Integration Advisor to the Health Department

Potrero Hill Health Center Renovation Gala Celebration

Department of Public Health Facilities Plan-update January 2013

The initial Facilities Plan was presented to the Health Commission on May 17, 2011.

This Facilities plan is updated (2013) and contains new emerging capital needs.

The purpose of this Facility Plan is to provide a road map and strategy for continued support, funding, and improvements to the Department of Public Health capital infrastructure.

The Plan chronicles past & recent capital improvement projects and contains project schedules for all ongoing Major Projects that are funded, exceeding $1 million. Please refer to Appendix B-Major Project Schedules contained in the plan.

Supports the City’s 10 yr Capital Plan to maintain City buildings in a state of good repair to support the efficient and effective delivery of services. *

*This Purpose statement is from the City’s Capital Plan

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Department of Public Health Facilities Plan-update

January 2013

The Facilities Plan is divided into four parts:

Part 1: Highlights of the Facilities Planning Retreat-September 2012

Part 2: Capital infrastructure background & overview

Capital assets overview

Past & recent accomplishments

Capital funding & Birth of the City’s 10 year Capital Plan

Part 3: Current major projects

Current on going major projects over $1 million-see Appendix B in the Facilities Plan project schedules

Project descriptions

Capital requests-FY12-13 through FY 14-15

Part 4: Emerging needs & future next steps

Emerging capital needs

Capital project list for future requests

Future General Obligation Bond-November 2015

Lessons Learned & Strategies for the future

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Part 1: CAPITAL PLANNING RETREAT:

o Held on September 10, 2012

o Over 40 participants-including Health Director & Deputies, CEO’s

from SFGH/LHH, CFO & Financial Directors, Facility/Operations

staff department wide attended

o Purpose of the Retreat was to:

o Collectively develop a road map for space planning

decisions

o Establish a framework for determining funding needs for

future major capital projects

Key Planning Drivers

To guide decision-making during the planning retreat, key drivers

were identified as noted below:

1. Consolidation : To increase operational efficiencies by

relocating departments currently scattered throughout the

campus and from off-site into locations that increase efficiencies

and reduce costs

2. Decompression: To relieve overcrowding of programs

3. Retrofit: To plan for the orderly retrofit of buildings identified in

previous assessments as requiring seismic upgrades.

Part 1: CAPITAL PLANNING RETREAT:

o Participants gained an understanding of the department’s space

needs

o Learned about future major capital projects required to achieve

seismic safety and meet objectives for relocation strategies

o Participated in the decision making regarding specific relocation

strategies for the Department at:

• SFGH CAMPUS

• LAGUNA HONDA CAMPUS

• DPH HEADQUARTERS-101 GROVE STREET

• STD CLINIC

• 1380 HOWARD STREET

o Learned about plans for major UC Projects on the SFGH CAMPUS

o Collectively develop a road map for space planning decisions & a

framework for determining future capital funding needs

Part 1: RETREAT OUTCOMES:

1. SFGH Campus: new hospital, existing hospital, older

brick buildings

2. STD/TB: relocation & consolidation strategies

3. UC: Planned Capital Projects: Impact on SFGH Campus

4. 101 Grove Street / Tom Waddell Clinic -seismic upgrade &

Lab relocation

5. 1380 Howard Street-swing space & relocation strategies

6. Laguna Honda Hospital Campus: re-use of remaining wing

buildings

Part 1: Six MAJOR SPACE NEEDS / RELOCATION

STRATEGIES WERE EXAMINED:

.

¼”

Behavioral Health

and Rehabilitation

B80

B90

B2

(Service

Building)

B

3

B4

B1

B100

B5

(Existing

Hospital)

B25 (New

Hospital)

B1

0

B2

0 B3

0

B4

0

B

9

Parkin

g

Garage

B/C Lot –

Proposed location

for UC Research

Building

SFGH CAMPUS MAP

MOVE 1:

A: ACUTE CARE SERVICES MOVE FROM EXISTING HOSPITAL BLDG. 5 TO NEW HOSPITAL BLDG.

