HomeMy WebLinkAboutMINUTES - 10131992 - 2.2 (3) zo:' BOARD OF SUPERVISORS
Contra
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FROM: PHIL BATCHELOR, COUNTY ADMINISTRATOR • . ,s Costa
MARK FINUCANE, HEALTH SERVICES DIRECTOR `
County
DATE: OCTOBER 13, 1992 aTTA *°
SUBJECT: APPROVAL OF DESIGN DEVELOPMENT PHASE FOR MERRITHEW MEMORIAL
HOSPITAL. REPLACEMENT PROJECT, 2500 ALHAMBRA AVE. , MARTINEZ
(WH580B)
SPECIFIC REOUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION
I. RECOMMENDATION
A. '°• ACCEPT report from County Administrator and Health Services
Director on design, schedule and cost estimate relating to the
Merrithew Memorial Hospital Replacement Project.
B. APPROVE the Design Development Phase documents for the
Merrithew Memorial Hospital Project submitted by the project
architect, Kaplan/McLaughlin/Diaz.
C. AUTHORIZE the County Administrator or his designee to direct
the project architect to proceed with Construction Documents
Phase of design and to take action necessary to keep the
project on time and within budget.
II. FINANCIAL IMPACT
Long term financing for all phases of the design and
construction was completed in May, 1992 in accordance with
Board of Supervisors direction.
The recently enacted 1992/93 state budget does not . modify or
delete the major funding sources utilized for the Hospital
Replacement Project.
Specifically, SB-1732/SB-2665, the "Construction Renovation
Reimbursement Program" and SB-855, the "Disproportionate Share
Provider Payment Program" remain in place.
CONTINUED ON ATTACHMENT: YES SIGNATURE:
RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE
APPROVE OTHER
SIGNATURE S:
ACTION OF BOARD ON C ° er APPROVED AS RECOMMENDED OTHER
Speakers were: Graig Crossley, 222 Scofield Drive, Moraga.
Jim Hicks, ArSCME, 1000 Court .Street, Martinez.
John Wolfe, Contra Costa Taxpayers Association, 820 Main St. , Martinez.
All persons desiring to speak were heard.
The Board APPROVED the recommendations set forth above. In addition,. the Board
REQUESTED 'the Health Services Director to report to the Board on November 17, 1992, on
a fund raising program for selling commemorative tiles of the Hospital.
VOTE OF SUPERVISORS
1 HEREBY CERTIFY THAT THIS IS A TRUE
UNANIMOUS(ABSENT - AND CORRECT COPY OF AN ACTION TAKEN
AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD
ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN.
ATTESTED October 13, 1992
Contact: CAO, D. Bell PHIL BATCHELOR.CLERK OF THE BOARD OF
'.c: GSD, Accounting SUPERVISORS AND CO U1 TY ADMINISTRATOR
Auditor-Controller
County Counsel
Health Services Department BY DEPUTY
Page 1 of 4
MERRITHEW MEMORIAL HOSPITAL REPLACEMENT
Approval of Design Development Phase
III. REASONS FOR RECOMMENDATIONS/BACKGROUND
A. HISTORY OF PROJECT .DEVELOPMENT
In 1986, the Board of Supervisors requested the Health Services
Department to undertake a comprehensive review aimed at
replacing Merrithew Memorial Hospital, including strategic,
architectural and financial planning studies. Numerous reports
.have been issued over the. past six years concluding that
Merrithew Memorial . Hospital is outdated and needs to be
replaced.
In 1988, the Board accepted a needs assessment prepared by
Arthur Young and Co. and Stone, Marraccini, and Patterson which
determined the initial financial feasibility and cost of
replacing Merrithew Memorial Hospital. Additional cost
analysis services were provided by Lewin/ICF which included a
market survey and identification of the level of financing
required to support a replacement hospital. The Board conducted `
workshops in April, 1989 to determine the relative bed size
need for the proposed project.
In July, 1989, the Board contracted with Kaplan/McLaughlin/Diaz
(KMD) for a master plan and pre-architectural program which
identified the project's program and functional space
requirements. The completed room-by-room program and
masterplan was approved by the Board in December 1990. The
following February, the County authorized KMD to proceed with
the Schematic Phase of Design in accordance with the approved
Master Plan Report, Alternate #3. On March 2, 1992, the Board
approved the Schematic Design documents and authorized the
Design Development phase of design. The Board also authorized
the County Administrator and Health Services Director to
negotiate a final Consulting Services Agreement with KMD, to
select a Construction Management firm, and to take the steps
required for borrowing the necessary project funds. All these
actions have since occurred. The Consulting Services Agreement
with Kaplan/McLaughlin/Diaz approved by the Board on August 11,
1992 provides the architectural services through the completion
of the project.
