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HomeMy WebLinkAbout06302015 City Council Work Session Notes - Discuss Possible CHC/Providence wYYl m 4/1 WORK SESSION NOTES ON . IScAS Po )efJ-Varardf �'D Ce n /ode n �� A Fic k it jtry fPurpose: 7b'C ThVidence ns��� /( J Present: A-VtA r k Lout a Kj Yl 11 Council Members Present: FAvdaKAyj, ked t rc in q-el' 36C ft I,J1IGlf� i 4( ry Irli/1 C (Yecji J � � � sem. �R � � , `--$ Cvai TbiioSi ) JVD- +r ng > -PUt 1141 4V' �0 1fi �1 nJ Sc HL J ft Called by: couw( 1 Time: 5 ' 3 1 " , Date: CP/ /15 ****************************************************** tngt Ji rird -E KliiirtOjai rn beraiii ,t k p etriverrtjAv ?Oil fvlGc,.r� I t adiv;i� .-t(S -dao bi of e d --f i d i � ack, fh - ;V,u 1 11 t�,Grrcy iii a I �j ayy� I� h I�,�`����� .i n�f i v!CI u a -� Y��,� _ fir° Not 2Y(4Gf a((� 1kt Nt: ibilitA (r 0\ -tb Watt -fDywarl -P09'19111 of aki 1 K WI plal-- vi (wool _7-10frdr(-- ) 100 1_ -kiaj . a fi c eXCPil focilm '. ,dy-) rv() )01- 1-3 (ill 061611'63 Yttomn'hd f pin)) pialit . ai‘syf fi.,/,'(..1 fili, ,.,..., - �� � � �yoriPON tow. .r chef ups. -� J (la/1,900 (5M - C�nSfi t� ( o (afi'mn Cr y 00VW515ADIQf iY\ iv/ C4Jovue, . yo\ I o VAYSZ laK ‘ Iv()() fire WO Alb �v� Mom fri-ericbd velrbupt/1 tik., IVINMOY\S-tie Dot A vii moral _ c _ bo ( ovi, ti4A- i*Aie,- --) Vlow AD 'lewd TN /t- ux A-"T-' ' Qkk-._ wd k (Witt) i , Qlevno1:'ve, -b P4U1/1°\ r Sponsored by: Hunt CITY OF SEWARD,ALASKA RESOLUTION 2015-029 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF SEWARD, ALASKA, AUTHORIZING THE SEWARD COMMUNITY HEALTH CENTER TO APPLY FOR A 2015 US DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH RESOURCES AND SERVICES ADMINISTRATION HEALTH INFRASTRUCTURE IMPROVEMENT PROGRAM GRANT REQUIRING CITY COMMITMENT OF ANY FUNDS NECESSARY TO COMPLETE THE PROJECT WHEREAS, improving health care services and access to health care services is in the best interests of the public; and , WHEREAS,the City of Seward has for,many years,pursued improvements in health care, both through partnership with Providence Seward Medical and Care Center (PSMCC), and more recently as grantee and co-applicant for funding to establish a Federally Qualified Health Center (FQHC),the Seward Community Health Center(SCHC); and WHEREAS, colocation of these organizations on a common campus and in common facilities results in efficienciesand,mutually supporting synergies for both,but that multiple space challenges exist for both organizations,as discussed in January 19,2015 and March 23,2015 work sessions with the City Council addressing Space Planning for SCHC and PSMCC; and WHEREAS,SCHC and PSMCC staff have worked collaboratively with Architects Alaska on conceptual modification,expansion and renovation designs using the existing City owned site and facility to effectively address operational and space needs for both health care organizations; and WHEREAS,the City acts as a legally separate co-applicant in order to obtain federal grant funds to support a FQHC in accordance with Section 330 of the Public Health Safety Act(42 USC §254b), requiring that the City serve as the public entity for receiving and disbursing federal 330 grant funds utilized by the FQHC; and WHEREAS, the US Department of Health and Human Services' Health Infrastructure Improvement Program (HIIP) offers up to one million dollars ($1,000,000)through a competitive grant program to existing Health Center Program grantees to be used to improve or increase services through alteration/renovation, expansion or construction of a facility; and WHEREAS,a condition of the grant is that the City,at a minimum,commit to provide any additional funds necessary to complete any and all SCHC portions of the project identified in the grant application; and WHEREAS, the base level project, identified as Phase I, including the expansion and U CITY OF SEWARD,ALASKA RESOLUTION 2015-029 renovation of the current facility necessary to complete all aspects of the project related to SCHC, has an estimated total project cost of$4,019,014 and, with the full federal award could result in $3,019,014 of additional estimated City funding necessary to complete Phase I; and WHEREAS, the SCHC Board of Directors met March 26, 2015, and recommended requesting City Council authorization to proceed with the HIIP grant application; and WHEREAS,the City desires that an application for HIIP funding be submitted in support of the SCHC portion of Phase I of the hospital facility improvement project. NOW,THEREFORE,BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF SEWARD,ALASKA that: Section 1. The City of Seward supports requesting the HIIP funding and authorizes the SCHC to prepare and submit the grant application on its behalf for up to one million dollars ($1,000,000)towards Phase I of the proposed hospital facility improvement project. Section 2. Contingent upon the grant being awarded, the City will provide the additional funding necessary to complete the project, identified as Phase I, with an estimated total cost of $4,019,014. Section 3. The City of Seward approves the expansion and renovation of the current facility as included in Phase I and commits to moving forward with Phase I of the proposed project, contingent upon the grant being awarded. Section 4. The City of Seward will take any and all steps necessary to the best of its ability to complete Phase I of the proposed project no later than August 31,2018,contingent upon the grant being awarded. Section 5. This resolution shall take effect immediately upon adoption. PASSED AND APPROVED by the City Council of the City of Seward, Alaska,this 13th day of April, 2015. CITY OF SEWARD,ALASKA RESOLUTION 2015-029 THE CITY OF SEWARD, ALASKA Marianna Keil,Vice Mayor AYES: Terry, Squires, Darling, Keil NOES: Casagranda, Butts ABSENT: Bardarson ABSTAIN: None ATTEST: Johanna Kinney, CMC City Clerk (City Seal) Sponsored by: Hunt CITY OF SEWARD,ALASKA RESOLUTION 2015-047 A RESOLUTION OF THE CITY COUNCIL OF SEWARD, ALASKA, AFFIRMING THAT THE COUNCIL MUST AUTHORIZE THE SEWARD COMMUNITY HEALTH CENTER'S 2015 US DEPARTMENT OF HEALTH AND HUMAN SERVICES' HEALTH