PDG - Program Definition

2.0 Program Definition

The program objective -- the answer to the question "why build anything" -- was defined by the Receiver as part of his sixth goal set out in the Turnaround Plan he provided to the Court: Provide for Necessary Clinical, Administrative and Housing Facilities. Program Development deals with the processes adopted to manage the continued development of the new facilities construction program.

This Chapter describes the interplay between the Facility Program Statement (the FPS) and the development of the Program. The FPS describes how the health care facilities to be built will deliver access to constitutionally minimal standards of care. This Chapter also discusses how the Prototype is being developed as a "kit of parts" (standardized elements of a prison health care facility that can be combined in many different ways to serve the unique needs of the specific facility) in order to accommodate the current and changing needs of CDCR's population. Built into the design of the Prototype is both quality (standard quality packages) and safety (designing elements to be installed and used in a safer manner).

Important to the delivery of the Program is determining the availability of sites for construction and the constraints each potential site brings. Those constraints include environmental challenges disclosed by California Environmental Quality Act (CEQA) review. Potential sites whose feasibility has been established will require various mitigation measures.

Guideline development and program validation support the utility of convening a System-wide Health Care Master Planning process for determining exactly how health care services can be delivered and maintained in California prisons at constitutionally adequate levels. The Master Planning effort will continue to inform the FPS and will impact how each project within the Program is delivered. One, solid, coordinated program for health care delivery is necessary to achieve the goals of this Program and thus a system-wide approach is likewise needed.

2.1 Program Planning and Guidelines

2.1.1 Facility Program Statement

Shortly after its creation, CPR identified the need to construct new health care facilities to accommodate approximately 5,000 beds for medical inmate-patients and 5,000 beds for mental health inmate-patients. The programmatic components of the new health care facilities were developed and are described in the Facility Program Statement (FPS). The FPS identifies programmatic physical plant components for the new facilities and describes how they address the medical and mental health needs of persons incarcerated in the State of California. It is intended to be a living document that changes as the elements of the program become more defined and/or are adjusted as part of a continuous improvement program.

The FPS is designed to respond to health care facility needs in multiple arrangements. Components of the FPS can be arranged in various arrays, based on the needs of a specific facility. The FPS provides data and standards to help determine the prescribed amount of support space needed based on numbers of beds, program requirements and operational factors. These ratios and multiple arrangements can serve to make quick determinations of needs at new and existing facilities. The sections of the FPS include the following:

  • Basis of Design
  • Diagnostic and Treatment
  • Housing (Units and Support)
  • General Support Buildings
  • Site and Landscaping
  • Programs (Rehabilitative programs, Housing)

The FPS describes proposed facilities that range in size between 750,000 and 1,000,000 square feet. The facilities will employ people working various shifts over a 24-hour period. The main structures include housing clusters, a diagnostic and treatment center, nurses' stations, visiting rooms, outdoor areas and dining facilities.

The SLE will provide oversight of the FPS to ensure it remains consistent with the Receiver's mission, is updated to reflect learning during design, construction and operations and that constructed facilities comport with its dictates.

2.1.2 The Prototype

The prototype is a conceptual model developed by the Program with the assistance of the SLE. It was developed in an effort to take the delivery requirements of the FPS and turn them into design for the physical facilities within which the FPS level of care can be provided. The prototype was developed to allow flexibility in responding to the emerging determination of the following:

  • The services of any given facility
  • The size of any given facility
  • The number of facilities that will need to be constructed
  • The geographic location of facilities

Given the uncertainty surrounding the condition of existing facilities and forecasts of future prison populations, the prototype has been designed to adapt to various needs, including new facilities, remodeling projects and/or infill development.

Like the FPS, the prototype is a "living" document. At the early stages of development, the prototype was more general in nature and included architectural features and engineering and equipment criteria. Key development phases include:

  • Prototype Development and the Kit of Parts
  • Preliminary Design and Site Adaptation
  • Detailed Design and Construction Documents
  • Prototype Control

2.1.2.1 The Kit of Parts

The development of the prototype resulted in a kit of parts. The kit of parts represents all the potential physical and structural elements necessary to support the various programmatic components identified in the FPS. Whether the facility is a stand-alone institution or a remodel/infill project, the kit-of-parts ensures a design solution that provides uniform inmate-patient care and treatment.

