Agenda

Return

D.1

To:	Board of Supervisors
From:	Monica Nino, County Administrator
Date:	December 14, 2021

Contra

Costa

County

Subject:

Measure X Sales Tax Revenue Allocation - Follow-up on Hospital Capital Projects

APPROVE	OTHER
RECOMMENDATION OF CNTY ADMINISTRATOR	RECOMMENDATION OF BOARD COMMITTEE

Action of Board On: 12/14/2021

APPROVED AS RECOMMENDED

OTHER

Clerks Notes:

VOTE OF SUPERVISORS

AYE:

John Gioia, District I Supervisor
Candace Andersen, District II Supervisor
Karen Mitchoff, District IV Supervisor
Federal D. Glover, District V Supervisor

ABSENT:

Diane Burgis, District III Supervisor

Contact:	Lisa Driscoll, County Finance Director (925) 655-2047
cc:	Robert Campbell, Auditor-Controller Eric Angstadt, Chief Deputy County Administrator Anna M. Roth, Director, CCC Health Services

I hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the date shown.
ATTESTED: December 14, 2021
Monica Nino, County Administrator

BY:	, Deputy

RECOMMENDATION(S):

CONSIDER adopting Measure X funding allocation in the amount of $75 million and associated appropriation adjustment (5021) for the Contra Costa Regional Medical Center capital projects.

FISCAL IMPACT:

The recommendations included in this follow-up report have a one-time cost of $75 million and will be funded with sales tax revenues generated through Measure X, which are general purpose revenues.

BACKGROUND:

On November 16, 2021, the Board of Supervisors received a report regarding their recommendations for allocating Measure X revenues. Included in the report was $80 million in one-time monies to provide much need infrastruture at the Contra Costa County Regional Medical Center (CCRMC) and Health Clinics (HCs).

BACKGROUND: (CONT'D)

As the primary Medi-Cal hospital and clinic delivery system for Contra Costa County, the current facilities are inadequate in size and scope to accommodate CCRMC/HCs continued need to provide clinical and health services to our assigned patient population. Over the last 2 decades, after construction of the Martinez Medical Campus, CCRMC/HCs empaneled patient assignment has grown over 540% to well over 142,000 individuals. An additional 78,000 lives seek specialty services, care coordination services, and hospital services within CCRMC/HCs infrastructure.

The projects were to expand the office complex by 40,000 square feet ($30 million); replace the Public Health Lab at 15,000 square feet ($25 million); build a parking structure with 325 additional spaces ($15 million); and expand the Interventional Radiology Suite by 5,000 square feet ($5 million). Note that the original recommendation included a 3,000 square foot expansion of Psychiatric Emergency Services ($5 million), which was approved on November 16. During the meeting, the Board unanimously supported the need for improved infrastructure at the CCRMC in order to provide health services to the Contra Costa County community. The Board also acknowledged the significant planning that has been performed over the last decade on these projects (see attached 2009 CCRMC Master Plan). Staff were requested to return with more details on four of the projects in order to provide the Board and public with a comprehensive presentation of the capital improvements planned for the CCRMC campus. Attached and below is additional information which will be expanded upon during the Board's discussion. At the conclusion of the discussion, staff recommends that the attached appropriation adjustment be adopted.

CCRMC Medical Clinic and Office Complex – 40,000 square feet expansion
Currently Building One serves as the primary medical clinic for the Martinez campus while Miller Wellness Center is primarily a Behavioral Health oriented clinic site. Over the last two decades CCRMC/HCs has dedicated efforts to provide community standard clinical services on campus. Meeting the clinical demand of our current and future patients requires expansion of services in areas such as primary care, ophthalmology, dermatology, oncology, urology, maxillofacial services, orthopedics, oncology, cardiology and pulmonary. At present, our biggest constraint to expanding these services is the limited amount of physical space to provide direct patient care on the Martinez Campus.

The Contra Costa Regional Medical Center campus master plan developed in 2009 called for construction of three medical office buildings to meet the demands of patient growth and increasing clinical care. CCRMC/HCs has largely outgrown its space and requires more exam rooms and clinical office space to improve patient access and allow care teams to provide the high-quality care our patients deserve. With the new clinical spaces CCRMC/HCs will be able to support better diagnostic services, better social services, improved access to medical and surgical specialists, and improved access to primary care providers. Not only will this improve patient care and outcomes, it will also support the County's Medi-Cal Waiver and supplemental funding requirements. Additionally, recruitment of staff and providers is difficult due to the dearth of medical office space required to perform mandatory activities like care coordination, electronic medical record keeping, quality improvement and regulatory oversight. This space would become available in the medical office space expansion.