25

B: MORGUE MOVES FROM BUILDING 3 TO NEW HOSPITAL BUILDING 25

MOVE 2:

A: RETROFIT EXISTING HOSPITAL BUILDING 5

MOVE 3:

A: ANATOMIC PATHOLOGY MOVES FROM BUILDING 3 TO BUILDING 5

B: PUBLIC HEALTH LAB MOVES TO BUILDING 3

C: OUTPATIENT SERVICES MOVE FROM BUILDINGS 80/90 TO BUILDING 5

D: STD CLINIC MOVES TO BUILDING 5

E: RETROFIT BUILDING 80 /90

MOVE 4:

A: BUILDING 40 TO BE USED AS CONSTRUCTION STAGING AREA

B: CONSTRUCT NEW UCSF RESEARCH BUILDING

MOVE 5:

A: UCSF DEPARTMENTS IN BUILDINGS 1, 10/20, AND 30/40 MOVE TO NEW UCSF RESEARCH BLDG.

B: RETROFIT BUILDINGS 1, 10/20, AND 30/40

SFGH CAMPUS SEQUENCING MOVES

Morgu

e

MOVE 1

RELOCATION B

LEGEND

Department Moving

Buildings are impacted

1”

MOVE 1:

A: ACUTE CARE SERVICES

MOVE FROM EXISTING

HOSPITAL BUILDING 5 TO

NEW HOSPITAL BUILDING 25

B: MORGUE MOVES FROM

BUILDING 3 TO NEW

HOSPITAL BUILDING 25

ACE

Admin – Nursing

Admitting

Cardiology / Cath Lab

Central Sterile

Processing

Clinical Lab – Blood

Bank

Diagnostic Imaging

Emergency Department

ICU / CCU

Med / Surg

Med / Surg - Forensic

Med / Surg - Step

Down

Med / Surg - Trauma

NICU

Obstetrics – Post

Partum / LDRP

Patient Intake /

Recovery

Pediatrics

Surgery / Operating

Rooms

MOVE 1

RELOCATION A

Diagram A-showing the sequenced relocations after completion of the new Acute Care Facility (Bldg. 25):

168,000 square feet of acute care services move from existing Main Hospital to New Facility

Morgue moves from Bldg. 3 into the new Acute Care Facility

Once the above moves are made-the existing Main Hospital is ready for renovation

Diagram A

1/4”

1/8”

LEGEND

Buildings are impacted

Proposed Building

Department Moving

MOVE 5:

A: UCSF DEPARTMENTS IN

BUILDINGS 1, 10/20, AND

30/40 MOVE TO NEW UCSF

RESEARCH BUILDING

B: RETROFIT BUILDINGS 1,

10/20, AND 30/40

Diagram C-showing the sequenced relocations to a proposed new UC Research Facility to be located on the

B/C surface parking lot adjacent to the existing Main Hospital.

UCSF Departments in Buildings 1,10/20,30/40, and 100 move into UCSF Research Facility

The Research facility is still be developed and programmed out-approximately 160,000 square

feet in size

The Research Facility be must completed and operational by 10/2019

Diagram C

1”

OVERVIEW OF SFDPH RELOCATION AND

SEISMIC RETROFIT MASTER PLAN

Diagram D depicts the phased relocation of occupants from 101 Grove Street to 1380 Howard

Street and the Public Health Lab to SFGH Building 3 to allow for the seismic upgrade work at

101 Grove Street.

This plan assumes that the occupants of 1380 Howard can be relocated to space at Laguna

Honda Hospital in Wards D,E,K,L,M, O. Once the construction work is complete, staff will

reoccupy 101 Grove Street-and the lease at 1380 Howard can be terminated. The lease

currently costs the Department $1.5 million annually.

Diagram D

.

North Building

South Building

Pavilio

n

Administratio

n Building H

Wards

B A

C D E K M

G F

L O

LHH CAMPUS MAP

Part 1: NEXT STEPS FROM THE RETREAT:

o Based on the roadmap developed in the planning retreat –prepare an implementation schedule of

planned projects at:

• SFGH CAMPUS

• LAGUNA HONDA CAMPUS (re-use of wings).

• DPH HEADQUARTERS-101 GROVE STREET SEISMIC UPGRADE (using 1380 Howard St. as swing

space).

o Based on the roadmap/schedule prepare updated cost estimates for:

• SFGH Buildings: 5, 80/90, 10,20,30,40

• 101 Grove St

• LHH reuse tenant improvements

o Submit updated funding needs to Capital Planning to inform City’s 10 yr Capital Plan.

o Include updated funding needs in the revised DPH Facilities Master Plan.

