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Home My WebLink About2006-05-09; City Council; 18559; Requesting presentation: Tri-City Medical Center8 CITY OF CARLSBAD - AGENDA BILL AB# 18,559 MTG. 5/9/2006 DEPT. CM TITLE: Request to Deliver a Presentation From Dr. Gonzalez and Dr. Burruss of Tri-City Medical Center DEPT. HD. CITY ATTY. <5&Z* CITY MGR (/X • co •H JJ CO 4Jc CD CO CD (-1 ft CU > •H <1J U OJ i-i •H Oc D O Z oz3 Oo RECOMMENDED ACTION: Receive a presentation from Dr. Gonzalez and Dr. Burruss of Tri-City Medical Center. ITEM EXPLANATION: The City Council provides an opportunity for citizens and organizations to have an item placed on a City Council Agenda by submitting a letter to the Mayor and/or City Manager. Attached is a letter (Exhibit 1) from Jeff Segall, Director of Community Relations of Tri-City Medical Center, requesting the opportunity to make a presentation to the City Council regarding the Master Facilities Plan and the upcoming Bond issue. FISCAL IMPACT: None. EXHIBITS: 1. Letter to Ray Patchett, from Jeff Segall, of Tri-City Medical Center. DEPARTMENT CONTACT: Courtney Enriquez, (760) 434-2958, Cenri@ci.carlsbad.ca.us Courtney Enriquez - Re: Council Agenda Presentation (FYI) Page 1 of2 EXHIBIT #1 From: Courtney Enriquez To: Pam Pretz Subject: Re: Council Agenda Presentation (FYI) message from Jeff Segall: >» "Jeff Segall" < SegallJ@TCMC.com > 04/20/2006 2:58 PM >» Ray: Tri-City Medical Center would like to request time before the Council to discuss our Master Facilities Plan and the Bond Issue appearing on the June 6th primary. Our intent is to provide the Council information on our long-range plans for the Medical Center. We will not be seeking the Council's collective endorsement, although volunteers with the Yes on F campaign may at some point contact the Mayor or Councilpersons individually for their support. I plan to have our President and CEO, Dr. Art Gonzalez and Emergency Department Medical Director, Dr. Richard Burruss, speak on this issue. We have a PowerPoint presentation, if desired by the Council. I understand that the Council generally allocates 10-minutes for such a presentation. We have a lot of data to cover in such a short amount of time, but are respectful if there is a time limit. Since the election is coming up soon, we'd like to get on your agenda soon. Joe indicated that the earliest would be May 9th. Could you please advise on whether we can appear on that date? Ray, thanks for your consideration. Jeff aboutblank 04/21/2006 Page 2 of2 Jeff Segall Director of Community Relations Tri-City Medical Center 2095 W. Vista Way Suite 214 Vista, California 92083 760-940-5337 Office 760-801-1240 Cell aboutblank 04/21/2006 For the past two-years, Tri-City Healthcare District(TCHD), through its Long-Term Planning Group, hasstudied the District’s facilityneeds. Through this effort, a Master Facilities Planningprocess was developed,withspecific recommendations on how the District could meetfuture facilities needs. In April,the District released its 150-pageMaster Facility Plan (MFP). One of the first issues the Groupaddressed was the age of thecurrent Medical Center. BecauseTri-City Medical Center (TCMC)was planned in the late 50's andbuilt in 1961, the originalbuildings – the core of the facility– will be over a half century old by 2013. This creates manyproblems for future growth. Planning Today for Our Healthcare Future Tri-City Medical Center is administered by Tri-City Healthcare District (A California Hospital District) For more information about Tri-City Medical Center or for the full text of its Master Facilities Plan and Bond Resolution, visit www.tricitymed.org on the Web. Master Facilities Plan Tri-City Healthcare District (TCHD)is seeking a $596 million generalobligation bond to renovate 1/3 of the current Hospital and build newfacilities. To pass, the measure needs a two-thirds approval from Districtvoters – in Oceanside, Carlsbad and Vista – who vote June 6th. The measure proposes to increase the square footage of the Hospital on the current Oceanside Campusfrom 496,000 square feet to 757,000square