Lynda Leedy, deputy director of Health and Community Services, presents Pinellas County Commissioners with a report April 22, detailing the latest information on the proposed Bayside Health Campus.
CLEARWATER – Pinellas County Commissioners listened carefully to the latest information about the Bayside Health Campus during an April 22 work session.
The topic has become somewhat contentious, as commissioners grew weary of requests for information with no results. A discussion at an April 15 meeting, which began with the firing of the county administrator, ended in commissioners requesting that the project be put on hold – essentially halting work by the design firm.
Commissioners passed the reins to assistant County Administrator Mark Woodard April 22, appointing him interim administrator. Woodard assured the commission that he would get answers to commissioners’ questions as soon as possible.
The April 22 work session agenda included a report on the Bayside Health Campus grant timeline and the history behind the project from Lynda Leedy, deputy director of Health and Community Services.
Leedy started at the beginning, when approval was given to staff to apply for a Health Resources and Services Administration grant in November 2011. In May of 2012, Health and Human Services awarded the county a $5 million HRSA capital grant.
The plan was to build a clinic to serve the county’s indigent population and supplement care provided by the Mobile Medical Unit. According to Leedy’s report, 45 percent of clients served by the county’s health program are homeless. Homeless families are the fastest growing segment of the homeless population.
In tandem with the MMU, Bayside Health Campus would provide a “necessary component of a comprehensive system of care that focuses on integrated access, stability and sustainable outcomes,” she wrote.
The MMU averages about 18 clinic days a month. It has two treatment rooms and can see about 20 to 30 clients a day. Clients often don’t seek services due to lines and wait times at some locations, she said. Capacity is limited. Equipment also is a challenge. There is no access to an X-ray machine.
“Further, the unpredictable nature of the MMU service downtime can exacerbate access without the development of extended service options for the homeless population,” Leedy wrote in her report.
From September 2013 through February 2014, the MMU was out of service for 37 days due to repairs, maintenance of specialized staffing.
In 2013, the MMU served 1,260 unique patients in a variety of locations, including Safe Harbor, Pinellas Hope and Salvation Army. Patients receive treatment for long- and short-term illnesses. They receive laboratory services, physicals, pregnancy testing and prescription medicine assistance. Referrals are provided for dental, mental health, substance abuse and other health concerns.
Bayside Health Campus would allow more capacity to provide specialty care targeted to the unique needs of the homeless. Staff estimates more than 3,700 clients a year could be served by Bayside in combination with the MMU.
In addition to health care, the Bayside Health Campus would provide access to services for housing, employment and education. People could get help registering for benefits and receive behavioral health care. They would have access to case management, computers, showers, clothing and other “wrap around” services, Leedy said. The facility would be child-friendly. Another important service would be respite care to provide a bridge for homeless released from the hospital – a savings to the county and local hospitals.
“With a vision of collaboration and integrated services, the intent of the project is to provide a location for services to come together under a single roof to address various barriers to stability for families and individuals,” Leedy said.
While the grant money will pay for construction of the facility, commissioners are concerned about ongoing costs of operation and maintenance. They are counting on assistance from organizations that already cater to the homeless population.
County staff met with community partners, the stakeholders in the care for the county’s homeless population from June to September 2012. In October of that year, the commission was presented with staff’s plan.
On May 8, 2013, a request for proposals for the design build contract was issued. Commissioners approved, 4-3, a contract with Creative Contractors on Aug. 20, 2013. On Feb. 25, 2014, the commission approved a final contract with Creative Contractors.
On March 28 of the current year, a land use application was submitted. A workshop on indigent care and Bayside Health Campus was scheduled on April 8. A planning review hearing took place April 14, followed by the April 22 work session. A Bayside Advisory Group meeting was scheduled for the week of April 28.
The tentative schedule calls for a May 12 meeting between an expanded group of stakeholders, followed by a June 2 presentation of design and development estimates to the commission. If everything goes according to plan, the design build work should be completed sometime between June and November.
Staff plans to present a construction contract to the commission in December. Groundbreaking for the new health campus is scheduled in January 2015. The HRSA grant expires in April - months ahead of an expected completion date of December 2015. Staff plans to request an extension.
To date, $26,088 has been invoiced by Creative Contractors and another $20,000 in estimated billable hours is owed to the county’s Real Estate department. The total cost of the design build contract is $378,725.
Staff asked the commission April 22 for permission to spend an additional $14,500 to allow Creative Contractors to complete programming activities, which would include diagrams of rooms, space and facility size, incorporating input from stakeholders, to come up with facility layouts. Leedy estimates that it would take about three weeks for Creative Contractors to complete the work, allowing staff to present a better look at activities that could be offered at Bayside.
But everything rests on the willingness of partners to equip and provide services at Bayside – something that may no longer be possible due to a breakdown in communication.
Leedy is confident she can fix relations and get the project back on track. Woodard and Seel support her.
But, the commission is reluctant to obligate the county for any additional costs until a grant extension is certain. Leedy said she has been told, in most cases, an extension is granted; however, she said it might be too early to ask.
She also said discussions have to take place to “right size” the building. Over-zealous planning resulted in a facility that is not affordable.
“Our eyes were bigger than our stomach,” Leedy said. “We need more space than we have budget.”
The new plan is to look at how much space can be built within budget and then figure out what services can be offered. The $14,500 to Creative Contractors would complete a feasibility study using new parameters. The grant would pay for a building of 16,500 square feet. A previous needs-based plan called for a structure of 25,000 square feet.
In addition, one of the county’s partners is concerned that a possible application for a change in status for Medicaid billing could place the two organizations in competition. Staff doubts the possibility of competition, as providers currently cannot serve everyone who needs medical help. A change in Medicaid status would allow the county to bill the government at a higher rate. However, the change is not required to operate Bayside.
“I have a lot of reservations,” Commissioner Norm Roche said. “If we can’t have an extension, it would put the county in a cautious situation with funding.”
He asked what would happen if no extension was granted.
“Would the county eat the money? It is time to put the horse back in front of the cart. If there can be no extension, this is all mute,” he said.
“I had a lot of concerns a year ago,” Commissioner Janet Long said. “… I understand deadlines and the federal grant, but the questions must be answered before we can move forward.”
Leedy said she would do her best to get all the answers before June 3.
“I understand your frustration and before we proceed we will get the answers,” Woodard added.
The commission OK’d the spending of an additional $14,500, but made it clear it wanted the answer to three questions – probability of an extension, proper size for the building, and agreement on the roles and responsibilities of community partners – by June 3.
“It is time to hit the reset button and have a full vetting,” Seel said.
She said reading correspondence between Health and Community Services staff and the partners showed a lot of back and forth – but no phone calls.
“We need to find a level of comfort and proceed with collaborative efforts,” she said.
“The cause and mission is still valid,” Roche agreed.