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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

3

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

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

5

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

6

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)

8

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)

9

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

12

Sustainability

13

Byers Hall and Genentech Hall

HousingArthur and Toni Rembe Rock Hall

William J. Rutter Center

Architectural Context• UCSF

• Mission BayResearch Campus

• Neighborhood

14

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

20

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

23

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

26

Financial Plan

27

$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

28

$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

31

Children’s Hospitals Bonds: $69M

• $30M authorized in 2004 (Proposition 61)

• $39M on November 2008 ballot (Proposition 3)

32

State Funds: $200M

• Target: November 2010 ballot• Consistent with amounts received by

UCLA, UC Irvine and UC Davis for seismic purposes

33

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

37

• 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

39

40

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