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UCSF Medical Center at Mission Bay
Cindy LimaProject DirectorUCSF Medical Center at Mission Bay
September, 2008
SIXTEENTH STREET
SIXTEENTH STREETFOURTH STREET
FOURTH STREET
Mark R. LaretChief Executive OfficerUCSF Medical Center
J. Michael Bishop, MDChancellorUCSF
2
Agenda
• Background and introduction• Design presentation• Financial plan
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UCSF Medical Center• Track record of achievement in applying advanced
research to clinical care– Top ten hospital in US News & World Report– One of original nationally-designated Centers of
Excellence in Women's Health– NCI-designated Comprehensive Cancer Center– Most kidney transplants performed in the world– Largest brain tumor treatment program in the nation
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Why UCSF Medical Center at Mission Bay?
• Comply with seismic law
• Address obsolete facilities
• Resolve capacity constraints
• Fulfill long-term potential for integrated clinical and research programs
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UCSF Mission Bay Hospitals Milestones• 2000: UCSF begins clinical facilities planning
process• 2004-2006: Regents approve Mission Bay
hospital land acquisition • January 2006: Regents endorse UCSF to pursue
Mission Bay hospital project and approve Mount Zion back-up plan
• May 2007: Regents approve fundraising campaign• March 2008: Regents receive project update• May 2008: Regents endorse preliminary design• Today: Request Regents approval of design,
EIR and project budget
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Design
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Program
• 183-bed children's hospital with urgent/ emergency care and pediatric primary and specialty ambulatory facilities
• 70-bed adult cancer hospital
• Women's hospital for cancer care, specialty surgery, a 36-bed birth center and select women's ambulatory services
• Energy center (central plant)
• Surface parking (450 spaces)
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Program – Future
• Separate related projects– Outpatient clinical cancer center– 580-car parking structure (total 1,030 spaces)– Faculty office space
• Future – West Block Expansion– Add up to 261 beds (550 total beds),
additional outpatient building and structured parking (total 1,400-1,750 spaces)
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Architectural Vision
• Patient- and Family-Centered
• Transformative: Flexible, expandable, adaptable -incorporating evidence-based design, patient safety
• Distinct identities: Children’s, Women’s, Cancer
• Efficient: Operational, first and life-cycle costs
• Integrated: Translational research, multi-disciplinary, education
• Sustainable: Reduce carbon footprint, healthy environment, water conservation
10 Color Scheme & Materials
Vision Glass Mullions Precast Concrete
Shadowbox/ Spandrel Glass Metal Stone Accents
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Patient-Centered Design
• Proximity of services• Patient/family support
– concierge, greeters, valet parking, security– in-room family sleep, living area with kitchen,
showers, laundry– resource rooms, SF Unified school in-house
• Gardens, landscaping, art• Separate public/service circulation• Areas of respite and engagement• On-demand food service
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Sustainability
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Byers Hall and Genentech Hall
HousingArthur and Toni Rembe Rock Hall
William J. Rutter Center
Architectural Context• UCSF
• Mission BayResearch Campus
• Neighborhood
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15 Site Plan
Phase 2 Site
Temporary Parking
Phase 1A Parking Structure
UCSF Research Campus
Phase 1A Cancer Outpatient Building
