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Backup Documents 03/12/2024 Item #11C PresentationPrepared By: Claudia Roncoroni, Project Manager Facilities Management Division March 12, 2024 Agenda Item 11.C Recommendation to accept a project update on the Collier County Behavioral Health Center and proceed with the design for 87 total beds (45 CSU, 30 CSU Medicare/Acute and 12 ESAC) with an estimated construction cost of $49.9 million. Infrastructure Surtax Fund (318), Project #50239 (District 3) 1Facilities Management Division 2Facilities Management Division Healthcare Consultant Maurizio Maso, AIA Hernan Rivera, AIA Alex Jordan, AIA Scott Burgess, CEO Nancy Dauphinais, COO Mary Ann Guerra, CCO Andy Stevens, Director of Facilities & Safety Officer Prime Consultant Ryan S. Richards, AIA, LEED AP Javier Salazar, AIA Construction Manager Reggie Morgan, COO, Principal Eric Brackin, CHC Project Executive John Hagan, Chief Estimator Healthcare John McCormick, PE Director Facilities Management Claudia Roncoroni, Project Manager 3Facilities Management Division •We are here to provide a project update to the Board and to recommend moving forward with the value- engineered design providing 87 total beds (45 CSU, 30 CSU Medicare/Acute and 12 ESAC) with an estimated construction cost of $49.9 million. •On June 27, 2023, County staff presented a project update and the Board provided direction to move forward with a design meeting current and future community needs: 87 beds, 60,000 SF with an estimated construction cost of $43.9 million based on the Schematic Design. •In December 2023, the Design Development package (60% design) was received. This stage of design more specifically develops the elements of the project; site design, building structure, main building systems, architectural elements and finishes, allowing more complete and specific cost estimates to be developed. •The December cost estimate developed by the Construction Manager (CM) was $53.1 million. •Following a substantial value engineering effort the estimate was reduced by $3.2 million to a construction cost estimate of $49.9 million. 4Facilities Management Division 5Facilities Management Division TARGET YES NO •Is 6/27/23 Project Update Budget met?√ •Is 6/27/23 Project Update Program met?√ •Is Value Engineering included?√ •Are Current Community needs met?√ •Are Future Community needs met?√ •Design: Change Order for Time & Money?√ 6Facilities Management Division 6/27/23 Project Update Schematic Design WITH Value Engineering 3/12/24 Project Update Design Development WITH Value Engineering 45 adult CSU 45 adult CSU 15 Acute 15 Acute 15 Medicare Inpatient 15 Medicare Inpatient 12 ESAC 12 ESAC 60,000 SF 60,000 SF $732/SF $832/SF 87 beds 87 beds $43.9M $49.9M CSU = Adult Crisis Stabilization Unit ESAC= Emergency Services Assessment Center Includes $3.2M VE Cost Savings Main Value Engineering Items •Tiltwall in lieu of CMU •Door/Frame/ Hardware substitutions •Changes to interior wall types •Low Voltage - Nurse Call reduction •Alternate Kitchen equipment package •Alternate light fixture package •Medical Air elimination •Architectural decorative elements removal •Loading dock and main entry canopy coverage reduction •Chain link fence at Generator in lieu of cast in place wall 7Facilities Management Division March 15, 2022 NTP was issued to RG Architects November 09, 2021 CMAR Solicitation Ranking was approved by the Board March 14, 2023 CMAR Preconstruction Services Contract was approved by the Board June 27, 2023 BCC Approved 87 Beds and a $43.9 million estimated construction cost Q4 2024 – Tentative: GMP approval including Site & Building March 12, 2024 Project update: proceed with design for 87 beds with a revised estimated construction cost of $49.9M March 14,2024 Surtax Committee Update 8Facilities Management Division Recommendation to accept a project update on the Collier County Behavioral Health Center and proceed with the design for 87 total beds (45 CSU, 30 CSU Medicare/Acute and 12 ESAC) with an estimated construction cost of $49.9 million. 