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Good morning, everybody. I'd like to call to order the March 24th, 2026 committee of the whole meeting. I am the chair of the committee, Jorge Baron.

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Today's agenda, we have two briefings related to Harborview Medical Center.

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And we may take them out of order, but I'll note it as if I have them on the agenda. For the first briefing, we'll be hearing from the representatives of Harborview.

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And the second briefing will be focused on a new King County Otter's letter report regarding in Harborview, Wont Project, and the executive response and update on the project.

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Before we get started, I do want to note to my colleagues that we have a hard stop at

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11 and hopefully actually able to finish a little bit before that to allow KCTV and all

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of us.

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I hope to get to the Women's History Day event in the Chinook Building, and I want to remind

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folks that if they are folks who are thinking about public comment, there's the for that

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reason we do not have action items on today's agenda, so we're not opening up for public

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for this meeting, let's note it in the agenda, but I want to remind community members that

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you can provide public comment via email or at today's Council meeting at 1 30 PM.

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With that introduction, we'll please call the roll.

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Clerk will switch to police call the roll.

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Thank you, Chair. Council member Balducci.

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Council member Dimbaoski.

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Here. Council member Dunn.

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Council member Fain.

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Here.

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Council member Lewis.

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Here.

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Council member Mosqueta.

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Here.

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Council member Perry.

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Chair, Council Member von Reikbauer, and Chair Barron.

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We do have a quorum.

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Next, we'll move to the minutes.

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Vice Chair Bauduccino.

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Have a motion for approval of the minutes of the meeting from February.

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Thank you.

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Chair, I move approval of the minutes.

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Thank you.

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The minutes are before us.

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Any questions or comments regarding the minutes?

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Seeing none.

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All those in favor of approving the minutes.

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Please say aye.

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Aye.

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Any opposed say nay?

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The meeting minutes are approved.

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I see our folks from Harvard we are right, so we are going to stick to the original plan of the agenda.

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Thank you.

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That first item on our agenda is a Harvard Medical Center update for any members of the public who might be listening in.

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I want to provide a bit of background on Harvard's relationship with King County.

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Harvard is owned by King County and operated in partnership with UW Medicine.

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Harvard considers a critical role as King County's primary safety net hospital,

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emphasizing care for the admission population, which is actually defined in a hospital services agreement

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that we have with Harbourview. That includes non-English speakers, uninsured and under-insured

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patients, survivors of domestic violence and sexual assault, people with severe mental illness

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and substance use disorder, people in incarcerated and county jails, and others.

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This committee, of course, the lead committee of jurisdiction regarding Harbourview,

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and one of my goals this year is to ensure that we stay informed on both operational and capital

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needs of the campus, notably being aware of changes to federal Medicaid programs that impact

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many of hardware research patients, which is our first panel was speak to and saying update

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on hardware use capital needs being addressed by the hardware review bond program, which is the

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second panel with discuss and more detail. And I will note that we are going to be having another

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touch, probably likely in the main meeting as a follow up to some of the things that we're going

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discussed today. I'd like to welcome our first panelist to the table. We are joined by

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Dorothy Teeter, who's serving as the President of the Harborview Board of Trustees. Go ahead

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and join us here at the table as I call you. Ian Goodhew, who is the Associate Vice President

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for External Affairs of Youth of Medicine and Summer at Kavino Wally, who is the CEO of Harborview

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Medical Center. Thank you all for joining us today and board President Teeter. I believe you will

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starting us off today. Please proceed and thank you and I'm sorry I'm calling you and you

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just as you arrive but you know we have a tight agenda today so go ahead.

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Is it a seat?

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Just a slight delay so just.

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Okay, you can hear me now.

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Yeah, perfect.

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I will not bore everybody with traffic problems because everybody has those very, okay well thank

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you very much for inviting us to come today. I'm going to leave you off with a whole um

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Yeah, maybe just pull your microphone, just a little closer there you go. Thank you.

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With the status of fundraising and philanthropy strategies for Harborview,

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we're going to just go through a series of findings that we had a consultant

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work with us on and then talk about some next steps that we as a board are going to recommend

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for following up with some with philanthropy fundraising. So if you go to the next slide, please.

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The reason that the board is interested in fundraising and philanthropy is because even with all of the

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fabulous support we get for a couple of fundraising from King County and the work that we do with

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UW Advancement. We had a burning question which we spent last year looking at in terms of,

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are we leaving any opportunities for fundraising on the table that we could use even more to support

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of our review. So in 2025,

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we contracted with a consulting firm, the CCS fundraising is the name of their firm.

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To determine whether, number one, the partnership we have with UW Advancement, is as effective as it can be,

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and should we continue that way or should we go with a different way to fund race.

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And secondly, what is the potential for philanthropy and fundraising for Harborview going forward?

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So the consulting firm was working for the board conducted an evaluation of the fundraising infrastructure that we currently use.

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They interviewed stakeholders across many different entities and experts to find out what their perceptions or about the fundraising and the opportunities.

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They then compare it to Harborview's fundraising potential and actual experience with other benchmark institutions.

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Similar to Harborview across the country, and then using that data did some analysis from their own level of expertise about fundraising with the potential might be.

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Next chair, I'm sorry to interrupt.

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Can I please ask the gentleman to lower that sign? Just a few inches. Just a few inches so that I can see the screen.

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Thank you. That's all. I appreciate you. Thank you.

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Thank you, Mr. Chair.

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So the findings from the fund raising consultants were these are very high level, but just

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they'll give you a really good sense.

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We raised, however, be raises more than experience institutions on an annual basis, and it also

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spends considerably less unfund raising expenses.

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Remember, we work in partnership with UW Advancement, so we were very happy to see that we

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were doing well relative to the amount of money that we're investing.

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However, they also, in this as a good news, I think, they identified nearly 20 million

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a year of potential additional funds that we could potentially be raising just with our existing

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donor base.

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So, that's just keep that in mind.

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And then they said, you know, there are some other pipelines or ideas that we have about

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where else you could look in addition to principal donors for additional funds, one of

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They call it a grateful pipeline.

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I like to think of it as making it easy if patients do want to donate to Harborview, make

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it easy for them to do that.

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And then, as we all know, we live in a fairly wealthy part of the country and wealthy

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part of the state and that they believe that there were some other opportunities that we could

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focus to get additional philanthropic support from other principal donors.

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And then lastly, and this is something that I didn't know.

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And we have over $6,700 foundations worth about $353 billion in assets in the state of Washington

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of that about 770, 787 of them give grants to health associations and health care institutions.

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So that's another opportunity they were suggesting that we could explore for funds.

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Next slide please.

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So when they put all of that together, again, it was the better retention of existing donors

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expanding the patient programs so that people that want to donate have an easier time

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doing that than targeting additional major donors and then additional foundation support.

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Their record, their conservative scenario for the potential would be that we could, instead

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of the 21 million annually that we currently raise from philanthropy, it could probably

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to move up to 30 million annually within five years.

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And the projected in, you know,

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put doing a little bit different math,

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that's a 40% increase in philanthropic revenue

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over the next five years.

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They're recommending this more balanced funding model

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that is identified above with the different pipelines.

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And most importantly, that kind of revenue

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would really help with expanded capacity

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for the critical programs that I know we all

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want to support for our review.

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And next slide, please.

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So the recommendations, and this is my last slide here.

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One of the questions we had, and UW advancement, I have to say,

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was extremely helpful during this process,

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helped share with information, recommendations,

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reviewed things.

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And the fundraising consulting from CCS recommended that we,

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indeed, continue to work with UW advancement.

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they've got a huge infrastructure, we have good working relationships with them, and they

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have been reviewed this information as well.

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So because every dollar that we raise philanthropically can really supplement the public

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funding and the needs that we have as an organization, you're going to hear more about that,

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I know from Ian and from Summer, this is really important, especially now, given the Medicaid

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potential cuts that are at the federal level in terms of policy.

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The other thing, so for her reviews board, this is a number one priority.

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To really work with UW advancement with our partners with all of you,

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to say how can we ensure that that potential is there at a conservative level.

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We can reach that potential over the next five years.

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So to those ends of the board request and we have formed a small subcommittee of board members to work with summer and her team and with UW advancement to say what are the next best steps we can take to ensure that we are meeting that potential and equally importantly how do we create reports and charts to show that we're all the different strategies we want to try our working that we can then share with all of you as well.

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So with that, I think we can take any questions or comments.

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Thank you so much, Dorothy, I appreciate it.

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I want to remind folks, I'm fine with the sciences,

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I'm also not blocking the screens or other people, okay?

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So I just please hold them so that they unlock the screens.

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Any questions, colleagues, for President Teeter?

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Councillor Morphine.

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Good morning.

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Thank you so much for the presentation, and thank you for your service

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on the volunteer board of trustees,

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questions about this, it's exciting to see the potential

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for $20 million one thing that I would think would be helpful to clarify for my colleagues

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here is maybe for some or to answer, this would not be operational dollars rate, a lot

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of fundraising that in philanthropy dollars that are raised are programatics, so they go to

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specific programs. So, summer what is the current proportion, or how much of the philanthropy

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dollars that come in are really available for operational spending other than programmatic?

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It does make sense, I don't have an exact amount, but you are correct that by and large.

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And I'm learning a lot about philanthropic work.

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You know, our partners, our philanthropic partners are interested in giving to technology, equipment, innovation, less to operations.

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The one exception that I've done a lot of work with is within our pediatric clinic with

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individuals with a few donors who have been very helpful in working with me on our outreach

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for homeless teens.

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So that has been an area and then we have a general fund for patients for greatest need.

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Those are smaller donations.

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The bigger donations that Dorothy is talking about really are directed and get specific, so I'm not able to move them around, but they're very specific for things like I want to fund a mammogram machine.

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I want to fund an MRI. I want to fund renovation of this X, right? So it's tied to something.

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There is also a lot that's tied to physicians and research.

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Thank you.

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Do you have a follow-up?

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Thank you.

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One other thing that I just want to commend summer on is we didn't previously have at the board.

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Sorry, at Harvard View, a commitment or a requirement for the CEO to really invest in play at the

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time and I know that you've done a lot of that and that explains a lot of the growth that

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there's been at her review around philanthropic dollars. One of the other potential areas of

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philanthropy that I know that was discussed last year was naming rights. Is that an issue or is

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identified by CCS include the potential for naming rates?

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I think my experience with this is that,

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depending on the donor, some are interested in that,

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and some aren't, and at this point,

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I think it's a very important question that will,

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in a way, have to be done in a case-by-case basis

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to see what the situation is,

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but certainly many donors, as we know,

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like to.

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Awesome.

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Many don't.

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Also, like to see their name attached to something. So, it's just part of the process that we'll have to go through when we see what some of the potentials are and engage with the county, obviously, in any situations like that.

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Thank you, Councillor Moreberry.

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Thank you. So, I know that some from a philanthropic standpoint, I know that there are restricted funds. Unfortunately, I know a lot about this.

