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HomeMy WebLinkAbout2023-002-E-AMS-CPL + RHA-PreDesign for Behavioral Health Crisis Diversion FacilityRevised 06/21 1 [Departmental Use Only] TITLE AMS Diversion FY 2022/2023 NORTH CAROLINA SERVICES AGREEMENT RFP/RFQ ORANGE COUNTY This Services Agreement (hereinafter “Agreement”), made and entered into this 15th day of December, 2022, (“Effective Date”) by and between Orange County, North Carolina a political subdivision of the State of North Carolina (hereinafter, the "County") andCPL Architecture Engineering Planning, (hereinafter, the "Provider"). WITNESSETH: That the County and Provider, for the consideration herein named, do hereby agree as follows: 1. Services a. Scope of Work. i) This Services Agreement (“Agreement”) is for services to be rendered by Provider to County with respect to (insert type of project): Predesign services for the operational and facility planning on a new Behavioral Health Crisis Diversion Facility in Hillsborough NC. Please See Attached Letter of Agreement dated 11/7/2022. ii) By executing this Agreement, the Provider represents and agrees that Provider is qualified to perform and fully capable of performing and providing the services required or necessary under this Agreement in a fully competent, professional and timely manner. iii) Time is of the essence with respect to this Agreement. iv) The services to be performed under this Agreement consist of Basic Services, as described and designated in Section 3 hereof. Compensation to the Provider for Basic Services under this Agreement shall be as set forth herein. 2. Responsibilities of the Provider a. Services to be provided. The Provider shall provide the County with all services required in Section 3 to satisfactorily complete the Project within the time limitations set forth herein and in accordance with the highest professional standards. b. Standard of Care. i) The Provider shall exercise reasonable care and diligence in performing services under this Agreement in accordance with the highest generally accepted standards DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 Revised 06/21 2 of this type of Provider practice throughout the United States and in accordance with applicable federal, state and local laws and regulations applicable to the performance of these services. Provider is solely responsible for the professional quality, accuracy and timely completion and submission of all work related to the Basic Services. ii) Provider shall be responsible for all errors or omissions of its agents, contractors, employees, or assigns in the performance of the Agreement. Provider shall correct any and all errors, omissions, discrepancies, ambiguities, mistakes or conflicts at no additional cost to the County. iii) The Provider shall not, except as otherwise provided for in this Agreement, subcontract the performance of any work under this Agreement without prior written permission of the County. No permission for subcontracting shall create, between the County and the subcontractor, any contract or any other relationship. iv) Provider is an independent contractor of County. Any and all employees of the Provider engaged by the Provider in the performance of any work or services required of the Provider under this Agreement, shall be considered employees or agents of the Provider only and not of the County, and any and all claims that may or might arise under any workers compensation or other law or contract on behalf of said employees while so engaged shall be the sole obligation and responsibility of the Provider. v) If activities related to the performance of this Agreement require specific licenses, certifications, or related credentials Provider represents that it or its employees, agents and subcontractors engaged in such activities possess such licenses, certifications, or credentials and that such licenses certifications, or credentials are current, active, and not in a state of suspension or revocation. vi) Should this Agreement involve project designs, the construction or creation of which is to be bid out or fulfilled by other contractors, and bidding or negotiation with contractors produce prices which, when added to the other elements of the approved total project cost, produce a cost that is in excess of the approved total project cost, the Provider shall participate with the County in negotiation and design adjustments to the extent such are necessary to obtain prices within the approved total project cost. All activity of the Provider with respect to these matters shall constitute Basic Services and shall be performed by the Provider without additional compensation. If negotiation and design adjustments fail to bring costs within the total project cost the County may reject all bids and Provider will redesign or reduce portions of the project in an effort to reduce the bid prices to within the total project cost and rebid the project. One such redesign is included within Basic Services. If this second letting for bids does not produce bids that are within the approved total project cost initially or after negotiations with the contractor the cost is not reduced to an amount within the total project cost, the Provider is not obligated to engage in further redesign. 3. Basic Services DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 Revised 06/21 3 a. Basic Services. i) The Provider shall perform as Basic Services the work and services described herein and as specified in the County’s Request for Proposals or Request for Qualifications (the “RFP”) “RFP Number 367-OC5359 for “Provide Preliminary/Advanced Planning Services for the Construction of Behavioral Health Crisis Diversion Facility serving Orange County, North Carolina” issued July 11, 2022, and the Provider’s proposal, which are fully incorporated and integrated herein by reference together with Attachments Letter of Agreement dated 11/07/2022, Bid Addendum #1 dated August 5, 2022 (designate all attachments). In the event a term or condition in any referenced document or attachment conflicts with a term or condition of this Agreement the term or condition in this Agreement shall control. Should such conflict arise the priority of documents shall be as follows: This Agreement, the County’s RFP together with attachments, Provider’s Proposal together with attachments. ii) The Basic Services will be performed by the Provider in accordance with the following schedule: (Insert milestones task list, dates and fees. If milestones are not established mark N/A under Milestone Task 1.) Milestone Task Milestone Date Milestone Fee 1. NA 2. 