Dignity Health Foundation - East Valley for Ak-Chin Grant Application
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Dignity Health Foundation – East Valley
Ak-Chin Indian Community Grant Application
Graduate Medical Education
Purpose of Grant
Program Description: Dignity Health East Valley is comprised of Chandler Regional Medical Center,
Mercy Gilbert Medical Center, Arizona General Hospital Mesa, Dignity Health Rehabilitation Hospital,
four urgent care facilities, eight freestanding emergency departments, and Dignity Health Foundation
East Valley. Our hospitals have been a leading force in increasing health and well-being for all who live
in Maricopa County and surrounding areas. We invite Ak-Chin Indian Community to join us in support of
the formation of the first Graduate Medical Education program in the East Valley.
Offering residency programs in key clinical areas will amplify the impact our ministry is able to make on
our community’s health, while also offering a place for community health providers to turn to recruit the
next generation of respected, compassionate providers. We aim to champion diversity and inclusion by
training the next generation of health care providers that best represent our community and our
neighbors such as Ak-Chin Indian Community.
Upon completion of medical school, physicians continue their didactic and clinical education in a medical
specialty of their choosing. This is graduate medical education. This further training prepares physicians
for the independent practice of medicine in that specialty. Graduate Medical Education (GME) is a
formal, hospital-sponsored or hospital-based training program for individuals who have completed
medical school and earned an MD or DO degree. It includes residency, internship, fellowship, specialty
and subspecialty programs.
Postgraduate residency programs provide guidance, evaluation and progressive supervision
and facilitate the resident’s ethical, professional and personal development while guaranteeing safe and
high-quality patient care. Advanced education of the highest quality combines teaching, clinical service,
safe patient care and research. Dignity Health’s GME program will be committed to prepare life-long
learners and competent physicians board-eligible in their specialties, with the highest academic, ethical,
clinical and professional standards of medicine, capable of providing comprehensive, compassionate and
continuous health care to the whole patient in the context of the family and the community.
As East Valley communities continue to grow at an unprecedented rate, our area is experiencing a
shortage of nearly 250 primary care providers. Due to an aging, growing, and increasingly insured
population, it is important to address both physician shortages and geographic maldistribution of
primary care physicians. According to the American Academy of Family Physicians, statewide, more than
3 out of 5 Arizonans live in a health professional shortage area. There are 47 medically underserved
areas in the state. It is projected that a 50% increase in physicians is needed by 2030 (nearly 2,000),
which underscores the current deficiency in personalized and specialized health care.
Residency-trained family physicians are particularly needed. These primary care specialists are
dedicated to treating the whole person. With a focus on prevention, primary care, and overall care
coordination, family physicians provide a wide variety of clinical services, and, when necessary, refer
their patients to specialists, while continuing to advocate for that patient's care. More Americans
depend on family physicians in the U.S. Health Care System than on any other medical specialty. Yet,
currently there is only one teaching health center program for family physicians in Arizona.
Dignity Health Foundation – East Valley
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Graduate Medical Education Infrastructure
Research shows that 50% of residents stay in the area after they complete their residency and many
physicians hand select the residents they want to continue to employ. Recruiting physicians from
outside the region is expensive and time-consuming. Ultimately, our GME program will provide savings
on these types of long-term costs for medical care in our area. Many physicians want to work at
teaching hospitals and will bring their labs and research with them if there is a local residency program
where they can build their career.
With our recent hospital expansion at Chandler Regional Medical Center and the Women’s and
Children’s Pavilion opening in spring 2023 at Mercy Gilbert Medical Center, Dignity Health is uniquely
positioned to address the growing healthcare needs of the entire East Valley. Our medical centers
provide industry-leading, award-winning care and are supported by some of the most respected and
skilled clinical care providers. Patients have numerous access points to their care, including Dignity
Health urgent care facilities and free-standing emergency departments.
Target Population. Our GME program will train physicians that will be learning in Dignity Health
hospitals in the East Valley that benefit the general public in the surrounding ares. Chandler Regional
has the only Level 1 trauma center in the area and serves residents in the suburbs of Gilbert, Maricopa,
Queen Creek, Apache Junction, San Tan Valley, and the Ak-Chin and Gila River Indian Communities,
totaling nearly 1 million people.