In August, 1992, KMD submitted the Design Development Phase
documents for the County's information and review. The
submittal consisted of the following:
Volume 1 - Executive Summary
Volume 2 - User Group Reports
Volume 3 - _Equipment
Volume 4 - Interior Elevations
Volume 5 —Interior Finishes
Volume 6 - Outline Specifications & Schedules
Volume 7 - Cost Estimate
Volume 8 - Engineering Calculations
Project Plans.
These submittal documents have been placed with the Clerk of
the Board.
B. DESIGN CONCEPTS
A great deal of attention has been paid to providing a facility
that minimized the impact to the adjoining neighborhood and
natural surroundings while organizing medical care and
treatment in a well defined and efficient manner.
Page 2 of 4
s
MERRITHEW MEMORIAL HOSPITAL REPLACEMENT
Approval of Design Development Phase
The new building is to be located at the site of the original
hospital. This five story, 207,000 sq. ft. new building will
house the following: Inpatient Nursing for Medical , Surgical,
Geriatrics, Obstetrics, Labor/Delivery, New Born Nursery and
Intensive Care; Surgery; Emergency; Crisis; Medical Imaging; as
well as necessary administration and support functions. Site
preparation consisting of rerouting utility services; building
demolition (including asbestos abatement) ; remodeling for the
interim relocation of Geriatrics; widening of roadways and the
relocation of modular buildings will commence during 1993 with
the main construction project starting in 1994.
As a result of developing this new building on the existing
hospital campus, a great deal of attention is being given to
assuring adequate health care services required by the
community it serves will continue without interruption. Site
logistics have been evaluated to ensure that patients, visitors
and staff will not be unreasonably disrupted during the
construction process. This attention to detail will take into
account impact on the surrounding property owners and residents
as well by establishing construction controls which include
standards for noise, dust, vehicular routes, parking , hours of
operation, etc.
C. DESIGN REVIEW
The Design Development submittal was distributed to the
County's project team members for review. KMD made a
presentation of the design to the hospital senior management
group. A technical review of the submittal documents have been
conducted by staff from Risk Management and the Health Services
and General Services Departments. A set of drawings was also
sent to the County Fire Protection District for its code
review. The affected utility companies were notified of the
availability of these plans for their review.
In addition to the County's review, the County's project
manager, O'Brien-Kreitzberg (OK) , provided a constructibility
review and conducted a value engineering workshop. The Value
Engineering workshop was held on September 2 through September
4. This workshop was a systematic approach of checking that the
project design concepts fulfill the project requirements at the -
least life-cycle cost. The workshop was staffed by value
engineering specialists, architects, civil, structural,
mechanical, and electrical engineers, and estimators working
for OK. The value engineering workshop identified and developed
86 cost-reduction. proposals. The County's Project Team, the
Architect and Project Manager have continued to review and
prioritized the workshop proposals. The cost saving
opportunities will allow the Architect greater flexibility in
maintaining the construction budget.
OK conducted a formal constructability review of the Design
Development documents from August 24 through August 31. The
constructability review was performed by a multi-disciplinary
team of construction, , mechanical, electrical, and . civil
engineers. They reviewed the Design Development documents to
reduce the adverse effect of the design on construction
operations, to advise on the monetary efficiency of the design
relative to market conditions, to reduce conflicting design
information and the subsequent construction changes, and to
reduce construction problems. The 17 page report consisting of
some 125 suggestions was presented to the Design Team and KMD
on August 31 for consideration in the next phase of design.
Page 3 of 4
, y .
MERRITHEW MEMORIAL-HOSPITAL REPLACEMENT
Approval of Design Development Phase
D. BUDGET
The program budget consists of all costs including but not
limited to consulting services, construction, furnishings and
equipment, county support, and communications for a total of
$81,841,000. The key budget information provided by the
Architect at the Design Development phase consists of the
detailed construction and equipment estimates which were
reviewed by OK, and are being reconciled consistent with the
level of detail provided by the documents. In addition to the
estimate reconciliation; design contingencies, alternates,
options and value engineering cost reductions have been
developed to maintain the project within the total budget. As
the project documents become more fully developed and the
detailed cost is defined, cost reductions will be used to
mitigate budget issues. It should be noted that in addition to
the normal variance of a design development estimate there
remain four areas of the program which are not fully defined in
terms of cost and scope; they are unforeseen underground
conditions, communications, signage and equipment. The
necessary funding for undefined areas will flow from the
aforementioned cost reductions, reductions in scope, or
contingencies. Should the project be bid below the estimate,
alternates have also been established for enhancements to the
project with in the program budget of $81,841, 000.