3. 4. 5. 6. 7. 8. 9. 10. iii) Should County reasonably determine that Provider has not met the Milestone Dates established in Section 3(a)(ii), County shall notify Provider of the failure to meet the Milestone Date. The County, at its discretion may provide the Provider seven (7) days to cure the breach. County may withhold the accompanying payment without penalty until such time as Provider cures the breach. In the alternative, upon Provider’s failure to meet any Milestone Date the County may modify the Milestone Date schedule. Should Provider or its representatives fail to cure the breach within seven (7) days, or fail to reasonably agree to such modified schedule, County may immediately terminate this Agreement in writing, without penalty or incurring further obligation to Provider. This section shall not be interpreted to limit the definition of breach to the failure to meet Milestone Dates. 4. Duration of Services a. Term. The term of this Agreement shall be from 12/15/2022 to 06/15/2024. DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 Revised 06/21 4 b. Scheduling of Services i) The Provider shall schedule and perform its activities in a timely manner so as to meet the Milestone Dates listed in Section 3. ii) Should the County determine that the Provider is behind schedule, it may require the Provider to expedite and accelerate its efforts, including providing additional resources and working overtime, as necessary, to perform its services in accordance with the approved project schedule at no additional cost to the County. iii) The Commencement Date for the Provider's Basic Services shall be 12/15/2022. 5. Compensation a. Compensation for Basic Services. Compensation for Basic Services shall include all compensation due the Provider from the County for all services satisfactorily (as determined by the County) performed pursuant to this Agreement. The maximum amount payable for Basic Services is One Hundred Seventy Two Thousand Three Hundred and Twenty Five Dollars ($172,325.00). In the event the amount stated on an invoice is disputed by the County, the County may withhold payment of all or a portion of the amount stated on an invoice until the parties resolve the dispute. Payment for Basic Services shall become due and payable in direct proportion to satisfactory services performed and work accomplished. Payments will be made as Project milestones as set out in Section 3(a)(ii) are achieved up to the corresponding milestone fee. (For example, Provider may invoice for the amount listed as the milestone fee corresponding to the first milestone task upon County’s acknowledgement of the satisfactory completion of Task one. Upon the County’s acknowledgement that the second Task has been satisfactorily completed Provider may invoice for that corresponding milestone fee.) Milestone fees shall be the maximum amount payable for its corresponding milestone task which shall not be altered except by written amendment. b. Additional Services. County shall not be responsible for costs related to any services in addition to the Basic Services performed by Provider unless County requests such additional services in writing and such additional services are evidenced by a written amendment to this Agreement. 6. Responsibilities of the County a. Cooperation and Coordination. The County has designated (Steve Arndt) to act as the County's representative with respect to the Project who shall have the authority to render decisions within guidelines established by the County Manager or the County Board o f Commissioners and who shall be available during working hours as often as may be reasonably required to render decisions and to furnish information. 7. Insurance a. General Requirements. Provider shall obtain, at its sole expense, Commercial General Liability Insurance, Automobile Insurance, Workers’ Compensation Insurance, and any additional insurance as may be required by County’s Risk Manager as such insurance DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 Revised 06/21 5 requirements are described in the Orange County Risk Transfer Policy and Orange County Minimum Insurance Coverage Requirements (each document is incorporated herein by reference and may be viewed at http://www.orangecountync.gov/departments/purchasing_division/contracts.php.) If County’s Risk Manager determines additional insurance coverage is required such additional insurance shall consist of NA (if no additional insurance required mark N/A as being not applicable). Provider shall not commence work until such insurance is in effect and certification thereof has been received by the County's Risk Manager. 8. Indemnity a. Indemnity. To the extent authorized by North Carolina law the Provider agrees, without limitation, to defend, indemnify and hold harmless the County from all loss, liability, claims or expense, including attorney's fees, arising out of or related to the Project and arising from property damage or bodily injury including death to any person or persons caused in whole or in part by the negligence or misconduct of the Provider except to the extent same are caused by the negligence or willful misconduct of the County. It is the intent of this provision to require the Provider to indemnify the County to the fullest extent permitted under North Carolina law. 9. Amendments to the Agreement a. Changes in Basic Services. Changes in the Basic Services and entitlement to additional compensation or a change in duration of this Agreement shall be made by a written Amendment to this Agreement executed by the County and the Provider. The Provider shall proceed to perform the Services required by the Amendment only after receiving a fully executed Amendment from the County. 