For almost 60 years Chandler Regional has been caring for our community. Our humble beginnings as a
true community hospital, which opened with only 40 beds, 25 employees and 91 volunteers, laid the
foundation for the full-service acute-care hospital it is today. Today, Chandler Regional is a 429-bed,
non-profit facility with more than 2,500 employees, and 1,090 doctors on staff representing all major
specialties and providing innovative and exceptional healthcare to East Valley residents. Dignity Health
Mercy Gilbert Medical Center is committed to providing the highest standards of care and healing the
patient’s physical, emotional and spiritual needs. With a total bed count of 198, the hospital is focused
on delivering compassionate care, improving the quality of life, and is a healing facility with a culture to
match. Since opening in June 2006, Mercy Gilbert has achieved national recognition for its healing
environment, leadership and efforts toward a healthier earth.
Our award-winning hospitals are home to a full range of services and have evolved as the population in
our communities have grown and changed. The formation of our GME program is the next step in that
evolution.
Project Goals and Objectives: Objectives of implementing our GME program are as follows:
•
Increasing the physician workforce pipeline, particularly for our area
•
Providing more clinical service coverage and efficiency in response to our growing population
•
Ensuring all East Valley residents, including those from surrounding rural areas, have ongoing
access to state-of-the-art patient care
•
Educating more physicians to be catalysts for complex care and achieving enhanced clinical
outcomes
•
Increasing our outreach of medical services to the community through community physician
partnerships, collaboration and instilling a vision for community service
In order to provide the appropriate space and resources for this valuable program, we need to adapt our
current space into an innovative learning environment. Implementation of our new GME program
consists of renovating hospital space, constructing new facilities, acquiring equipment for a simulation
Dignity Health Foundation – East Valley
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Graduate Medical Education Infrastructure
lab and teaching areas and providing robotic, laparoscopic and endoscopic trainers. The facilities being
renovated and built will provide the clinical and teaching space necessary for our residents to
successfully complete their training and provide patient care.
We will be offering GME in the following service areas with 124 residents at full capacity which align
with the specialties most needed in the East Valley:
Project Timetable. The project to build-out the necessary resources for our GME program will begin in
July 2022 with a 14-month construction timeline scheduled for completion in 2023. Below is a timeline
of the entire project, including implementation of the residency program.
Resources
Current Funding Sources. Capital funds made available by Dignity Health for one-time use will be
utilized to help launch this program. Additionally this spring, we began fundraising efforts for the
program and have received some long-term commitments from employees within our organization who
understand the value of providing GME here in our local community.
Dignity Health Foundation – East Valley
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Graduate Medical Education Infrastructure
Project Partners. Partners in our GME enterprise include:
•
Construction and design partners which will be renovating and building the required spaces.
•
The Accreditation Council for Graduate Medical Education sets and monitors voluntary
professional educational standards essential in preparing physicians to deliver safe, high-quality
medical care.
•
Each residency program has a robust network of top-tier physicians with a variety of sub-
specialty expertise (Full Faculty list available upon request).
Sustainability. Dignity Health’s Graduate Medical Education program is new to the East Valley. While
startup costs are significant, $7.2 million for construction and equipment, once the program is running,
it will become part of the hospitals’ ongoing operational costs. The Executive Leadership of Dignity
Health East Valley undertakes the responsibility for overseeing the operations of all assets, as well as
making frontline recommendations for budget and capital allocations.
Indian Tribe Requests. Pending and unsuccessful requests within the last eighteen months include:
•
Ak-Chin Indian Community – Support for construction of the Women’s and Children’s Pavilion at
Mercy Gilbert Medical Center (unsuccessful)
•
Fort McDowell Yavapai Nation – Support for the purchase of simulation training equipment
(pending)
•
Gila River Indian Community - Support for the purchase of simulation training equipment
(pending)
Funded requests in the last five years include:
•
Gila River Indian Community – $119,000 awarded for ECMO pump purchase
•
Salt River Pima-Maricopa Indian Community - $25,000 awarded for children’s dental services
•
Ak-Chin Indian Community - $240,000 awarded for tower construction at Chandler Regional
Medical Center
•
Gila River Indian Community - $500,000 awarded for tower construction at Chandler Regional
Medical Center
Reports
Funding Management. Dignity Health brings an extensive corporate infrastructure to all our grant
programs. Our programs are run by managers who are guided by the organization mission and by
Executive Leadership and the Community Board. Dignity Health always matches grant funds by providing
interdepartmental support from Finance, IT, Human Resources, Education Department, Employee
Wellness, Quality Assurance, and Compliance. Dignity Health provides insurance coverage, licensure,
legal support and corporate oversite to ensure regulatory compliance. For all grants, we collaborate
with our Finance department for the accounting of dollars and hours. For larger grants, separate cost
centers are set up to ensure timely facilitation of all financial components of the grant.
