California Department of Corrections and Rehabilitation California Health Care Facility (CHCF)

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1 California Department of Corrections and Rehabilitation California Health Care Facility (CHCF) Stockton, CA

2 project details Project Cost $900 million (total project) $512.9 million (DB-2 Package) Square Footage 77-acre (DB-2 Package) Building Components 1,722-bed licensed medical and mental healthcare facility Inmate-patient housing Permanent work crew housing Diagnostic and treatment center Dialysis Co-located medical, dental and mental health services Standby emergency medical services Wayfinding to help inmatepatients navigate the facility Central Utility Plant Warehouse distribution Visitor/staff entry building Central kitchen Staff training facilities Staff and visitor parking areas 24/7 patrol High security perimeter (utilizing a lethal, electrified fence with guard towers) Designed to LEED Silver certification Design hours: approximately 170,000 Trade hours: approximately 2 million Completion Date July 2013 Architect/Engineer HDR Architecture, Inc. Key Design Partners HGA, Crosby Group, and Marshall Associates CONSTRUCTION PARTNER Clark-McCarthy A Joint Venture (CMAJV) Acknowledgements California Department of Corrections & Rehabilitation California Prison Receivership

3 project description CHCF-Stockton is a 1,722-bed intermediate, medical and mental health care facility for inmate-patients of the California Department of Corrections and Rehabilitation (CDCR) prison system. It was designed and constructed to consolidate facilities for long term medical, and acute and intermediate mental health inmate-patients into one central location for more efficient and cost-effective delivery of services. This new, sub-acute health care facility will allow California Prison Health Care Services to provide the required Constitutional level of care to inmatepatients from across the state. Located in Stockton, the facility occupies 77 acres of the 144-acre site of the former Karl Holton Youth Facility. CHCF will provide quality care within the context of a correctional setting appropriate to this inmate-patient population. From planning and design, through organization, staffing and operations, this facility emphasizes an environment which is conducive to appropriate levels of treatment, and programs for both medical and mental health inmate-patients. The project is designed to create a healing environment based on principles of evidence-based design, which contribute to improvements such as decreased lengths of stay and reduced infection rates. The facility is also designed to be compliant with the Americans with Disabilities Act (ADA). This new facility will provide for the long term care needed for a rapidly aging inmate population with a wide variety of serious and chronic medical and mental health issues, in a safe and secure environment. CHCF represents the initial implementation of the CDCR Medical Classification System. Inmatepatients who qualify to be admitted for treatment at CHCF will be encouraged to take individual responsibility for managing and achieving recovery goals mutually established with healthcare professionals.

4 THe background CHCF-Stockton was designed and constructed to fulfill an agreement between the California Department of Corrections and Rehabilitation and the Federal Receiver in charge of prison healthcare. The facility is specifically developed to meet the state s overall mission of reducing avoidable morbidity and mortality, while protecting public health by providing inmate-patients with timely access to safe, effective and efficient medical care. To fulfill the court-mandated timeframe, the facility had an extremely ambitious schedule of 22 months from preliminary design through construction, licensing and occupancy. In order to accomplish this goal, new sustainable models of care in housing, treatment and programs were developed in collaboration with representatives of CDCR, the Department of Mental Health (DMH), California Prison Health Care Services (CPHCS), and California Prison Receivership (CPR); along with the Court Monitors. Project Funding The project was funded through Assembly Bill 900 (Solorio), an historic and comprehensive bill providing resources to improve public safety and reduce recidivism. Governor Arnold Schwartzenegger signed AB900 into law on May 3, The total project cost was approximately $900 million. Annual operating cost of $300 million, of which approximately $50 million will be offset by savings realized from decreased inmate transfers and reduced costs incurred from outside hospitals.

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6 Project Delivery CHCF-Stockton was developed through the Design-Build delivery process, rather than the traditional Design-Bid- Build process, to spark creative and innovative ideas and to ensure the accelerated schedule was met. The facility was developed in three Design- Build components. DB-1 provided the clearing and rough grading of the site, the lethal perimeter fence, central plant, and warehouse and logistics system, as well as new parking areas. The Clark-McCarthy/HDR team developed and completed the fast-track DB-2 component that encompasses the majority of the project, including all of the housing, diagnostic/treatment, administration and support facilities inside the perimeter fence, as well as the visitor/staff entry building. DB-3 is currently underway to repurpose the adjacent, former DeWitt Nelson Youth Correctional Facility for use by CDCR and CPHCS.

7 The aggressive court-mandated schedule required an extraordinary amount of collaboration and coordination among the designbuild teams, and CDCR, including all of its stakeholders and consultants. The Clark-McCarthy/HDR team produced the design and construction documents, and obtained agency approvals (Office of Statewide Health Planning and Development (OSHPD), California State Fire Marshal, Department of Health Services, Licensing and Public Health, and ADA) in less than five months.