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So there are restricted funds.

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It's a legally defined term.

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It can only be used for that thing.

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And there are quasi-endowments and full-endowments.

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So the quasi-endowments, the board can mess around with it

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and bring the endowment down itself,

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take the principle, but also take the interest,

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but also work are able to take principle out over time.

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A true endowment, the legal term,

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you can never touch the principle,

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and you get the interest as it goes.

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And there are usually levels for quasi-entrue

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for any kind of support for patients and for any kind of program that you would have that would be named.

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There would typically be a level associated with that.

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But when you're doing this and you're seeking it, are you creating a restricted fund

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or are the dollars going to the general fund when philanthropists are asked to give?

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I think it's a brilliant idea. I love the public private. I love all that.

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But the restricted fund piece of it is really important.

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And so I'm wondering if you are looking at a restricted fund for that amount with, you know,

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silent donors and then a campaign for that so forth.

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Yeah, so it's the answers, yes, to all of it, to you are absolutely right.

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We are really working on a cadre of options and provide them all to the potential donors and the philanthropic partners.

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But have a mixture of restricted funds,

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a mixture of funds that can be used for greatest needs.

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So the definition is much broader.

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So I can use it for supplies and the ED,

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for individuals who are on house, things like that, right?

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And then we also have restricted funds,

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where people come in and say,

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I want to give to X.

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I have a new endowed fund that is in through the CEO office

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That will allow me to continue to grow and then provide funding for things that are of the CEO's interest, right?

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So that's where a lot of the dollars have gone for the homeless teens and the shelters that we staff there has been my priority in that area.

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But it's a mixture.

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Thank you very much.

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I'm going to go to Councilmember Lewis and then I'm going to move us along because we got a tight agenda to keep.

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Thank you.

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Thank you. I'm going to ask this question and I can, I'm happy to take the answer offline,

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but back to the naming rights issue. I'm wondering what the county's policy is about naming

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rights for county facilities and then whether or not the harbor view operating a hospital

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operating agreement addresses naming rights. So we can, we can do that offline.

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Thank you. Okay. Yep. Sounds like we, that's what we're going to do. Wonderful. Thank you so

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much for the questions, and now I'm going to turn it over to, are you the medicine colleagues?

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Thank you, Chair Barone. And thank you, Council members, for inviting me back today. I will try

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to move quickly through this in the essence of time. So, some are Claven O'Walley, Chief Executive

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Officer, Harborview Medical Center.

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Always start off every presentation I do here with the

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But I know that you already went through it chair-barone, so it's just here for all of us to center ourselves for so next slide.

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Today, I'm going to try to give you a brief update on the status of healthcare.

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I'm going to then talk about some of the incredible work we are doing with the tax dollars that you have so kindly

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worked with us on ensuring that Harborview has access to for our patients in our community.

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And then I'm going to talk about a few priorities for additional tax dollar allocation that

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we'd like to propose or that we're proposing to the council for the next round of

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appropriations.

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First of all, thank you for this slide.

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If we think about what's happening in health care, so I think that a lot of people have talked

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about federal and state funding cuts, if we think about where we are at Harborview, we're

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about, said we're at an expectation of about 700 million in reduced reimbursement, okay, reimbursement

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reductions over the next five years. And that's with a combination of the federal cuts that

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are part of HR1 that everyone is very familiar with, along with state cuts that have happened

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because of severe budget issues at the state level also. As you can see, that leaves enormous

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holds for us from our long-range financial plan and how we will continue to ensure we have operational

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funding for the future coverage and service if we think about what that means or what we've

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started to see. So this has been a question several of you have asked me. Am I seeing changes in the

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environment already even though only you know one or two things have gone forward or have been

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that I'm looking at right now between fiscal year 25 and 26 has changed about has increased

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about 3%. And if you think about what that means to harbor view every 1% of increase and

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uninsured is about 8 million. So less revenue when you have uninsured. So we are seeing patterns

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of changes particularly through our transfer center. We are also in combination with a change

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in that pattern of more uninsured coming into Harborview, we are also seeing a decrease in transfers

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from other hospitals and other systems that typically would have helped us subsidize services

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that have lower reimbursement. And we know historically at Harborview that's been very important.

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For example, the trauma transfers that come in. We have seen a significant decrease in the ones

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that have more of a higher reimbursement that has always helped us subsidize the other care we do at Harborview.

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Thirdly, we continue to experience space capacity constraints that is not new to all of you.

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But just, you know, is incredibly important for us to continue to think about particularly as we move forward with the bond

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and any campus construction we can do to open up access and open up space for better experiences

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for our patients and better access for our patients that we serve.

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Okay, next slide.

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So I want again, thank you guys, in 2025, we were able to have through the County Hospital

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Levy 46 million in crucial operating support, and that is incredible.

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Today, I want to talk to you about kind of overall where what we've done with that 46 million,

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and then highlight a few of the programs specifically that that 46 million is helping us fund.

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The dollars are currently supporting about 265 FTEs in the following subset.

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So primary care clinics at Harborview, including things like our International Medicine,

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Pediatric, Family Medicine, etc., are off-campus clinics. You often hear that.

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We talk about those as in our Pioneer Square clinic, our hubs in place clinic, our downtown programs.

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I'll describe that a little bit more in depth, and then in our behavioral health and psychiatry.

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So all of that, 46 million is going into FTEs that are supporting that incredibly key work.

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I want to highlight a few of these clinics, because I'd like to make sure I'm starting to bring you more information about how the impact

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we're having on the population, we're here to serve.

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So next slide, please.

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First of all, I want to spotlight our international medicine clinic.

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And those of you that have two, Harborview have probably been able, and they have had the

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privilege to tour this clinic, which is staffed by amazing staff, amazing physicians, and does

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incredible work.

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It is a comprehensive clinic that serves both, or that provides both primary and mental health

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care for refugees and immigrants over the age of 16.

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Under the age of 16, we have RP after clinic that serves those individuals.

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We have a very robust community house call program that goes into in-home and providing

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follow-up care.

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We have on-site pharmacy, we have robust patient care coordination, navigators, cultural

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mediators, interpreters, nutrition, social work, everything embedded within one clinic.

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really focused on that refugee and immigrant population that we're here to serve.

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In the last fiscal year, we were able to provide 12,000 visits in that clinical loan.

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And the tax pay are the tax dollars you helped provide us was able to support that work.

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Next slide.

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Another program I want to highlight is what you hear us call our downtown programs.

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And this is just a piece of our downtown programs, but they're vast and they're robust.

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So I wanted to highlight three areas for you as the Council to know about.

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In 2025, we were able to provide almost 4,000 visits to with nurses, providers, and mental

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health staff that go into housing units with our partners in DEC and Plymouth.

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So go into different housing environments to provide care within somebody's actual home

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environment.

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So we don't have to rely on them coming into the hospital in order to get care.

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really trying to decrease our loss to follow up in the health disparity, you see in that area.

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Healthcare for the homeless, we were able to provide about 2,500 in that cadre of services,

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where again, we have nurses, providers, mental health providers embedded in shelters throughout the city.

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So again, providing, trying to reduce health disparity and providing care and meeting our individuals,

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where they are. And then a very special service I wanted you guys to know about.

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That has been highlighted numerous times, particularly in the news and things like that,

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palliative care for the homeless.

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So about 314 individuals were seen over the last year where we are providing palliative

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care that you would typically get in a hospital setting or in a home setting to individuals

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that are living on the streets or in unstable housing, where we're providing that same level

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of intense wraparound treatment at end of life

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for a severe illness levels.

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Next slide.

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Lastly, I wanted to highlight some of our behavioral health programs.

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So in patients like Hydritory,

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you've heard me talk about.

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We have three units to acute care, one ICU,

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and then we also have our ED psychiatric emergency services.

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Our ED psychiatric emergency services are the only,

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that is the only ED in the state

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that provides psychiatric care, including psychiatrists, staff, 24-7 for those that are in the most severe mental health crises.

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We are also the largest ICU for intense psychiatric acute illnesses.

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Can I ask you to pause for a second?

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Yes.

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Folks, we need to have signs that are not blocking other people.

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So just please make sure you block the screens or other people who are here to watch the hearing.

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Thank you.

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All right, I talked about our psychiatric emergency services really there for those in a acute crisis and then our downtown programs field base.

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So similar to our primary care that we're providing in the field meeting people where they need to be met in their living environments.

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I'm not relying on individuals coming in to receive care.

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Okay, next slide.

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All right.

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Really grateful to all of you for the work you did last fall,

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appropriating Harborview-based provisions for the county tax levy,

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increasing it to 15 cents, funding new building,

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the new building for Pioneer Square,

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Duncan, the Duncan building, very excited about that.

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Providing additional support for the bond,

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funding operational and emergency support for the

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as HR1 is implemented, supporting critical infrastructure that we have that needs fixing at Harbor

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View.

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And then funding the design phases and permitting phases of a parking garage that is going

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to be so desperately needed as a bond construction commences on campus.

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And we lose a great deal of parking, which is patient-facing.

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Next slide.

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Additional capital priorities for 2026, 2027 that I'd like to give you guys a heads up

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for us asking for a consideration are that new parking facility, so actually funding the parking

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facility, which is going to be incredibly key to have in place before construction starts on

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the tower. We cannot lose more parking on campus and continue to function as a health care environment.

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And then lastly, that neurosciences in Fusion Center, that helps us provide care to individuals with

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Alzheimer's and dementia drugs for that, along with the other infusions that we provide

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at Harborview for individuals who are more vulnerable in at risk and don't go to other

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infusions centers at U.S. medicine or other areas to get care.

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So, really, a lot of wrap-around care we provide currently.

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I will pause there and see if there's any questions.

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Thank you very much, Summer.

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Any questions from colleagues?

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Councillor Morphin.

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Oh, I didn't do too much.

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Just a quick clarification when you're talking about the parking facility or you're talking about the 9th and Alder.

375
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Yeah, do you want to go to slide Sam?

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I was going really fast and I missed a slide.

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00:29:23,850 --> 00:29:24,170
Yes.

378
00:29:25,890 --> 00:29:27,730
You want me to cover, did you have a question?

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No, I just wanted to make sure.

380
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I'm sorry, yes.

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Parking on 9th and Alder, Tony will also be talking about that.

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But it's the 9th and Alder site that was purchased by the county.

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and that was appropriated money for the planning and permitting of a site there.

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Thank you.

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Sumer, I did have a question for you on the uninsured rate.

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You mentioned the increase of 3%.

387
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I imagine there might have been some variability over time,

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but is there a 3% kind of like a significant...

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If it can increase from where you've seen the past or have you, I'm curious what the history has been.

390
00:30:05,280 --> 00:30:15,640
It's a good question. So prior to the ACA being enacted, we had around 13 percent. As we all know, the state of Washington, incredible job.

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And frankly, we at Harvard, we didn't incredible job expanding and ensuring people got on Medicaid programs.

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and so we were running around two to three percent for a very long time.