Project Progress Tracking and Documentation. Dignity Health Foundation – East Valley will provide
regular community campaign updates as well as an annual interim progress report and a final report at
the end of the grant period. The reports will document major gifts received and also will provide
updates on the construction project. Tribal leadership will be invited to participate in all of the
ceremonies and celebrations that will be held in honor of the launching of our GME program.
Budget
Dignity Health Foundation – East Valley
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Graduate Medical Education Infrastructure
Budget and Budget Justification. Please see attached budget detail. Funds will be used within one year
to offset renovation and constructions costs.
Request and Additional Information. We are requesting Ak-Chin Indian Community contribute
$500,000 to support the construction and renovation costs associated with launching the GME program.
In recognition of the Ak-Chin Indian Community’s generous gift, we would like to honor the Community
with a permanent naming opportunity such as the simulation lab, clinical care space, or other teaching
areas.
ID
Lawson Activity
Key Project Information
GME
@ CRMC
GME
@ MGMC
Total
Project
Assumptions / Clarifications / Comments
1
11,083
1,950
13,033
Per OW Feasibility Report dated 4.8.2022
4
234
$
151
$
222
$
5
310
$
200
$
294
$
6
Total Project Cost per SF
551
$
348
$
520
$
8
Construction Costs
9
CRMC - Basement Auditorium - 3,700 SF
350.00
$
$ per SF
1,295,000
$
1,295,000
$
Major Remodel - Convert existing dining/servery area to a 250 seat Auditorium per OW Feasibility Report
dated 4.8.2022. Cost/SF based on PDC estimate
10
CRMC - 1st Floor Resident Lounge & Lactation Rm - 1,550 SF
100.00
$
$ per SF
155,000
$
155,000
$
Minor Remodel - Repurpose existing Cardiac Rehab to GME Resident Lounge per OW Feasibility Report
dated 4.8.2022. Cost/SF based on PDC estimate
11
CRMC - 2nd Floor Simulation Lab - 3,100 SF
200.00
$
$ per SF
620,000
$
620,000
$
Moderate Remodel - Convert existing TICU space to Sim Lab & offices per OW Feasibility Report dated
4.8.2022
12
CRMC - 3rd Floor On-Call Suite - 2,300 SF
200.00
$
$ per SF
460,000
$
460,000
$
Moderate Remodel - Repurpose offices to Sleep Rooms & buildout/renovate 2 1/2 restrooms per OW
Feasibility Report dated 4.8.2022. Cost/SF based on PDC estimate
13
CRMC - 3rd Floor Add'l Sleep Rms - 600 SF
100.00
$
$ per SF
60,000
$
60,000
$
Limited Scope - Repurpose offices to Sleep Rooms per OW Feasibility Report dated 4.8.2022
14
CRMC - 4th Floor Staff Lactation Rm - 33 SF
100.00
$
$ per SF
3,300
$
3,300
$
Limited Scope - No renovation anticipated, just signage per OW Feasibility Report dated 4.8.2022. Cost/SF
based on PDC estimate
15
MGMC - 3rd Floor Resident Lounge - 840 SF
350.00
$
$ per SF
-
$
294,000
$
294,000
$
Major Remodel - Convert existing Waiting Rm to GME Resident Lounge per OW Feasibility Report dated