feet. Additionally, a 220,000square foot Outpatient Facility will be built contiguous with the Hospital.The proposed Hospital will have 335private rooms to accommodate ananticipated increasing census. The measure will add $23.40 per$100,000 of assessed valuation. Themedian assessed value of a residencein the District is approximately$205,000. Based on this assessedvalue, the homeowner would payabout $46.80 per year, or $3.90 permonth. The appraised value of theproperty – what it is worth today – is not used to calculate the tax. All owners of real property in theDistrict – residential, commercial,industrial, agricultural and absenteelandlords – will be assessed this tax.Landlords may pass the tax increaseon to their renters, but renters willnot be directly assessed the taxincrease. Construction is planned to becompleted by January 1, 2013. The proceeds from the Bond Measurecan only be used for “bricks andmortar” (for construction, renovationand demolition of facilities) and forthe purchase of land contiguous withthe Oceanside campus (if needed, butnot currently anticipated) or possiblyfor proposed off-site CommunityHealth Centers within the District. No funds can be used for the purchaseof furniture or equipment. Thosefunds will come from the District’sdebt capacity, operations, andphilanthropy – and not fromtaxpayers. No funds can be used foradministrators’ or employees’ salaries. If approved, the District will berequired to establish an IndependentCitizens’ Oversight Committee toensure that bond monies go only to improvements articulated in theBond Resolution, and not for anyother purposes. As a result of the Long-termPlanning Group’s study, theDistrict is proposing to upgradeand modernize its facilities for the following reasons:Comply with earthquakesafety standards mandated by the State of California.TCMC must meet thesecompliance requirements by January 2013.Relieve overcrowding in theEmergency Department (ED).TCMC has the second busiestED in San Diego County withnearly 60,000 visits last year.Accommodate anticipatedpopulation growth in NorthCounty, which is expected to increase to 1.3 million over the next 20 years. Upgrade the infrastructure to accommodate: •advances in medicaltechnology for diagnosticsand interventionaltreatment; •safety and security features; •energy efficiencies inbuilding design to reduceenergy costs and savenatural resources; •comforts patients requirewhen they are sick andrecovering from theiraccident or illness; and •efficiencies in operations.Functions should be placednear compatible uses; notbased on space availability. The Master Facilities Plan proposes to: Parking Garage Hospital Outpatient Services ED Renovation Demo Renovation Renovation Surgery Renovation Central Plant ASC (Development by Third Party)Construct new facilitiesand renovate otherportions of theHospital, therebyensuring the MedicalCenter complies withstate-mandated earth-quake safety standardsby 2013. Construct twin,patient-bed towers for treatment of acute,critical and intensivecare patients. Renovate, upgrade and reuse the followingseismically compliantbuildings and areas: •Surgery•EmergencyDepartment•Pavilion Tower •Behavioral Healthbuilding Establish a newOutpatient Center to separate inpatienthospital functions withoutpatient needs inorder to streamline and improve patientcare in both areas. Expand the number of operating rooms and patient recovery areas. Upgrade and expand the Central Plant andReceiving dock. Improve on-site traffic flow and parking. Renovate, construct andexpand all service areas thatsupport patient treatment. Renovate and construct facilitiesto improve patient and staffsafety and security, and toaccommodate technologicaladvances in medical diagnosisand treatment. Establish off-campusCommunity Health Centers in the District to improve localaccessibility to healthcare. Expand and improve core services such as: •Women’s and Children’s Services•Neonatal Intensive Care Unit•Interventional and DiagnosticRadiology•Orthopedics •Cardiovascular•Neurology and Stroke•General Surgery•Behavioral Health The Long-Term Planning Group