CCRMC Parking Structure – 325 spaces
The growth in patient volume has spotlighted the urgent need for additional parking for both patients and staff. The 2009 campus master plan called for additional parking construction which has not yet been completed. The resulting traffic and congestion have become a critical safety concern. Compounding the problem is the upcoming loss of 72 spaces currently being leased from the Teamsters effective 2022. At an annual cost of $480,000, CCRMC is using valet service for patient and staff parking to capitalize on space around parking spaces that are ‘stacked’ in order to provide more parking. Due to space limitations, the valet does not meet the County's current demand. Additionally, due to the COVID-19 pandemic, many patients and staff do not feel comfortable using this service. Patients with physical disabilities, small children, and cognitive difficulties often miss appointments because they are unable to find convenient and safe parking. Families coming to see loved ones and newborns in hospital often are limited to after-hours visits due to parking limitations. We are proposing a new parking structure to enhance the patient care experience, improve safety and improve access for patients and staff.

CCRMC Interventional Radiology – 5,000 square feet suite
Modernization of certain hospital diagnostic and interventional procedures are required to provide safer procedural care in the hospital. Over the last two decades there has been a shift to small incision and non-surgical interventions to manage acute conditions with improved outcomes – it has become the standard of care. Diagnostic and therapeutic procedures that are commonly performed require our patient’s transfer to surrounding hospitals with the associated delays in care due to coordination, transportation, and availability of services. Patients needing pain control, catheter or port placements, cancer medication infusions, abscess and infection drainage, and interventional diagnostics would benefit from these services being provided on demand at CCRMC.

New Public Health Lab – 15,000 square feet
Contra Costa Health Services is proposing construction of a new $25 million Public Health Laboratory to improve upon and expand existing clinical and public health diagnostic laboratory testing. Current facilities are inadequate to permit expansion for modernization as well as accommodate current and future laboratory emergency preparedness.

The Contra Costa Public Health Laboratory and Contra Costa Regional Medical Center (CCRMC) Clinical Laboratory currently occupy the same dedicated laboratory building. A new Public Health Laboratory will result in better diagnostic and testing availability for county residents and health care providers including CCRMC, John Muir, Kaiser Permanente, Sutter Health and many others in situations such as the COVID-19 pandemic, foodborne outbreaks like E.coli and salmonella, hazardous materials incidents and rabies testing of animals.

Both laboratories, while at space capacity, are unable to onboard new, modern diagnostic and disease detection technologies due to limited laboratory bench and floor space and exceeding electrical capacity within the facility. Additionally, some supplies are stored in open spaces due to the already crowded storage spaces. Relocating the Public Health laboratory to a contemporary structure facilitates upgrading to modern molecular technologies, workflows, and instrumentation that have been heavily relied upon during the COVID-19 pandemic, such as detection of COVID-19 and identification of variants and will ensure that these crucial public health services will continue to be available for residents and health providers across the whole county. Relocation additionally permits the CCRMC hospital clinical laboratory to improve its own diagnostic testing capacity.

We are proposing that the unreinforced masonry building at 20 Allen Street, on the CCRMC campus, be demolished and a new building constructed there to accommodate a replacement to the existing Public Health Laboratory. This new building will house the Public Health Lab including current testing, expansion of molecular instrumentation, and workspace for bioinformatic computing needs. The proposed move would also fix overcrowding of the CCRMC Clinical Laboratory which shares the current building with the Public Health Laboratory, as the CCRMC Clinical Laboratory would expand into the space vacated by the Public Health Laboratory.

CONSEQUENCE OF NEGATIVE ACTION:

Delay in providing services to the Contra Costa County community.

CLERK'S ADDENDUM

Speakers: No name given; no name given; Elizabeth Mullin, CCRMC residency program; Shawn Gilbert, East County; Diana Hoenig, Multi-faith ACTION Coalition; Dan; Brian, Program Director CCRMC; Marianna Moore; Jan Warren; Roxanne Garza, Healthy Richmond. Written commentary provided by: Pat Reyes, Multi-faith ACTION Coalition (attatched).