euhpn 2016 presentation benchmark building projects for mentally disabled persons

Developments in building for

mentally disabled persons

Fred Bisschop, Leo Mimpen, Theo Staats

24 November 2016 nCZB - EuHPN Workshop Madrid 1

Who we are

• 35 years of experience in healthcare building design and construction

• Backgrounds in economics and construction

• Reviewed numerous healthcare projects andbusinesscases

• We support large insurance companies and health care providers

• We make publications of general interest, including guidelines and standards

• We do our work independent

• Therefore our valuation of healthcare projects is important for attracting loans from banks


Content

• Developments in the care for mentally disabled

• Benchmark project

• Examples of recent projects

• Concerns for the future


Developments concerning building projects

until 2009

• Until 2009 institutions needed approval for their building plans

• Investments were without financial risks

• New projects needed to comply building guidelines and costs

• For existing buildings there were more moderate criteria


The quality of housing used to be very bad

• In 2003 we carried out a survey about the quality of the buildings forhousing patients

• Conclusions: over 50% of the buildings did not meet the standards set by the government itself

• A lot of people were just being “put away”

• Result: the government gave extra money for quality improvement


• Since 2009 institutions need no longer approval for projects

• Building guidelines do no longer exist

• Budget for housing costs however is derived from the formerguidelines

• Risk was introduced by making budget depending on number of clients

• Institutions professionalized their real estate departments

• Obsolete housing has been replaced in many cases

• Patients with relatively few disabilities are no longer entitled to home care

Developments concerning building projects

since 2009


Consequences of deregulation

• Government advocated in the past decentralisation and small groups.

• Institutions are now forced to move clients back to the campus and increase the size of groups.

• The exchange of information and knowledge betweeninstitutions stopped


Benchmark project

• Institutions are starting to share information about their building activities again

• Together with 3 large institutions we created a benchmarkgroup

• They represent 7% of the total capacity in the Netherlands

• Each institution gave extensive data of 3 or more recent projects

• We analysed the projects on aspects like m², m² per patient, costs etc

• This will result in reference data which may help optimizing futureprojects


Benchmark some results

• We defined 4 different patient groups in relation to the building demands

• For each group we analysed several projects

• Most projects seem to fit in this approach

• Output will be presented as a range of m2 and cost per patient

• Although the number of projects is limited it seems that building on a campus is cheaper than in a residential neighbourhood


4 examples of projects from the benchmark

1. Regular care for mentally handicapped and people with braindamage

2. Regular care for mentally handicapped on the campus

3. Care for clients with difficult behaviour on the campus

4. Care for ageing clients on the campus


Project 1: Project 1: Project 1: Project 1: 48 clients, regular care and care for

people with brain damage


Project 1: Project 1: Project 1: Project 1: 48 clients, regular care and care for



Living room 24,3m²

Bedroom 9,3m²

Bathroom 6,8m²

Project 1:Project 1:Project 1:Project 1: 48 clients, regular care and care for



Project 2Project 2Project 2Project 2: regular care for 62 mentally

handicapped clients on the campus


Project 2Project 2Project 2Project 2: regular care for 62 mentally



Living room

Bedroom 19,7m²

Bathroom 4,5m²

Project 2: Project 2: Project 2: Project 2: regular care for 62 mentally



Project 3Project 3Project 3Project 3: care for 20 clients with difficult

behaviour on the campus


Project 3: Project 3: Project 3: Project 3: care for 20 clients with difficult



Project 3 : Project 3 : Project 3 : Project 3 : care for 20 clients with difficult


Living room 15,4m²

Bedroom 8,1m²

Bathroom 5,2m²


Project 4: Project 4: Project 4: Project 4: care for 64 ageing clients on the

campus


Project 4:Project 4:Project 4:Project 4:care for 64 ageing clients on the

campus


Bedroom 20,9m²

Bathroom 8,1m²

Project 4: Project 4: Project 4: Project 4: care for 64 ageing clients on the

campus


Concerns for the future

• Due to the improving economy building projects become more expensive.

• Reimbursement for housing costs will go down

• The government no longer feel resonpsable for the quality of housing


euhpn 2016 presentation benchmark building projects for mentally disabled persons

Healthcare