evaluated manyoptions before proposing to renovate one-third of the current facility combined with building newfacilities. All dollars are escalated to 2013 estimatesfor comparison purposes. The Group recommended,and the Board approved, scenario 3: 1. Seismically retrofit current facility only: $425 - $599 million2.Build new hospital and demolish old facility: $694 million3.Renovate 1/3 and construct new facilities: $602.3 million Increase the capacity of the Emergency Department by adding additional beds in the ICU and creating an Urgent Care and Short Stay Observation area. Tri-City Healthcare DistrictMaster Facilities Plan Briefing & Community Feedback Results 2Tri-City Medical Center 1961 3Tri-City Medical Center Today 4Map of District 5Primary and Secondary Service AreaPSASSA92008 9200392009 9200792054 9202492056 9202592057 9202692069 9202792078 9202892081 9202992083 9208292084 9259192592Definition 6Long-Term Strategic Planning Process Led to Need for a Master Facilities Plan1.Comply with State-mandated seismic requirements by 2013.2.Relieve Emergency Department overcrowding. Second busiest in San Diego County.3.Accommodate future growth in Coastal North County.4.Current Hospital central core was built in 1961. Will be halfcentury old in 2013. Building lacks: ¾Infrastructure for current and future medical technology enhancements.¾Safety and security features.¾Energy efficiencies in building design.¾Comforts in facility design that focus on the patient.¾Operational efficiencies. Current Hospital functions are laid out based on space availability rather than synergies of functions.5.Traffic and parking problems. 7Community Feedback ResultsMailer CampaignMailer CampaignMail Recipients: 56,500 Mail Recipients: 56,500 Returned Forms: 3,229 Returned Forms: 3,229 Speakers BureauSpeakers BureauTotal Presentations: 96 Total Presentations: 96 Total Attendees: 5,000 plusTotal Attendees: 5,000 plusPublic Opinion PollsPublic Opinion PollsSeptember 2004 September 2004 November 2005 November 2005 February 2006February 2006CitizensCitizens’’Task ForceTask ForceAugust 2005August 2005February 2006February 2006March 2006March 2006 8Master Facilities Plan(150 Page Plan)Tri-City Healthcare DistrictMaster Facilities PlanApril 5, 2006 9The Long-Term Planning Group evaluated many options before proposing to renovate one-third of the current facility combined with building new facilities.•Seismically retrofit current facility only: $425 - $599 million•Build new hospital and demolish old facility: $694 million•Renovate 1/3 and construct new facilities: $602.3 million 10Speaker’s Bureau & Mailing Campaign Results CombinedThe following priorities are important:83% - Reducing ER overcrowding and shortening wait times.77% - Attracting and retaining top quality doctors and nurses.76% - Installing up-to-date technology and lifesaving medical equipment.72% - Providing more responsive Emergency Room care.67% - Upgrading electrical wiring and power generation systems.57% - Repairing leaky roofs. 11Master Facilities Plan Features5Renovate, upgrade and reuse 1/3 of the current hospital on current Oceanside site: Surgery, ER, Pavilion Tower, and Behavioral Health building.5Create new 757,000 square foot seismically compliant Hospital and 220,000 square foot Outpatient Center. 5New Hospital will have twin, patient-bed towers. Total capacity is 335 beds.5Increase Emergency Room capacity by adding to ICU, and creating Short Stay and Urgent Care units.5Expand OR and patient recovery areas.5Establish Outpatient Center to separate inpatient functions in order to streamline and improve patient care in both areas. 12Master Facilities Plan Features5Upgrade Central Plant and Receiving functions.5Improve on-site parking and traffic flow.5Renovate, construct and expand all service areas that support patient treatment.5Renovate and construct facilities to accommodate technological advances in medicine.5Expand and improve core services: Women’s and Children’s, the Neonatal ICU, Interventional and Diagnostic Radiology, Orthopedics, Cardiovascular, Neurology and Stroke, General Surgery and Behavioral Health. 