In summary there are budget issues still to be resolved during
the next phase as the construction documents become more fully
defined. The architect and project manager have identified and
developed work around strategies to maintain the budget and the
scope.
E. CONSTRUCTIONS DOCUMENTS PHASE
Approval of the project's Design Development phase submittal
initiates the Construction Documents phase of design on
schedule. During this phase, KMD will continue to refine the
design, respond to the recommendations of the V.E. workshop and
constructability review, and prepare three separate bid
packages. This phase also includes additional time for the
Office of Statewide Health Planning and Development (OSHPD) and
the State Fire Marshal (SFM) review and approval process.
Specifically, .this phase will produce a complete set of bidding
documents including contract conditions, specifications and
drawings for each construction contract. A separate set of
construction documents will be prepared for each of the
followings scopes of work: 1. The remodel of Wards. E, G, I and
J to accommodate changes required to prepare :-,for resulting
construction; 2. , The demolition of the original hospital
building, relocation of site utilities, 'road changes, partial
building excavation and installation of construction safety and
protection structures; 3. , The construction of the replacement
hospital.
There will continue to be periodic review meetings with county
staff, OSHPD, SFM, the County Fire Protection District, utility
companies, the project/construction managers and the affected
neighborhood organizations.
BOORD1. 001
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Page 4 of 4
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Sri�aUn PRESENTATION O o WffCaL
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APPROVAL : DESIGN DEVELOPMENT DOCUMENT PHASE
AUTHORIZE: CONSTRUCTION DOCUMENT PHASE
O'Brien-Kreitzberg
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TABLE OF CONTENTS AND CLINICS
I. Design Development Document Review
II. Constructability Review
III. Value Engineering Work Shop
IV. Project Budget
V. Construction Estimate
VI. Project Schedule
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CLINICS
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�, Design Development Document Review
I. Design Development Document Review
On August 20, 1992 Kaplan/McLaughlin/Diaz presented to Contra Costa
County their Design Development Document submission. The County's
Project Manager, O'Brien-Kreitzberg (OK), distributed to the County's
project team members this Document Set for review. This review
consisted of the following elements.
KMD presented the design to the Senior Hospital Management staff and
Physicians.
A technical review has been conducted by County staff from Risk
Management, the Department of Health Services, the Department of
General Services including: Architecture, Building Services and
Communications. The Contra Costa County Fire Protection District has
reviewed and commented on the Documents for the purpose of code
compliance with those comments having been transmitted to KMD for
inclusion into the Construction Documents phase. The utility providers to
the Hospital have been notified of availability of these Documents for their
review and comment.
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AND CLINICS
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Il. Constructability Review
II. Con structability Review
In addition to the County's review, OK provided a constructability review
and conducted a value engineering workshop. The formal constructability
review of the . Design Development Documents was conducted from
August 24 through August 31. The constructability review was performed
by a multi-disciplinary team of construction, mechanical, electrical and civil
engineers. They reviewed the Design Development Documents to reduce
the adverse effect of the design on construction operations, to advise on
the monetary efficiency of the design relative to market conditions, to
reduce conflicting design information with their inherent potential for
construction bulletins and subsequent change order requests, requests for
time extensions and claims and overall reduce problems normally
encountered during construction. The seventeen page report consisting of
some one hundred twenty five suggestions was presented to the Design
Team and KMD on August 31 for consideration in the next phase of
design.
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III. Value Engineering Workshop
A formal Value Engineering workshop was conducted from September 2
through September 4. This workshop was conducted in accordance with
the techniques and principles as recommended by the Society of American
Value Engineers. This workshop was a systematic approach of checking
that the project design concepts fulfill the project requirements at the least
life-cycle cost. The workshop was staffed by a certified value specialist,
architects, civil, structural, mechanical and electrical engineers, and
estimators under the coordination of OK. The Value Engineering
workshop identified one hundred and sixty eight ideas during the
speculation phase. The VE ideas were ranked by the project team and
have subsequently been ranked by Senior Management of the Hospital as
follows:
A - KMD is directed to incorporate into the next phase of design
B - KMD is directed to develop as an add alternate
C - The idea has been rejected by the Hospital
These proposals have the potential of reducing and/or controlling the
Project Budget and will be further evaluated during the forthcoming
Construction Documents phase of design.
�v.