Department of Public Health Facilities Plan-update January 2013- Part 2: Capital infrastructure background & overview

DPH operates and maintains over 42 facilities that provide direct public health services to city

residents.

The 42 facilities account for over 2.4 million square feet of space.

DPH leases another 18 sites, totaling 222,672 square feet.

DPH ranks #2, with 2.4 million square feet, just behind the Department of Real Estate which serves as the City’s landlord

Of the 42 facilities, DPH operates two large medical campuses

which together account for 24 facilities, and constitute 65% of the department’s overall facility capacity.

City Departments Department of Real Estate 5,393,738 Department of Public Health 2,404,578 Department of Recreation & Parks 1,880,039 Sheriff 829,674

War Memorial 792,700

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Departments with Most Square Footage

(Top 5)

ADM

5,393,738

DPH

2,692,383

REC

1,907,539

WAR

792,700

SHF

716,600

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January 2013- Part 2: Capital infrastructure background & overview

An Unprecedented wave of over $1.7 billion of capital improvements to the Department’s facilities has occurred in the last 10 years (including on-going work).

During this time, over 60% (1.5 million square feet) of the Department’s facilities/sites were in some phase of design and/or construction.

Of the $1.7 billion, over $ 1 billion is underway in either design, or in construction. The majority of this work is at SFGH Medical center where the new acute Care Hospital is under construction, nearing 50% completion on target for final occupancy in late 2015.

Several major capital improvement programs make up the majority of a $1.7 billion capital investment over the last 10 years Laguna Honda Rebuild- $585 million, the 500,000 square feet of new construction and 150,000

square feet of remodeling.

Primary Care Modernization Program-9 Health Clinics, $17 million, increased exam rooms by 48%

SOAR –, $10 million, San Francisco Office of AIDS Renovation Project-95% complete

SFGH Rebuild-$887.4 million, new 448,000 square feet Acute Care Hospital, -50% complete

Golden Gate Avenue Tenderloin Clinic,-$3 million, 11,000 sq. ft., adds 19 exam rooms-complete-2012

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January 2013- Part 2

Results of the Primary Care/ Behavioral Health Modernization Program include: Renovation of nine clinics -$17 million, The total number of exam rooms at

clinics have increased by 48% adding 16 rooms for a new total of 55 system- wide. New and reconfigured space in the clinics will increase potential medical visit capacity by 30% (2008) to 34,100 visits per year

Elevator improvements at 4 clinics increased program & ADA access to services to the second floor

Potrero Hill Renovation –complete 2012

Sunset Renovation Project –complete 2012

220 Golden Gate Avenue-Tenderloin Clinic-11,000 sq. ft & 19 Exam rms

Results of the SFGH Rebuild Acute Care Hospital: 50 % complete while maintaining overall budget-$887.4 million

Results of the SOAR Renovation Project: 95 % complete while maintaining overall budget-$10 million

On target for final completion –January 2013, one year ahead of original schedule

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JANUARY 2013- Part 2: Past Capital Funding

Table 3 of the report-Overview of Capital investments over the

last seven years

GF

Appropriation

s to DPH

MOD-DPH

Projects

Other Non-

GF

Total % of

Total (All

Sources)

FY 06-07 18,401,000 2,479,365 0 20,880,365 16%

FY 07-08 17,824,500 2,793,361 0 20,617,861 17%

FY 08-09 11,629,348 3,032,500 83,938,851 98,600,699 54%

FY 09-10 2,303,941 1,533,868 24,282,700 28,120,509 12%

FY 10-11 3,980,000 3,500,000 0 7,480,000 6%

FY 11-12

6,195,000 2,951,824 10,852,907 19,999,731 24%

FY 12-13

8,540,000 7,033,200 0 15,573,200 16%

Total 68,873,789 23,324,118 119,074,458 211,272,365 22%

Adjusted

Total

63,285,481 18,140,837 119,074,458 200,500,775 21%


JANUARY 2013- Part 2: Past Capital Funding

Table 3 shows the level of funding from the General Fund over the last 7 years. In FY 06/07 thru FY 12/13 substantial funding was provided for pre-planning on the SFGH Rebuild.

This funding ensured the project would complete its CEQA findings into a certified EIR approved by the Board of Supervisors in July 2008, as required before the project could be place on the ballot in November 2008.

