COUNTY OF SAN MATEO

Inter-Departmental Correspondence

Department of Public Works

DATE:

November 28, 2005

BOARD MEETING DATE:

December 13, 2005

SPECIAL NOTICE/HEARING:

None

VOTE REQUIRED:

Majority

TO:

Honorable Board of Supervisors

FROM:

Neil R. Cullen, Director of Public Works

SUBJECT:

Keller Women’s & Children’s Services Unit at the San Mateo Medical Center

Recommendation

Adopt a resolution authorizing the Director of Public Works to call for sealed proposals to renovate the ground floor nursing wing at the San Mateo Medical Center (Medical Center) to provide the Keller Women’s and Children’s Services Unit (Birthing Center).

Vision Alignment

Commitment: Ensure basic health and safety for all.

Goal(s): Residents have access to healthcare and preventive care.

The proposed project will provide a needed service at the Medical Center for the residents of San Mateo County.

Background

Previous Board Action

1.

Approved the concept plan for building the Birthing Center at the Medical Center (August 31, 2004).

2.

Adopted a resolution on August 26, 2005, to call for bids for the Birthing Center no later than July 22, 2005, as we anticipated that the Office of State Hospital Planning and Development (OSHPD) would have approved the plans prior to that date.

History

The Medical Center proposed the construction of the Birthing Center as there are over 10,000 births annually from San Mateo County, with over 2,000 being Medi-Cal financed births. Over half these Medi-Cal births are currently delivered in hospitals outside of San Mateo County. The Medical Center also conducted patient focus groups which confirmed that there is patient interest and willingness to use a new labor and delivery service at the Medical Center.

The Medical Center concluded that the Birthing Center will bring obstetric services to the community in support of the Medical Center’s mission; will provide a continuum of care for mothers and infants; will fill empty beds and maintain licensed bed count; will attract women, who are the primary heath care decision makers, to the Medical Center; and will compete in the market place and capture market share of obstetric and pediatric services to generate revenue.

We recommended and your Board approved calling for bids for the Birthing Center in April 2005, while plans were in the OSHPD review process for permit approval. However, we were not able to proceed with the call for bids within the time frame provided in the resolution, due to OSHPD’s interpretation of the Building and Hospital Licensing Code. The Medical Center appealed OSHPD’s interpretation through the State’s “program flexibility process”. This process required additional review and interpretation by the State Office of Hospital Licensing and additional OSHPD review. Licensing and OSHPD have approved our appeal.

Discussion

The Medical Center now wishes to again move forward with the construction of the Birthing Center that will provide obstetric services to include 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 bid documents are still with OSHPD, but we expect a permit to be issued by OSHPD in December/early January. Concurrently a second financial analysis for the Birthing Center is being conducted under the supervision of the County Manager and we anticipate that the analysis will be completed by early December.

We are recommending that your Board authorize the Director of Public Works to call for bids now, in order to expedite the completion of the Birthing Center in a timely fashion. We anticipate that there may be some minor changes to the plans based on OSHPD’s final review, and will notify plan holders of these changes through the standard contract addendum process. Your Board will then be able to consider the plans with any modifications, the summary of the bids received, and the conclusions of the financial analysis when considering moving forward with the project.

A resolution has been approved as to form by County Counsel.

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

Fiscal Impact

The estimated construction cost is $4,800,000 and is proposed to be financed with a combination of grant funds from the Keller Trust, funds from the Medical Center Foundation and a capital loan from the General Fund. The required amounts necessary from each of these funding sources will not be known until after bids are opened and the low bid determined. We will provide your Board with a detailed analysis of the required funds and any necessary agreements to facilitate the financing of the project before an award of a contract is recommended.

There is no net impact to the General Fund as the capital loan will be repaid by the Medical Center from its future operating income.