10. Termination a. Termination for Convenience of the County. This Agreement may be terminated without cause by the County and for its convenience upon seven (7) days prior written notice to the Provider. b. Other Termination. The Provider may terminate this Agreement based upon the County's material breach of this Agreement; provided, the County has not taken all reasonable actions to remedy the breach. The Provider shall give the County seven (7) days' prior written notice of its intent to terminate this Agreement for cause. Either party may terminate this Agreement upon notice to the other party that obligations pursuant to this Agreement are made impractical due to declarations of emergency by Orange County or by North Carolina due to events directly impacting Orange County. Both parties shall remain responsible for all payment and performance due up to the receipt of such notice, but shall have no further obligation or responsibility beyond that date provided the terminating party has taken all reasonable steps to complete the performance of its obligations. c. Compensation After Termination. DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 Revised 06/21 6 i) In the event of termination, the Provider shall be paid that portion of the fees and expenses that it has earned to the date of termination, less any costs or expenses incurred or anticipated to be incurred by the County due to errors or omissions of the Provider. Upon request of the County, the Provider shall submit to County all relevant documentation, including but not limited to, job cost records, to support its claims for final compensation. ii) Should this Agreement be terminated, the Provider shall deliver to the County within seven (7) days, at no additional cost, all deliverables including any electronic data or files relating to the Project. d. Waiver. The payment of any sums by the County under this Agreement or the failure of the County to require compliance by the Provider with any provisions of this Agreement or the waiver by the County of any breach of this Agreement shall not constitute a waiver of any claim for damages by the County for any breach of this Agreement or a waiver of any other required compliance with this Agreement. e. Suspension. County may suspend the Basic Services and this Agreement at any time for County’s convenience and without penalty to County upon three (3) days’ notice to Provider. Upon any suspension by County, Provider shall discontinue the Basic Services and shall not resume the Basic Services until notified to proceed by County. 11. Additional Provisions a. Limitation and Assignment. The County and the Provider each bind themselves, their successors, assigns and legal representatives to the terms of this Agreement. Neither the County nor the Provider shall assign or transfer its interest in this Agreement without the written consent of the other. b. Governing Law. This Agreement and the duties, responsibilities, obligations and rights of respective parties hereunder shall be governed by the laws of the State of North Carolina. c. Compliance with Laws. Provider shall at all times remain in compliance with all applicable local, state, and federal laws, rules, and regulations including but not limited to all state and federal anti-discrimination laws, policies, rules, and regulations and the Orange County Non-Discrimination Policy and Orange County Living Wage Policy (each policy is incorporated herein by reference and may be viewed at http://www.orangecountync.gov/departments/purchasing_division/contracts.php.) Any violation of this requirement is a breach of this Agreement and County ma y immediately terminate this Agreement without further obligation on the part of the County. This paragraph is not intended to limit and does not limit the definition of breach to discrimination. By executing this Agreement Provider affirms that Provider and any subcontractors of Provider are and shall remain in compliance with Article 2 of Chapter 64 of the North Carolina General Statutes. By executing this Agreement Provider certifies that Provider has not been identified, and has not utilized the services of any agent or subcontractor identified, on the list created by the State Treasurer pursuant to G.S. 147-86.58. By executing this Agreement Provider certifies that Provider has not DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 Revised 06/21 7 been identified, and has not utilized the services of any agent or subcontractor identified, on the list created by the State Treasurer pursuant to G.S. 147-86.81. d. Dispute Resolution. Any and all suits or actions to enforce, interpret or seek damages with respect to any provision of, or the performance or non-performance of, this Agreement shall be brought in the General Court of Justice of North Carolina sitting in Orange County, North Carolina. It is agreed by the parties that no other court shall have jurisdiction or venue with respect to such suits or actions. Binding arbitration may not be initiated by either Party, however, the Parties may agree to nonbinding mediation of any dispute prior to the bringing of a suit or action. e. Entire Agreement. This Agreement, together with the RFP and its attachments and the Proposal and its attachments, represents the entire and integrated agreement between the County and the Provider and supersedes all prior negotiations, representations or agreements, either written or oral. This Agreement may be amended on ly by written instrument signed by both parties. Modifications may be evidenced by facsimile signatures. f. Severability. If any provision of this Agreement is held as a matter of law to be unenforceable, the remainder of this Agreement shall be valid and binding upon the Parties. g. Ownership of Work Product. Should Provider’s performance of this Agreement generate documents, items or things that are specific to this Project such documents, items or things shall become the property of the County and may be used on any other project without additional compensation to the Provider. The use of the documents, items or things by the County or by any person or entity for any purpose other than the Project as set forth in this Agreement shall be at the full risk of the County. h. Non-Appropriation and Government Action. Provider acknowledges that County is a governmental entity, and the validity of this Agreement is based upon the availability of public funding under the authority of its statutory mandate. In the event that public funds are unavailable or not appropriated for the performance of County’s obligations under this Agreement, then this Agreement shall automatically expire without penalty to County immediately upon written notice to Provider of the unavailability or non-appropriation of public funds. It is expressly agreed that County shall not activate this non-appropriation provision for its convenience or to circumvent the requirements of this Agreement. In the event of a change in the County’s statutory authority, mandate or mandated functions, by state or federal legislative or regulatory action, which adversely affects County’s authority to continue its obligations