The Table also indicated non General Fund-COP-Certificates of Participation that helped fund FFE for the Laguna Honda Rebuild in FY 80/09 & FY 09/10.

*Also note the bottom row-labeled Adjusted Total: This adjusted total reflects mid year cuts that occurred during FY 08/09 thru FY 10/11.

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JANUARY 2013-Part 2: City’s 10 year Capital Plan

How the Plan came into existence

In August 2005, concerns from City leaders, citizens, Mayor Newson and the Board of Supervisors culminated in developing Administrative Code sections 3.20 and 3.21 requiring the City to annually develop and adopt a ten-year constrained capital expenditure plan for city-owned facilities and infrastructure.

Capital Plan timelines

By March 1 of each odd-numbered year, the City Administrator shall submit to the Mayor and Board of Supervisors a ten-year capital expenditure plan.

By May 1 of the same year, the Mayor and Board of Supervisors shall annually review, update, amend, and adopt by resolution the ten-year capital expenditure plan.

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January 2013- Part 3 Current Major Projects-15 Projects

Major projects are defined as those that either have full or partial funding-over $1 million, and have enough scope definition to prepare a project baseline schedule. In most cases, these projects are in advanced phases of design and/or construction.

PRIMARY CARE, BEHAVIORAL HEALTH SERVICES – (4 Projects) Sunset Mental-base project complete-additional work being done

Southeast Health Center Behavioral Health Services Integration Project

SOAR Renovation Project

Maxine Hall Elevator & Health Services Improvements Project

LAGUNA HONDA CAMPUS - (2 Projects) Laguna Honda Remodel Project-Wards A, B, C, H

Site Improvements

SFGH CAMPUS - ( 9 Projects) Rebuild, Emergency Generator

Fema Equipment Bracing

Bldg. 80/90 Elevators, Bldg.5 Elevators

Bldg. 5 ADA-2 projects

SFGH Campus Signage

ADA improvements –Public restrooms & exterior ramps

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2012-2013 Capital Request for DPH The FY 2012-13 capital budget totals $15.5 million in for maintenance, capital renewal and

accessibility improvements at health clinics and hospitals.

Overall Capital Projected Need $ 36,439,000

Capital Budget Proposed Funding $15,573,200 -this is 58% less than the projected capital funding need

FY 12-13 Capital Budget

by Service Category Column 1 Column 2 Column 3 Column 4

GF Sources Only Pie Chart A Pie Chart B Pie Chart C Pie Chart D

GF REQUEST Scenario 1 Scenario 2 Scenario 3

Capital Plan* Mid-level Low-level

Economic Development $ 1,700,000 $ 1,000,000 $ 500,000 $ 500,000

General Government $ 10,914,478 $ 4,927,093 $ 4,095,393 $ 3,630,242

Public Health $ 18,169,746 $ 11,344,000 $ 9,643,000 $ 8,540,000

Human Services $ 11,377,591 $ 10,539,155 $ 9,009,544 $ 8,920,097

Infrastructure & Streets $ 22,351,793 $ 13,268,294 $ 11,293,866 $ 9,297,472

Public Safety $ 37,044,251 $ 10,735,782 $ 8,643,709 $ 7,214,635

Recreation, Culture &

Education $ 29,249,364 $ 11,109,883 $ 9,534,633 $ 7,823,327

Pay-as-you-go Total $ 130,807,223 $ 62,924,207 $ 52,720,144 $ 43,425,773

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2012-2013 Capital Budget for DPH

Facility Requested Funding CPC Approved Budget

SFGH FM NA $1,100,000

LHH FM NA $950,000

101 Grove St FM NA $50,000

Behavioral Health FM NA $110,000

Primary Care FM NA $300,000

SFGH Bldg. 5 Elevator Replacement $2,000,000 $2,000,000

Southeast HC Consolidation Project $2,500,000 $2,500,000

Seismic Studies: 101 Grove St, Bldg. 5

& SFGH Campus Buildings

$1,000,000 $1,000,000

Laguna Honda Hospital Boiler Retrofit $280,000 $280,000

Curry Rear Wall Repair $250,000 $250,000

Mayor’s Office on Disability funding $7,033,200 $7,033,200

TOTALS $25,020,946 * $15,573,200

The approved FY 2012-13 capital budget totals $15.5 million in for maintenance, capital renewal and accessibility

improvements at health clinics and hospitals. This budget represents 62% less than the projected need for FY2012-13.