9Facilities Management Division 10Facilities Management Division •The Collier County Behavioral Health Center is an important Community Priority Project endorsed by the voters in 2018 and identified as the number one priority of the Collier County Mental Health and Addiction Ad Hoc Advisory Committee (now under the auspices of the Collier Coalition of Healthy Minds). This project is funded by Infrastructure Sale Surtax Funding. •This project’s name, originally Collier County Mental Health Facility and often labeled by the Public or by the Media as Mental Health Facility, Central Receiving Facility or David Lawrence Centers Expansion, has been formally changed to Collier County Behavioral Health Center. •The Facility will function as the Central Receiving Facility for those receiving services under both the Baker and the Marchman Acts and will greatly increase mental health crisis support in Collier County. •The proposed new Facility will serve the mental health needs of Collier County's expanding population and will reduce demands currently placed on the Collier County Sheriff’s Office. 11Facilities Management Division Project Programming and Master Planning Factors – Behavioral Health Center (Adult Beds): •The average number of adults under the Marchman Act at Collier County Sheriff’s Office jail facility is 10 beds per month. •The average number of adults within the existing David Lawrence Centers (DLC) facility is approximately 29 beds per day. •The peak number of occupied beds experienced by DLC is 42 beds per day. There has been an increase of two beds since the June 27, 2023, project update. •The existing programmatic need for beds based on today’s demand is between 39 and 52 inpatient beds per day. • 12 Emergency Services Assessment Center (ESAC) beds are required. •Recent University of South Florida Baker Act reporting indicates that approximately 439 Collier residents per year travel outside of Collier County for Baker Act services due to lack of capacity within Collier County. 12Facilities Management Division 13Facilities Management Division MAIN ITEMS DESCRIPTION SCHEMATIC DESIGN VALUE DESIGN DEVELOPMENT VALUE VARIANCE PERCENTAGE •ELECTRICAL $3,983,000 $6,037,000 $2.05M 51% •INDIRECT COST $5,715,000 $6,774,000 $1.06M 19% •LOW VOLTAGE $785,000 $1,808,000 $1.02M 130% •FINISHES $1,566,000 $2,435,000 $869K 55% •ESCALATION $1,658,000 2,453,000 $796K 48% •DRYWALL / FRAMING / STUCCO $3,226,000 $4,012,000 $786K 24% •HVAC $3,400,000 $3,991,000 $591K 17% •CONCRETE $1,506,000 $2,031,000 $525K 34% •SITE WORK $1,875,000 $2,339,000 $464K 24% •SAFETY & SECURITY SYSTEMS $425,000 $819,000 $394K 92% •FLOORING $598,000 $959,000 $361K 60% •DOORS / FRAMES / HARDWARE $1,660,000 $1,981,000 $321K 19% •OWNER CONTINGENCY $1,098,000 $1,328,000 $230K 20% •CANOPIES $274,000 $494,000 $220K 80% •KITCHEN EQUIPMENT $595,000 $728,000 $133K 22% •FIRE PROTECTION $255.000 $320,000 $65K 25% •SAFETY PADDING $174,000 $219,000 $45K 25% 14Facilities Management Division Program reduction: 15 beds. 1 Medicare Pod is shelled 50% Reduction in Medicare Services TARGET YES NO •Is 6/27/23 Project Update Budget met?√ •Is 6/27/23 Project Update Program met?√ •Is Value Engineering included?√ •Are Current Community needs met?√ •Are Future Community needs met?