INFRASTRUCTURE IMPROVEMENT PROGRAM GRANT APPLICATION WHEREAS, the City Council held a work session with representatives from Providence Seward Medical and Care Center (PSMCC), Seward Community Health Center(SCHC), and the public on March 23, 2015; and WHEREAS, the work session considered different expansion/improvement models for the City-owned shared use medical facility, and potential funding sources for the projects, particularly the current open application period for a US Department of Health and Human Services' Health Infrastructure Improvement Program (HIIP) grant and the related steps and components required by the application; and WHEREAS, at its April 13, 2015 regular meeting the Council passed and approved Resolution 2015-029, authorizing the SCHC to prepare and submit the grant application on its behalf for up to one million dollars ($1,000,000), and contingent upon the grant being awarded, committing the City to moving forward with the proposed project and providing any additional funds necessary to complete the project, all of which are conditions of the grant application; and WHEREAS,the City serves as the public entity for receiving and disbursing federal grant funds utilized by the SCHC, and as the legislative and appropriating body of the City, Council approval is necessary for those grant applications; and WHEREAS, such approval may be rescinded prior to September 1, 2015. NOW,THEREFORE,BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF SEWARD, ALASKA that: Section 1. The Seward City Council directs the City Manager to bring forward a resolution by August 10, 2015 to formally authorize the Seward Community Health Center's application process with the US Department of Health and Human Services' Health Infrastructure Improvement Program grant application. Section 2. This resolution shall take effect immediately upon adoption. 20:023L � OtYlv4 �Ywav, l AIudho�� ,2 ? N - va,,�uon-21m a �i �at1w�- K,e ,� u t� rt .i u elowV1 15-02q Ir-45- 7 . A`humino� u�li Held pro �S CITY OF SEWARD,ALASKA RESOLUTION 2015-047 PASSED AND APPROVED by the City Council of the City of Seward,Alaska,this 26th day of May, 2015. THE CITY OF SEWARD,ALASKA Jean Bardarson, Mayor AYES: Terry, Butts, Squires, Darling, Bardarson NOES: None ABSENT: Keil, Casagranda ABSTAIN: None ATTEST: Johanna Kinney, CMC City Clerk (City Seal) (/ 3o ( i5 Brenda Ballou WAS V141'04 From: Johanna Kinney (ct4c) Sent: Friday, June 26, 2015 4:37 PM To: Christy Terry; Dale Butts; David Squires;Iris Darling;Jean Bardarson; Marianna Keil; Ristine Casagranda Cc: Jim Hunt; Ron Long;Jackie Wilde; Brenda Ballou; Nanci Richey; Kris Erchinger Subject: Work Session Advance Materials for 6/30 Attachments: Cover Memo for June 30, 2015 Work Session - 6.26.15.docx; Short-Term Impacts to Delay Expansion with Cover Memo - 6.26.15.docx; Summary of Project Levels and Cost Estimates for Work Session - 6.30.15.docx Hi Council, Please find the attached documents for TUESDAY's work session. This is from Pat at the SCHC. We also anticipate something from Joe at Providence. Once we get that, we'll provide hard copies as well, at least by Monday night before your work session on the land use policy. Also, it was requested at Monday's meeting that the PowerPoint from March be provided Tuesday. I confirmed with Pat and Joe that the slides shown of the price estimates of the project(s) and the various drawings were the actual "slides". Those were printed off for you for the 6/18 work session—if you need copies of those again, please let me know. Thanks, 20/tea t, From: Patrick Linton [mailto:plinton@sewardhealthcenter.orq] Sent: Friday, June 26, 2015 4:23 PM To: Johanna Kinney Cc: Brenda Ballou; Fong, Joseph Subject: Work Session Advance Materials Hello Johanna, This took me just a bit longer to get to you as Joe asked me to do the 1 page summary of project completion levels and cost estimates. Attached you will find: 1. Cover Memo 2. 1 page summary of current and projected space issues and constraints to growth for SCHC 3. 1 page summary of project completion levels and cost estimates Thank you so much for getting this out to Council Members today as well as to Jim, Ron and Kris. Joe should soon be getting to you his items to also distribute. Please let me know if you have questions or requests for additional information items. Have a wonderful and restful weekend, 1 Pat Linton Executive Director Seward Community Health Center 907-224-8505 Spam Not spam Forget previous vote 2 SEWARD COMMUNITY HEALTH CENTER PO Box 2895/ 417 First Avenue -- Seward, AK 99664-2895 • aCOMMUNITY PHONE (907) 224-2273 3 HEALTH FAX (907) 224-8501 T C E NTE R www.sewardhealthcenter.org June 26, 2015 TO: Seward City Council Members Jim Hunt, City Manager Ron Long, Assistant City Manager Kris Erchinger, Finance Director FROM: Patrick Linton, Executive Director SUBJ: June 30, 2015 Work Session Information Item Thank you for your timely efforts to re-schedule the special work session related to the Seward Community Health Center capital grant application and the proposed hospital facility improvement project to Tuesday,June 30, 2015 at 5:30 pm in City Council chambers. We look forward to another informative and productive session on these important topics working in collaboration with the City leadership and Providence Seward Medical and Care Center administrative staff. In preparation for the work session we are providing two information documents. The first document is a 1 page table that summarizes the main space issues and limitations that will constrain the growth in services, providers and patients at SCHC over the next few years in our currently allocated space at Providence Seward Medical Center. The second document is a simple summary of the levels of project completion and certified cost estimates for the proposed project at the current hospital site. Cost estimates, including construction costs, professional fees, design contingency amounts (20%) and overall project contingency amounts(15%)were provided by Estimations and Architects Alaska, both of Anchorage. Please feel free to contact me at any time should