Howard Hospital Foundation v. Kemper

Last March Howard Hospital Foundation President Margie Handley introduced the “project manager” her foundation had hired for about $40k to prepare a cost estimate for converting the Old Howard Hospital in Willits into a Psychiatric Health Facility to the newly formed Measure B Mental Health Facilities advisory committee. The project manager, who runs a construction outfit called Heller & Sons with experience building PHF units, said that he had received a “list of needs” from the county which he'd used to determine room configurations, building code requirements and plans, which he’d then used to prepare a “proposal.” These proposed specs, he told the Measure B folks, could easily be converted into plans for an $11 million to $15 million upgrade/remodel for Mendo PHF II. He added that the cost range was based on either “market rates” for labor at $11 million or about $15 million if done under government contract with government specified “prevailing wages” for labor.

Then at the April Measure B Committee meeting, Willits City Manager Stephanie Garrabrant-Sierra questioned the Heller & Sons estimate, which Ms. Garrabrant-Sierra said assumed that the remodeled building would not need to meet California’s restrictive “OSHPD” (Office of Statewide Health Planning and Development) hospital (seismic) construction standards, and, if it did, would raise the cost from their current estimates of $11-$15 million to an even higher number.

Fast forward to the August 29 meeting of the Measure B/Mental Health Facilities Advisory Committee, when consultant Lee Kemper summarized his well-prepared “needs assessment” report for the committee including a cost estimate for a new Psychiatric Health Facility (PHF) — somewhere, not necessarily Willits. Kemper estimated that a PHF (not including the land) could be built for around $8 million.

Oops.

So, the consultant says a new PHF would cost a lot less than remodeling old Howard Hospital, undermining the assumption everyone seems to think was the main objective of Measure B in the first place. 

Committee member Ross Liberty, who seems to have assumed that because he knows how to weld an exhaust pipe he also knows about mental health planning and construction costs said:

“Accepting this report does not mean we take everything as fact. In fact, I have some serious concerns about the $7.5 million budget for a building, for example [that Kemper provided]. And I have some concerns about some of the assumptions made on what it’s gonna cost net-net to run the psychiatric unit. So you’re saying we’re gonna accept it, not necessary believe it all. I don’t know how else to put that. No offense [turning to Mr. Kemper]. But I’m really challenging those numbers as they are unbidden. … It seems to me that the recommendation circles around some assumptions there which are, um, you know, based on verbal discussions and— not that I want to say there’s anything wrong with them, but…”

But Liberty’s attempt at “no offense” didn’t work. 

Apparently Mr. Kemper took enough offense that this month Mr. Kemper — on his own initiative and at no additional cost — sent the Board of Supervisors a “Follow Up to August 29, 2018 Presentation” which is in Tuesday’s board agenda packet.

In that follow-up, Mr. Kemper defended his cost estimates against Liberty’s “offensive” comments:

“Kemper Consulting Group has been able to verify that [our] cost estimate of $5 million to $6 million for construction of a Psychiatric Health Facility (PHF), not including land, was not based on a prevailing wage requirement. It was based on construction costs for a private business. Based upon our subsequent research, we project the impact of a prevailing wage requirement on PHF construction costs would be an increase of 30%* above the top range of $6 million. This would increase the estimated cost to $7.8 million (not including land). Our original top-end estimate was $7.5 million.”

Also at the August 29 Kemper presentation, other Measure B committee members noted less insultingly that perhaps apples were being compared to oranges in considering the Foundation’s much higher old Howard Hospital remodel cost against Kemper’s lower number.

Kemper’s recent “follow-up” addresses that too, saying that if apples are being compared to oranges, then the problem is with the apples, not the oranges. That is, the assumptions (“from the county”) that Ms. Handley and her Foundation may have used to prepare their own private needs assessment should be revised and a new cost estimate should be submitted to the County based on Kemper’s much more comprehensive overall needs assessment.

Mr. Kemper concludes his “follow-up” with:

“3. Comparability of Cost Estimates for PHF Construction — During discussions with the Measure B Committee, it was reported that the estimate of $11.2 million to $14.9 million for rehabilitation of the old Howard Hospital building included costs for two facilities: a PHF and a separate psychiatric rehabilitation facility. To enable an ‘apples to apples’ comparison of estimated PHF construction costs between this estimate and the estimate we have provided in our report, we recommend that the Measure B Committee ask the Howard R. Hospital Foundation for a revised proposal from Heller & Sons that shows the separate costs of construction of each of these facilities. Kemper Consulting Group has recommended that a PHF be constructed with Measure B funds along with a Crisis Residential Treatment facility and a Crisis Stabilization Unit. Our firm has not recommended construction of a psychiatric rehabilitation facility [as included in the Foundation’s proposal] in addition to these recommended facilities.”

WE’RE NOT SURE how all this wrangling will play out. We doubt that Ms. Handley will shell out more money for a revised estimate from Heller & Sons — although that would be helpful, if at the same time delaying things. But it does seem clear that the Measure B Committee will now need to decide if they want to use Ms. Handley’s Foundation’s informal and as yet unpublicized “needs assessment” or Mr. Kemper’s $68,000 county-paid needs assessment based on his highly-praised professional report.

MEANWHILE, we again suggest that if the Sheriff and the Committee want to get going with a PHF — and they certainly should — why don’t they follow-up on Behavioral Health Advisory Committee Chairperson Jan McGourty’s suggestion that a pre-fab mobile/trailer facility be placed in Willits or Ukiah and get going with it for the short term with an initial preliminary staff from the legions of staffers now working under Camille Schraeder’s $28 million mental health services contract, while the “needs” are defined and the apples, oranges, and, well, nuts are sorted out. Not only would this provide short-term relief to law enforcement, but it would let the County get a feel for what it will take to staff and deliver a functional PHF someday.