under this Agreement, then this Agreement shall automatically terminate without penalty to County upon written notice to Provider of such limitation or change in County’s legal authority. i. Signatures. This Agreement together with any amendments or modifications may be executed electronically. All electronic signatures affixed hereto evidence the consent of the Parties to utilize electronic signatures and the intent of the Parties to comply with DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 Revised 06/21 8 Article 11A and Article 40 of North Carolina General Statute Chapter 66. j. Notices. Any notice required by this Agreement shall be in writing and delivered by certified or registered mail, return receipt requested to the following: Orange County Provider’s Name & Address Attention: Steve Arndt CPL + RHA P.O. Box 8181 255 Woodcliff Drive Hillsborough, NC 27278 Fairport, NY 14450 IN WITNESS WHEREOF, the Parties, by and through their authorized agents, have hereunder set their hands and seal, all as of the day and year first above written. ORANGE COUNTY: PROVIDER: By: _________________________________ Bonnie Hammersley By: __________________________________ Adam Chahulski Printed Name and Title DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 12/28/20221/4/2023 Revised 06/21 9 ORANGE COUNTY—DEPARTMENT USE ONLY ______________________________________________________________________________ Department Party/Vendor Name: CPL + RHA Party/Vendor Contact Person: Adam Chahulski Contact Phone: 704-331-9131 Party/Vendor Address: 255 Woodcliff Drive City Fairport State: NY Zip: 14450 Department: AMS Amount: $172,325.00 Purpose: PreDesign for Behavioral Health Crisis Diversion Facility Budget Code(s): 61370035- 870000-10080 Vendor # 67895 (N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New Renewal Amendment Effective Date Approved by Board Yes No Agenda Date: --- For Section XIV. c. contracts only, Approved by Board in Current FY Budget Yes No This agreement is approved as to technical form and co ntent and I as Department Director affirmatively state work on this project has not been initiated prior to execution of the agreement: Department Director’s Signature ________________________________________ Date: ________ Agreements for emergency services or repair are not subject to the above affirmation. If services related to this agreement have already begun or been completed please briefly describe the nature of the emergency condition that was addressed: Information Technologies (Applicable only to hardware/software purchases and related services) This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer___________________________________ Date: ________ Risk Management This agreement is approved for sufficie ncy of insurance standards, specifications, and requirements: Office of the Risk Management Officer___________________________________ Date: _________ Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer ____________________________________ Date: _________ Legal Services This agreement is approved as to legal form and sufficiency: Office of the County Attorney __________________________________________Date: ________ Clerk to the Board Received for record retention: All Docusign contracts must be copied to the Clerk upon completion: occlerkdocs@orangecountync.gov The following signature block is for hard copies only and is not required for Docusign contracts: Office of the Clerk to the Board __________________________________________Date:_________ DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 12/19/2022 12/29/2022 1/4/2023 1/4/2023 6302 Fairview Road, Suite 102 I Charlotte, NC 28210 I 704.331.9131 I cplteam.com November 7, 2022 Via Email Mr. Steven Arndt, MBA, CFM (sarndt@orangecountync.gov) Asset Management Services Director Orange County 405 Meadowlands Drive Hillsborough, NC 27278 RE: BEHAVIORAL HEALTH CRISIS DIVERSION FACILITY Orange County Hillsborough, NC Dear Steven: On behalf of CPL + RHA, we are pleased to submit the following proposal for design services for the operational and facility planning on a new Behavioral Health Crisis Diversion Facility in Hillsborough, North Carolina. PROJECT UNDERSTANDING CPL + RHA understands Orange County (Client) wishes to contract with CPL + RHA to provide architectural and operational planning on a new Crisis Diversion Facility for the residents of Orange County. The initial effort will be to develop programming documents, preliminary/schematic design, site requirements, and opinions of cost for the project, The scope of the project will include, but not be limited to: · Front Entrance / Waiting Areas · Rear Entrance · BHUC Clinical Areas · Adult FBC Areas · Medical Areas · Facility Security · Outpatient Service Areas · General Purpose Areas · Community Partner Offices SCOPE OF SERVICES Task I – Validation / Schematic Design CPL + RHA will lead operational planning sessions to assist in the process to establish/clarify space needs, bed and chair allowances, requirements and licensing and input on design specifications to ensure the best practices for service delivery. In addition, we will lead parallel efforts in reviewing potential sites to house the new Crisis Diversion Center. This will include assessments on property zoning, utilities, storm water management, parking, and building massing to understand if the site can accommodate a DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 LETTER OF AGREEMENT Behavioral Health Crisis Diversion Facility Orange County November 7, 2022 Page 2 of 3 one or two-story building based on the developed clinical programming. At the conclusion of our planning efforts our deliverables will include, but not be limited to: 1. Site Plan(s) and required narrative assessments 2. Building program 3. Operational framework/service delivery, as well as operational costs estimates 4. Plan bubble diagrams 5. M/E/P narratives and single line diagrams 6. Renderings (As required) 7. Construction cost estimates SCHEDULE While no overall schedule has been determined, CPL + RHA will proceed forward in the most expeditious manner possible. Our proposed duration of the efforts described within this proposal are further described in the schedule included in our RFP response to Orange County. EXCLUSIONS AND CLARIFICATIONS 1. This proposal is based off the scope of work as described in RFQ No 367-OC535 issued by Orange County. 2. This fee proposal does not include medical equipment planning fees. 3. Site borings, and special inspections are excluded from CPL’s scope of services. 