Collaborating to Design Your SBHC Facility
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- Egbert Haynes
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1 Collaborating to Design Your SBHC Facility March 12, 2012 Presentation by: Mara Larsen-Fleming, MPP, MPH, SBHC Program Manager, OUSD David Byrens, AIA, Principal, Byrens Kim Design Works Dong Kim, AIA, LEED AP, Principal, Byrens Kim Design Works Oakland Unified School District Learning Objectives After participating in this workshop, participants will be able to: Explain the key steps and timeline associated with the design ofa school-based health center facility Identify the key stakeholders that should be included in the design process and define their roles and responsibilities Identify administrative agencies and codes governing the design of school-based health center facilities Describe the basic space requirements and other important considerations for layout Identify common and potentially costly pitfalls encountered during the SBHC facilities development process 2
2 SBHC Expansion in Oakland Seven original health centers in Oakland, developed between 1989 and 2005 In 2006, Oakland voters passed Measure B, which allocated $435 million in facilities bond dollars to be administered by OUSD for school modernization projects Allocated funding for construction of 10 school-based health centers facilities 8 new sites 2 renovations 3 Oakland SBHC Model Operated by a number of Community-Based Organizations, primarily Federally Qualified Health Centers School-Based Health Centers in Oakland are contracted by Alameda County Health Care Services Agency to provide: Medical Services Behavioral Health Services Health Education Services/Programming Youth Development Programming Dental Services (5 sites only) 4
3 Typical Space Requirements Type of Space Waiting/Reception Area Confidential Office Spaces (Minimum of 3) Triage Room/Resting Area Charting Area Exam Rooms (2) Estimated Sq. Footage Dental Exam Room Bathroom (2) Laboratory Record Storage General Storage Conference/group/mtg. space/break room Considerations for Layout Program Requirements Population(s) Served Versatility/Function Space Limitations Regulations (e.g. ADA, OSHPD 3) 6
4 Madison Middle School 7 Madison Middle School 8
5 Madison Middle School 9 Madison Middle School 10
6 Madison Middle School 11 Havenscourt Middle/High School Campus 12
7 Havenscourt Middle/High School Campus 13 Havenscourt Middle/High School Campus 14
8 Havenscourt Middle/High School Campus 15 Havenscourt Middle/High School Campus 16
9 Havenscourt Middle/High School Campus 17 Skyline High School 18
10 Skyline High School 19 Skyline High School 20
11 Key Steps Design Phase: Balance ideal layout with ensuring design meets minimal requirements (6 months) Fire code Division of State Architect Pre Application ADA OSHPD 3 (outpatient health facilities) Submit drawings for approval by Division of the State Architect (DSA) Permitting Agency (3-6 months) Construction (6-9 months depending on scope) Fire Clearance/Licensing (1-2 months) Schedule visit with Fire Department Resolve issues identified in safety report Add satellite site to project scope with HRSA (longer for independent license) 21 Cost Cost per square foot (Construction Cost) $350/SF to $450/SF San Francisco Bay Area Cost Index Project Construction Cost: Madison Health Center: $950,000 Havenscourt Health Center: $840,000 Skyline Health Clinic: $386,000 Average budget = $0.75 $1.5 Million Includes Hard Cost (i.e. construction) and Soft Cost (e.g. permit, design, management, etc.) Considerations for Cost Impact 22
12 Collaborative Process Roles and Responsibilities Facilities Department Project Manager SBHC Program Manager Architect Contractor Lead Partner Agency Site/School Administrator Community 23 Lessons Learned (Process) Include lead partner agency in design process as early as possible: Clinic Manager, Medical, Facilities, IT Directors, etc. Needs to meet licensing requirements Needs to account for staff needs/flow of services/privacy & confidentiality Change orders are costly Consider needs of others that will live in space (e.g. School Nurse & Mental Health Clinicians) Including broader community builds buy-in and relationships, but takes additional time (structured process is key!) Get in touch with Fire Department early in order to identify potential issues 24
13 Lessons Learned (Facility) Consider separate community entrance Dental operatories are expensive & have another layer of regulation Anticipate facilities needs associated with EHR implementation Budget up front for security, furniture and equipment Make sure to include licensing requirements: clean and dirty sinks in lab, eye wash station in lab, sinks in exam rooms, etc. Dosweat the small stuff: Sound-proofing, sink in triage room, ventilation, lighting, pass through from bathroom to lab, no carpeting. 25 Contact Mara Larsen-Fleming, MPP, MPH, SBHC Program Manager, OUSD Mobile David Byrens, AIA, Principal, Byrens Kim Design Works Dong Kim, AIA, LEED AP, Principal, Byrens Kim Design Works 26
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