you have questions or items you would like to discuss, or to have a tour of the facility to see the current space we are using at the hospital. Kind regards, Pat Where your health matters SEWARD COMMUNITY HEALTH CENTER Facility Related Constraints to Growth with Delay of Expansion Project YEAR CONSTRAINT COMMENTS 2015 No room for specialty clinics We would like to add part-time outreach clinics for OB, Internal Medicine, Orthopedics and, possibly, pediatrics 2015 No room for behavioral health We would like to collaborate with SeaView integration to add a licensed clinical social worker to integrate behavioral health services with primary care for individuals and groups 2015 No room to support HRSA We are expecting an announcement for supplemental expanded services another HRSA expanded services grant for grant and FTE's $223,000 added to our base grant which equates to about 3.0 new FTE positions 2017 -2018 No room to expand patient At our present growth rate with 3.0 FTE base/visits providers and at target productivity levels per provider, our estimated capacity in current space is 3,500 patients, 10,000 visits or 63% market share which we could hit as soon as 2016 or 2017 2018 No room to add a fourth primary A recent market analysis conducted by our care provider consultants for the capital grant indicated the service area could support one more full-time primary care provider beyond those already being provided by SCHC, Northstar Clinic and Glacier Medical. 2016—2017 No room to develop care Under healthcare reform and patient coordination services centered medical home standards, developing care coordination services and programs at the primary care level will be critical,which will also become a revenue stream of its own Present and 1. Cramped offices for 3 providers Ongoing and clinical support staff in space designed for 2 providers 2. Disjointed spaces and flows in 4 non-contiguous areas 3. Ongoing use of ATCO office building required 4. Limited storage space 5. No room to add 4th work station in registration area 6. No separate (and private) waiting area,conference room, or identity for SCHC 7. Other issues not listed here Summary of Proposed Project Completion Levels and Cost Estimates Prepared for Seward City Council Members For Their Work Session June 30, 2015 The following summarizes the various levels of completion for the proposed expansion and renovation of the current hospital facilities located at 417 First Avenue based on the schematic drawings presented to the Council at its work session held on March 23, 2015. Project designs of floor plans and site plans were prepared by Architects Alaska following two days of on-site assessment and space planning sessions held with Providence Seward Medical and Care Center staff and Seward Community Health Center staff and Board members. Certified estimates of construction costs were prepared by Estimations and include a 20%design contingency amount. Estimates of professional fees were prepared by Architects Alaska as well as an overall project contingency of 15%applied to all project cost elements. Detailed breakdowns of all construction, project and contingency cost estimates can be provided upon request. Level of Project Completion or Project Portion Total Cost Estimate I. SCHC portion only -for grant purposes $2,652,684 (includes SCHC portion of the expansion, build-out and renovation) II. Minimum Level of Completion (for grant and CON purposes): A. SCHC expansion, build-out and renovation $2,652,684 B. PSMC expansion—shell only 1,336,330 Total $4,019,014 Ill. Full Expansion ("Project A"): A. SCHC expansion, build-out and renovation $2,652,684 B. PSMC expansion—shell only 1, 336,330 C. PSMC expansion—build out 687,180 Total $4,706,194 IV. Complete Expansion and Renovation (Project A and Project B): A. Project A-expansion $4,706,194 B. Project B—five phases of renovation of existing space 3,694,619 Total $8,400,812 5L � Johanna Kinney From: Fong, Joseph <Joseph.Fong@providence.org> Sent: Friday, June 26, 2015 4:57 PM To: Johanna Kinney; Patrick Linton Cc: Brenda Ballou Subject: RE: Work Session Advance Materials Attachments: Discussion Item - Seward City Council - Work Session - 2015-06-30.pdf; A - Existing Department Floor Plan.pdf; C - Proposed Department Floor Plan.pdf; B - Proposed Site Plan.pdf Johanna, Attached are the remaining documents. 1. Summary document of PSMC related operating issues and other discussion topics 2. Existing Department Floor Plan 3. Proposed Expansion Site Plan 4. Proposed Department Floor Plan Thank you. Joe From: Johanna Kinney [mailto:jkinney@cityofseward.net] Sent: Friday, June 26, 2015 4:31 PM To: Patrick Linton Cc: Brenda Ballou; Fong, Joseph Subject: RE: Work Session Advance Materials Thank you! We will forward on to council now and provide hard copies, same with Joe's information. Thanks! yoh-churl a IST rvri e� From: Patrick Linton [mailto:plinton@sewardhealthcenter.orcl] Sent: Friday, June 26, 2015 4:23 PM To: Johanna Kinney Cc: Brenda Ballou; Fong, Joseph Subject: Work Session Advance Materials Hello Johanna, i This took me just a bit longer to get to you as Joe asked me to do the 1 page summary of project completion levels and cost estimates. Attached you will find: 1. Cover Memo 2. 1 page summary of current and projected space issues and constraints to growth for SCHC 3. 1 page summary of project completion levels and cost estimates Thank you so much for getting this out to Council Members today as well as to Jim, Ron and Kris. Joe should soon be getting to you his items to also distribute. Please let me know if you have questions or requests for additional information items. Have a wonderful and restful weekend, Pat Linton Executive Director Seward Community Health Center 907-224-8505 ........