Outpatient Building
Energy Center
Hospitals
N
Mariposa Street
Sixteenth Street
Ow
ens Street Third Street
Fourth Street
Phase 1
Phase 1.A
Mariposa City Park
Highw
ay 280
16 Phase 2 – Site Plan
UCSF Research Campus
Phase 1A Cancer Outpatient Building
Outpatient Building
Energy Center
Hospitals
Phase 2 Hospital
Phase 1A Parking Structure
N
Mariposa Street
Sixteenth Street
Ow
ens Street Third Street
Fourth Street
Phase 2 Clinical Plinth
Phase 2
Phase 2 Parking Structure
Highw
ay 280
Mariposa City Park
17 Landscape Site Plan
N
50’ 100’ 200’
Graphic Scale
0’
PHASE 1A CANCER OUTPATIENT BUILDING
Mariposa Street
Sixteenth Street
Ow
ens Street
Fourth Street
PHASE 1A PARKING
STRUCTURE
MARIPOSA CITY PARK
Cancer View Garden
Fourth Street Plaza
S
Third Street Plaza
Women’s View Garden
Meditation Garden
Teaching Garden
Children’s Play Plaza
Campanile Plaza
Campus Gateway
Landscape Setback
18 View from Southwest
Children’s Hospital(183 beds)
Women’s & CancerHospitals (106 beds)
Energy Center
OutpatientBuilding
UCSFUCSFResearchResearchCampusCampus
Phase 1A CancerOutpatient Building
MAR
IPO
SA S
TREE
T
MAR
IPO
SA S
TREE
T
FOURTH STREET
FOURTH STREET NN
19 View from Southeast
ENERGY CENTER
CHILDREN’S HOSPITAL
WOMEN’S & CANCER HOSPITALS
SIXTEENTH STREET
SIXTEENTH STREET
FOURTH STREET
FOURTH STREET
THIR
D STR
EET
THIR
D STR
EET
MARIPOSA STREET
MARIPOSA STREET
PHASE 1A PARKING STRUCTURE
OUTPATIENTBUILDING
PHASE 1A CANCEROUTPATIENT BUILDING
OWENS STREET
OWENS STREET
NN
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East Elevation (Third Street)
West Elevation (Fourth Street)
Building Elevations
30’ 60’ 120’
Graphic Scale
0’
Children’s Hospital(183 beds)
Women’s & CancerHospitals (106 beds)
OutpatientBuilding
Energy Center
Phase 1A CancerOutpatient Building
Women’s & CancerHospitals (106 beds)
Children’s Hospital(183 beds)
21 Color-Coded Floor Plan – Level 1
N
30’ 60’ 120’
Graphic Scale
0’
Servery
Dining
Food Services
Plant Ops/ Materiel
ManagementEVS/ EH&S
Conference Center
Imaging
Radiation Oncology
Children’s Hospital
Lobby
Administration
Outpatient Building Lobby
Energy Center
Urgent Care / Emergency
Women’s & Cancer Hospitals Lobby
Third Street Entrance Lobby
22Color-Coded Floor Plan – Level 5
N
30’ 60’ 120’
Graphic Scale
0’
Peds Surgical Specialty Clinics
Sky Lobby
Waiting
Dental
PrepareRehabilitation Services
Women’s & Cancer Acute Care
Peds Acute Care
Peds Transitional Care
Peds Child Life
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Cost Control - Design
• Highly efficient design• Third party reviewers • Independent cost estimators• OSHPD partnership• Building Information Management (BIM)• Lessons learned
24
Cost Control - Delivery
• Best value contractor selection • Top-notch general contractor: DPR• Pre-construction services• Performance incentives• Tight management of change requests
25
UCSF Medical Center at Mission Bay Children’s, Women’s & Cancer Hospitals
SIXTEENTH STREET
SIXTEENTH STREETFOURTH STREET
FOURTH STREET
NN
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Financial Plan
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$1.686 BillionProject Cost Breakdown
Design Fees$70M
Project Management
$30M
Surveys, Tests, Plans and
Specifications$22.8M
Special Items/Capitalized
Interest$174.6M
Contingency @ 5%
$54.7M
Equipment & Furnishings
$239M
Construction$1,094.9M
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$1.686 Billion Project Funding Sources
Gifts$600M
State Funds$200M
Children's Hospital Bonds
$69M
Medical Center Equity$117M
Medical Center Debt
$700M
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Medical Center Debt: $700M
• UC Medical Centers Pooled Credit Revenue Bonds
• Debt capacity verified by UC Finance and Lehman Brothers
• Primary repayment source: hospital cash flow
30
Medical Center Equity: $117M