5Establish off-campus Community Health Centers. 13Conceptual RenderingCentral PlantParkingGarageRenovationDemoRenovationASC (Development by Third Party)Outpatient ServicesSurgery RenovationED RenovationHospital 14Conceptual Rendering 15How will this be done?5Proposition F on June 6 ballot seeks $596 million general obligation bond. 5Requires 2/3’s vote of district residents --- Oceanside, Carlsbad and Vista.5$23.40 per $100,000 of assessedvalue, notappraisedvalue.5Median residential assessed value in District is approximately $205,000. Annual tax would be approximately $46.80, or $3.90 per month.5All real property owners pay. Residential, Commercial, Industrial, etc.5Bond will cover “bricks and mortar” only.5Operations, debt capacity and philanthropy to cover furnishings,equipment and any costs beyond amount of bond.5No funds can be used for administrators’ or employees’ salaries.5An Independent Citizens’ Oversight Committee appointed by Board will ensure expenditures match improvements promised in Bond Resolution.5Construction planned to be complete by January 2013. 16Major Endorsements•San Diego County Taxpayers’ Association•San Diego Union-Tribune•North County Times•League of Women Voters – North County •Carlsbad Chamber of Commerce•Vista Chamber of Commerce•Oceanside Chamber of Commerce•San Diego North Economic Development Council•Carlsbad City Council•Vista City Council•Oceanside Firefighters Association•Carlsbad Firefighters Association•Vista Firefighters Association 17For more information visit our web sitetricitymed.org 18Long-Term Planning Group•Tri-City Healthcare District Board of Directors•Leaders of the Medical StaffRadiology, Chief of StaffNeurologist, Past Chief of StaffDepartment Chair, Emergency Department Chair, PathologyDepartment Chair, OB-GYN General SurgeryMedical Director, Cardiology Orthopedics, Chief of SurgeryPrimary Care, Chief of Staff ElectLeaders of Three Largest Primary Care Groups•Senior Management•Hammes Company & Other Advisors 19Planning Considerations•Current Land Use Analysis•Traffic and Site Circulation•Property Acquisition Options•Population Projections•Future Age Demographics•Future Hospital Market Share•Socio-cultural Factors•Consumerism•Legal•Public Opinion•Financing Options•Payment and Economics•New Medical Technologies•Shift to Outpatient Services•Future Inpatient Length of Stay•Inpatient Projections•Outpatient Projections•Future Expansion Options•Options into the Next Century•Multiple Alternatives Considered 20Speaker’s Bureau & MailingWritten Comments/Concerns Included:¾Elaboration of previously identified priorities. ¾Suggestions and recommendations on issues not already identified.¾Positive or negative comments about specific experiences.Recurring issues identified by the public included:¾Lack of adequate parking.¾Use the ER for non-emergencies.¾Suggestion to create an urgent care unit for non-emergencies.¾Concerns about the uninsured and illegal aliens. 21Conceptual Rendering 22Construction CostsMain Campus Renovation, Construction and Infrastructure CostsWithoutMedical Equipment and FurnishingsPhase 1$ 366.3 millionPhase 29.9 millionPhase 3226.0 millionTotal$ 602.2 million 23Seismic Retrofit Option•Expert Recommendations Against Retrofit as Option¾Central Core of Hospital Requires the Most Seismic Upgrade¾Effective Hospital Design Has Changed Significantly Over Time¾Infrastructure Issues (Plumbing, HVAC, Electrical, Leaky Roofs)¾Long-Term Intangible Image Costs and Clinical Quality Issues•Estimated Tangible Retrofit CostsSeismic Retrofit Construction$ 130 - 158 millionBusiness Disruption220 - 291 millionNew Construction & Infrastructure Costs 50 - 100 millionSafety, Traffic, Cosmetic25 - 50 millionPermanent Loss of Patients???Total$ 425 - 599 millioni 24Next Steps•Programming, Design and Development¾Selection of Architect and Pre-Construction Manager¾Environmental Impact Review, City of Oceanside, OSHPD¾Additional planning/programming meetings with staff, physicians and community•Determination of Costs¾Moveable Medical Equipment¾Furnishings¾Community Health Centers»Location»Scope of Services