_._.......................... Spam Not spam Forget previous vote This message is intended for the sole use of the addressee,and may contain information that is privileged,confidential and exempt from disclosure under applicable law.If you are not the addressee you are hereby notified that you may not use,copy,disclose,or distribute to anyone the message or any information contained in the message.If you have received this message in error,please immediately advise the sender by reply email and delete this message. Spam Not spam Forget previous vote 2 SEWARD CITY COUNCIL Special Work Session Tuesday, June 30, 2015 Topic: Space Planning for Seward Community Health Center and Providence Seward Medical Center Prepared By: Joseph Fong, Administrator, PSMCC Summary of the PSMCC related Discussion Topics: The purpose of this work session of the Seward City Council is to continue discussion related to site and space planning for Seward Community Health Center(SCHC) and Providence Seward Medical Center(PSMC). Previous work sessions were held January 19,2015 and March 23, 2015. Below is a recap of the issues under discussion from the PSMC perspective: • Present and predicted future operational needs • Project scope • Site location • Cost and financing options Along with the information presented by SCHC, we hope this helps City Council make an informed decision on whether or not to continue to pursue the HRSA HIIP capital grant opportunity. A. Operating Constraints CT equipment • We have had patient privacy issues and employee injuries related to the trailer • The path from hospital to trailer crosses a utility easement, preventing a covered walkway from being built from the hospital to the trailer Patient Capacity_ • Patient rooms are double occupancy and/or multi-use which is a more efficient design but limits the number of patients we can see in the ER, inpatients or swing bed patients o 2 inpatient rooms also serve as ER rooms; an increased in either inpatient or ER patients reduces our ability to care for the other patients o Double occupancy rooms reduce patient and family privacy and limits the types of patients that can share a room which limits the total number of patients we can care for o Especially during summer months, conversations are held on whether we should admit qualified inpatient and swing bed patients over concerns we do not have enough rooms to treat all the ER patients Patient Flow/Privacy • Patient care areas are not contiguous,resulting in patients being transported through public areas, for example, from inpatients rooms to therapy gym; ED patients to the helipad • Administrative staff similarly must travel through public or patient care areas to conduct their business Space Utilization/Allocation • Questions have been raised regarding the therapy space and whether it is underutilized or even necessary. A space for rehab therapy is a necessary component of the swing bed program. Financially, reducing and or reallocating that space would affect Medicaid reimbursement, which takes into account costs associated with the square footage of space utilized for clinical activities. Therefore, reallocated some or all of that space, or any other clinical space;to-SCHC will negatively affect the hospital operationally and financially. New Programs/Future Needs • Specialty Clinics and Telehealth technologies create the opportunity for new patients, or provide care to patients in Seward who currently seek it elsewhere; examples could include ENT, cardiology, ophthalmology, sleep lab, GI • There is no space currently to add new services or handle additional volume for existing services B. Project Scope • There are a lot of details related to separate needs of PSMC and SCHC, Certificate of Need requirements and the HRSA HIIP capital grant, which necessitates phasing of the project but ultimately we are,looking to address all of the issues C. Site Location • Co-location with SCHC is preferred in the short and long term. If not in the same building, consideration should be made to keep the two entities on the same or adjacent properties. This yields the greatest efficiencies for the clinic and hospital but also provides the most seamless experience for the patient. • Discussion has occurred around whether to continue to utilized the existing site or consider a new site. Some of the advantages and disadvantages to each include: o Current site 1. Has space for expansion of hospital and clinic functions 2. Infrastructure requires minimal upgrades to support an expanded building footprint 3. Most cost effective 4. May still require long term consideration for new site/facility o New Site/Location 1. If closer to Mountain Haven,this would yield operating efficiencies for staff that travel between facilities. 2. Could integrate other healthcare entities yielding even greater collaboration across the whole spectrum of care and not just primary and hospital care. 3. Could better serve long term needs 4. More costly; longer timeline; requires additional vetting D. Cost and Financing • Expansion and remodel of the current campus to include all proposed clinic and hospital phases is estimated at $8.4 million. This is a certified estimate based on the current phase but could change as we continue through the design process. Timing would also affect total costs. Conservative estimates add 4%per year for construction costs. • Traditional financing methodology is through bonding. There may be other forms of financing,that may apply to a portion or the whole cost. • Financing repayment o Considerations for repayment could include the use of a portion of the 1% sales tax that is designated for healthcare use. • Medicaid reimbursement methodology takes into consideration certain capital construction costs. The hospital costs are approximately $6 million. We estimate approximately 30-40%of the bond payments related to the $6 million could be repaid through cost based reimbursement. E. Other Financial Obligations • We are committed to reimburse the City of Seward for the bonds raised to pay for Seward Mountain Haven. • To date, bond payments have been paid in full. • We are currently working on a financial plan to ensure future bond payments can be made. Tactics include increasing census and reviewing the repayment schedule. • We are not aware of any other monetary advances, loans or obligations from the City that have not been paid in full. II/ —i- — —i — —I — 7 — o pNIIIIrin=_ sty■ ., nom ' M 11B,111 `a— ki7i -3 I 11111 Wim_, ; HJT I Ai ,, _SFA 4: L!' illkli:1 rokkimiar.:II ...7 1yYn� r�:.» '.."