Inter-Departmental Correspondence

Department of Public Works



December 3, 2004


December 14, 2004



Honorable Board of Supervisors


Neil R. Cullen, Director of Public Works


Amendment to the Architectural Agreement for the Design of the Delivery Unit at the San Mateo Medical Center




Approve an Appropriation Transfer Request (ATR) that increases the appropriation in the Capital Improvement Projects Fund by $600,000 (from $344,315 to $944,315) for design and professional architectural and engineering consultation services, supplemental project development costs, and project management of the Keller Women & Children Services Unit (KWCSU) at the San Mateo Medical Center (Medical Center) (4/5ths vote required); and



If your Board approves the ATR, then adopt a resolution authorizing the President of the Board to execute Amendment No. 1 to the existing agreement with the firm of Thistlethwaite Architectural Group for architectural services, which increases the architectural fees from $400,000 to $820,000 for the design of the KWCSU at the Medical Center.


Previous Board Action

Adopted resolutions authorizing the President of the Board to:



execute an agreement with the firm of Thistlethwaite Architectural Group for architectural services for the design of a KWCSU at the Medical Center; and



approve the master plan for the KWCSU.


Key Facts

The revised approved master plan for the KWCSU requires an increase in architectural services which in turn requires an increase in the architectural fees and other project costs.




The San Mateo Medical Center Board, in June 2003, gave the Medical Center Administration approval to move forward with the development of the KWCSU. A small planning committee was formed including medical center administration and physicians. Packard Children’s Hospital was chosen as the university partner to act as a consultant for the planning of the services to be provided as this is a new program for the Medical Center. The KWCSU as envisioned consisted of a ten-bed labor delivery recovery postpartum unit, delivery suite and supporting intermediate care services.


The Thistlethwaite Architectural Group was then retained pursuant to the County’s Request for Proposal process, to do preliminary designs of the KWSCU. It was determined through a series of meetings with the architect and Medical Center staff that the original plan would not meet the current needs and goals of the Medical Center and a new master plan for the KWCSU was developed and subsequently approved by your Board.


The Medical Center now wishes to move forward with the construction documents for the revised project which includes eight (8) labor delivery recovery postpartum rooms, two (2) recovery beds, two (2) ante partum beds, two (2) nurse’s stations, one (1) delivery suite with the potential for a second suite in the future, a well baby nursery, a Level II nursery, eight (8) post partum rooms, support areas and offices. The estimated construction cost of the KWCSU is $5,285,000 with equipment costs estimated at $2,592,000. A final prebid estimate will be prepared by the architect upon completion of the construction documents.


Consultant Services to be Provided

We are recommending that the not to exceed amount of the consultant's fees be increased from $400,000 to $820,000, which includes a base fee of $769,076, an allowance of $20,924 for reimbursable business expenses as described in the proposed amendment to the agreement, and an allowance of $30,000 for optional miscellaneous services as may be provided. The reimbursable expenses and optional miscellaneous expenses must be approved by the County in advance and in writing.


The consultant services to be provided include verification of the preliminary schematic design as envisioned by the Medical Center, a revision to the KWCSU master plan, presentations to the Medical Center Board, preparation of alternate layouts and cost estimates once it was determined that the initial plan did not meet the needs or goals of the Medical Center, preparing specialized equipment and furnishing lists for the expanded scope of work, developing a larger Level II nursery, preparing construction documents for the larger project, obtaining an Office of Statewide Health Planning and Development (OSHP&D) permit, assistance in bidding, construction administration, and equipment and fixture design and placement.


The additional $180,000 in the recommended ATR is necessary for project administrative costs, costs for special testing and documentation, OSHP&D permit fees, advertising, bidding and project management during the design phase of the project.


Vision Alignment

We believe our recommendation is consistent with the Shared Commitment to “ensure basic health and safety for all,” and Goal Number 5, “residents have access to healthcare and preventive care,” as the KWCSU will provide a needed service to the residents of San Mateo County.


Fiscal Impact

The cost of the architectural services and management is proposed to be financed with Medical Center Enterprise funds. The ATR is necessary as Public Works will be administering the contract with payments made out of the County’s Capital Project budget.


There is no impact to the General Fund.


The total project cost for the KWCSU is estimated at $9.8 Million. The Medical Center is proposing to finance the work from its capital account supported in part by contributions from the San Mateo Medical Center Foundation, Keller Trust and a capital loan. We and the Medical Center will return to your Board with a recommendation to call for bids for construction after the bid documents are complete, the necessary permits obtained and the funding sources defined. We also believe that it is prudent to move forward with architectural plans at this time as funding sources, in some instances, are dependent on the review of completed plans.


A form of resolution and an amendment to the original agreement has been approved by County Counsel and the architect has executed the agreement.


The Chief Executive Officer of the Medical Center concurs with our recommendation.