To: Board of Supervisors
From: Warren Lai, Public Works Director/Chief Engineer
Report Title: Authorization to Execute Contract Amendment for Pre-Construction Services for Contra Costa Regional Medical Center Cafeteria Building Upgrades Project
☒Recommendation of the County Administrator ☐ Recommendation of Board Committee
RECOMMENDATIONS:
APPROVE and AUTHORIZE the Public Works Director, or designee, to execute a contract amendment with Truebeck Construction, Inc. to increase the payment limit by $3,000,000.00 to a new payment limit of $7,266,080.41 to provide additional pre-construction services for Contra Costa Regional Medical Center’s Cafeteria Building Upgrade project.
FISCAL IMPACT:
The total project budget is currently estimated at approximately $117 million, funded primarily through Measure X ($80 M), with additional funding provided by the Hospital Enterprise Fund ($37 M). This total budget estimate will be finalized and presented to the Board for approval in conjunction with the Phase 2 construction contract.
BACKGROUND:
Regulatory Necessity (SB 1953 Compliance): The Contra Costa Regional Medical Center (CCRMC) is subject to the Alfred E. Alquist Hospital Facilities Seismic Safety Act (SB 1953). Under this law, all acute care hospital buildings must achieve SPC-5 (Structural Performance Category) and NPC-5 (Non-Structural Performance Category) compliance by January 1, 2030. This mandates that critical support services-specifically dietary operations-remain fully operational for 72 hours following a major seismic event. The existing cafeteria does not meet these standards, putting the hospital's operating license at risk.
Solicitation and Original Scope In December 2024, Public Works issued a Request for Proposals (RFP) to procure a Progressive Design-Build entity. During the solicitation process, consultation with Department of Health Care Access and Information (HCAI) and California Department of Public Health (CDPH) confirmed that upgrading the existing remote cafeteria is not a viable option as it will create a non-compliant condition.
Consequently, Public Works issued an addendum to the RFP revising the scope to a compliant solution: the construction of a new cafeteria building connected to the main hospital, requiring the demolition of the existing "Ward E" building. On March 25, 2025, the Board of Supervisors awarded the Phase 1 Pre-Construction contract to Truebeck Construction, Inc. (Truebeck) based on this revised scope.
Validation Findings: A primary benefit of the Progressive Design-Build delivery method is the Phase 1 Validation Period, where the contractor investigates site conditions and validates programming requirements before construction pricing is set. During this phase, two significant factors emerged that necessitate this amendment:
1. Scope Expansion (Right-Sizing): Extensive programming discussions with hospital administration, HCAI, and CDPH revealed that a single-story structure would be insufficient to house the required dietetic kitchen and staff support functions. To meet basic hospital operational needs, the building design was right-sized from a one-story structure to a three-story facility.
2. Ward E Relocation Complexity: The validation study confirmed that Ward E houses critical infrastructure essential to basic hospital operations that must be relocated prior to demolition or included within the new building. These include morgue operations, general storage, laundry/materials management, employee locker rooms, and critical data infrastructure.
Reason for Amendment This Amendment increases the pre-construction services contract by $3,000,000 to fund the expanded design and project management effort required for the larger three-story facility and the complex engineering of interim and permanent relocations for Ward E functions. This investment ensures that critical hospital operations-specifically the morgue and data system remain fully functional during construction.
Anticipated Timeline and Next Steps: Public Works anticipates finalizing negotiations for the Phase 2 Construction agreement in Q2 2026. The Department expects to return to the Board in the Second Quarter of 2026 to recommend the award of the Phase 2 Design-Build Contract and to request approval of the total project budget, contingent upon the successful negotiation of a Guaranteed Maximum Price (GMP).
CONSEQUENCE OF NEGATIVE ACTION:
Failure to approve this action would leave Public Works without adequate authority to execute the necessary contract changes required to meet State law. This delay would trigger non-compliance penalties against the County, potentially leading to:
1. Financial penalties assessed by the State;
2. Refusal by HCAI to issue future building permits; and
3. The potential closure of CCRMC's food service facilities, which could ultimately force the termination of general acute care services at the Medical Center.