„ • IM YInLI45 — MCNNNNSI ►r� 'r.��_- III (6 Imo.^._ 4a ® Sri- U *AI liiiiia �rrtr <.,2 3 IA.�,i. : [NII !_lT �� f:— —_ -�_� J� giAl _ -. „iii — 12 C ITS . Y I ==I -^—u• r 'r`ra -� I I II 1 iiziow-----2, 1%,„-.. -.-L11:k.--dtliir4 All M mwssmil.I� .I� 0__ _k _. [ ___111.1114 ilalrm %NH .,Q1-4, OExisting– Seward Facility Diagram 1 I I I 1 AREA LFCFND y]t'-f-tl'e+drlr.HN1 PUBLIC IRi.(1pRrx H I ADMINISTRATION 0 0 G I I RADIOLOGY "-- P 1 , I I INPATIENT SERVICES(PSMC) ® -Mil II II r I I OUTPATIENT SERVICES(LAB) I _� I I ri STAFF SUPPORT V 6 r - - , I I FACILITIES 7/....."-- I I I CLINIC(SCHC)2388ft' 7 - Existing– Seward Facility Diagram (��\� N ao 4 A I T T T T F B m a C N I I Ia I I I . i, / I\I 3 F i. ° -_, ) AW 49- ft, / ..- iga k_ , - . M. _ A .__._' lir _ " ! '444 5 II 1 $ �` P14 Ii 1m i TT I !J_' 1 I I ��T l: =, .,.I — '� — v. go . 1 1 441, , i i p . 7t J EMI. n , { I U 101 . � _ � ,IIS p.m VA I ilk_ I I 1 1 Ilk liF H • , qi al ;. INi , i �� 'II : i _ 1re . 1 a ; a I _,— �_. a __ 1 `J ,14,4ft, W -i'iwL ® - IP • I I 1iiiil i i I I I I I I I I I I I 1 1 I 0 I II ..r, A , N C Z g > 2 n S $, s y p ; m 'V F, ut _ ro N s AN NG 5 9 i n ` MI Pmpcl/15013.01 Seward Medical Center Site&Facility Master Plan -- Seward,Alaska L Ma,cn 10,2015 - < „, \\ /\ /5....diavb.d / \ \ \ �L'EL 'ANKH I I R N `o C f0. I 1 • aYR hcoco,w., alu p :,_� o 0. j1 /L •E CHI_LERJ DL+.oS iER� g r� GENERA-JR Ig °T /j *U CU IL LI, as f3b, EL Oa 1 Fes' � 1 1 i I Korean La.05, I N if. Gr.b.pp..(5, R in ie” 5.1. - d \ •I.,„, ,,,....3.:0,;,... 471/ Li.!3, \ cu. ,fi ` �. �. Di .uY.d/65, Usa. * ,.,,p„ Oto4lO`(S`. r vain_ u „1 Canada Rsd t9, ._ N.I. pl.! 1' 1101 r0 �p nnr rww.d,r.y r3,'' / D.rrn D�anop'.lu.d f93, (n AMBULANCE HELI PAD BOO _ Y.dth W!IdflGu.r IL11d,47 4.4•••ciot.vnrcy l3il ...d D,.reo.W..d f35, STAFF Sr, .46 PARKING � N ta \ \ BUILDING l\ ;r 7 EXPANSION 37 YIL .� I ' I•' 1."-H.�.•y � 6`,/�/� NEW SIDEWALK JNnf1FFASFMENr 7 1 ^�-A _ Ir4x - " i s 1l"enc' FIRST AVENUE O Long 1' . term Site Development Plan -Y 6Wm a' M tl.[xmtx . . Historical Tim line..,.. ,_-_ , , . 4. , ,d, • 1917: Flooding from Lowell Creek washed . away the school house and destroyed or damaged a number of homes • 1926-27: Timber flume construction routed .-,goommmaimmommiall="1""le flow through city down Jefferson Street) • 1935: Flume fails because of debris .*'i•: (estimated 10,000 cubic yards) causing _ —: - -- # major damage to the power plant and i. . '�----- - `�' " =- r, railroad facilities i T b ... .4..r :�ti, , . ,:',.._ .,..._ _ k4. _ . • 1937: Federal Flood Control Act provided ...,_14;171'441::::4V• 4':, F - -s - authorization and funding for a diversionlirr.--.'i"-- or ._ , 4: : j :- �$. dam and concrete lined tunnel through Bear Mountain F4_ ,..- - _ u.' .w'.r _ at-4 r.` •}{ +'i:`4 �,.�:µri.:+.. ' , ;;r,,e, -,-..4. • 1939-41 . Construction of the division dam •,� and tunnel. Project turned over to the City V4 , '. 4 '' _' _!a:7.,i of Seward - ': ` • rte -*"4' ' ...., Timber flume '1955 '` " 5 1 "`� �:.� : Project Features io . Ira` 4t ? ? Darn• DaCORPS OF ENGINEERS U.S. AP�IY ti :-e — 202 ft (LiDAR, NAVD 88) i D❑00D 1D Elevation, 1 � — Maximum Crest height, 25 ft unrno.4 Lin OF I II MIll '' ' ''' .. FEOERAL PROJECT iFi — Crest width, 5 ft �' Ilt � - ^' 0 ill• Abutments f_. -- ,. . ,..,..,.....„„_,,„ — Left constructed against canyon wall; 4:17 !rot? j: -Yr N slope with concrete slab attached with "� i��� 11 dowels against rock face f'; illp i© `'" — Right tied into entrance of tunnel; cast into. , �` ��i 1 ' ` ° •a bedrock . ._._ / ! t�1 _WW1.? • 1 �" _ c�5'¢a I Emergency Spillway i n 198 ft LiDAR NAVD 88 .y — Elevation ( ) i.IN.r r 1 - Discharge capacity, 1700 cfs ,.� j -•r) , N1 ,K , _ MEuRC COM+ERsioNS 1 • Reservoir -"-� my �I I /i r6/K + �+f .r 1N r; Rd �fl{ 4..1 �YJ r� r .• r r -' ••`let S ' •_ W — No permanent pool delee dell 14417 TYPICAL, SE�____FUNNAL -ca. n�..aornsco . w a is a c — Max storage capacity, 2.0 acre-feet "Y° s — Surface area at spillway crest, 0.51 acres •••••••••••• f•/H/N/ / ■■ ■ .■N:/::■M/MN •li$ •••r: LO0O CON1R04 4 owELLCREEx • Primary Spillway (Tunnel) /i-1c-:� aiv=..ri■ ALASKA avped 1495 . , - Nominal 10-ft diameter — Horseshoe-shaped pRQFILE of TUNNEL T=.1.11=1 --,....=..... — Discharge capacity, about 2600 cfs 15 C''',(:...!..,, .4,...:70 ---- ) . Lowell Creek Flood Scenario Mappingy' • 2-D Hydraulic Modeling of three _ i*: Lowell Creek Flooding Scenarios. T I N ,x .. • One flow path uncertain scenario ....„... , .„.t , Iusing alluvial fan flooding ...... ,. , ,„,„.„.....„, ... _ +i t ~v � ' equations. � - _ • Results showing the limits of oma► -.. A,. ° • -: - - flooding are approximate and 1 } . should be used solely as a `� N `� a__ _ `y , guideline for planning purposes and facilitating an evacuation. 18 t Lowell Creek - Flood Mapping Scenario ,, , "*" . . . .. Total Inundation Flow mode Warning estimated Hazard Scenario (cubic feet per second — cfs ) Time Flow Scenario 1 Tunnel No flow through the tunnel Velocities at the entrance of the Blocked 2,000 cfs overtopping dam canyon 6-7 ft/sec. Structural damage expected, cars and large 2,000 cfs Seconds objects to be moved by flood waters. Scenario 2 3,000* cfs through tunnel Velocities at the entrance of the Probable Maximum 4,600 cfs overtopping dam Minutes to canyon 8-10 ft/sec. Structural Flood (PMF) with 7,600 cfs possible 1 hour damage expected, cars and large tunnel operational or more objects moved by flood waters. Scenario 3 3,000* cfs through tunnel Velocities at the entrance of the PMF Surge 15,800 cfs overtopping canyon 10-14 ft/sec. Structural Release, tunnel 19,000 cfs Seconds damage expected, large objects operational moved by flood waters. Scenario 4 3,000* cfs through tunnel Minutes to Depth and velocity based on Uncertain Flow 7,600 cfs 4,600 cfs overtopping dam possible 1 hour empirical relationships for alluvial Path — PMF w/ or more flooding. tunnel operational 19 *Approximate flow rates given, surge release scenario will be slightly higher due to the increase in head. • ' •a" y11.., fv. FIGURE 0 -Before thy rrlsctreg project was L , , -• cnnsrnrr.rcd. Lovell Creek $047 carried o throughSeward In an elevated wooden flume A flood in 1939 (ander) plugged Cry • P the flume and burled the lover part of the it,''•--- city. The power plant tour icing fright) ! '' vn. hurled to rail" top of rhe fCrct floor:�;�' the huubu rtuxt 4luur was burled to the "-,i' 04111111111111r . ... '/ .41.b. vi r - - .. 