P10lect Bu,get
IV. Project Budget
The architect's estimates of Construction and Furnishings and Equipment
costs were incorporated into the project budget. Also, $1,000,000 was
included to cover the cost of the Telephone and other Electronic Systems
that are to be purchased and installed by the Hospital. To cover the cost
of the Communications System, the Owner's contingency was reduced by
$1,000,000. The County is evaluating their equipment needs to stay within
the budget. A summary of the current budget is:
2.0 Consultant Services $ 8,893,461
3.0 County Staff $ 644,000
4.0 Permits, Printing, & Misc. $ 1 ,656,000
5.0 Construction $56,401,736
6.0 Furnishings & Equipment $ 9,094,000
7.0 Communications $ 1 ,000,000
8.0 Contingencies $ 1 ,178,139
9.0 Escalations $ 2,973,664
Total $81,841,000
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V, construction Estimate
V. Construction Estimate
The Architect employed Beach Associates to estimate the probable cost
of constructing the project based upon the Design Development Drawings.
O'Brien-Kreitzberg & Associates did a check estimate including complete
estimates of certain systems of work and a review of Beach Associates'
estimate. Representatives of the Construction Manager, the Architect, and
the Estimators met to review the estimates and to reconcile the
differences. The final reconciled estimate of the cost of construction is
$53,661.00 plus a contingency of $2,685,797 for a total of $56,401 ,736. A
summary of the estimate is as follows:
Systems Summary $K
Foundation 2,003
Vertical Structure 1 ,940
Horizontal Structure 3,910
Exterior Closure 4,250
Roofing & Waterproofing 410
Interior Partitions 4,438
Interior Finishes 1 ,795
Equipment & Specialities 4,325
Vertical Transport 1 ,274
Plumbing 3,344
HVAC 6,380
Electrical 5,246
Fire Protection 659
Building Cost 39,982
Site Work 2,496
General Conditions 3,398
Overhead & Profit 1,835
Remodal Wards 508
Design Contingency 2,386
Escalation 3,056
Total 53,661
Construction Company 2,686
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AN4D CLINICS
VI, project Schedule
VI. Project Schedule
After meetings with the County, Hospital, and Architect, and studying the
Design Development Drawings, the Construction Manager developed a
master project schedule. The Construction Manager suggests a project
with three construction phases. Phase II is a make-ready phase consisting
of relocating utility lines and demolition. Phase III consists of constructing
the new building. The project remains on schedule. A summary of the
master schedule is as follows:
a. Design Development 27 July 92 thru 06 Oct. 92
b. Phase I, Remodel Wards 09 Dec. 92 thru 06 Oct. 93
c. Phase II, Make Ready 07 Oct. 92 thru 30 June 94
d. Phase III, Building 07 Oct. 92 thru 23 Jan 97
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CONTRA COSTA COUNTY
s- MERRITHEW MEMORIAL HOSPITAL REPLACEMENT
DESIGN DEVELOPMENT PHASE
EXECUTIVE SUMMARY
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Kaplan / McLaughlin l Diaz Volume 1
13 October 1992
Merrithew Memorial Hospital KMD
Martinez, California
DESIGN DEVELOPMENT PHASE
� EXECUTIVE SUMMARY
Where We Are Phases One and Two of the Master Plan as previously approved by the County, are
now completed through the design development phase of the current project. From
March through August, the architects, Kaplan/McLaughlin/Diaz have been refining the
scope and design of the project. At this point all of the design, planning and policy
decisions concerning the project are made, with the exception of the selection of some
equipment items. The approval of this phase of the project effectively permanently
sets the scope of the project, and the project construction budget. The next phase,
construction contract documents, will have the architect preparing the actual plans and
specifications for the State of California to review for the building permit and from
which contractors will bid and build.
How We Got There The design development phase was guided by the Steering Committee, a group
consisting of executive representatives from the Contra Costa County Administrator's
Office, Health Services Department, Merrithew Memorial Hospital and Clinics,
General Services Department, the architect and many other parties. This group set
policy for the design of the project and responded to policy issues raised in the user
group meetings. The user group meetings were conducted by the architect. The
architect met in four rounds of extensive meetings with each department that was to
be in the project or have its operation affected by the project. The purpose of these
meetings was to engage the departmental users into a participatory process.
Architectural floor plans, operational procedures, equipment needs and major
furnishings were reviewed by the users. All of the design and decision making
occurred within the context of the project budget and to fulfill the mission of the
County Health Services and the Hospital. At the conclusion of the fourth round of
the user group meetings, all users "signed off' on the drawings with any final
comments. To close out this process, the hospital CEO personally held a review with
each of the department's key staff to summarize the project and receive any final
comments.
i�
The Bid Packaging The construction project will be divided into three bid packages to facilitate
contracting and for budget control. Phase One of the Master Plan, or the "Make
Ready" phase will consist of two bid packages. Bid Package #1 will alter existing
Wards "E", "G" and "J" to accommodate the new building and interim operations.