4.8.2022. Cost/SF based on PDC estimate.
16
MGMC - Sleep Rooms - 1,110 SF
-
$
$ per SF
-
$
-
$
-
$
No Scope - No renovation anticipated as part of this project per OW Feasibility Report dated 4.8.2022
17
Sub-Total Direct Construction Cost
2,593,300
$
294,000
$
2,887,300
$
18
General Requirements
6.00%
% of Direct
155,598
$
17,640
$
173,238
$
19
General Conditions
6.00%
% of Direct
155,598
$
17,640
$
173,238
$
20
Contractor Fee
5.50%
% of Dir+GCGR
159,747
$
18,110
$
177,858
$
% per PDC Metric
21
Bonds & Insurance
3.25%
of Dir+GCGR+F
99,588
$
11,290
$
110,878
$
% per PDC Metric
22
Builders Contingency (inc. Design Contingency)
4.00%
Dir+GCGR+Fee
126,553
$
14,347
$
140,900
$
% per PDC Metric
23
Escalation Allowance
4.50%
GCGR+Fee+B&
148,067
$
16,786
$
164,854
$
% per PDC Metric
24
Sub-Total In-Direct Construction Cost
845,152
$
95,814
$
940,966
$
25
293 Total Construction Cost
3,438,452
$
389,814
$
3,828,266
$
Total Construction Budget based on Kitchell Estimate dated 4.21.22
26
Equipment Costs
27
105
Group 1 - 4 Medical Equipment
-
$
Allowance
1,330,520
$
33,000
$
1,363,520
$
Per Garner Resources Estimate dated 04.22.22 for CRMC & MGMC. Includes Furniture & AV
28
Group 1 - 4 Medical Equipment Discount
-
$
Allowance
-
$
-
$
-
$
Included in Medical Equipment
29
Tax, Freight, Warehousing, Installation
-
$
Allowance
-
$
-
$
-
$
Included in Medical Equipment
30
123
Furniture, Fixtures & Equipment
-
$
Allowance
-
$
-
$
-
$
Furniture Included in Medical Equipment
31
111
Graphic / Signage / Artwork / Plants
-
$
Allowance
33,249
$
5,850
$
39,099
$
Per Takeform budget numbers provided 4.14.22 and Arch Framing budget numbers from Nov 2021
32
Nursecall & Code Blue Systems
-
$
Allowance
-
$
-
$
-
$
No allowance included
33
Intercom/Public Address/Fixed AV
-
$
Allowance
5,000
$
2,500
$
7,500
$
Includes minor allownaces in the event some OH paging needs to be modified or relocated
34
Radio Systems
-
$
Allowance
-
$
-
$
-
$
No allowance included
35
Dictation Systems
-
$
Allowance
-
$
-
$
-
$
No allowance included
36
116
Security/Video Surveillance/Access Control
-
$
Allowance
15,000
$
1,500
$
16,500
$
(6) CR's at CRMC: 1) On-Call Lounge, 2) GME Lounge, 3) 2 @ Auditorium/Storage, & (1) CR at MGMC area.
(3) Cameras at CRMC: All 3 at Auiditorium
37
Sub-Total Furniture, Fixtures & Equipment Cost
1,383,769
$
42,850
$
1,426,619
$
38
Structured Cabling
350.00
$
$ per Drop
21,000
$
7,000
$
28,000
$
Assumes (20) drops per renovated area (includes extending Cox Cable & Network Drops into the TV's)
39
PBX -Telecom
-
$
Allowance
12,800
$
3,800
$
16,600
$
Per PDC IT Estimate dated 4.25.22
40
Desktop Devices (Desktops, Laptops, Handhelds)
-
$
Allowance
67,358
$
18,684
$
86,042
$
Per PDC IT Estimate dated 4.25.22
41
Network Electronics
-
$
Allowance
20,630
$
7,760
$
28,390
$
Per PDC IT Estimate dated 4.25.22
42
Software Applications
-
$
Allowance
2,500
$
2,500
$
5,000
$
Per PDC IT Estimate dated 4.25.22
43
Time & Attendance
-
$
Allowance
-
$
-
$
-
$
Per PDC IT Estimate dated 4.25.22
44
168
IT Project Management
-
$
Allowance
89,806
$
32,413
$
122,219
$
Per PDC IT Estimate dated 4.25.22 (includes all IT labor)
45
Sub-Total IT Cost
214,094
$
72,157
$
286,251
$
46
Other Equipment Costs
-
$
-
$
-
$
47
Total Equipment Costs
1,597,863
$
115,007
$
1,712,870
$
48