7 .;::1.'4':11111H: ‘141.:;.1 1. 14111 eavex 4. - , ., a 10,414. - . :ham _ ' 1 . I": ' •.7•ri,l - 4 et :(1.-. ..:7'7, -'.- - : . .. . -. . .. - . .'' )1114 4.14:. 41 , : .. I : dill. L ' 4 ii: 4 1, %1 4 e� a ti Or- it".". t* ti-11. ". A, _I ' -1. ••.111 .. - . it, lit •. i.:. ' +' •R Ago- 20 V t .%: ' ;,� Scenario 1 - 1 % Exceedance Flood — Tunnel Blocked : se. : est. flow — 2,000 cfs (overtopping the dam), warning time - seconds, velocities 6-7 ft/sec y Depth x Velocity(t 02/0 SO 1s 4, .. ` s ireit..e , z 1 S b 1141 -or.lit 1 `�~' __..1` lir dr.--1 -----PL.-P-3,------7:C-73,i---- ••1r , ittritiprioreelkiV - ,• lit = ► . . , • ^ ., s. A , - A '101' irl J.b 21 r,�, Scenario 2 - Flood PMF — Tunnel Operational irilliillH • 'est. flow 7,600 cfs (3,000 cfs thru tunnel, 4,600 cfs over topping) warning time — minutes to 1 hour, velocities 8-10 ft/sec Ocp1h V x ••Iocity if162 s} , • A 15 S ' . + `Ts; .r i i u IA , r — -. z J' aS a it e � - - - �� _. ``ill ; ,"l • syt alb I -.' :' '' dome `, lite r / Ilk R1 le ... i I* _ :4: . • 40'yA . V I,i1S. i , O k i ,, • . +Y '' E Y r - .. Pi _ i ,A�l . ' 22 ...,�� "' . Scenario 3 - Flood PMF with Surge Release, Tunnel Operatio Pig est. flow 19,000 cfs (3,000 cfs thru tunnel, 15,800 cfs over dam), warning time — seconds, velocities 10 , 14 ft/sec Depth■1Moclly( tA2la) 1^ Cl 5 95f Id° . if Ille; fit . , 41- et . if, , I • e Lam, • .. 1' -A . 'i.:-':,' rte" r) .:-.2'` -) -- 04 --, I, ‘ (-,..,'i ,_ .4r0101125. 407 i AO INN. 1‘.. , 11( • 1:...„...,1:...„...,' $ Ile 0 ra : .,1 1 4 a 23 r, Lowell Creek Tunnel Outlet - Alluvial Fan Flooding 1986 ..a_ _.--) / f i ' s spi 0000.1 r � . .� , 24 Scenario -- Uncertain Flow Path Flood PMF, Tunnel Opera i51.1 est. flow 7,600 cfs (3,000 cfs thru tunnel, 4,600 cfs over dam , warning time — minutes to 1 hour Depth x Velocity Ifta7Js) . 50 t 011.104 . 15 t4 illi 'S 1 o _ Multi—Channel Area l e Single Channel ‘ ' `i. j _. liti R ft . .' - 1. It 25 � F • • SEWARD COMMUNITY HEALTH CENTER PO Box 2895/417 First Avenue - Seward,AK 99664-2895 COMMUNITY ` H EA LTh PHONE (907)224-2273 9CENTER FAX (907) 2248501 www.sewardhealthcenter.org May 15, 2015 RECEIVED Mr. Jim Hunt, City Manager MAY 15 2015 Mr. Ron Long, Deputy City Manager Ms. Kris Erchinger, Finance Director OFFICE OF THE City of Seward CITY CLERK PO Box 167 Seward, Alaska 99664 Mr. Joseph Fong, Administrator Providence Seward Medical and Care Center 417 First Avenue Seward, Alaska 99664 RE: Questions for the SCHC Capital Grant/Project Due Diligence Process Dear Jim, Ron, Kris and Joe: Following the passage of Resolution 2015-029 by the City Council on April 13, 2015, the Board of Directors and Administrative leadership of SCHC initiated a formal due diligence process related to the proposed construction project and HRSA Health Infrastructure Investment Program (HIIP) capital grant application now being submitted. We felt this was an important process to undertake in fulfillment of our fiduciary responsibilities and commitments made to the City Council and the people of Seward. An Ad Hoc Committee was established to oversee this process comprised of the combined members of the Board's Executive and Finance Committees along with our Executive Director. The goals of this due diligence process are threefold: 1. To support the City Council to make an informed decision by its regular Council meeting on August 10, 2015 whether to continue with the HIIP grant application or have it withdrawn; 2. To assist in determining whether or not pursuing a building project at this time would be in the best interests of SCHC, the City and the community, and if so, what project that should be, and; 3. To maintain and improve the integrity and collaborative working relationships of SCHC and its leadership with the City, PSMCC and the community throughout the course of this process, regardless of the final decisions made. We are significantly well along in this process which addresses a number of detailed questions and analyses in the following six areas of investigation as they primarily apply to SCHC: • Current and Projected Space Issues and Needs of SCHC • Building Project Options to Consider • Financial and Business Issues and Projections • Project Timing Where your health matters • , ® SEWARD COMMUNITY HEALTH CENTER PO Box 2895/417 First Avenue —Seward,AK 99664-2895 pe PHONE (907) 224-2273 .FIEALTH • E E FAX (907) 224-8501 www.sewardhealthcenter.org • Supporting and Restraining Factors in the SCHC Operating Environment • Supporting and Restraining Factors in the Community and Political Environment Our work schedule calls for us to complete our work by July 3rd at which time we intend to begin reporting our findings and recommendations to the City Council, City Administration and PSMCC Administration. This may very well be followed by one or two special work sessions with the City Council in July and early August leading up to our final recommendations regarding, at the very least, the HRSA capital grant application by the Council's meeting on August 10, 2015. We anticipate inviting Council members and each of you to attend Ad Hoc Committee meetings in late June to provide input and guidance to our process, and to ensure we are addressing the issues that are of most concern as we formulate our findings and recommendations. There are a number of critical questions we are not able to sufficiently address solely from the SCHC perspective given the nature of the proposed project and the inter-connected roles and responsibilities of the City, PSMCC and SCHC. Consequently, we are respectfully requesting that you assist us by answering the questions in Attachment A to the best of your knowledge in a manner