UCSF Medical Center at Mission Bay

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1 UCSF Medical Center at Mission Bay SIXTEENTH STREET FOURTH STREET J. Michael Bishop, MD Chancellor UCSF Mark R. Laret Chief Executive Officer UCSF Medical Center Cindy Lima Project Director UCSF Medical Center at Mission Bay September, 2008

2 Agenda Background and introduction Design presentation Financial plan 2

3 UCSF Medical Center Track record of achievement in applying advanced research to clinical care Highest-ranked children s hospital in Bay Area Northern California's only nationally-designated Center of Excellence in Women's Health National Cancer Institute-designated Comprehensive Cancer Center Most kidney transplants performed in the world Most liver transplants performed in Northern California Largest brain tumor treatment program in the nation 3

4 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 4

5 Why Now? 2013 deadline for Mount Zion Hospital retrofit or replacement 2015 extension requires plans for new hospital be submitted by December

6 UCSF Mission Bay Hospitals Milestones 2000: UCSF begins hospital replacement process : Regents approve Mission Bay hospital land acquisition January 2006: Regents urge UCSF to pursue Mission Bay project May 2007: March 2008: May 2008: Regents approve fundraising campaign Regents receive project update Regents endorse preliminary design 6

7 Planning Groundwork Design team led by healthcare experts Anshen + Allen Sustainability specialists William McDonough + Partners Nationally recognized DPR Construction, Inc., selected as general contractor Project delivery team with local market knowledge and strong OSHPD experience Lessons learned from other hospital projects City agencies and elected officials engaged 7

8 Design

9 Program Phase bed children's hospital 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) 9

10 Program Future Cancer Outpatient Building & Parking (1A) Outpatient clinical cancer center (design now; build as soon as possible) 580-car parking structure (total 1,030 spaces) Future West Block Expansion (2) Add up to 261 beds (550 total beds), additional outpatient building and structured parking (total 1,400-1,750 spaces) 10

11 Architectural Vision Transformative: Flexible, expandable, adaptable - incorporating evidence-based design, patient safety and family areas Distinct identities: Children s, Women s, Cancer Efficient: Operational, first and life-cycle costs Integrated: Translational research, multidisciplinary, education Sustainable: Reduce carbon footprint, healthy environment, water conservation 11

12 Sustainability 12

13 Architectural Context UCSF Mission Bay Research Campus Byers Hall and Genentech Hall Neighborhood William J. Rutter Center Arthur and Toni Rembe Rock Hall Housing

14 14

15 UCSF Research Campus Phase 2 Site Fourth Street Phase 1A Cancer Outpatient Building Sixteenth Street Phase 1A Parking Structure Outpatient Building Energy Center Temporary Parking Mariposa City Park Phase 1 Phase 1.A Highway 280 Owens Street Mariposa Street Third Street Hospitals N 15 Phase 1 Site Plan

16 UCSF Research Campus Phase 2 Clinical Plinth Phase 2 Hospital Fourth Street Phase 1A Cancer Outpatient Building Sixteenth Street Phase 1A Parking Structure Phase 2 Parking Structure Mariposa City Park Phase 2 Highway 280 Owens Street Mariposa Street Third Street Outpatient Building Energy Center Hospitals N 16 Phase 2 Site Plan

17 Sixteenth Street Campus Gateway Campanile Plaza PHASE 1A CANCER OUTPATIENT BUILDING PHASE 1A PARKING STRUCTURE Fourth Street Plaza Cancer View Garden Women s View Garden Teaching Garden S Meditation Garden Third Street Plaza Owens Street MARIPOSA CITY PARK Fourth Street Children s Play Plaza Landscape Setback N Mariposa Street Graphic Scale Landscape Site Plan

18 Phase 1A Cancer Outpatient Building Outpatient Building Energy Center Women s & Cancer Hospitals (106 beds) Children s Hospital (183 beds) UCSF Research Campus MARIPOSA MARIPOSA STREET FOURTH STREET N 18 View from Southwest

19 SIXTEENTH SIXTEENTH STREET STREET ENERGY CENTER WOMEN S & CANCER HOSPITALS CHILDREN S HOSPITAL THIRD STREET 19 View from Southeast FOURTH FOURTH STREET STREET PHASE 1A PARKING STRUCTURE PHASE 1A CANCER OUTPATIENT BUILDING OUTPATIENT BUILDING N OWENS OWENS STREET STREET MARIPOSA STREET MARIPOSA STREET

20 Outpatient Building Women s & Cancer Hospitals (106 beds) Children s Hospital (183 beds) West Elevation (Fourth Street) Children s Hospital (183 beds) Women s & Cancer Hospitals (106 beds) Energy Center Phase 1A Cancer Outpatient Building East Elevation (Third Street) Graphic Scale Building Elevations

