To: Board of Supervisors
From: Anna Roth, Health Services Director
Report Title: Update on Measure X Funded Capital Projects by Contra Costa Health
☒Recommendation of the County Administrator ☐ Recommendation of Board Committee
RECOMMENDATIONS:
ACCEPT an update about Measure X-Funded Capital Projects on the campus of the Contra Costa Regional Medical Center in Martinez,
APPROVE the repurposing of $80 million in one-time Measure X funds to fund four capital projects,
APPROVE Public Works to initiate Requests for Qualifications for contractors for four projects, and
APPROVE Public Works to use any combination of design-bid-build, design-build, progressive design-build, and/or Job Order Contracting for project delivery.
FISCAL IMPACT:
The three identified projects for Contra Costa Regional Medical Center (CCRMC) have an estimated construction cost of $26-52M. The initial estimate for a new Public Health building is currently unknown. A total of $80M has been allocated for capital projects to Contra Costa Health from Measure X.
The estimated cost to renovate the Food Services Building at CCRMC to comply with Seismic Performance Category (SPC) regulations is $25-50M. The estimated cost to bring the main hospital and lab into compliance with the Non-structural Performance Category (NPC) fire sprinkler requirements is estimated to be $1-2M. The cost to complete all NPC work to create 72-hour emergency supply of potable water, fuel, sewage and liquid waste storage is currently unknown. The remaining funds from the Measure X allocation will be applied to build a new Public Health Lab. There is no additional fiscal impact to the County General Fund or Contra Costa Regional Medical Center because of this action.
BACKGROUND:
In 2022, the Board of Supervisors allocated $80M to Contra Costa Health for capital projects on the campus of CCRMC. The funding was initially earmarked for five projects: (1) New Medical Clinic and Office Building Complex, (2) New Parking Structure, (3) New Interventional Radiology Suite, (4) Expanded and Modernized Psychiatric Emergency Room, and (5) Public Health Lab. Public Works hired a construction management firm, Vanir Construction Management, Inc. (Vanir), to develop a facility master plan. That plan, completed in April 2024, identified several Measure X, strategic program and seismic compliance projects for the Martinez campus. Contra Costa Health is now recommending four separate projects to be initiated and funded by the previously allocated Measure X funds. The most urgent of the projects are to comply with state seismic requirements and construct a new Public Health Lab.
CCRMC must comply with the SPC and NPC requirements and timetables, including submission of architectural plans by January 1, 2026, and complete construction by January 1, 2030, or it will have to cease operations until it meets the seismic standards. California Hospital Association sponsored Senate Bill 1432 to provide hospitals more time to comply with the 2030 seismic standards was recently vetoed by Governor Newsom. That group and the California Association of Public Hospitals are working to determine next steps considering the significant financial burden the seismic mandates are having on hospitals.
The fourth project, to build a new Public Health Lab, is needed to create adequate space for current and future equipment and staff of the department. There are no other currently available sources of funding for these capital projects other than the Contra Costa Health Measure X allocation.
Food Services/Cafeteria Building (SPC)
This project is to bring this building up to structural seismic (SPC) standards. It will include enhancements to the roof, walls and flooring, HVAC upgrades, construction to comply with the American Disability Act (ADA), and replacement of much of the equipment in the Food Services building. There is a January 1, 2026, deadline for CCRMC to submit a permit request, including construction drawings, to the California Department of Health Care Access and Information (HCAI). In addition, there is a January 1, 2030, deadline to complete construction and obtain an occupancy permit. Following the Board’s approval, CCRMC will work with Public Works to develop a Request for Qualifications to identify a design/build team to create and submit construction documents by the 2030 deadline. The estimated cost to comply with the SPC requirements in the Food Services/Cafeteria building is $25-50M.
Fire Sprinkler Bracing (NPC)
There is an initial estimate of $1-2M for this project to brace the end of each fire sprinkler line in the main hospital and the lab. The work essentially involves applying a metal strap to the end of each of the fire sprinkler lines and attaching them to the ceilings.
Emergency Water and Liquid Waste Storage (NPC)
This project is to create sufficient potable water, fuel, liquid waste and sewage storage capacity for 72 hours of emergency use. HCAI responded to CCRMC’s water mitigation plan that was submitted in December 2023 by requesting additional information regarding total water and liquid waste volume and requested plans identifying the location of the storage tanks. There is no estimate of the total project cost. It is recommended an external team be hired to develop cost estimates, respond to HCAI questions and create a set of documents that meets the NPC requirements.
Public Health Lab
The creation of a new Public Health Lab on the CCRMC campus will expand laboratory space and testing capabilities of the department as well as ensure better preparedness and detection of novel or pandemic infectious diseases. Currently, the Public Health Lab is on the second floor of a building that also houses the hospital lab. Both labs are extremely crowded with equipment, staff, and lack the necessary electrical capacity to run and maintain instrumentation. The new Public Health Lab, estimated to be 18,000 square feet, will hold current and future diagnostic instrumentation and permit CCRMC lab to expand into the entire second floor space. The Public Health Laboratory will be able to update and expand much needed enhanced molecular testing and surveillance, such as the polymerase chain reaction (PCR) detection and sequencing seen with COVID-19, as well as add new surveillance testing capabilities, such as drug-resistance and wastewater testing, within the new facility.
Health Services, CCRMC and Public Health leadership have reviewed this plan and recommend Public Works initiate Requests for Qualifications for the four-project scope of work. It is also recommended Public Works use any combination of a design-bid-build, design-build, progressive design-build, and/or Job Order Contracting for the project delivery.
The facility master plan that was developed by Vanir identified several other projects on the CCRMC campus. Those include additional parking structures, a Medical Office Building, an Interventional Radiology suite, additional Psychiatric Emergency Services space, and a new Behavioral Health Building. It is recommended the Measure X funds be used to complete the required SPC and NPC upgrades and build the new Public Health Lab before proceeding with any of the other Master Plan projects. Any remaining funds from the Measure X allocation will be applied to improve parking for CCRMC. An updated plan for the use of the remaining Measure X funds either on or off the Martinez campus will be presented to the Board in the future.
CONSEQUENCE OF NEGATIVE ACTION:
Food Services is classified as an essential service for all General Acute Care Hospitals. The Food Service/Cafeteria building at CCRMC is not compliant with state seismic standards and will have to be taken out of service by January 1, 2030, if the appropriate SPC upgrades are not completed. In a similar manner, the fire sprinkler line project and the water and liquid waste project are required for CCRMC to meet state seismic standards by 2030. Failure to comply with the SPC and NPC requirements and timetables will result in CCRMC having to cease operations until it meets the seismic standards. The current space of the Public Health Lab is inadequate for current and future needs. Additional testing by Public Health will not be able to be completed and the lab may not be able to adequately ensure better preparedness and detection of novel or pandemic infectious diseases without creation of a new lab building. There are currently no other available sources of funding for these capital projects other than the Contra Costa Health Measure X allocation.