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Pretty stable.

394
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We didn't really see a lot of fluctuations in that.

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Took a lot of support.

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A lot of financial counseling.

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A lot of insurance of ensuring we had the wrap-around support.

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But yeah, so a 3% increase over the last few months is...

399
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I'm sorry.

400
00:30:42,960 --> 00:30:43,780
In rough for a second.

401
00:30:44,400 --> 00:30:47,060
Folks, we can't have the front row.

402
00:30:48,620 --> 00:30:54,300
Because we have rules that we said, we, I'm telling you what the rules are.

403
00:30:55,000 --> 00:30:59,260
There are seats available in the rows behind you, and we need folks to be there.

404
00:31:00,880 --> 00:31:02,680
No, that has nothing to do.

405
00:31:02,840 --> 00:31:06,560
Everybody, everybody, if you're a presenter, you have the seats in the front.

406
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I need folks to please be quiet, so that we can continue the meeting.

407
00:31:15,120 --> 00:31:15,740
Summer, go ahead.

408
00:31:16,520 --> 00:31:17,040
Go ahead and finish.

409
00:31:17,040 --> 00:31:18,080
Oh, you're not okay.

410
00:31:18,800 --> 00:31:19,520
All right, thank you.

411
00:31:19,620 --> 00:31:20,220
Thank you.

412
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So with a 3% increase over just a few months, and I think we're seeing that frankly because of an increase in the number of other hospital systems, finding ways not to intake patients who are uninsured, so they're finding their way to harbor view.

413
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So, over just a two to three month period, that has a potential impact right if each percent increase is 8 million of approximately 24 million dollars.

414
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So, you can actually see there how impactful the operating dollars that the county,

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both the council and the executive provided is to our review. It's real-time budgeting.

416
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We're losing potentially 24 million on what we planned a budget for the fiscal year, yet we have that funding there from the tax to fill that gap.

417
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that that's how critical that is. And that is a that is a big percent increase. So now around 6% and our concern is that when HR1 actually starts to hit in January with job or court work requirements other eligibility criteria that are really designed just to kick people off of the program.

418
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That that percentage will continue to grow.

419
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Thank you very much.

420
00:32:35,480 --> 00:32:41,820
Thank you chair. Thank you for the presentation and thank you chair for scheduling these

421
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more regularly. I think it's going to be really good to keep in closer touch with what's

422
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going on at our county hospital. Two things. One first I just wanted to convey a long term

423
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and very well loved member of our county family has been going through a very serious health

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challenges lately and has been being treated at Harborview, and was sharing with us earlier this week

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how very much she values and appreciates the life-sustaining care that she has been receiving.

426
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I just wanted to pass that along. I mean it touches all of us and it touches the King County family

427
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certainly as well. So thank you to you and your whole team for the care you give to everyone and to our colleague.

428
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The second thing is a question. So in the last two years, when we've had these conversations,

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We have occasionally seen Harborview having challenges with patients that have very high levels

430
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of need beyond medical care, and so it's difficult to discharge them to an appropriate place

431
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where they can get the supportive services they need that are not Harborviews to provide,

432
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but you don't want to just push these people out the door because they need other services,

433
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and that at times caused us to close the doors. How is that going these days?

434
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So we made a lot of progress with partnering at the state level with, you know, the managed Medicaid plans and with individuals over the departments at the state level, including health care authority and DSHS, etc.

435
00:34:13,120 --> 00:34:21,440
However, we still have a cadre of individuals that are the most significantly complex, that

436
00:34:21,440 --> 00:34:23,340
are very difficult to discharge.

437
00:34:24,040 --> 00:34:29,780
My worry is though that as everything starts to shift with Medicaid changes, people not

438
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having funding, we've already seen people falling off from the subsidies being reduced,

439
00:34:34,940 --> 00:34:53,240
We're going to, that's going to rear its head again because we have it fundamentally fix the problem around matching the post-to-cute care entities having the reimbursement they need to supply the types of care they need to have available at those facilities to match the level of complexity of individuals.

440
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So.

441
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But we've been able to maintain.

442
00:34:57,940 --> 00:34:59,220
We've done much.

443
00:34:59,220 --> 00:35:03,880
Yes, we have not closed doors at all since that time period.

444
00:35:04,140 --> 00:35:04,960
Really, really good to hear.

445
00:35:05,200 --> 00:35:06,580
And just for those following along,

446
00:35:06,980 --> 00:35:09,580
this is the healthcare social safety net we're talking about here.

447
00:35:09,860 --> 00:35:11,520
This is where people without insurance,

448
00:35:11,980 --> 00:35:12,800
without documentation,

449
00:35:13,440 --> 00:35:16,980
without resources can get the healthcare that they need,

450
00:35:17,040 --> 00:35:18,500
and it is under strain.

451
00:35:19,000 --> 00:35:20,060
And so that's what we're talking about.

452
00:35:20,080 --> 00:35:24,080
How do we support and continue to provide this healthcare to people who badly need it?

453
00:35:24,280 --> 00:35:28,580
When other parts of our healthcare system and our government are pulling back,

454
00:35:28,580 --> 00:35:31,800
And that's putting even more pressure on this organization.

455
00:35:31,940 --> 00:35:32,920
So thank you for your report.

456
00:35:33,020 --> 00:35:33,680
I appreciate the time.

457
00:35:33,960 --> 00:35:34,460
Thanks, Councilmember.

458
00:35:35,100 --> 00:35:35,760
Thank you so much.

459
00:35:35,860 --> 00:35:36,580
I'm going to move this long.

460
00:35:36,640 --> 00:35:37,500
Thank you, Dorothy.

461
00:35:37,500 --> 00:35:39,060
Summer, Ian, appreciate it.

462
00:35:39,140 --> 00:35:41,380
Of course, welcome state for the next presentation.

463
00:35:41,660 --> 00:35:46,260
I'm going to invite our colleagues from the Elders team and from the executive, from the

464
00:35:46,260 --> 00:35:47,380
Harborview project.

465
00:35:48,260 --> 00:35:54,440
Because the second briefing is an update on the King County Harborview audit letter that we

466
00:35:54,440 --> 00:35:58,640
received a Senate Brigadier copy and that has been released today.

467
00:35:59,240 --> 00:36:03,720
For background in 2020, King County voters approved a bond measure to address the extensive

468
00:36:03,720 --> 00:36:05,460
capital needs on Harbor East Campus.

469
00:36:05,820 --> 00:36:08,880
Within King County, the Harbor View bond program has been managed by the Harbor View

470
00:36:08,880 --> 00:36:13,460
Construction and Infrastructure Division, who will hear from today after report from the

471
00:36:13,460 --> 00:36:15,840
auditor on the program's progress towards its goals.

472
00:36:16,240 --> 00:36:19,900
We'll start by hearing from Ben Thompson with the King County Honors Office, and then we'll

473
00:36:19,900 --> 00:36:23,160
follow that with the presentation from Tony and Patrick with King County's Harbor View

474
00:36:23,160 --> 00:36:28,480
instruction and infrastructure division, and I do want to note again that this is a kind

475
00:36:28,480 --> 00:36:33,680
of a first touch on this. We're probably going to bring Tony back, especially in May, with

476
00:36:33,680 --> 00:36:39,260
some more information, but we wanted to highlight this letter that we are received from the

477
00:36:39,260 --> 00:36:46,000
auditor formally today, and hopefully you all will have questions that we can then send to Tony

478
00:36:46,560 --> 00:36:52,420
to report back on at the May meeting. It's my hope with this presentation today. So Ben,

479
00:36:52,420 --> 00:36:56,560
Thank you per being here and for your work on this and please take it away.

480
00:36:57,140 --> 00:37:00,720
Thank you, Mr. Chair, for the record, Ben Thompson, King County Autors Office.

481
00:37:01,720 --> 00:37:07,120
The King County Autors Office under our Capital Projects Oversight Program started oversight

482
00:37:07,120 --> 00:37:12,400
of the 2020 part of your bond delivery program in 2021.

483
00:37:13,800 --> 00:37:18,920
We are planning to continue our oversight for the length of the program and today I'm going

484
00:37:18,920 --> 00:37:23,360
talked to you about a divided summary of a letter that we will

485
00:37:23,360 --> 00:37:27,680
publicize and post on our website at the conclusion of this briefing.

486
00:37:29,020 --> 00:37:30,280
First, a little context.

487
00:37:31,480 --> 00:37:36,380
Voters approved a $1.7 billion bond in November 2020.

488
00:37:37,340 --> 00:37:39,340
And there are several components of that bond.

489
00:37:39,520 --> 00:37:47,560
One of the primary ones was a new inpatient tower on the

490
00:37:47,560 --> 00:37:54,740
With three, it was recognized that the cost of delivering the full scope of the bond was not

491
00:37:54,740 --> 00:37:59,560
going to be achievable given a variety of cost increases largely due to the pandemic,

492
00:38:00,340 --> 00:38:04,860
from things like inflation, from materials cost increases, from labor cost increases.

493
00:38:05,560 --> 00:38:09,420
Therefore, the Council put together the ordinance working group, or OWG.

494
00:38:09,420 --> 00:38:20,180
The OWG then did their work in 2023 and eventually the Council approved the updated OWG scope in October 2023.

495
00:38:22,680 --> 00:38:26,880
And now we'll talk a little bit about some of the teams working together to deliver this program.

496
00:38:27,760 --> 00:38:39,720
At the center you have the Harborview Bond program team and this is composed of staff at both King County as well as supported by the Harborview Medical Center staff and they are in charge of program delivery.

497
00:38:39,720 --> 00:38:43,120
The next component is an owner advisor.

498
00:38:43,740 --> 00:38:48,780
This group provides technical support and organizational support for the Harborview

499
00:38:48,780 --> 00:38:50,500
Bond program team.

500
00:38:51,040 --> 00:38:53,300
Lastly, you have a design builder.

501
00:38:54,120 --> 00:38:56,880
The design builder is Mortensen and Perkins and Will.

502
00:38:57,240 --> 00:38:59,760
The design builder was brought on last year.

503
00:39:00,060 --> 00:39:03,900
And the design builders role in this project is to provide both design

504
00:39:03,900 --> 00:39:08,820
and construction of the capital program at the Harborview Medical Center.

505
00:39:10,360 --> 00:39:13,380
Now I'll provide some key takeaways from our letter.

506
00:39:14,260 --> 00:39:22,280
First, the full OWG scope approved in October 2023 may not be delivered without additional funding.

507
00:39:22,940 --> 00:39:26,280
This is, we put May here, this is not a certainty.

508
00:39:27,080 --> 00:39:32,860
There's a number of analytic steps that have to move forward to determine this, but this

509
00:39:32,860 --> 00:39:34,340
is our concern at this point.

510
00:39:35,400 --> 00:39:47,380
Additionally, the new impatient towers estimated to open in early 2032, which is three years later than the OWG estimate that was provided to you several years ago.