21 Radiation Oncology Outpatient Building Lobby Plant Ops/ Materiel Management EVS/ EH&S Energy Center Food Services Women s & Cancer Hospitals Lobby Conference Center Servery Dining Third Street Entrance Lobby Children s Hospital Lobby Imaging Administration N Graphic Scale Urgent Care / Emergency Color-Coded Floor Plan Level 1

22 Dental Prepare Rehabilitation Services Waiting Peds Surgical Specialty Clinics Sky Lobby Women s & Cancer Acute Care Peds Child Life Peds Transitional Care Peds Acute Care Graphic Scale N Color-Coded Floor Plan Level 5 22

23 Vision Glass Mullions Precast Concrete Shadowbox/ Spandrel Glass Metal Stone Accents 23 Color Scheme & Materials

24 N UCSF Medical Center at Mission Bay Children s, Women s & Cancer Hospitals 24 FOURTH FOURTH STREET STREET SIXTEENTH SIXTEENTH STREET STREET

25 Video Animation

26 Financial Plan

27 $1.686 Billion Project Cost Breakdown Special Items/Capitalized Interest $174.6M 5% $54.7M Equipment & Furnishings $239M Surveys, Tests, Plans and Specifications $22.8M Construction $1,094.9M Project Management $30M Design Fees $70M 27

28 $1.686 Billion Project Funding Sources Gifts $600M Medical Center Debt $700M State Funds $200M Children's Hospital Bonds $69M Medical Center Equity $117M 28

29 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 29

30 Medical Center Equity: $117M $81M from hospital operating cash flow Average annual cash flow FY2004- FY2008: $146M $36M in interest income from giftfunded portion of construction fund 30

31 Children s Hospitals Bonds: $69M $30M authorized in 2004 (Proposition 61) $39M on November 2008 ballot (Proposition 3) 31

32 State Funds: $200M Targeting November 2010 ballot Consistent with amounts received by UCLA, UC Irvine and UC Davis for seismic repairs 32

33 Gifts: $600M Strong support from UCSF Foundation and UCSF Medical Center Executive Council Premier campaign cabinet established Fundraising campaign underway 33

34 Financial Risks Operating performance does not support debt Voters do not approve ballot initiatives Philanthropy does not materialize Construction escalation exceeds budget assumptions 34

35 Amelioration of Shortfalls Compensate from other sources Modify scope Potential bridge financing Seek state authorization to extend seismic deadline Implement Mount Zion retrofit and clinical expansion 35

36 UCSF Medical Center at Mission Bay Benefits the University, San Francisco, California and the world Plan has been vetted against hospital projects locally, across UC and nationally We have the momentum and the opportunity We appreciate the magnitude Risks and contingencies identified 36

37 UCSF Medical Center at Mission Bay FOURTH FOURTH STREET STREET SIXTEENTH SIXTEENTH STREET STREET 37

38 38

39 Back up slides

40 Outpatient Building (Sixteenth & Fourth Streets) 40 N

41 41 Inpatient Buildings (Fourth Street) N

42 42 Women s and Cancer Hospitals EntranceN

43 43 Children s Hospital N

44 44 Children s Hospital Entrance N

45 N Children s Hospital (Mariposa and Fourth Streets) 45

46 N Inpatient Buildings and Plaza (Third Street) 46

47 47 N Energy Center (Third Street )

48 Radiation Oncology Outpatient Building Lobby Plant Ops/ Materiel Management Energy Center Food Services Women s & Cancer Hospitals Lobby Conference Center Servery Dining Children s Hospital Lobby Imaging Administration N Graphic Scale Emergency / Urgent Care Color-Coded Floor Plan Level 1

49 Radiation Oncology Materiel Support Clinical Lab Pathology Sterile Processing Cancer Outpatient Adult Perioperative House Staff/ On-Call Children s Perioperative Graphic Scale N Color-Coded Floor Plan Level 2

50 Concierge Medicine Fetal Treatment Center Waiting Women s Surgery Satellite Op Perinatal Clinic/ Antenatal Test PDC Sky Lobby Mother- Baby Care Intrapartum Care NCPL ICN Graphic Scale N Color-Coded Floor Plan Level 3

51 Waiting Imaging Exam Suite Dialysis Peds Primary Care Clinic Peds Medical Specialty Clinic Peds Clinics Shared Support Respiratory Therapy Sky Lobby On-Call Administrative Support Adult ICU Compass Care Pharmacy PCICU Pediatric Transitional PICU Graphic Scale N Color-Coded Floor Plan Level 4

52 Dental Prepare Rehabilitation Services Waiting Peds Surgical Specialty Clinic Sky Lobby Women s & Cancer Acute Care Peds Transitional Care Peds Acute Care Graphic Scale N Color-Coded Floor Plan Level 5

53 ChildLife, Peds SS Peds Specialty Clinic (Cancer) PCRC/ PTRT Sky Lobby Women s & Cancer Acute Care On-Call Peds Park Peds BMT Pediatric Hematology Oncology Pediatric Acute - PCRC Graphic Scale N Color-Coded Floor Plan Level 6

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