8 THe design The DB-2 component of CHCF-Stockton provides 1,722 medical and mental healthcare beds and 1.2 million square feet of space on a 77-acre site in central California. The project breakdown incorporates four basic sets of programmatic components: housing, facility shared services, facility support, and secure perimeter. Housing buildings are grouped into treatment clusters based on specific inmate-patient medical and mental health acuity levels. These treatment clusters are organized along streets, one for medical and one for mental health, which lead to a central Facility Shared Services (FSS) complex providing clinics and programs, as well as administrative services. The concept of neighborhoods along streets leading to Main Street was designed to allow inmate-patients to live in a more normal environment, encouraging them to take greater responsibility for their own well-being, including Activities of Daily Living (ADLs), treatment, and rehabilitation and recovery. Interdisciplinary Treatment Teams (IDTT) combine case management practices with the ability for the inmate-patient to participate fully in his own recovery plan. The inmatepatient s current behavior and clinical needs directly influence his housing assignment and amount of independent movement within the facility. This planning concept is supported by wayfinding and signage to help inmate-patients with mobility challenges, hearing and sight impairments, as well as cognitive dysfunction, to navigate the health care system and campus. Security for CHCF is based on the direct supervision model of management which requires direct, personal interaction between staff and inmatepatients, minimizing unnecessary physical barriers. Throughout the facility, special care was given to create a healing environment by using appropriate natural daylight, proportioned spaces, along with suitable landscaping, and specific materials and finishes.

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10 Housing Housing units comprise the basic element in the design of CHCF and represent the majority of buildings on the site. Although inmate-patients will be encouraged to participate in centralized treatment and programs at the FSS, the housing unit is where inmate-patients will spend much of their time, particularly the more acute inmate-patients. Housing units were based on a prototype design providing programming and treatment capabilities within each unit. Each housing building is designed with two housing units paired around a shared staff/support core. All housing units include nurse stations, custody officer stations, and examination and consultation rooms, along with isolation and observation rooms. Medication rooms are organized around dayrooms filled with natural light from light monitors above. In addition, all units have outdoor recreation yards and multi-purpose spaces for group treatment and programs. Padded safety cells are provided for the mental health units. Dining is provided in the housing units, typically in the dayrooms. The more acute inmate-patients, or those less mobile (for medical or mental health reasons), can receive their treatment and programs on-unit, rather than having to go to the central

11 facilities. This gives CDCR a great deal of flexibility in the classification and management of inmate-patients, now and as inmate-patient populations and acuity levels change. This prototypical approach streamlined the design, and improved constructability and economy of scale, helping to keep construction on-budget and on-schedule. Five different housing types address the levels of care provided at CHCF: High Acuity Medical Mental Health Crisis Intermediate Care Facility (ICF), operated by the California Department of Mental Health Acute Psychiatric Program Mental Health (APP), operated by the California Department of Mental Health Additionally, there is one housing building for Permanent Work Crew (PWC), a more conventional corrections housing unit for inmates who will work at this facility. Low Acuity Medical

12 Facility Shared Services The Facility Shared Services (FSS) Mental Health Outpatient Clinic, consists of three buildings which front Standby Emergency Medical Services, Main Street. Together they provide and the Patient Management Unit for the various components of the where inmate-patients are admitted Diagnostic and Treatment Center; and discharged from the facility. inmate-patient community programs; and administration and facility The inmate-patient community support elements. programs include visitation and Board of Parole hearings, family The Diagnostic and Treatment Center visiting, education and rehabilitation is comprised of: Physical Medicine and programs, in addition to activity Rehabilitation, Pharmacy, Diagnostic therapy, religious programs, a library and Procedure Center, Dialysis Clinic, and legal library. The FSS supports Central Services, Central Health the interdisciplinary team concept of Records, Medical and Dental Clinics, treatment and continuum of care.

13 Secure Perimeter The safe and secure operation of this facility is an essential requirement of the complex. A lethal electrified fence encloses approximately 77 acres of the site where inmate-patients are confined. This perimeter incorporates dedicated patrol roads inside and outside the fence. The perimeter has two controlled access points to this fenced area called sallyports, one for pedestrian staff and visitors, the other for vehicles carrying inmatepatients, supplies and equipment for the facility. Both sallyports have guard towers that are manned 24/7. In addition, there are unmanned perimeter guard towers available for surveillance and armed response. Other components include an armory, sallyport gatehouses, emergency/security lighting and electronic surveillance of the site. Facility Support Facility Support buildings and systems provide basic infrastructure and support to the entire site. CHCF is a stand-alone facility with its own central utility plant, a central warehouse and logistics system, a central kitchen, canteen, plant maintenance facilities, as well as parking for staff and visitors.

14 Economic Benefits to the Stockton Community/San Joaquin County The CHCF facility will create more than 2,400 civil service jobs More than half of the construction work was awarded to businesses in the Stockton region More than half of the 5,500 construction jobs were filled by local craftsmen $240 million to local contractors more than half of the contract dollars $1.2 million for transportation improvements $700,000 over four years to Stockton Unified School District and the Health Careers Academy High School to support the new high school $690,000 mitigation fee to Stockton Unified School District and to local government $680,000 mitigation fee to San Joaquin County Estimated $1 million in sales tax to the county from construction materials purchased With funding provided by the State of California, Delta Community College expanded its accredited program to train psychiatric technician aides needed by CHCF. The program will enroll 270 students over three-four years The California Prison Health Care Services entered into a multi-year contract with San Joaquin General Hospital to provide care not available at CHCF. Inmate-patients will be housed in a separate, guarded unit at the hospital

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