511
00:39:48,320 --> 00:39:52,860
And lastly, the program faces several significant risks that I'm going to talk about now.

512
00:39:55,100 --> 00:40:03,040
First, though, some program status, the parking solution was identified with a plan garage at

513
00:40:03,040 --> 00:40:09,080
9th and Alder that would help mitigate the loss of the view park 1 garage, which is going

514
00:40:09,080 --> 00:40:13,220
to be demolished in order to make space for the new impatient tower.

515
00:40:14,260 --> 00:40:20,300
Secondly, as of last month when we wrote our letter, there was a lack of agreement on target

516
00:40:20,300 --> 00:40:21,560
value of for design.

517
00:40:22,200 --> 00:40:26,900
This is an agreement around both the scope and some of the component costs between the program

518
00:40:26,900 --> 00:40:28,860
team and the design builder.

519
00:40:29,860 --> 00:40:35,900
And this is essential to determine before what's called schematic design can begin.

520
00:40:36,560 --> 00:40:42,440
And schematic design is an incredibly important component or milestone in this project,

521
00:40:42,940 --> 00:40:48,920
where we'll be actually figuring out what is going to be built the full scope, the size

522
00:40:48,920 --> 00:40:56,840
of spaces and so on. And once schematic design is achieved or agreed upon, we'll have much greater

523
00:40:56,840 --> 00:41:01,960
clarity around both the cost and the schedule of the program because we have them the units

524
00:41:01,960 --> 00:41:03,900
that we need to do that analysis.

525
00:41:06,040 --> 00:41:10,200
What we're seeing so far is cost estimates are rising. This is due to a variety of factors.

526
00:41:10,640 --> 00:41:14,960
We're seeing inflation just like in our daily lives. There's a great deal of inflation

527
00:41:14,960 --> 00:41:21,700
of capital projects around the county and this program is also subject to that. We're seeing

528
00:41:21,700 --> 00:41:25,980
some updated building codes, particularly on seismic standards that's driving increased

529
00:41:25,980 --> 00:41:30,860
costs. There's the potential for some new geotechnical information and that's basically

530
00:41:30,860 --> 00:41:38,180
the soil around where the new inpatient tower is going to be. As Tony can talk about, there's

531
00:41:38,180 --> 00:41:43,900
additional boring as being done to understand whether the current plan foundation will be sufficient

532
00:41:43,900 --> 00:41:50,060
for the soil or whether additional and potentially costly steps will have to take in order

533
00:41:50,060 --> 00:41:52,660
to guarantee the stability of that tower.

534
00:41:53,700 --> 00:41:58,520
And as I talked about, when we wrote the letter, there were significant differences between

535
00:41:58,520 --> 00:42:02,580
the owner and visor and the design builder estimates for target value.

536
00:42:04,980 --> 00:42:15,580
This slide shows some of the milestone and schedule estimates that were provided by the

537
00:42:15,580 --> 00:42:22,860
You can see along the y-axis, a number of milestones, and then you can see the estimates of the dates at that time.

538
00:42:24,900 --> 00:42:34,800
These are the items that were completed since the OWG of estimates were provided, so you can see these three items have now been done.

539
00:42:36,320 --> 00:42:44,540
These are the current estimates of when a variety of these milestones are going to occur, and I'd just like to highlight too.

540
00:42:44,540 --> 00:42:56,400
The first is the amendment to the major institutions master plan, or MIMP that's going to be required in order to get many of the permits needed to deliver this program.

541
00:42:57,080 --> 00:43:02,060
The second is the, or on the bottom that I already spoke about is the occupation of the new tower.

542
00:43:02,660 --> 00:43:07,980
So these are two components that have both shifted since the OWG estimate.

543
00:43:07,980 --> 00:43:14,180
In talking to the executive and their staff around these to try to understand some of these

544
00:43:14,180 --> 00:43:19,720
scheduled shifts, they raised the issue that many of the estimates included the OWG report

545
00:43:19,720 --> 00:43:24,560
were very preliminary and not as rigorous as the ones that are being completed now.

546
00:43:25,220 --> 00:43:31,740
So we hope that as both target value for design and schematic design is completed that we

547
00:43:31,740 --> 00:43:38,840
can get a much more rigorous schedule that then we can hold the program accountable for.

548
00:43:40,180 --> 00:43:46,140
Some of the sources of delay in opening the new tower is around more time than originally

549
00:43:46,140 --> 00:43:50,380
estimated for both permitting and construction and I'll talk about both of those.

550
00:43:51,480 --> 00:43:56,800
And some risks exist that could delay opening even further, which again I will talk about when

551
00:43:56,800 --> 00:43:58,320
we get to the risk section.

552
00:43:58,320 --> 00:44:04,000
So, the first major risk we see is around the amendment to the major institution's master plan.

553
00:44:04,640 --> 00:44:09,220
This is required to get many of the permits that will be needed to deliver this program.

554
00:44:10,040 --> 00:44:18,080
Currently, the amendment is with the City of Seattle's Department of Construction and Infrastructure and Inspections.

555
00:44:18,560 --> 00:44:25,720
And it will need to get a recommendation from the Director of STCI in order to move to the Seattle Hearing Examiner.

556
00:44:25,720 --> 00:44:33,740
the hearing examiner than considers the amendment and if they approve of it it goes on to the Seattle City Council.

557
00:44:34,160 --> 00:44:38,700
So this is a multi-step process and through none of these steps do we have control.

558
00:44:39,100 --> 00:44:44,900
So this is all an external taking county process that will require coordination with the city.

559
00:44:46,300 --> 00:44:51,920
And the limited work can be permitted prior to this amendment being approved, which is the challenge.

560
00:44:51,920 --> 00:44:57,800
This is why, from early on in the project, achieving this amendment to the Major Institutions

561
00:44:57,800 --> 00:44:59,980
Master Plan has been one of the primary...

562
00:45:00,000 --> 00:45:06,400
Elements from the critical path for this project. And the concern is both the lack of control, but

563
00:45:06,400 --> 00:45:12,100
also that the city council could add additional conditions that could increase costs for the program.

564
00:45:13,820 --> 00:45:20,220
The next risk that we point out are incomplete management documents. As of the rating of this letter,

565
00:45:20,500 --> 00:45:24,640
neither a program charter nor a program management plan had yet to be finalized.

566
00:45:26,900 --> 00:45:30,860
Additionally, individual project manager plans have not been completed.

567
00:45:32,060 --> 00:45:36,740
These plans kind of set the rules of the road or the rules of the game for a program.

568
00:45:37,220 --> 00:45:43,140
They set how issues will be escalated, how decisions will be made, the thresholds of decision-making,

569
00:45:43,580 --> 00:45:50,700
and the really essential for a project that's as complicated and large as this capital program.

570
00:45:52,280 --> 00:45:55,600
The next risk that we talk about in our letter is parking.

571
00:45:55,960 --> 00:46:02,340
With the demolition of you park one garage, there was a substantial loss of parking on

572
00:46:02,340 --> 00:46:06,460
the campus, and there's an potential increase for demand.

573
00:46:06,640 --> 00:46:11,340
There's temporary demand for the needs of almost a thousand construction workers at the peak

574
00:46:11,340 --> 00:46:16,340
of the program, and under the Project Labor Agreement, we're required to provide parking

575
00:46:16,340 --> 00:46:20,200
for those construction workers that is the responsibility of the design builder.

576
00:46:20,200 --> 00:46:23,440
but it's potential to add congestion on the site.

577
00:46:24,300 --> 00:46:27,000
The new tower drives significant future needs,

578
00:46:27,400 --> 00:46:30,660
both from patients, staff, as well as guests.

579
00:46:31,860 --> 00:46:36,360
And UW Medicine has identified some longer term unmet needs

580
00:46:36,360 --> 00:46:37,080
at the campus.

581
00:46:37,800 --> 00:46:40,020
And all of the decision making around how much parking

582
00:46:40,020 --> 00:46:43,260
what the bond is going to pay for is all a risk

583
00:46:43,260 --> 00:46:45,380
that exists that we're concerned about

584
00:46:45,380 --> 00:46:47,500
because, as you well know, providing parking

585
00:46:47,500 --> 00:46:48,720
is incredibly expensive.

586
00:46:48,720 --> 00:46:52,540
this is a constraint site and there are a number of challenges.

587
00:46:54,680 --> 00:46:57,540
The last two risks I'll talk about are around roads.

588
00:46:57,760 --> 00:47:01,280
The first is for what's called the permanent loop road.

589
00:47:01,760 --> 00:47:04,820
As you can see from this picture and it's kind of small,

590
00:47:04,980 --> 00:47:05,560
so I apologize.

591
00:47:06,120 --> 00:47:10,700
There's a road there between the new impatient tower and i5.

592
00:47:10,780 --> 00:47:16,040
That's a permanent loop road that would provide circulation around the campus.

593
00:47:16,040 --> 00:47:20,040
And so it would alleviate sort of the congestion that the campus sees.

594
00:47:20,960 --> 00:47:26,480
The challenge is that this property is owned by Washington, and they must either grant

595
00:47:26,480 --> 00:47:31,440
a lease or transfer ownership in order for us to build this permanent loop road.

596
00:47:32,740 --> 00:47:38,260
There's the risk that we see here is whether Washington insists on a NEPA process, which

597
00:47:38,260 --> 00:47:43,300
is a federal environmental review process that could add years to the timeline if it's required,

598
00:47:43,300 --> 00:47:48,700
or could require redesigning the tower if it's chosen

599
00:47:48,700 --> 00:47:50,500
that the need for process isn't feasible.

600
00:47:52,100 --> 00:47:55,440
The second road is called a temporary hall road.

601
00:47:55,700 --> 00:47:58,080
This is, as it says, a temporary road

602
00:47:58,080 --> 00:48:01,480
that would provide access for materials equipment

603
00:48:01,480 --> 00:48:04,160
and workers to the site.

604
00:48:05,200 --> 00:48:11,200
And it also requires a temporary lease of land from washed out

605
00:48:11,200 --> 00:48:18,980
And a lack of achieving this lease could increase construction time, as well as increase traffic impacts around the campus.

606
00:48:19,500 --> 00:48:25,600
However, the whole road is less risky than the loop road because of its temporary nature.

607
00:48:26,140 --> 00:48:33,360
And the fact that there could be mitigating steps that the program team could take if it proves necessary.

608
00:48:34,580 --> 00:48:39,080
So again, I want to summarize some of the key takeaways we are concerned that the full

609
00:48:39,080 --> 00:48:42,500
OWG scope may not be delivered without additional funding.

610
00:48:43,580 --> 00:48:49,720
There are some scheduled shifts across the program and there are several significant

611
00:48:49,720 --> 00:48:51,960
risks that we've highlighted to the program.

612
00:48:52,820 --> 00:48:58,240
I'd like to thank Tony Wright, Patrick Hamaker and the Harvard Review Construction Infrastructure

613
00:48:58,240 --> 00:49:00,780
Division for their cooperation and our work.