4. Cost estimation and building massing assumes cost comparisons will be required for up to two different sites. 5. The schematic package will not be submitted to DHSR unless specifically requested by the Client. 6. Additional exclusions and clarifications as noted in the accompanying sub-consultant proposals. 7. Site surveys are included in the proposal as an allowance that will only be billed once costs are incurred, and/or necessary. The cost of the survey was estimated on two sites needing boundary, topo, and utility location. 8. Any items not contained in our Scope of Services or contrary to the assumptions listed above will be deemed additional services. If requested by the Client, additional services will be provided on an hourly basis at our Standard Hourly Billing rates, or as a fixed fee mutually agreed to in advance by both parties. CLIENT RESPONSIBILITIES The Client shall appoint an “Owner’s Representative” to act as the point of contact for CPL. It shall be the responsibility of the client to provide the following: · Reasonable advance notice of scheduled meetings. · Decisions on critical issues in a timely manner. · Payment of all invoices in accordance with this agreement. COMPENSATION CPL agrees to provide the professional design services listed in the Scope of Services. Our fee proposal is based upon work-effort projections and applicable billing rates for the scope of work anticipated for this project. We propose a fixed fee of $172,325.00, summarized in the following table. Normal and customary reimbursable expenses are included in our fee. DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 LETTER OF AGREEMENT Behavioral Health Crisis Diversion Facility Orange County November 7, 2022 Page 3 of 3 Description Fee CPL – Architectural/Interiors $34,560.00 RHA – Behavioral Health Service Provider $30,000.00 RMF – M/E/P Engineering $30,600.000 Timmons Group – Site/Civil $19,600.00 35 North – Cost Estimators $7,665.00 Site Survey Allowance $50,000.00 Total Design Fee (including Site Survey Allowance) $172,325.00 We will bill monthly for the progress of the work. CONCLUSION This document serves as the Owner – Architect Agreement. If these terms are acceptable, please countersign and return one copy to our office. The proposed fee is valid for 90 days from the date of this proposal. We look forward to working with you on the successful completion of this project. Sincerely, CPL Adam M. Chahulski, AIA, LEED AP, NCARB Principal ACCEPTED: ORANGE COUNTY By: Title: Dated: DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 August 12, 2022 QUALIFICATIONS FOR Orange County, NC RFQ No. 367-0C5359 Preliminary/Advanced Planning Services for Construction of a Behavioral Health Crisis Division Facility DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 1. Cover Letter August 12, 2022 Jovana Amaro, Purchasing Agent, Orange County jamaro@orangecountync.gov RFQ#: 367-OC5359: to Provide Preliminary/Advanced Planning Services for the Construction of a Behavioral Health Crisis Diversion Facility serving Orange County, NC., CPL Dear Ms. Amaro and Members of the Selection Committee: On behalf of CPL + RHA, we are pleased to submit our qualifications and proposal for professional design and service-provider services related to the Crisis Diversion Facility (CDF) located in Orange County. More than ever, these facilities are so important to our local communities because they provide different care options for individuals going through mental health and substance abuse crisis. They create real options for early intervention and recovery. CPL + RHA has assisted many of our community partners over the years with feasibility studies and design solutions for Crisis Diversion Facilities, as well as provided guidance on clinical operations and management of these facilities. In addition to CDFs, our team has a wealth of experience with Behavioral Health projects, including over 30+ years of guiding projects through North Carolina’s Division of Health Service Regulation plan review department, as well as working with independent skilled operators of these facilities. Among our Behavioral Health project experience: • RHA Health Services • Vaya Health • Atrium Health • Caldwell UNC Healthcare • Cone Health • Erlanger Western Carolina Hospital • Mission Health • Wayne UNC Healthcare • Wake Forest Baptist Medical Center CPL + RHA is committed to providing operationally efficient planning and design that truly enhances patient and caregiver experiences. With a team of over 450 multi-disciplined architects, engineers and planners, we focus on performance, innovation and adaptability—we challenge conventional thinking while planning for the future. We believe we are the right team for this project and look forward to the opportunity to introduce our team and further discuss our unique approach to the design of this special project. Very truly yours,6302 Fairview Road, Suite 102 I Charlotte, NC 28210 I 704.331.9131 I CPLteam.comAdam M. Chahulski, AIA, NCARB, LEED AP Principal AChahulski@CPLteam.com 704.770.8999 Sandy Feutz, Chief Operating Officer sfeutz@rhanet.org DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 | 3 2. Qualifications 6302 Fairview Road, Suite 102 I Charlotte, NC 28210 I 704.331.9131 I CPLteam.comAt CPL, we feel inspired every day to make our world a better place through exceptional design, dedicated service and lasting client relationships. CPL has been serving public and private clients since 1975. Our team of over 450 dedicated professionals provides design services of exceptional quality and value. We maintain offices in New York, Pennsylvania, Georgia, North Carolina and South Carolina and offer expertise in architecture, engineering, planning and construction services. CPL’s philosophy grows from: - Our Belief in Full Service Capabilities - Our Focus on Personal Attention - Our Commitment to Principal Participation Our Services Being full-service means bringing innovation to our clients in terms of service delivery. Our highly collaborative and multi-disciplined team is capable of solving every challenge posed by your project. Our design professionals could literally create a city—from the earliest planning stages to the ribbon cutting—approaching every aspect of each project with full service, personal attention and principal participation. Our in-house expertise includes: • Architecture and Interior Design • Mechanical, Electrical & Plumbing Engineering • Structural Engineering • Civil Engineering • LEED Design and Energy Performance Contracting • Municipal Services & Planning • Transportation Engineering The CPL Charlotte office will be supporting your project. Primary Contact & Location Adam Chahulski, AIA, NCARB, LEED AP Principal in Charge (Charlotte office) achahulski@CPLteam.com 704.770.8999 CPL Charlotte 6302 Fairview Rd., Suite 102 Charlotte, NC 28210 704.331.9131 Rounding out our team will be (qualifications provided in Section 4): • RHA Health Services, our qualified behavioral health services consultant • RMF Engineering providing MEP Engineering • Timmons Group providing CIvil/Site Engineering • 35 North providing professional Cost Estimating We are engineers, architects, planners and technical specialists. We are community leaders, business owners and friends. Orange County DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 | 4 2. Qualifications Behavioral Health Qualifications We design healing spaces that elevate the human spirit . Our leadership is by example, not by resume or personalities. We promote the breaking down of silos and designing as a team where information is shared across disciplines. CPL has the respect of the design and construction communities because of our continued success on projects of this type and size. As a full-service firm, collaboration is at the heart of what we do. We combine the expertise of various disciplines to approach projects from every angle. We will put the right people in the right place for your project’s success. This project requires a team with a track-record of success in working together. You need a team that has the capacity and experience to manage technically complex projects at multiple locations on the same site with different stakeholders and operational organizations; one that keeps your projects on budget and schedule, who are experts in behavioral healthcare designs, and will make your project a priority. Our team has the experience you need. As Principal, Adam Chahulski will see that appropriate resources are assigned and overall project goals are being met. Day-to-day management of projects and communication will be handled by Robin Washco, our designated project manager. All requests and required services will either be completed by Robin or delegated to the appropriate team member. Representation at all meetings will include team members with the appropriate level of understanding and expertise. Project Approach Our experience informs our design approach. Differentiators We are disruptors. We believe the way we work can add meaning and value to the world. Creativity inspires change, and sometimes coloring outside the lines brings a new perspective. The small details matter within the bigger picture. Above all, we believe collaboration is the best way forward. Our healthcare design philosophy is grounded in our commitment to patient-centered design that is operationally efficient, fiscally responsible, and supports the needs of patients, families, and the caregivers that serve them. Patient-centered design is the common thread that unifies our work. Patient-centered design requires a holistic approach that considers the outcomes for patients, the experience of care-givers, and particularly for CDFs...safety and comfort. DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 | 5 2. Qualifications Collaboration We are nimble enough to respond quickly and deliver a project that is efficient, cost effective, and in alignment with your expectations. Our dedicated team of 20+ healthcare planners and architects across North Carolina have experience working on Behavioral projects across the state—where we are influencing and changing patient environments through evidence based design. We boast 30+ years’ experience working with DHSR’s planning and construction division, and we understand the rules and regulations under which these projects will be reviewed. Considerations The design of Crisis Diversion Facilities must be flexible and adaptable to acknowledge that our understanding of mental and behavioral health will continue to evolve and change the way we design. From the plan layout, down to the electrical outlets that are specified, the entire design needs to be cohesive. Details matter. In order to offer patients the sense of privacy and security, thoughtful program consideration will need to be given to private versus shared rooms, community areas, accessibility to staff, and openness of the environment. Engaging the community, local hospitals, and law enforcement agencies can go a long way in promoting a successful design of these types of facilities—ensuring care begins before a patient walks through the doors. CPL CREATIVE LABS Our team leverages state-of- the-art technology to better serve our clients. The CPL team utilizes BIM in conjunction with industry standard A/E applications such as 3D Studio Max, Sketch Up Pro, Lumion, Enscape and Adobe Creative Suite in order to generate presentation graphics and renderings. These are used to demonstrate potential design solutions using the same model that will be used to generate the construction documents and pricing documents. These engaging applications allow the client and user to be involved in the creation and development of the project design. We offer programs such as Mixed Reality, Renderings/ Animations and Reality Capturing capabilities. • Mixed Reality – Whether it be virtual (VR) or augmented reality (AR) these tools allow us to immerse our clients into the project early on • Renderings/Animations – As another means of project visualization our team uses a multitude of tools to produce renderings or animations to fit the project needs • Reality Capturing – Whether it be drones or laser scanning, accurately capturing the physical environment of any given site is important to project success. The days of getting back to the office with missed dimensions are over! BIM Model Final Lobby Take a picture with your smart phone camera to learn more about CPL Creative Labs’ capabilities. Take a picture with your smart phone camera for an immersive experience. DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 | 6 3. Scope and Timeline Our Approach to Your Project 3a. An indication of your understanding of the project. North Carolina is experiencing increasing numbers of individuals in behavioral health crisis. Local hospital emergency departments (ED) and detention facilities are the most often used resources during these episodes of