Geriatric patients will be temporarily relocated during construction from the "H" ward
that is to be demolished. Bid Package #2 will consist of the widening of Street Four
for fire access and circulation, the demolition of the old brick hospital, the relocation
of existing utilities to clear the new building site, partial excavation at the new
building site, and installation of new utility services for the new building and
eventually the master plan build out. This phase is important because it will disclose
the unknown conditions that commonly occur in underground work on old sites. This
work is often the source of the most expensive change orders during construction.
This knowledge will minimize such changes occurring with the construction of the
new building and might otherwise encumber the project.
Phase Two of the Master Plan, the construction of the new hospital building and
landscaping will occur as Bid Package#3. This will be the largest, longest and most
expensive of the three bid packages. It will require over two years for the
construction.
�1
Merrithew Memorial Hospital KMD
Martinez, California
DESIGN DEVELOPMENT PHASE
EXECUTIVE SUMMARY
Construction Cost The construction cost of the project designed by Kaplan/McLaughlin/Diaz is estimated
to be $53,661,000. This figure is to be the maximum limit for bid prices. Since
bidding for the new hospital will occur almost two years from now and to protect the
project from high bids in that unknown bid climate, the new building as designed to
date will be subdivided into a series of bid alternates and base bid project. In the
event of low bids and availability of funds, some other alternates will be designed to
take advantage of a competitive market. Items such as the generator, boiler and chiller
for the future build-out of the Master Plan are potentially slated as alternates.
Also to realize the maximum benefit of the State reimbursement programs such as
SB 1732/SB2665, equipment and other items that can be built into the construction
under the program guidelines have been included when the reimbursement is
economically feasible. Some funds estimated for the equipment budget have been
transferred to the construction budget to recognize this change.
The New Hospital The new hospital is a five story building with a mechanical penthouse. The building .
is set into the hillside, with the public entrances at the first and third levels. The total
area of the building is approximately 210,000 square feet of building and four acres
of site work and landscaping. There are 144 beds in the current design. The
functional areas to be included in the new building are:
First Floor - Main entrance Lobby, Medical Records, Pharmacy, Admitting, Gift
Shop & Volunteers, Material Management, Communications &
Security and the Central Energy Plant.
Second Floor - Surgery, Central Supply, Inpatient and Outpatient Recovery, Central
Energy Plant.
Third Floor - Emergency, Imaging (Radiology), Crisis Unit, Intensive Care Unit(8
beds) and Step-down Unit (10 beds)
Fourth Floor - Geriatric Nursing Unit (8 beds), Medical Nursing Unit (30 beds),
Surgical Nursing Unit(30 beds), and Family Care Nursing Unit (30
beds).
Fifth Floor - Labor/Delivery, Nursery, Intensive Care Neonatal Nursery (6
bassinets) Post-Partum Nursing Unit (22 beds).
Building Systems The building is required to meet the State standards for hospital construction, hospital
accreditation standards, many other standards and ADA. It will have a useful life of
a minimum of fifty years. The building is mandated to be functional after most
earthquakes. Given these requirements, the materials must be of a reasonably good
standard. Therefore, the structural frame will be steel and the floors metal deck and
concrete. Most of the exterior wall will be simple flat wall and lightweight exterior
finished insulation system. At the main and emergency entrances the architecture has
been highlighted with metal panels and glazed walls. Interior partitions are metal
stud and drywall with a painted finish. The primary floor finish is vinyl composition
tile, with some carpeting in select areas. In general, the facility has been designed to
support the basic medical mission with reasonable fiscal responsibility.
Energy Considerations The new hospital design utilizes common energy saving applications. The energy
plant is located in the new hospital to eliminate utility travel distances and to facilitate
maintenance, and be central to the redeveloped campus. The exterior walls are
constructed with an insulation system. Windows will be double glazed. Heat will be
Merrithew Memorial Hospital KMD
Martinez, California
DESIGN DEVELOPMENT PHASE
EXECUTIVE SUMMARY
recovered from the generators. Administrative areas will be programmed to shut
down after hours. There are separate boilers for steam generation and heating, and
circulating domestic hot water. This facility does not contain any expensive high
tech or experimental equipment. Energy conservation in hospitals is a goal.
However, stringent requirements for the operation of a hospital often limit the
achievable conservation in comparison to other types of buildings.
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