614
00:49:00,780 --> 00:49:06,640
we plan to continue our oversight of this project and provide periodic updates to the council

615
00:49:06,640 --> 00:49:11,960
and our four port will be available online at the conclusion of this committee briefing.

616
00:49:13,160 --> 00:49:19,980
Thank you so much, Ben. I'm going to call on Tony to go next because you might start addressing

617
00:49:19,980 --> 00:49:24,220
some of the questions that we might have, but Tony once you go ahead.

618
00:49:30,530 --> 00:49:31,550
Thank you, Mr. Chair,

619
00:49:31,550 --> 00:49:34,810
for the record, Tony Wright, Director of Harbourview Construction, and I'm going to have to

620
00:49:34,810 --> 00:49:35,710
have to shut your division.

621
00:49:36,710 --> 00:49:40,830
I'm going to start off by thanking the Council for creating the Division Minament.

622
00:49:42,110 --> 00:49:48,630
But the first thing that I want to address is a couple of the specific questions that came

623
00:49:50,250 --> 00:49:53,610
out that were asked to address with this particular meeting.

624
00:49:54,970 --> 00:49:58,050
And then I can respond to questions and a couple of my thoughts.

625
00:49:58,050 --> 00:50:06,110
I also want to thank the Auditor's Office for an excellent report, although sometimes we disagree

626
00:50:06,110 --> 00:50:11,610
on the magnitude or where the concern is that it's a very factual and balanced report on

627
00:50:11,610 --> 00:50:13,490
what is happening with the project.

628
00:50:14,550 --> 00:50:20,690
So first off, and Bena really talked about this, but the Washington right away, that is

629
00:50:20,690 --> 00:50:21,170
a risk.

630
00:50:21,170 --> 00:50:28,330
It was an extraordinary risk, a while back, because although we had been talking to Washington

631
00:50:28,330 --> 00:50:34,210
for a couple of years, the individual that was handling our responses and telling us it

632
00:50:34,210 --> 00:50:38,530
was not going to be a problem retired without telling anybody what he had done.

633
00:50:40,070 --> 00:50:42,570
That was the start of our challenges.

634
00:50:43,930 --> 00:50:49,830
We initially escalated that with the support of the hospital, the executive, and the

635
00:50:49,830 --> 00:51:00,770
GAR teams and they came back to the table and we had very productive discussions about the soil conditions that are in the

636
00:51:00,770 --> 00:51:04,170
The green shaded area next I5.

637
00:51:04,910 --> 00:51:11,230
Most of us are very concerned about it because there is a historical challenge with this when I5 was built.

638
00:51:11,450 --> 00:51:17,750
There were agresized movements of land north of there based on some challenging soil conditions.

639
00:51:17,750 --> 00:51:23,330
And there's an extraordinary complex structure built into that slope below the hospital.

640
00:51:24,810 --> 00:51:28,070
They were concerned about our impact on that.

641
00:51:29,770 --> 00:51:35,190
We all agreed that having the hospital slide down on the I-5 was not going to be a good

642
00:51:35,190 --> 00:51:35,650
thing.

643
00:51:36,250 --> 00:51:41,170
So we spent a bunch of time with some geotechnical engineers and various other pieces identifying

644
00:51:41,170 --> 00:51:45,510
what the risks was, them better understanding what we were going to do.

645
00:51:45,510 --> 00:51:56,570
And we've, with some additional boardings that we're conducting on the slope, you may have seen those drove rigs running along the top of that retaining wall.

646
00:51:57,030 --> 00:51:58,410
I think we're in very good condition.

647
00:51:58,770 --> 00:52:04,490
I speak regularly with the Regional Administrator for Washington that we covered this particular area.

648
00:52:04,830 --> 00:52:10,790
And we are moving into the leasing negotiations for the hall road.

649
00:52:10,790 --> 00:52:15,550
I did have the whole road, got it as an amber risk.

650
00:52:15,790 --> 00:52:17,930
I no longer have the whole road as an amber risk.

651
00:52:18,010 --> 00:52:19,470
I'm confident that we will get that.

652
00:52:20,450 --> 00:52:22,710
There is still the potential of the NEPA consideration

653
00:52:22,710 --> 00:52:24,890
that Ben brought up for the permanent road,

654
00:52:25,250 --> 00:52:28,970
as whether or not that falls into a categorical exclusion or not.

655
00:52:29,130 --> 00:52:32,090
We have several steps that we can take with that.

656
00:52:32,170 --> 00:52:34,130
As some of you know, I'm a recovering fed.

657
00:52:34,450 --> 00:52:36,690
So I spent a lot of time in the NEPA arena.

658
00:52:36,690 --> 00:52:41,390
And there are several steps that we can take.

659
00:52:41,810 --> 00:52:47,670
I still consider the permanent loop road to be in what I would call it amber risk.

660
00:52:48,050 --> 00:52:51,430
There's some work that we need to do, we're addressing it.

661
00:52:51,430 --> 00:52:54,630
But the conversation with Washington is quite productive.

662
00:52:55,230 --> 00:53:00,790
If you look at the slide above, you can see what our current conceptual design is for the loop road.

663
00:53:02,850 --> 00:53:05,270
There's a street that's called 8th Avenue.

664
00:53:05,270 --> 00:53:07,050
It's not actually a street.

665
00:53:08,230 --> 00:53:09,610
It's county property.

666
00:53:10,070 --> 00:53:11,710
It's been vacated long ago.

667
00:53:13,150 --> 00:53:15,790
The way this is, we will no longer have traffic running

668
00:53:15,790 --> 00:53:19,970
between the new tower along what you would normally see as 8th Avenue.

669
00:53:20,070 --> 00:53:21,950
And the regular entrance to the hospital.

670
00:53:22,250 --> 00:53:26,510
If you see the little circular turnaround area there,

671
00:53:26,510 --> 00:53:28,010
that's where that's going to happen.

672
00:53:28,010 --> 00:53:37,810
but the ambulances in such will be coming down, Jefferson, as they do now, and come in to the ambulance entry issue in the screen.

673
00:53:38,970 --> 00:53:48,410
That's a much more efficient design, and by entering into what we currently believe is a long-term lease for the loop road condition.

674
00:53:48,410 --> 00:53:56,090
we will be and we can create a more effective traffic flow and maximize the capabilities of

675
00:53:56,090 --> 00:53:59,660
that site. Next slide.

676
00:54:02,630 --> 00:54:07,510
The next question that was asked was the use of the Broadway clinic

677
00:54:07,510 --> 00:54:13,590
that still under way, obviously the Broadway clinic is being used by the Department of Community

678
00:54:13,590 --> 00:54:19,230
and Human Services for the Crisis Care Center. There is additional space of remaining in that,

679
00:54:19,230 --> 00:54:21,770
which we have all discussed at different times.

680
00:54:23,130 --> 00:54:25,110
And the library is looking at it,

681
00:54:25,110 --> 00:54:28,590
both for potential, for temporary uses,

682
00:54:28,890 --> 00:54:30,150
and for longer term uses.

683
00:54:30,290 --> 00:54:34,090
I'm going to work through those occupancy pieces

684
00:54:34,090 --> 00:54:35,870
as they work through the programming

685
00:54:36,670 --> 00:54:39,850
with getting to a decision by this summer.

686
00:54:42,190 --> 00:54:42,910
Next slide.

687
00:54:45,010 --> 00:54:45,810
That's it.

688
00:54:46,290 --> 00:54:48,790
So I did want to just take,

689
00:54:48,790 --> 00:54:51,950
I talked a little bit about the soil conditions.

690
00:54:51,950 --> 00:55:01,110
I talked a little bit about the loop road, parking, parking is, I can't go into a meeting

691
00:55:01,110 --> 00:55:05,270
talking about how are you construction for more than five minutes without parking coming

692
00:55:05,270 --> 00:55:06,690
up as a key issue.

693
00:55:06,910 --> 00:55:13,910
It seems odd, but when you look at the campus and its constraints and the way people come

694
00:55:13,910 --> 00:55:19,950
to this hospital, it is something that we constantly need to worry about.

695
00:55:20,670 --> 00:55:26,010
Our solutions for that, as Ben said, none of them are inexpensive.

696
00:55:27,570 --> 00:55:30,330
I'm less concerned though about the workforce parking.

697
00:55:30,930 --> 00:55:35,610
We have identified particular locations for them to park that we can lease some of which

698
00:55:35,610 --> 00:55:40,310
are within a short enough distance that we don't have to pay additional labor fees for that

699
00:55:40,310 --> 00:55:41,470
transport time.

700
00:55:41,770 --> 00:55:43,950
This actually can be a productivity impact.

701
00:55:45,710 --> 00:55:49,930
We will not be allowing, although it will still happen.

702
00:55:49,930 --> 00:55:54,330
because this is all of us sometimes park over and not supposed to.

703
00:55:54,570 --> 00:55:57,350
We're not going to be allowing any construction parking on campus.

704
00:55:57,530 --> 00:55:59,150
It's all going to have to be offset.

705
00:56:00,410 --> 00:56:02,350
In terms of the governance structures,

706
00:56:02,790 --> 00:56:04,590
they talked about the program management plan.

707
00:56:06,210 --> 00:56:07,430
But that has been problematic.

708
00:56:07,890 --> 00:56:16,070
We have what I would consider the critical elements of the PGMP established and operating.

709
00:56:16,910 --> 00:56:24,870
But if we do not have a plan that has been finalized appropriately, I anticipate that the

710
00:56:24,870 --> 00:56:32,930
new owner's advisor, which we are moving to different firms and manner, we have solicited

711
00:56:32,930 --> 00:56:38,570
for them, and we will soon have them under contract when they are, I can tell you they

712
00:56:40,950 --> 00:56:54,210
But we will have a new owner's advisor and they're anticipate that we will get the program management plan finalized to a better degree of structure.

713
00:56:55,350 --> 00:57:08,210
In the interim, as I said, we have worked through governance and decision making and escalating tools closely with the hospital because, of course, everything that we do in this project is to get to that mission population.

714
00:57:08,210 --> 00:57:34,150
And so there's a very close relationship and I meet all the time with the hospital and we sit next to each other and the integration of this clinical requirements with the real budget constraints that we have in other pieces, that's the last item that I wanted to address is the cost increases.

715
00:57:36,410 --> 00:57:45,330
One of the largest drivers on the cost increase, and what we're seeing right now, is the Seattle and state energy codes.

716
00:57:47,750 --> 00:57:56,050
It seismic is also increasing it, and this hospital obviously has to survive through a maximum design earthquake,

717
00:57:56,050 --> 00:58:00,750
and be running at when it's a building stop shaking or well-shaking, I suppose.

718
00:58:03,130 --> 00:58:17,070
But the energy code requirements have created at least a $200 million in cost growth.

719
00:58:17,210 --> 00:58:18,630
Just from energy code changes.