that is most effective and convenient for you. This could be accommodated by direct conversation or in writing, whichever you feel is most convenient. It would be very helpful if your responses, even if preliminary, could be provided to us no later than Friday June 12, 2015. This would then give us three weeks to integrate them into the final stages of our process as well as inform our conversations with you and City Council members the latter part of June. In the course of our research to develop our list of detailed due diligence questions, a number of them may also be of interest to you in your own respective processes. We have, therefore, taken the liberty of providing these in Attachment B in the hopes that they may be of benefit as we all move forward together to eventually arrive at informed decisions that are in our respective best interests and ultimately those of the citizens of Seward. Please accept our sincere appreciation in advance for your thoughtful and timely responses to these questions. We look forward to a productive and mutually supportive process over the ensuing weeks and months. Sincerely, Ric an Cruse, Chair, Board of Directors Patrick L nton, Executive Director Cc/Seward City Council Members Where your health matters e • • SEWARD COMMUNITY HEALTH CENTER °COMMUNITY PO Box 2895/ 417 First Avenue -Seward,AK 99664-2895 H EALTH PHONE (907) 224-2273 CENTER FAX (907) 224-8501 www.sewardhealthcenter.org ATTACHMENT A Questions to Assist the SCHC Due Diligence Process 1. Is the option of a new, integrated healthcare campus being seriously considered? How likely is this option to occur? How much would it cost (we have heard professional estimates are in the $25-$30 million range)? How would this affect the use of the 1% sales tax and the portion allocated to SCHC? How soon will a decision be made to either pursue this option or take it off the table if financially or politically not feasible? 2. Is it a serious concern to continue investing in the current location in light of the natural disaster scenarios that are often mentioned? Will these concerns block decisions and forward progress on the proposed project at the current site? When will this question be addressed and resolved? 3. What possibilities exist for PSMCC to allocate more of its current space to SCHC? How was the decision made to allocate space between SCHC and PSMCC as currently apportioned? Have we fully explored the possibilities of re-allocating additional space to SCHC in order to avoid the cost, time and inconvenience of expanding and renovating? 4. Regarding the proposed project plan being considered, how much of Project A and Project B is PSMCC wanting to see happen and by when? As a reminder, the"Minimum Project"to support SCHC as contained in Resolution 2015-029 and the HIIP grant application includes SCHC expansion and build-out + PSMCC expansion (shell only, no build-out) @ $4,019,014. "Project A" includes the Minimum Project + Build-out of PSMCC shelled expansion space @ $4,706,194. "Project B"includes a series of renovations of existing space within and for PSMCC @ $3,694,619. The estimated cost of Project A + Project B, the "Total Project", is $8,400,812 not including FFE costs. 5. Would the City and PSMCC prefer or insist that SCHC remain co-located with the hospital at the current site? If SCHC were to relocate off-site to either a newly constructed facility or a leased/renovated existing facility, how would PSMCC use the space vacated by SCHC? Would this be sufficient to meet its space needs for the foreseeable future without the need to expand the current facility? The costs to build a new stand-alone facility for SCHC are preliminarily estimated at over $4,700,000. This option appears to be less cost effective than the proposed project at the current site. But if this option saves costs overall between SCHC and PSMCC, it may be more feasible than it initially appears. 6. If the default option were chosen to do nothing and remain where we are for the foreseeable future, could PSMCC make this work? What would be the impacts? What low cost changes or improvements would have to be made in order to make this work? How much would the default/do nothing option limit PSMCC's Where your health matters • • SEWARD COMMUNITY HEALTH CENTER PO Box 2895/417 First Avenue --Seward,AK 99664-2895 °COMMUNITY PHONE (907) 224-2273 HEALTH to CENTER FAX (907) 224-8501 www.sewardhealthcenter.org projected growth in services, patients and revenues? Would PSMCC risk losing patients, staff and providers if this option were chosen? 7. Looking only at the proposed project at the current site, how will this project be funded and by whom? How much of the proposed project is being considered for financing and completion? Are you comfortable with the current project cost estimates or will additional planning and estimating need to be completed? What financial analyses are being conducted by the City and/or PSMCC? When will these be completed? What are the projected financing costs, fees and reserve requirements for this project, and how much would these financing related costs/requirements add to total project cost? 8. How would this project and its financing affect the allocation and use of the 1% sales tax allocated to healthcare? How might future allocations to SCHC be impacted? 9. What is the City's and PSMCC's time frame for completing this due diligence process in order to make informed decisions about the proposed project? What are the target dates to make"go/no go"decisions? By whom? Is more time needed by the City and PSMCC to build reserves, complete the due diligence process, hold work and business sessions with the City Council and allow for adequate public input? If so, what is a realistic time frame and process to be followed? Where your health matters SEWARD COMMUNITY HEALTH CENTER PO Box 2895/417 First Avenue - Seward,AK 99664-2895 °COMMUNITY C MMNIT PHONE (907) 224-2273 CENTER FAX (907) 2248501 www.sewardhealthcenter.org ATTACHMENT B Additional Due Diligence Questions for Reference and Possible Consideration In the course of researching and developing the set of due diligence questions being addressed by SCHC, it was suggested that sharing these in a form adapted for use by the City and PSMCC might be of benefit. The following questions are, therefore, offered for your possible use and consideration. A. Current and Future Space Issues and Needs: 1. What are the current issues being experienced by PSMCC in the hospital facility? 