crisis. Local ED’s often do not have the capacity to treat persons with primary behavioral health needs resulting in individuals being “boarded” for several hours or even days before a placement can be located or the person is safe to be discharged. This ED stay sometimes occurs without effective assessment, treatment or linkage to the ongoing community services and support needed to prevent ED utilization for future psychiatric crises. The availability of other specialized community-based crisis services can assess, treat, and connect individuals more quickly to behavioral health specific resources which support an individual’s path to recovery. A number of individuals who commit crimes typically do so due to their unstable and untreated behavioral health concerns. This is often a direct result of a lack of medication and treatment options and/or lack of suitable community resources, supports or referrals. Charges, usually misdemeanor and nuisance type charges result in incarceration. This puts a strain on the local criminal justice and public safety entities, particularly law enforcement, detention centers and courts in Orange County. This strain has negative clinical, fiscal, and societal affects. In 2019, Orange County participated in a Sequential Intercept Mapping (SIM) exercise to determine current Behavioral Health resources and gaps. The SIM exercise resulted in creating a work group and sophisticated data collection resulting in the identification of needs and solutions. The data, current crisis continuum services, and identified gaps support the need for a robust crisis continuum to: • Provide a safe place for de-escalation and treatment including case management and linkage to the assessed level of care. This will occur as the preferred alternative to the jail or local emergency department. • Provide multiple levels of care within the Crisis Continuum in order to stabilize individuals. • Decreased delays in the initiation of treatment and increased engagement in the outpatient service array. The availability of other specialized community-based crisis services to support an individual’s path to recovery. A partnership and venture to develop crisis continuum services will succeed in paving the path toward creating a crisis center in Orange County to be the first line option and alternative to ED for persons with behavioral health crises. DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 | 7 3. Scope and Timeline Guided by the shared mission, vision, and values of PACE—Passion, Accountability, Communication & Ethics—RHA’s service delivery and treatment philosophy are person-centered and focuses on the use of evidence-based practices through screening, assessment, treatments, staffing via credentialed positions, counseling, medications, safety and after care planning, and documentation. Operated by RHA, the proposed Behavioral Health Urgent Care (BHUC) will become the primary access point for children, adolescents, and adults in crisis in Orange County and will become a part of their statewide array of mental health, substance use, and intellectual/ developmental disability services. This BHUC will be co-located among a full continuum of services at the proposed site. The location of this facility is a central component of the proposed plan to decrease ED utilization in Orange County and increase access to and utilization of services for members of the community seeking crisis support, routine care, and/or community-based services. The BHUC will be staffed by a multi-disciplinary team that includes physicians and extenders, licensed clinicians, registered nurses (RN), qualified professionals (QP), certified peer support specialists (CPSS), and administrative support. The use of certified peer support specialists is an integral part of RHA’s successful service delivery and marks its commitment to promoting a recovery-oriented system of care within its service array. Whereas the program will be staffed primarily by RHA employees, contractual relationships may be developed for medical and licensed clinical staff, as well as security officers via an Orange County Law Enforcement agency. Prescriber staff will have routine hours on- site, with 24/7/365 on-call availability. Telemedicine equipment will be available for situations when telehealth is needed; however, clinical services will be delivered face-to face whenever possible. DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 | 8 3. Scope and Timeline Everyone who presents at the BHUC, regardless of age or disability, will participate in an initial evaluation to identify their primary needs and establish a preliminary treatment plan. Those who are identified as presenting with routine needs will be offered a Comprehensive Clinical Assessment (CCA), which is the golden thread gateway to diagnosis and level of care determinations resulting in appropriate service referrals and linkages. Outpatient Services will be available on the same day for individuals presenting Monday through Friday between the hours of 8:00AM and 8:00PM, or the following business day for individuals presenting after hours or on weekends. Meanwhile, an individual who presents with Urgent or Emergent needs will receive a CCA and/or a Crisis Assessment, a referral to the appropriate level of outpatient care, and/ or will have access to one of the BHUC’s 23-hour observation bays. This portion of the program will not only allow for further assessment, observation, treatment, and safety planning while the individual is working to manage his or her recovery, but also grants the individual access to CPSS staff who can offer additional support, coaching, and connection to recovery and treatment resources. The Facility-Based Crisis (FBC) and Non- Hospital Medical Detox component of the proposed program will be comprised of a sixteen- bed unit for adults with mental health and detox from substances in Orange County. The unit will be co-located with the BHUC, alongside a full array of outpatient services. Following their participation in a BHUC assessment, individuals in need of more intensive residential support will be referred to the FBC as an alternative to inpatient or hospital-based care. Historically, individuals seeking behavioral health crisis services through the ED have encountered long wait times in their efforts to receive inpatient care and have then experienced lengthy hospital stays. The BHUC program, in contrast, enables individuals to not only access FBC/Detox services more quickly, but