720
00:58:19,370 --> 00:58:24,130
So when you combine that with some of the other aspects that are with there, there are lots

721
00:58:24,130 --> 00:58:28,650
different cost pressures that are occurring, we're looking through those closely.

722
00:58:30,030 --> 00:58:38,030
The task that we are in right now is to finish the target value design, and that is

723
00:58:38,030 --> 00:58:43,010
having a general agreement on scope and what the cost of that particular scope is.

724
00:58:43,050 --> 00:58:49,510
In this case, how many operating rooms, how bigger they're going to be, how many patient

725
00:58:49,510 --> 00:58:53,830
floors, what size are they going to be, and what the general idea of the cost per square

726
00:58:53,830 --> 00:58:54,170
foot?

727
00:58:54,290 --> 00:59:01,570
We then will enter into essentially an agreement with the design builder that, okay, this

728
00:59:01,570 --> 00:59:06,310
is how much each of these buckets has for money, and they will enter into schematic design

729
00:59:06,310 --> 00:59:10,190
with that parameter and budget, so to speak.

730
00:59:10,750 --> 00:59:18,630
That in a progressive design build, the livery model is a much better way to avoid various components

731
00:59:18,630 --> 00:59:23,830
getting out of control and driving the cost or curtailing scope, critical scope and other

732
00:59:23,830 --> 00:59:24,270
pieces.

733
00:59:25,590 --> 00:59:29,990
As Ben said, we were not in agreement on prices for square foot.

734
00:59:30,030 --> 00:59:32,930
We've spent a much of time working through that.

735
00:59:33,430 --> 00:59:40,530
I delays schematic design for a month because it is critically important for this project.

736
00:59:40,630 --> 00:59:45,210
I'm going to deliver this project within budget to enter schematic design with good target

737
00:59:45,210 --> 00:59:45,650
values.

738
00:59:45,650 --> 00:59:54,750
I feel like we're pretty close right now and that we should be able to proceed without another delay of this schematic design.

739
00:59:56,210 --> 00:59:59,620
And I think I covered.

740
01:00:00,000 --> 01:00:11,060
Most of the points there, but I want to finish by saying this is a complicated project and it does have risks. And we have lots of folks working to address them each day.

741
01:00:14,080 --> 01:00:25,040
And I appreciate the auditors comments in here and I don't have any other than clarifying some of the risks associated with that. I have no problem to the report. I think it's very fair.

742
01:00:25,040 --> 01:00:29,060
balance. Thank you, Mr. Chair. Thank you, Tony, I appreciate it.

743
01:00:29,260 --> 01:00:32,400
Colleagues, we have a little time for questions here. Vice Chair Balducci.

744
01:00:32,800 --> 01:00:34,260
Thank you.

745
01:00:35,000 --> 01:00:41,040
As a member, one of two members of the ordinance working group here, I have to say we are debating

746
01:00:41,040 --> 01:00:44,360
whether this is a trip down memory lane or PTSD or both.

747
01:00:45,220 --> 01:00:50,900
But I have to say, I am surprised at how we keep not talking about the reasons for all the delay.

748
01:00:50,900 --> 01:00:53,040
The costs essentially are linked to delay.

749
01:00:53,200 --> 01:00:54,780
The more we delay, the more it costs,

750
01:00:55,280 --> 01:00:59,240
then details are round what's driving the cost differ over time,

751
01:00:59,240 --> 01:01:01,400
but it's all about because we're not moving.

752
01:01:02,080 --> 01:01:06,400
We're subject to costs increases in many, many ways.

753
01:01:06,740 --> 01:01:09,760
And I still haven't heard a rationale for all the delays,

754
01:01:09,780 --> 01:01:13,080
like just headlines, permitting and construction delays.

755
01:01:13,320 --> 01:01:16,560
That doesn't tell me why we're not moving.

756
01:01:16,560 --> 01:01:22,360
And we're not moving, we're three years behind where we were when we were at the operational

757
01:01:22,360 --> 01:01:23,760
ordinance working group.

758
01:01:24,220 --> 01:01:25,440
And that was a delay.

759
01:01:25,920 --> 01:01:29,040
So I don't know how many years behind we are compared to what we promised the voters

760
01:01:29,040 --> 01:01:35,440
in the bond measure, but it's several years now, and I do not understand why, so can somebody

761
01:01:35,440 --> 01:01:40,260
please help me understand why and how we get out of this doom loop and move this project

762
01:01:40,260 --> 01:01:40,740
forward?

763
01:01:44,640 --> 01:01:48,440
Tony, Tony, it's not on, you have to hit it in just wait a second.

764
01:01:49,420 --> 01:01:49,620
Very good.

765
01:01:52,340 --> 01:01:53,720
I'll try to address that question.

766
01:01:54,360 --> 01:01:55,680
And there are a number of delays.

767
01:01:57,460 --> 01:02:05,440
The in the OWG that I was also part of and it was a accelerated and painful process.

768
01:02:06,560 --> 01:02:11,300
We made a series of assumptions on what the construction time would be.

769
01:02:12,700 --> 01:02:19,400
Those were, in terms of tower construction, by a couple of years, those assumptions that we

770
01:02:19,400 --> 01:02:19,720
made.

771
01:02:20,160 --> 01:02:24,940
As we got a design builder on board, and as we gathered more research with time, and you'll

772
01:02:24,940 --> 01:02:30,180
see that in the monthly reports that we've sent in, that's when the shift occurred.

773
01:02:30,380 --> 01:02:37,180
One of the other elements of the delay is an OWG we were talking about, beneficial occupancy

774
01:02:37,180 --> 01:02:44,320
dates, meaning that the hospital could move in, and the dates we're talking now, which are

775
01:02:44,320 --> 01:02:48,320
more relevant, are when the hospital concerned patients.

776
01:02:48,380 --> 01:02:55,360
There's a large amount of time, and I'll let the hospital address that more, but we've

777
01:02:55,360 --> 01:03:03,380
just finished a large project up in the mailing building, and also in the Ninth of Jefferson

778
01:03:03,380 --> 01:03:08,360
building, bringing up, bringing rooms online, and the activation time, we're looking at

779
01:03:08,360 --> 01:03:12,400
activation time of almost a year between beneficial occupants in there.

780
01:03:12,580 --> 01:03:14,220
That counts for part of the delay.

781
01:03:14,840 --> 01:03:23,720
The part of the delay before that is a number of things that the MIMP should have moved

782
01:03:23,720 --> 01:03:25,100
faster than it did.

783
01:03:25,100 --> 01:03:33,820
It did not get completed on the times that it should, and that was, and went, what is happening

784
01:03:33,820 --> 01:03:39,220
with it, the parts that were within our control were not completed on time.

785
01:03:39,780 --> 01:03:45,220
The quality of the document that was within our control was not completed on time.

786
01:03:45,260 --> 01:03:50,820
I can't go back and fix that, but that is one of the reasons that we're very real reason

787
01:03:50,820 --> 01:03:54,140
for delay that you can point at and say that was a problem.

788
01:03:55,220 --> 01:03:56,800
We are taking some risks.

789
01:03:56,840 --> 01:04:03,460
One of the risks that Ben did not address is the fact that we've entered into a contract,

790
01:04:03,580 --> 01:04:08,860
a progressive design build contract, so we have some off-ramps, but we've entered into a contract

791
01:04:08,860 --> 01:04:16,020
trying to gain time because we actually don't have the entitlements to build what we've

792
01:04:16,020 --> 01:04:18,920
hired a contract to for, and that's a significant risk.

793
01:04:19,080 --> 01:04:24,100
It's underwritten and we believe that's an appropriate risk, but we can't get too

794
01:04:24,100 --> 01:04:32,400
ahead of the permitting time one. But as you remember, we were behind, and as you accurately

795
01:04:32,400 --> 01:04:39,920
stated, Gems member, we were, we were, we were behind then, and we are further behind now.

796
01:04:40,780 --> 01:04:46,220
We think that we have a much more informed schedule based on the design partners that we have.

797
01:04:47,380 --> 01:04:54,060
And I plan on coming in with a detailed schedule of delivery in May, based on what I'm

798
01:04:54,060 --> 01:04:55,800
And what's the target value design?

799
01:04:57,850 --> 01:04:58,790
Just quick follow up.

800
01:04:59,070 --> 01:05:00,710
Thank you.

801
01:05:01,130 --> 01:05:09,890
What internal or project functions have we set up

802
01:05:09,890 --> 01:05:12,370
to ensure transparency and urgency

803
01:05:12,370 --> 01:05:13,950
around moving the project forward?

804
01:05:14,030 --> 01:05:16,350
How do we govern this thing?

805
01:05:17,850 --> 01:05:21,650
We have a series of governance elements that

806
01:05:21,650 --> 01:05:25,250
are combined teams of what we call the honors group,

807
01:05:25,250 --> 01:05:32,130
which is the county, the UW Medicine, and our owner advisor, combined with our design

808
01:05:32,130 --> 01:05:38,250
build team, and we have a governance structure that covers those particular issues.

809
01:05:38,490 --> 01:05:46,750
We have a schedule that identifies the various necessary components to get ready to do the work.

810
01:05:46,830 --> 01:05:49,610
We call it some of those critical make ready work.

811
01:05:50,270 --> 01:05:54,830
Things like moving the entrance to the hospital, as you saw where the new building is going

812
01:05:54,830 --> 01:06:00,690
have to move the entrance hospitals, we have these various lines of operations, amongst the

813
01:06:00,690 --> 01:06:05,750
three groups, the three buckets that came out of the OWG, as you recall, it was the tower

814
01:06:05,750 --> 01:06:10,670
and the revisions associated with tower, general revisions of space on the campus and

815
01:06:10,670 --> 01:06:16,070
then infrastructure repairs. Those are identified in a particular lines of operation that are

816
01:06:16,070 --> 01:06:22,650
governed at a leadership team level, a working team level, these meet regularly to cover

817
01:06:22,650 --> 01:06:30,230
these identify scope, develop A3s for getting decisions, work through those pieces, and then

818
01:06:32,220 --> 01:06:34,640
we're working closely with clinical staff.

819
01:06:34,900 --> 01:06:41,200
So there's both the structural energy that's getting this on schedule and recruiting

820
01:06:41,200 --> 01:06:41,740
the priority.

821
01:06:42,300 --> 01:06:46,880
But there's also the emotional energy as when some are facing.

822
01:06:46,960 --> 01:06:47,620
Can I pause you there?

823
01:06:47,940 --> 01:06:47,980
Sure.

824
01:06:47,980 --> 01:06:49,500
I really just want to know the formal structure.

825
01:06:49,780 --> 01:06:53,820
The organization, the owners working group, that's the formal structure where the urgency

826
01:06:53,820 --> 01:06:55,140
comes from?

827
01:06:55,880 --> 01:06:56,340
Yes.

828
01:06:57,520 --> 01:07:02,960
I'll send you a chart on how we're structured after this council member, I don't have one to show

829
01:07:02,960 --> 01:07:04,920
you on this, but I can show you how that works.