√ *√ * •Design: Change Order for Time & Money?√ * This condition is partially met – Option2 provides only 8 inpatient beds more than today’s demand. Future needs will be fully met only when Tenant Built Out, adding 15 more inpatient beds, is implemented. 15Facilities Management Division Program reduction: 30 beds. 2 CSU Pods are shelled. TARGET YES NO •Is 6/27/23 Project Update Budget met?√ •Is 6/27/23 Project Update Program met?√ •Is Value Engineering included?√ •Are Current Community needs met?√*√* •Are Future Community needs met?√** √** •Design: Change Order for Time & Money?√ •* Current inpatient beds demands fluctuates between 39 and 52; peak demand is not met. ** Future needs will be fully met only when Tenant Built Out, adding 30 inpatient beds, is implemented. 16Facilities Management Division Permanent Program reduction: 30 beds. 2 CSU Pods are not built. TARGET YES NO •Is 6/27/23 Project Update Budget met?√ •Is 6/27/23 Project Update Program met?√ •Is Value Engineering included?√ •Are Current Community needs met?√*√* •Are Future Community needs met?√ •Design: Change Order for Time & Money?√ •*Current inpatient beds demands fluctuates between 39 and 52; peak demand is not met. 6/27/2023 Project Update •Value Engineering Schematic Design Estimate 3/12/2024 BCC Option 1 •No Changes to Program •Changes to Budget •Value Engineering Design Development (Recommended) 3/12/2024 BCC Option 2 •Changes to Program •Changes to Budget •Value Engineering •1 Pod: Shelled Design Development 3/12/2024 BCC Option 3 •Changes to Program •Changes to Budget •Value Engineering •2 Pods: Shelled Design Development 3/12/2024 BCC Option 4 •Changes to Program •No Changes to Budget •Value Engineering •2 Pods: Eliminated Design Development 45 adult CSU 45 adult CSU 45 adult CSU 15 adult CSU 15 adult CSU 15 Acute Medicare 15 Acute Medicare 15 Acute Medicare 15 Acute Medicare 15 Acute Medicare 15 Medicare Inpatient 15 Medicare Inpatient 0 Medicare Inpatient 15 Medicare Inpatient 15 Medicare Inpatient 12 ESAC 12 ESAC 12 ESAC 12 ESAC 12 ESAC 60,000 SF 60,000 SF 60,000 SF 60,000 SF 47,574 SF $732/SF $832/SF $785/SF $746/SF $911/SF 87 Beds 87 Beds 72 Beds 57 Beds 57 Beds $43.9M $49.9M $47.1M $44.8M $43.3M $6.0M Funding Gap $3.2M Funding Gap $850K Funding Gap ($600K) Funding Gap CSU = Adult Crisis Stabilization Unit ESAC= Emergency Services Assessment Center 17Facilities Management Division 18Facilities Management Division 6/27/23 Project Update Schematic Design (30%) WITH Value Engineering 3/12/24 Project Update Design Development WITHOUT Value Evaluation 3/12/24 Project Update Design Development WITH Value Engineering 45 adult CSU 45 adult CSU 45 adult CSU 15 Acute 15 Acute 15 Acute 15 Medicare Inpatient 15 Medicare Inpatient 15 Medicare Inpatient 12 ESAC 12 ESAC 12 ESAC 60,000 SF 60,000 SF 60,000 SF $732/SF $885/SF $832/SF 87 beds 87 beds 87 beds $43.9M $53.1M $49.9M CSU = Adult Crisis Stabilization Unit ESAC= Emergency Services Assessment Center $3.2M VE Cost Savings Main Value Engineering Items •Tiltwall in lieu of CMU •Door/Frame/ Hardware substitutions •Changes to interior wall types •Low Voltage - Nurse Call reduction •Alternate Kitchen equipment package •Alternate light fixture package •Medical Air elimination •Architectural decorative elements removal •Loading dock and main entry canopy coverage reduction •Chain link fence at Generator in lieu of cast in place wall The Collier County Mental Health Facility is a Community Priority project funded by Infrastructure Surtax. In accordance with Exhibit A of Ordinance 2018-21 the project had a program budget of $25M, increased to $43.9M last year. The project is