2. How severe are these issues? Describe the problems they are currently causing. 3. What are the anticipated issues that will be experienced by PSMCC in the future? 4. When is it projected that these issues will be experienced to the point where something needs to happen? 5. Is PSMCC expected to add new services that will require additional space? Is PSMCC expected to grow or decrease in patient volume in its current services over the years ahead? B. Project Options and Management: 1. What would be the advantages and disadvantages to PSMCC remaining co-located with SCHC? How would these change if SCHC were to be located elsewhere? 2. How would the City and PSMCC like to see this project take place (i.e. what would the phasing of this project look like) and over what period of time? What would a realistic project schedule look like? 3. Who will manage and oversee this project? Would a project team be assembled and who would be on it? 4. How will disruptions to PSMCC operations be managed and minimized during the course of construction and renovation? C. Financial and Business Issues: 1. What are the primary financing options available and being seriously considered for a large, hospital capital project? Which of the following are most likely to be considered: a. General obligation bonds? b. Unenhanced fixed-rate bonds? c. Variable-rate tax exempt bonds? d. Privately placed tax exempt bonds? e. FHA/HUD Section 242 Mortgage loan insurance? f. USDA Business and Industry Guaranteed Loan Program? g. USDA Community Facilities Loan and Grant Program? h. Critical Access Hospital grants? i. Rural Health Viability grants? Where your health matters • SEWARD COMMUNITY HEALTH CENTER j4)11111C: PO Box 2895/417 First Avenue -Seward, AK 99664-2895 °COMMUNITY PHONE (907) 22::: 73 <HEALTH :T E SITE R FAX (907) 01 www.sewardhealthcenter.org j. State grants? k. Foundation and Charitable Trust grants? I. Corporate and Private donations? 2. How much will PSMCC cost-based reimbursement be counted upon to fund the debt service? Who is assessing this? How confident are the City and PSMCC that this method of reimbursement will continue into the future? 3. Will PSMCC need to build its cash reserves before it can realistically consider moving forward on this project? 4. What are the current market conditions for debt financing? Are they favorable or unfavorable? How are these projected to change in the future? 5. Have the City and PSMCC conducted feasibility analyses and developed realistic business/financial plans to assess the financial and operational impacts of this project? Are the City and PSMCC confident that this project can be handled financially? 6. What is the current credit profile and debt capacity of the City? Would current debt obligations be affected if new debt were taken on to fund this project? 7. Considering available cash, reserves, grants, contributions and debt capacity available or conservatively projected, what is the maximum budget that this project can have and still be feasible? 8. What other major capital projects are now being considered by the City? Where does this proposed project fit into the City's priority list of projects? Would other projects have to be delayed or removed from this list to make room for this proposed project? D. Project Timing: 1. From the City's and PSMCC's perspectives, is this the best time to seriously consider and pursue this project? When would be a better time if not now? Why? 2. What forces and factors support moving forward with this project now? What forces and factors support waiting to pursue this project at another time, if at all? E. Assessing the Operating Environment: 1. What are the key factors, trends and dynamics in the local, state and federal operating environments that might either support or restrain this project from the perspective of the City and PSMCC? 2. Local demographic and economic factors? 3. State demographic and economic factors? 4. National demographic and economic factors? 5. Trends and changes in third party payers (Medicaid, Medicare, Commercial Insurers)? 6. Utilization and payment/reimbursement trends for small critical access hospitals? 7. State and national healthcare reforms and other healthcare industry trends and changes? 8. Local "competition"and possible changes by other healthcare providers in the service area? 9. Do these factors, individually and collectively, tend to support or work against this major debt- financed capital project? Where your health matters . • • SEWARD COMMUNITY HEALTH CENTER PO Box 2895/417 First Avenue - Seward,AK 99664-2895 °C OMMUNITY S C EALTH PHONE (907) 224-2273 N-CENTER FAX (907) 224-8501 www.sewardhealthcenter.org F. Assessing the Community and Political Environment: 1. Who are the major stakeholders and persons of influence regarding this project? Have we spoken to them to assess their positons on this project? Do we fully understand the reasons why they might support this project or why they may not support this project? a. City Council Members b. City Administration Members c. PSMC Administration (local and regional) d. Chamber of Commerce and local businesses e. The Community-at-Large f. Patients g. Schools, Churches and other Health and Social Service Organizations/agencies h. Borough, State and Federal Officials i. Other 2. Will this require additional work sessions with the City Council? 3. Will this require sessions with Planning and Zoning? 4. What history in Seward might positively or negatively impact this project in the minds of Council Members and members of the community? 5. How could the reputation and image of PSMC and the City and City Council Members be positively or negatively impacted by this project? Where your health matters