830
01:07:05,060 --> 01:07:05,880
I appreciate that.

831
01:07:06,000 --> 01:07:10,240
And then just to hand over the microphones, I know others have questions and comments.

832
01:07:11,060 --> 01:07:17,340
This project is on fire, and it has been for a long time, and we need to elevate and make

833
01:07:17,340 --> 01:07:21,140
it transparent so that we can address the problems collectively and move it forward.

834
01:07:21,140 --> 01:07:29,260
It's just we owe it to the voters and to the people who need these services to move it faster, to move it better.

835
01:07:29,760 --> 01:07:36,640
And I've said in too many rooms for too many hours to feel like we've really got this and I want to feel like we got this.

836
01:07:37,220 --> 01:07:44,200
So maybe we can go back to regular reporting, we used to ask for a regular report in writing, just to keep eyes here on what's happening.

837
01:07:44,200 --> 01:07:52,340
that might be a thing, we should revisit, but I'm very, very interested to re-engage as a council

838
01:07:52,340 --> 01:07:55,460
with this project to make sure that it's moving as it should.

839
01:07:55,640 --> 01:07:56,000
Thank you, Tony.

840
01:07:56,060 --> 01:07:57,860
I know you're doing everything you can.

841
01:07:58,480 --> 01:07:59,420
It's very challenging.

842
01:07:59,700 --> 01:08:01,020
It's very challenging to watch.

843
01:08:02,060 --> 01:08:06,600
There's, I do the only thing I would like to say is we are providing a monthly report council

844
01:08:07,200 --> 01:08:07,720
on this.

845
01:08:07,720 --> 01:08:09,680
It is voluminous.

846
01:08:10,160 --> 01:08:15,820
And perhaps we need to have something that's more digestible that we can come in.

847
01:08:15,840 --> 01:08:16,340
Thank you, Richard.

848
01:08:16,580 --> 01:08:16,960
Thank you, Tony.

849
01:08:17,460 --> 01:08:22,140
Yes, we have seen those reports, but I think I agree with the vice chair that we need to

850
01:08:22,140 --> 01:08:24,060
kind of dig in more into some of the information.

851
01:08:24,240 --> 01:08:28,080
And that is why we're going to have another follow-up expected in May to come.

852
01:08:28,140 --> 01:08:29,560
Councillor Mirdonbowski online.

853
01:08:30,620 --> 01:08:35,400
Thank you very much, Mr. Chair, and I have joined in the concerns expressed by Chair

854
01:08:35,400 --> 01:08:39,140
Well, douchey, it's a very high level numbers.

855
01:08:39,380 --> 01:08:42,140
There we have about a $1.74 billion bond.

856
01:08:42,720 --> 01:08:45,840
We purchased a building from the Pioneer Square clinic.

857
01:08:46,120 --> 01:08:47,560
We're doing investments at the campus.

858
01:08:47,620 --> 01:08:53,200
We bought property for parking garage of the capacity that's left.

859
01:08:53,380 --> 01:08:54,420
Can you give me that number?

860
01:08:54,660 --> 01:08:57,040
And then, can you tell me what the design

861
01:08:57,040 --> 01:08:59,440
build firm thinks it's going to cost to build a tower

862
01:08:59,440 --> 01:09:02,880
and what our owner's rep side thinks it's going to cost?

863
01:09:03,140 --> 01:09:03,980
How much is left?

864
01:09:03,980 --> 01:09:08,960
and what's the disparity between the two estimates to build the tower? Brown numbers.

865
01:09:10,080 --> 01:09:17,480
So I think about 1.6 is left, 1.64 or something like that.

866
01:09:21,360 --> 01:09:25,140
The design builder wants to build

867
01:09:25,140 --> 01:09:28,980
a bigger tower than when we have scope for that's why we've been negotiating with it.

868
01:09:28,980 --> 01:09:31,060
So I could tell you their number, but the number,

869
01:09:31,560 --> 01:09:33,980
council member wouldn't, wouldn't mean much

870
01:09:33,980 --> 01:09:36,780
because it's more than we want them to build.

871
01:09:37,040 --> 01:09:39,760
So we, the part of the challenges with target value

872
01:09:39,760 --> 01:09:42,060
is they've come in with some,

873
01:09:42,060 --> 01:09:45,440
they think that certain spaces need to be a certain size.

874
01:09:45,600 --> 01:09:48,360
We have different fiscal limitations

875
01:09:48,360 --> 01:09:50,320
and such in the work with that.

876
01:09:50,720 --> 01:09:54,320
But if we build the tower that design builder

877
01:09:54,320 --> 01:10:02,760
wanted us to build, then it's, we need about, you know, $2.6 billion dollars. That's about

878
01:10:02,760 --> 01:10:07,700
a billion dollars sure of what we have. We're not obviously going to do that. I can't

879
01:10:07,700 --> 01:10:12,800
answer your question until I finish this target value and then I can say, okay, this is what

880
01:10:12,800 --> 01:10:17,940
we're going to build. And this is, and we are agreeing that this is the limitations, but we know

881
01:10:17,940 --> 01:10:19,400
what money we have.

882
01:10:20,660 --> 01:10:23,700
I think we're going to get very close to the OWD scope.

883
01:10:24,920 --> 01:10:28,100
I'm concerned about whether we can get to that full scope.

884
01:10:29,640 --> 01:10:32,480
But if I was going to pick a difference in price,

885
01:10:33,740 --> 01:10:36,880
I think we're probably about 200 million short.

886
01:10:37,420 --> 01:10:38,800
$2,200 million?

887
01:10:39,080 --> 01:10:39,780
Yes, sir.

888
01:10:41,220 --> 01:10:43,260
But if this is a very preliminary, of course,

889
01:10:43,260 --> 01:10:48,880
But before you give a notice to proceed on the project to really get going,

890
01:10:49,240 --> 01:10:51,620
does that count or require, what kind of counsel and involvement?

891
01:10:51,720 --> 01:10:52,720
Because here's my concern.

892
01:10:53,780 --> 01:10:56,440
I just remember what happened on the youth jail,

893
01:10:57,220 --> 01:11:00,060
where we ended up with one contractor, similar type of structure.

894
01:11:01,340 --> 01:11:04,380
And you talked about off-ramps, but they end row and he don't exist.

895
01:11:05,380 --> 01:11:09,020
Because once you've got, once you're into it, you can't really stop.

896
01:11:09,020 --> 01:11:16,700
And I see what, I see a path ahead where Council is, we come back to us, say we need more money.

897
01:11:17,660 --> 01:11:21,120
And we're required to take our race taxes to do it.

898
01:11:21,800 --> 01:11:28,200
So, I'm interested, we don't have to answer it here, but I think we ought to talk about the governance issue.

899
01:11:28,340 --> 01:11:32,880
And we did a little bit in the budget when we set up this office, but there's probably more work to do.

900
01:11:32,880 --> 01:11:43,760
Really quickly, one of the things that the auditor identified as a risk was the operating process over at the city of Seattle for the major institutions plan update.

901
01:11:44,440 --> 01:11:50,240
We put a few hundred thousand dollars of money in the budget for you to hire a lobbyist specifically with city of Seattle skills.

902
01:11:50,720 --> 01:11:56,580
My understanding is that maybe this is wrong, but there hasn't been movement to go out and get that group or persons.

903
01:11:56,580 --> 01:12:04,700
I would encourage you given the auditors finding here, and that that's a risk and the delay that you've talked about over there.

904
01:12:05,220 --> 01:12:08,380
To engage some professional help to move that process along.

905
01:12:08,660 --> 01:12:12,480
We put it in the budget, and I hope you'll take advantage of it.

906
01:12:12,940 --> 01:12:13,640
Thank you very much.

907
01:12:14,200 --> 01:12:14,860
It counts a number.

908
01:12:15,060 --> 01:12:20,680
I would say that in terms of the off ramp, we're using a different delivery model.

909
01:12:21,260 --> 01:12:22,720
Then we use with the use shell.

910
01:12:22,720 --> 01:12:30,600
That was a traditional design build we're using, a progressive design build, and their needs

911
01:12:30,600 --> 01:12:36,640
to come to a point where we get a guaranteed maximum price that we agree with various

912
01:12:36,640 --> 01:12:37,120
parameters.

913
01:12:38,060 --> 01:12:42,580
That gate will be before we win, and notice proceed.

914
01:12:42,760 --> 01:12:47,720
We will probably have some enabeling projects that will occur in advance of that, but just

915
01:12:47,720 --> 01:12:48,300
to be clear.

916
01:12:49,480 --> 01:12:55,000
That's that off ramp, all those expensive off ramp to take, given design investment.

917
01:12:56,060 --> 01:13:01,520
We, in a progressive design, build all of the design documents when we get to that face.

918
01:13:02,260 --> 01:13:08,620
So we can, it's not completely sung, but yes, it's not an off ramp you want to take,

919
01:13:08,620 --> 01:13:11,860
but it's a stronger off ramp than we had at the CCFJC.

920
01:13:12,640 --> 01:13:13,820
Okay, thank you so much.

921
01:13:14,440 --> 01:13:15,140
Thank you.

922
01:13:15,320 --> 01:13:16,120
Councilor Biscuit.

923
01:13:16,820 --> 01:13:25,840
Thank you very much. First, I want to say because I miss the chance to say it to the previous panel, but it's on topic, Mr. Chair. Thanks to the team at Harperview as well for your support.

924
01:13:26,100 --> 01:13:40,660
In Olympia this year, lobbying for the Representative Bergville, which allows for us to have additional support for public health services overall. I know that the more that we can add to public health system. The fewer people end up going to Harborview for meeting their needs. I just want to say thank you for that. It was a really rough session.

925
01:13:40,660 --> 01:13:46,660
I also want to say thanks for your presentation here today at the table.

926
01:13:47,620 --> 01:13:52,900
One piece I want to lift up is that the report and your presentation have emphasized what

927
01:13:52,900 --> 01:13:56,180
we are dealing with is a delay in spending the dollars.

928
01:13:56,420 --> 01:14:00,980
What we are not dealing with is any sort of fraud or mismanagement and given the coverage

929
01:14:00,980 --> 01:14:04,240
that King County has experienced in recent months.

930
01:14:04,300 --> 01:14:05,920
I just want to make sure to lift that up.

931
01:14:05,960 --> 01:14:09,580
You mentioned it, the report mentioned it and it's important thing for a voter sender

932
01:14:09,580 --> 01:14:14,480
And while we're not talking about financial mismanagement or fraud happening at our

933
01:14:14,480 --> 01:14:18,880
video, what we're trying to solve for here is that we are nearly half a decade in from

934
01:14:18,880 --> 01:14:23,820
the passage of the levy and we really have not seen tangible progress on some really critical

935
01:14:23,820 --> 01:14:29,820
infrastructure that we know the community, the providers and you all at the county are desperate

936
01:14:29,820 --> 01:14:30,780
to see an action.