Consultant Fees
49
231
Architect & Engineering Fees
8.00%
% of Const
275,076
$
31,185
$
306,261
$
Per OW Estimate emailed 4.25.22
52
Equipment Planner Fees
-
$
% of Const
25,000
$
10,000
$
35,000
$
Allowance
53
Other Consultant Fees - Commissioning
-
$
% of Const
15,000
$
5,000
$
20,000
$
Allowance
54
Other Consultant Fees - Audit
-
$
Allowance
-
$
-
$
-
$
Assume no Audit on this project
55
231 Total Consultant Fees
315,076
$
46,185
$
361,261
$
56
Administrative Costs
57
233
Permit Fees
1.50%
% of Const
51,577
$
5,847
$
57,424
$
Per PDC Metric
58
IOR Fees
% of Const
-
$
-
$
-
$
No IOR Required
59
234
Site Survey, Testing, Boring, and Reports
0.125%
% of Const
-
$
-
$
-
$
No Site Site Survey, Testing, Boring, and Reports Required
60
235
Testing Services
0.25%
% of Const
8,596
$
975
$
9,571
$
Per PDC Metric
61
230
Legal Fees
% of Const
-
$
-
$
-
$
Assume no Legal Fees
62
236
Move-in - Start-up Costs
-
$
per SF
-
$
-
$
-
$
Assume Operational Expense
63
237
Project Management (FTE * Project Duration * Hr Rate)
1.00
1.17
135,893
$
58,240
$
194,133
$
Assume 1 FTE and 14 Months Total Project Duration, Blended PM rate $160/hr
64
Other Administrative Costs
-
$
-
$
-
$
65
Total Administrative Cost
196,066
$
65,062
$
261,128
$
66
Land & Site Development
67
100
Land Acquisition
-
$
-
$
-
$
-
$
Assume No Land Costs
68
101
Off Site Development
-
$
-
$
-
$
-
$
Assume No Off Site Costs
69
Total Land & Site Development Cost
-
$
-
$
-
$
70
Total (Construction + Equipment + Consultant Fees + Admin + Land Costs)
5,547,457
$
616,068
$
6,163,525
$
71
Owner's Contingencies
72
273
Owner's Contingency
10.00%
% of Cost
554,746
$
61,607
$
616,353
$
Per PDC Metric
73
Project Escalation - other than construction
% of Cost
-
$
-
$
-
$
Assume no Project Escalation. There is Construction Escalation in Line 293 above
74
Total Owner's Contingencies
554,746
$
61,607
$
616,353
$
75
Total Project Cost excluding Financing
6,102,203
$
677,675
$
6,779,878
$
76
294
Financing Costs
BCOC
-
$
-
$
-
$
Assume no Financing Costs as constuction duration less than 12 months
77
Total Project Cost including Financing
6,102,203
$
677,675
$
6,779,878
$
78
Non-Capitalized Project Cost
79
Transition and Occupancy Expenses
-
$
-
$
-
$
80
Non-Capitalized Equipment Expense
6.50%
% of equip
386,866
$
47,465
$
434,331
$
Per Garner Resources Estimate dated 4.22.22
81
Equipment Procurement
-
$
-
$
-
$
82
Demolition - Full Building
-
$
-
$
-
$
83
Total Non-Capital Project Cost
386,866
$
47,465
$
434,331
$
84
Total Project Cost - Capital + Non-Capital
6,489,069
$
725,140
$
7,214,208
$
Metric & Description
Metric & Description
Square Feet - Gross
Construction Cost per SF (Direct)
Construction Cost per SF (Direct + Indirect)
Metric & Description
Metric & Description
Metric & Description
Metric & Description
Metric & Description
Metric & Description
Metric & Description
Metric & Description
CONCEPTUAL OPINION OF PROBABLE COST (OPC)
Chandler Regional Medical Center
Graduate Medical Education (GME)
April 26, 2022
DRAFT - NOT FOR APPROVAL PURPOSES
Assume 14 month total project duration from capital approval (1 mo Planning, 2 mo Design, 2 mo Agency
Review, 6 mo Construction, 1 mo Occupancy + 2 mo Closeout)
2022 04 26 CRMC & MGMC GME OPC OCM DRAFT JM.xlsx
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