The following describes the various components included in the kit of parts:

  • Architecture -- Plans developed based on the most current FPS with building and structural plans showing size of room, doors, wall construction, windows. Exterior building envelopes identified.
  • Integrated Security Plan (ISP) -- A design document recording security systems, operational decisions, and staffing. Includes security criteria/policy, functional narratives, workstations/staffing, hardware/keying systems, specifications, schedules, and control panel functions.
  • Structural -- Major structural assemblies, components and locations identified. Loads and seismic requirements identified.
  • Mechanical -- Major mechanical air distribution systems. Central plant layout. Equipment loads, sizing and placement.
  • Plumbing -- All fixtures identified and placed. Major piping locations established.
  • Fire Sprinkler and Equipment -- All fire sprinkler zones identified. Alarm annunciation protocol established.
  • Electrical -- Major loads, equipment and room requirements. General room layouts for lighting, outlets and electrical equipment.
  • Furnishings, Fixtures and Equipment (FF&E) -- All items identified and tabulated. Preliminary floor plans developed.
  • Specifications -- Draft of General Conditions and all sections in CSI format.
  • Project Schedule -- Overall project schedule reflecting key milestones.
  • Materials Management and Material Handling -- Operational criteria for service departments including Material Management, Material Handling, Linen, Wastes, and other Support Services.
  • Food Service -- Food system/delivery integrated into the Prototype for dietary needs and delivery.

Key consultants participating in prototype refinement include:

  • Code Consultant -- Life safety and security zoning
  • Security Consultant -- Electronic security, nurse call, telemedicine systems
  • Medical Equipment -- All medical equipment identified and tabulated
  • OSHPD Consultant -- Compliance with OSHPD regulations
  • Work Flow Consultants/Value Stream Mapping -- Functional spaces and staffing adjusted based on analysis
  • State Fire Marshall -- Integration of fire and life safety review
  • Energy -- Energy usage defined, conservation strategies developed, energy modeling performed

2.1.2.2 Functional Organization Chart

Deployment of appropriate resources requires organizing around the processes necessary to efficiently and effectively complete each phase of the Program. A single, Functional Organization Chart ("FOC") has been created which treats all IPD team members as integral staff, as if they all worked for one company. A collaboration between all Core Team members, specialty consultants and the PM executive leadership created the FOC. It is designed to use the best resources available on the Project regardless of that resource's "home" company.

The FOC first describes functions or categories of processes required to successfully complete the program in the fastest and most cost-effective manner. Within each function, the relevant processes are described. For each specific process, each task needed to complete the process is designated and then each task is broken down into a job description.

2.1.2.3 Quality and Safety

In contrast to traditional quality and safety programs where the greatest emphasis on quality and/or safety occurs during the construction phase, the Program requires all stakeholders to maintain an integrated, collaborative focus on quality and safety starting with planning, through design, into and through construction and finishing with activation. Considerations of quality and safety are woven into the fabric of the entire program.

Quality

Quality serves as a basis for design throughout the Program. "Built-in Quality" is a key component of Lean Project Delivery because it assumes that the final product meets the customer's definition of value. An early understanding of the customer's conditions of quality satisfaction influences both design and construction while helping to reduce waste. Waste in the quality context covers two main ideas:

  • Quality that exceeds the customer's needs -- taking unnecessary steps to over process the work
  • Quality less than the customer's requirements -- results in unacceptable work requiring repair or rework, scrap, replacement production, re-inspection and delay

During the planning and prototype development processes, the Program invited a number of stakeholders to assist in defining acceptable levels of facility quality throughout the program:

  • A group consisting of doctors, nurses, security, operations managers and professional planners toured the country to investigate the ranges of prison health care programs currently available
  • End users, particularly doctors, nurses, security and operations managers were brought in the early stages of prototype development to refine needs and expectations

Safety

The Program recognizes the importance of a program-wide view of safety. Effective safety management throughout planning, design and construction can minimize risk to the health and safety of people who construct, occupy and maintain a facility. Safety concerns are addressed in three specific areas:

  • Safety-In-Planning -- Including stakeholders as early as possible for realistic logistics and sequencing plans
  • Safety-In-Design -- Incorporating safety into the construction documents and daily plans
  • Safety-In-Action -- Building an organization that supports a safety culture through leadership, management, worker empowerment and incident investigation

Developed safety strategies are based on the following principles:

  • Projects are inherently unsafe -- this truth is acknowledged
  • Procedures alone cannot guarantee safety -- safety comes from skillful and knowledgeable workers who are alert to known safety concerns
  • Human error is a symptom of trouble deeper inside the system -- people do not intentionally cause accidents

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