937
01:14:31,040 --> 01:14:32,360
So I'm optimistic, right?

938
01:14:32,360 --> 01:14:36,440
I can only be optimistic that you're continuing to make progress, but we have to get on the

939
01:14:36,440 --> 01:14:42,420
page on how we're going to remedy this issue. It's critical that we have the ability to show

940
01:14:42,420 --> 01:14:47,680
voters that what they pass is being put into action. I urge you to just say that we're not

941
01:14:47,680 --> 01:14:51,720
going to be able to get to full scope and you mentioned an initial dollar figure that you think

942
01:14:51,720 --> 01:14:59,600
we're short of. In other words, what are we going to do? How is what's the process along the lines

943
01:14:59,600 --> 01:14:59,980
of what comes.

944
01:15:00,000 --> 01:15:06,440
Members, the Valsky noted, what is the process for making sure that we are all on the same page

945
01:15:06,440 --> 01:15:15,780
about what this may be scope reduction means? And if we are not going to see certain projects

946
01:15:15,780 --> 01:15:21,500
completed, does that mean that second-tier projects from the OWG process are even more unlikely

947
01:15:21,500 --> 01:15:22,480
did it get completed?

948
01:15:25,980 --> 01:15:31,560
In answering the, there are several, the Council's established, the County Hospital

949
01:15:31,560 --> 01:15:35,420
Levy, which a component of that was to go for elements of the bond.

950
01:15:35,940 --> 01:15:41,140
When I talk about the shortfall, I'm talking about a shortfall of the existing bond

951
01:15:41,140 --> 01:15:47,900
measure, not using any of these additional sources which were designed to, I believe,

952
01:15:52,980 --> 01:15:52,980
to help

953
01:15:52,980 --> 01:16:01,120
full scope, but I just declare a fine council member. I don't think I can get to that full scope for

954
01:16:01,120 --> 01:16:06,480
that original number. It's, but I think we can get close and I think the other funding sources

955
01:16:06,480 --> 01:16:16,780
that are available to us might be entertained, but I would want to work with our budget director

956
01:16:16,780 --> 01:16:21,600
I'm a bit over the ski, my skis, and I'm talking about how we would pay for it.

957
01:16:23,690 --> 01:16:33,330
Thank you, Tony, and Councillor Roscai. Just on that point, I just want to add this because I think this is highlighting kind of one of the issues that I'm concerned about is.

958
01:16:33,790 --> 01:16:36,670
We're seeing increased costs.

959
01:16:37,890 --> 01:16:46,930
We know already that with the bond project, the original bond, we can't do what voters voted for in 2020, right?

960
01:16:46,930 --> 01:16:53,030
That was the OWG process, 2023, where we scaled down this body, scaled down the scope.

961
01:16:54,030 --> 01:16:59,850
Now we're in a situation where even that scale scope may not be accomplished with what

962
01:16:59,850 --> 01:17:00,710
the voters provided.

963
01:17:01,610 --> 01:17:07,130
So I think we have supported in the last two years some additional support from the County

964
01:17:07,130 --> 01:17:15,070
Hospital tax towards this project, they overall scope, but there are other demands on those

965
01:17:15,070 --> 01:17:18,250
resources, and of course, we heard from you the medicine of the swine.

966
01:17:18,570 --> 01:17:21,810
I thought putting this panel together with these issues is to highlight that there are

967
01:17:21,810 --> 01:17:26,170
very serious strains because of the changes in federal policy,

968
01:17:28,910 --> 01:17:30,690
that the operating part

969
01:17:30,690 --> 01:17:36,870
of Harborview is dealing with, and yet we have these shortfalls in the bond project.

970
01:17:39,590 --> 01:17:43,490
And we're trying, you know, we're trying to navigate, obviously we're kind of in a two-year

971
01:17:43,490 --> 01:17:47,650
budget right now where we made some decisions, but as we consider kind of where the county

972
01:17:47,650 --> 01:17:52,310
hospital tax is going to be used, we need to understand what the costs are going to be.

973
01:17:52,510 --> 01:17:55,610
How far are we going to get and what additional resources we're going to need?

974
01:17:56,150 --> 01:18:00,510
And so that's the question that I hope in our main meeting that we actually get a little bit

975
01:18:00,510 --> 01:18:05,330
that you'll have more estimates to what Councilmember DeBouski was asking, some more specifics.

976
01:18:06,930 --> 01:18:11,510
I realize that people who have been through the OWG process might hear hate us saying this,

977
01:18:11,510 --> 01:18:14,310
but we may have to have a revised version of that

978
01:18:14,310 --> 01:18:16,330
to figure out what we can do at this point.

979
01:18:18,650 --> 01:18:20,230
And I'm just throwing that out there

980
01:18:20,230 --> 01:18:22,090
just because I'm seeing where we're headed.

981
01:18:22,910 --> 01:18:24,490
The question I have for you Tony is,

982
01:18:24,790 --> 01:18:27,070
and this may be something we may need to fall off line two

983
01:18:27,070 --> 01:18:31,270
is one of the things that the otters I'll let her point it out

984
01:18:31,270 --> 01:18:33,290
is this issue of the program management plan.

985
01:18:33,330 --> 01:18:35,130
And I have to say that I don't really understand

986
01:18:35,130 --> 01:18:36,030
what that entails.

987
01:18:37,090 --> 01:18:39,070
You mentioned it that it's in work and progress.

988
01:18:39,070 --> 01:18:47,510
I mean, somebody asked me, you know, it's been over five years since the voters voted

989
01:18:47,510 --> 01:18:51,930
for this, how do we not five years into this, have a plan?

990
01:18:53,750 --> 01:18:57,470
What would be your, what kind of tell constituent who would ask me that question?

991
01:18:58,110 --> 01:19:02,150
The first thing I was saying is, we do have a plan, and even on events like this, so that

992
01:19:02,150 --> 01:19:03,110
it's not finalized.

993
01:19:03,110 --> 01:19:10,410
And it's also a living document, so it evolves as we bring different players on and different

994
01:19:10,410 --> 01:19:11,090
other pieces.

995
01:19:11,730 --> 01:19:21,930
It has some components in terms of some project delivery, escalation elements, stuff for

996
01:19:21,930 --> 01:19:25,950
lower-level projects that is not complete and I'm not happy with.

997
01:19:27,250 --> 01:19:31,230
I'm hopeful that our new contractor can be more responsive.

998
01:19:31,230 --> 01:19:43,010
But we have a plan, it's just not finalized as such, it's missing some components that I agree with the auditors should be there.

999
01:19:44,230 --> 01:19:49,090
Some of those components, though, in my opinion, are not affecting our progress.

1000
01:19:50,030 --> 01:19:56,210
Some of those components, there's a escalation and decision making pieces which were affecting our progress.

1001
01:19:56,210 --> 01:20:01,250
We think we have a good governance structure with that with various tensions, but that's what

1002
01:20:01,250 --> 01:20:01,990
I would say.

1003
01:20:03,510 --> 01:20:10,830
I mean, I've never actually seen a program management plan and kind of you get it to a

1004
01:20:10,830 --> 01:20:11,070
point.

1005
01:20:11,090 --> 01:20:11,950
Say, this looks good.

1006
01:20:12,090 --> 01:20:14,450
We're walking with it, and then it continues to evolve.

1007
01:20:15,370 --> 01:20:15,530
Great.

1008
01:20:15,630 --> 01:20:17,890
I'm going to let Councilman Fein have the last word here.

1009
01:20:18,010 --> 01:20:18,910
We wrap up.

1010
01:20:19,090 --> 01:20:19,510
Thank you.

1011
01:20:19,610 --> 01:20:23,890
And I don't need an answer today, but I would ask that the next time we have this discussion,

1012
01:20:23,890 --> 01:20:32,930
And we look at the OWG report, which summarizes our nine months putting this work together,

1013
01:20:33,470 --> 01:20:39,670
talking about the recommendation for a new tower, seven, seven built out, three-sheld,

1014
01:20:39,970 --> 01:20:50,010
floors, and other components, certainly, and the county expansion pieces that were there.

1015
01:20:50,030 --> 01:20:51,630
So those were what we recommended.

1016
01:20:51,630 --> 01:20:58,430
I think there are opportunities and I'd be interested to hear more about this with the crisis

1017
01:20:58,430 --> 01:21:06,490
care center moving in, you know, relatively close by, what we can do to address some

1018
01:21:06,490 --> 01:21:12,430
of the recommended changes to our expanded behavioral health services at Harborview with the

1019
01:21:12,430 --> 01:21:14,230
PEDs unit and the crisis stabilization.

1020
01:21:14,990 --> 01:21:19,150
How does that factor in with the crisis care center moving in nearby?

1021
01:21:19,150 --> 01:21:28,130
But I would like to see a breakdown of where the increased costs are and what it is that the design

1022
01:21:28,130 --> 01:21:35,490
build contractors trying to do more of or less of and how those all pencil out because I think

1023
01:21:35,490 --> 01:21:42,310
conceptually 200 million doesn't make sense for me in terms of how does that plug in?

1024
01:21:42,370 --> 01:21:45,330
What have we changed? What are we not addressing?

1025
01:21:45,970 --> 01:21:54,450
compared to what we have the council outlined from the OWG group and in the ordinance.

1026
01:21:54,830 --> 01:22:01,410
So I would like to see that at the next presentation and I would welcome further discussion

1027
01:22:01,410 --> 01:22:07,770
on how we can become more engaged again and ensure that we are doing our due diligence

1028
01:22:07,770 --> 01:22:12,510
to make sure that the bond dollars are going to the projects that have been outlined through

1029
01:22:12,510 --> 01:22:14,150
the OWG group.

1030
01:22:15,890 --> 01:22:26,450
Thank you, Councillor Morbiffane. Well, colleagues, I really appreciate an engagement. I think it sort of reinforces my sense that this is a topic that we do want to spend more time on this year.

1031
01:22:27,110 --> 01:22:36,990
So we are planning on having this topic back on our agenda in May when we expect that we will have some updated cost estimates that will help us have a further conversation.

1032
01:22:36,990 --> 01:22:41,310
And I think, Tony, you heard some of the questions that we want more detail on.

1033
01:22:41,570 --> 01:22:42,770
So I look forward to that discussion.

1034
01:22:43,030 --> 01:22:46,610
I also want to acknowledge that we're going to have our labor partners also join that

1035
01:22:46,610 --> 01:22:49,710
conversation, because we were able to include them in this conversation, but I also want

1036
01:22:49,710 --> 01:22:50,790
to hear from them then.

1037
01:22:51,010 --> 01:22:55,870
And then we will have that back on our agenda again.

1038
01:22:56,570 --> 01:22:58,750
Thank you to everybody who participate in today's meeting.

1039
01:22:59,010 --> 01:23:02,230
If there's no further business to come before the committee, we're adjourned, and we look forward

1040
01:23:02,230 --> 01:23:05,270
to seeing many of you at the Women's History Panel event.