currently at the end of the Design Development Phase. Four design/construction options have been identified as provided in the table on slide 15. Estimated construction budgets for the four options range from $49.9M to $43.3M – the $43.3M option permanently eliminates part of the 6/27/2023 project update program, and does not meet current adult beds peak demand nor future community beds need. 19Facilities Management Division 20Facilities Management Division The project construction cost estimates discussed in the previous slide do not provide for: •Estimated $4.4M requirement for furniture, fixtures, and equipment nor estimated net annual operating costs of $4M (after considering program revenue and grant sources). •As presented at the 06/27/23 meeting, staff in coordination with David Lawrence Center leadership met with key community stakeholders to address these unfunded aspects of the program. •DLC has launched a naming rights initiative that will provide for additional funding. 21Facilities Management Division •Because of the timing of achieving the $490M combined County/Municipality aggregate Surtax collection threshold collections continued through December 31, 2023. •A portion of additional Surtax collections can be made available for the Mental Health Facility. •County Staff will go before Surtax Committee seeking additional Funds. 22Facilities Management Division 23Facilities Management Division 6/27/23 Project Update Schematic Design WITH Value Engineering 3/12/24 Project Update Design Development WITHOUT Value Evaluation 3/12/24 Project Update Design Development WITH Value Engineering 45 adult CSU 45 adult CSU 45 adult CSU 15 Acute 15 Acute 15 Acute 15 Medicare Inpatient 15 Medicare Inpatient 15 Medicare Inpatient 12 ESAC 12 ESAC 12 ESAC 60,000 SF 60,000 SF 60,000 SF $732/SF $885/SF $832/SF 87 beds 87 beds 87 beds $43,927,875 $53,100,357 $49,927,295 CSU = Adult Crisis Stabilization Unit ESAC= Emergency Services Assessment Center $3,173, 062 VE Cost Savings Main Value Engineering Items •Tiltwall in lieu of CMU •Door/Frame/ Hardware substitutions •Changes to interior wall types •Low Voltage - Nurse Call reduction •Alternate Kitchen equipment package •Alternate light fixture package •Medical Air elimination •Elimination of Architectural decorative elements •Reduction of loading dock canopy •Chain link fence at Generator in lieu of cast in place wall 24Facilities Management Division 6/27/2023 Project Update •Value Engineering Schematic Design Estimate 3/12/2024 BCC Option 1 •No Changes to Program •Changes to Budget •Value Engineering Design Development Estimate (Recommended) 3/12/2024 BCC Option 2 •Changes to Program •Changes to Budget •Value Engineering •1 Pod: Shelled Design Development Estimate 3/12/2024 BCC Option 3 •Changes to Program •Changes to Budget •Value Engineering •2 Pods: Shelled Design Development Estimate 3/12/2024 BCC Option 4 •Changes to Program •No Changes to Budget •Value Engineering •2 Pods: Eliminated Design Development Estimate 45 adult CSU 45 adult CSU 45 adult CSU 15 adult CSU 15 adult CSU 15 Acute Medicare 15 Acute Medicare 15 Acute Medicare 15 Acute Medicare 15 Acute Medicare 15 Medicare Inpatient 15 Medicare Inpatient 0 Medicare Inpatient 15 Medicare Inpatient 15 Medicare Inpatient 12 ESAC 12 ESAC 12 ESAC 12 ESAC 12 ESAC 60,000 SF 60,000 SF 60,000 SF 60,000 SF 47,574 SF $732/SF $832/SF $785/SF $746/SF $911/SF 87 Beds 87 Beds 72 Beds 57 Beds 57 Beds $43,927,875 $49,927,295 $47,107,035 $44,777,823 $43,328,383 $5,999,420 Funding Gap $3,179,160 Funding Gap $849,948 Funding Gap ($599,492) Funding Gap CSU = Adult Crisis Stabilization Unit ESAC= Emergency Services Assessment Center