• $81M from hospital operating cash flow– Average annual cash flow FY2004-
FY2008: $146M• $36M in interest income from gift-
funded portion of construction fund
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Children’s Hospitals Bonds: $69M
• $30M authorized in 2004 (Proposition 61)
• $39M on November 2008 ballot (Proposition 3)
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State Funds: $200M
• Target: November 2010 ballot• Consistent with amounts received by
UCLA, UC Irvine and UC Davis for seismic purposes
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Gifts: $600M• Strong support from UCSF Foundation
and UCSF Medical Center Executive Council
• Premier campaign cabinet established• Fundraising campaign underway
34
Financial Risks
• Operating performance does not support debt
• Voters do not approve ballot initiatives• Philanthropy falls short of goal• Construction escalation exceeds pro
forma estimate
35
Potential Responses to Financial Shortfall1. Compensate from other sources2. Modify scope3. Secure bridge financing 4. Seek state authorization to extend
seismic deadline 5. Implement Mount Zion retrofit and
clinical expansion
36 36
Project Schedule2
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2008Jan-Dec 2009 2010 2011 2012 2013 2014
Steel Bid/Fab
Outpatient Construction
Hospital Design
OSHPD Review
General Election:
Children’s Hospital Bond
11/2008
General Election:
Possible State Bond
11/2010
Hospital Construction
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• Action requested:– Approve project contingent upon
meeting financing plan by December 2010
• Subsequent Regental updates/actions:– Review and approve changes in project– Review and approve changes in
financing plan– Continuous updates including formal
reports in January and November 2010
38
UCSF Medical Center at Mission Bay
SIXTEENTH STREET
SIXTEENTH STREETFOURTH STREET
FOURTH STREET
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Back up slides
41
Outpatient Building (Sixteenth & Fourth Streets) NN
42Inpatient Buildings (Fourth Street)
NN
43
Women’s and Cancer Hospitals EntranceNN
44Children’s Hospital
NN
45Children’s Hospital Entrance
NN
46
Children’s Hospital (Mariposa and Fourth Streets)NN
47
Inpatient Buildings and Plaza (Third Street)NN
48Energy Center (Third Street )
NN
49Color-Coded Floor Plan – Level 1
N
30’ 60’ 120’
Graphic Scale
0’
Servery
Dining
Food Services
Plant Ops/ Materiel
Management
Conference Center
Imaging
Radiation Oncology
Children’s Hospital
Lobby
Administration
Outpatient Building Lobby
Energy Center
Emergency / Urgent Care
Women’s & Cancer Hospitals Lobby
50Color-Coded Floor Plan – Level 2
N
30’ 60’ 120’
Graphic Scale
0’
Adult Perioperative
Cancer Outpatient
Pathology
Clinical Lab
Radiation Oncology
Materiel Support
Sterile Processing
Children’s Perioperative
House Staff/ On-Call
51Color-Coded Floor Plan – Level 3
N
30’ 60’ 120’
Graphic Scale
0’
Sky Lobby Mother-
Baby Care
Concierge Medicine
Fetal Treatment Center
Waiting
Women’s Surgery
Satellite Op
Perinatal Clinic/
Antenatal Test
PDC
Intrapartum Care
NCPL
ICN
52Color-Coded Floor Plan – Level 4
N
30’ 60’ 120’
Graphic Scale
0’
Waiting
Imaging Exam Suite Dialysis
Peds Primary Care Clinic
Peds Medical Specialty Clinic
Peds Clinics Shared Support
Sky Lobby Adult
ICUOn-Call
Administrative Support
PCICU PICU
Pediatric Transitional
Pharmacy
Respiratory Therapy
Compass Care
53Color-Coded Floor Plan – Level 5
N
30’ 60’ 120’
Graphic Scale
0’
Peds Surgical Specialty Clinic
Sky Lobby
Waiting
Dental
PrepareRehabilitation Services
Women’s & Cancer Acute Care
Peds Acute Care
Peds Transitional Care
54Color-Coded Floor Plan – Level 6
N
30’ 60’ 120’
Graphic Scale
0’
PCRC/ PTRT
Peds Specialty Clinic (Cancer)
ChildLife, Peds SS
Sky Lobby
On-Call
Women’s & Cancer Acute Care
Peds Park
Peds BMT Pediatric Hematology Oncology
Pediatric Acute - PCRC