* This number includes other smaller requests listed in detail on page 18 of the Facilities Plan 23


January 2013-Part 4 : Emerging capital needs & future next steps

Even though the Department, through various funding sources, has invested over

$1.7 billion in its capital infrastructure, it is projected that another approximately $1

billion remains to be implemented (when escalated into the future to mid-point-of-

construction).

The Department is aggressively planning on and advocating for a bond measure on

the November 2015 Ballot, amount estimated to be $435 million, to include the

following: Existing Main Hospital-Bldg. 5- $190 million

Bldg.'s 80/90-SFGH Campus- $60 million + $13 million for Cooling Towers

101 Grove Street, DPH Headquarters-$150 million

Southeast Health Center- Behavioral Health Services Consolidation -$22 million

In February 2012, DPH & UC initiated a task force to foster collaboration of planned

capital improvements between the agencies on the SFGH Campus. UC is planning

for a new research facility on campus along with interim seismic measures at various

buildings on campus.

In 2012, the Department initiated a study into the possible re-use of the older LHH

wings to accommodate DPH programs in leased space throughout the City.

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January 2013- Part 4 : Future Bond Measure

25

Last year, the Department was successful in getting a place holder for some of the seismic

upgrading work into the City’s 10 year Capital Plan for 101 Grove Street, including a new

extension to Van Ness Avenue, and funding for the Existing Main Hospital in a General

Obligation Bond currently planned for 2016, in the amount of $510 million.

However, after reviewing preliminary seismic reports, behavioral health services integration

plans, and the priorities for back filing the existing main hospital at SFGH, the planned

Bond program was re-configured to include the following projects:

Existing Main Hospital (Building 5): $190 million1

Building: 80/90: $60 million1

Critical renewal infrastructure-SFGH-cooling towers/roof: $13 million

101 Grove Street: $150 million1

Southeast Health Center/Behavioral Health Services Integration Project: $22 million2

Total: $435 million

1 Estimated project costs are rough order of magnitude. Additional seismic studies and more detailed cost

estimates will be prepared in 2013. 2 The Southeast HC project’s total cost is $25 million. The project has $3 million in MHSA funding.


January 2013- Part 4 : Emerging capital needs & future next steps

CAPITAL ACTIVITIES FOR 2013-PRIMARY CARE/BEHAVIORAL

HEALTH SERVICES/ADMINISTRATION 1. Request funding for Clinic Patient Enhancement Program-this work would make improvements

/enhancements to several primary care clinics in advance of 2014 Healthcare Reform

2. Request funding for expansion potential at specific primary care clinic sites

3. Request additional funding to make patient care improvements to the 2nd floor at Maxine Hall

4. Initiate review and study of Tom Waddell Urgent Care services

5. Work with the Controller’s Office of Public Finance to identify alternate funding strategies for

the Southeast Health Center Project

6. Continue to review technical requirements & refine cost estimates for projects included in the

future bond measure

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CAPITAL ACTIVITIES FOR 2013-SFGH CAMPUS 1. Continue technical studies & refine cost estimates for project on campus included in the future

bond measure

2. Review programming requirements for Bldg. 5

3. Continue collaboration with UCSF on interim seismic measures and planning for the new

Research Facility and planning for expanded parking on campus

4. Request funding for In-patient pharmacy expansion

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CAPITAL ACTIVITIES FOR 2013-Laguna Honda Campus 1. Complete studies for and initiate improvements to the re-use of Wards: D,E,K,L,M,O

2. Complete RFP process and initiate procurement for the Dialysis Project

3. Request funding for a Master Plan

4. Continue exterior waterproofing & window replacement program

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Lessons Learned & Strategies for the future Several key strategies that have emerged as valuable lessons to be applied to

future capital projects. They include:

Early and continued advocacy with past capital funding partners-.i.e. Mayor’s

Office on Disability, Mayor’s Office of Community Development, and Public Utility

Commission.

Establish client- based project teams including operational staff input early in the

project initiation

Acquire pre-bond funding for planning ,and environmental activities for large

major projects

Maximize opportunities to relocate staff from leased space into City-owned

properties

Include Information technology Staff –DPH/DT in programming meetings early

on in the project budgeting process

Utilize alternate delivery projects methods on projects where the process will

benefit the project either through project savings or in schedule enhancements

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