also engages them in preventative and outpatient services, reducing the need for transfers to the hospital. The immediate linkage option from BHUC to FBC/Detox includes medical clearances to prevent the individual having to enter an ED for behavioral health assessment and treatment. Additionally, due to medical clearance being provided on BHUC site, external referrals to other behavioral health/detox units can be made without the person entering the local ED. DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 | 9 3. Scope and Timeline Under the proposed plan, law enforcement will utilize the proposed new location for all behavioral health drop-offs as the facility is proposed to be an IVC designated facility. With the additional expansion of co-located services and continued education and training for law enforcement officers. Supporting individuals in their efforts to remain in the community and out of the hospital ED is a primary objective of the proposed plan. As noted previously, Orange County has identified a clear need for increased behavioral health capacity aimed at the expansion of the crisis continuum to more effectively stabilize and support individual in crisis. The co-location of these programs will allow for increased coordination, communication, and integration, bringing together programs that are now provided at multiple locations throughout the community). RHA has demonstrated success with crisis service delivery, as well as after-care referral and coordination of care with other providers. RHA staff will continue to work closely with other service providers to ensure ongoing communication and collaboration throughout the community to ensure active engagement and successful outcomes for individuals served. 3b. Descriptions of similar projects that the firm has completed. RHA’s C3356 program located in Buncombe County was created and operational in 2016. This center hosts a Crisis Continuum for Buncombe and surrounding counties including a behavioral health urgent care, walk-in crisis services, a Facility Based Crisis and non-hospital detox unit and a peer living room. This center also operates robust outpatient and Community Based services. C3356 has shown a reduction of Law Enforcement and First Responder Drop-offs and an increase in individuals entering Crisis Services as an alternative to emergency departments. RHA’s participation and development of a single facility for Crisis Continuum services has been replicated throughout North Carolina as a solution to community needs. RHA has hosted other behavioral health providers, hospitals, communities and National providers and assisted in the understanding of this model and provided tours as well as informational sessions. RHA’s deep rooted experience in this work has resulted in policies and procedures that support individuals and communities. In 2017 RHA and CPL completed construction and began programming and operating the Foothills Regional Treatment Center in Lenoir, NC targeting Caldwell, Alexander and McDowell counties as priority counties and serving surrounding counties in need. This program houses a Facility Based Crisis and detox units with robust community-based programming and outpatient services including a crisis walk in center in the same building. The program has strong partnerships with local opioid response teams, regional hospitals, and local law enforcement. Since 2010, RHA has operated a Tier II Behavioral Health Crisis Center in Burlington, NC and expanded to a Tier III Behavioral Health Urgent Care and Law Enforcement drop-off center. DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 | 10 3. Scope and Timeline Proposed Timeline ID Task Name Start Finish Duration 1 Notice to Proceed Thu 9/1/22 Thu 9/1/22 1 d 2 Orange County Crisis Diversion Center Thu 9/1/22 Thu 12/1/22 3.2 mons 3 4 Project Validation Thu 9/1/22 Thu 9/29/22 21 d 5 Project Kick-off Meeting Thu 9/1/22 Thu 9/1/22 1 d 6 Scope / Operational Validation Meeting Thu 9/8/22 Thu 9/8/22 1 d 7 Scope / Operational Refinement MeetingThu 9/22/22 Thu 9/22/22 1 d 8 Scope / Operational Sign-off Thu 9/29/22 Thu 9/29/22 1 d? 9 10 Site Analysis / Selection Thu 9/8/22 Mon 10/3/22 18 d 11 Tour Potetial Sites Thu 9/8/22 Thu 9/8/22 1 d 12 Site Feasibility Analysis Mon 9/12/22 Fri 9/30/22 3 w 13 Site Selection Mon 10/3/22 Mon 10/3/22 1 d 14 15 Plan Development Mon 10/10/22Thu 11/10/22 24 d 16 Plan Review Mon 10/10/22Mon 10/10/22 1 d 17 Plan Development Tue 10/11/22Mon 10/24/22 10 d 18 Plan Review Tue 10/25/22Tue 10/25/22 1 d 19 Plan Development Wed 10/26/22Tue 11/8/22 10 d 20 Plan Review Wed 11/9/22Wed 11/9/22 1 d 21 Plan Sign-off Thu 11/10/22Thu 11/10/22 1 d 22 23 Project Budgeting Thu 11/10/22Thu 12/1/22 2.8 w 24 Project Budget Development Thu 11/10/22Wed 11/30/22 13 d 25 Present Budget Presented Thu 12/1/22 Thu 12/1/22 1 d 9/1 9/299/29 9/1 9/8 9/22 9/29 10/310/3 9/8 9/30 10/3 11/1011/10 10/10 10/24 10/25 11/10 12/112/1 11/30 12/1 M T W T F S S M T W T F S S Aug 21, '22Sep 11, '22Oct 2, '22Oct 23, '22Nov 13, '22Dec 4, '22 M B E Project: 2022-08-11 Orange County Schedule.mpp Date: Thu 8/11/22 Page 1 DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 | 11 4. Project Team CPL + RHA Project Leadership Adam Chahulski, AIA, NCARB, LEED AP Principal in Charge Sandy Feutz Chief Operating Officer Robin Washco, AIA, NCARB Project Manager CPL + RHA Architecture & Interior Design Danielle Scesney, AIA, NCARB Project Architect Sara Huffamn Regional Director of Operations Molly Livingstone, CHID, NCIDQ, LEED AP BD+C Sr. Interior Designer RMF Engineering MEP Engineering Jose Torres, PE Principal – MEP Engineering Kirstie Nugent, PE, HFDP Project Manager – MEP Jacek Grabowski, PE, LEED AP, HFDP Lead Electrical Engineer Benjamin Grobe Electrical Designer 35 North Cost Modeling (HUB, SDVOSB, SWaM) Ron Deckman Chief Cost Manager CPL Structural Engineering Brian Cooney, PE Sr. Structural Engineer Seth Wittlinger, PE Structural Engineer Timmons Group Site/Civil Engineering Blake Hall, PE, PLA Principal Civil/Site Chris Glass, PLA Landscape Architect Team Organization Chart Our team has been anticipating this project and looking forward to further developing our relationship with Orange County. This is a very important project for CPL + RHA and in support of this, our core team is backed by a staff of over 450 professionals within the CPL system to ensure capable resources are available and focused on a successful process and outcome. DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 | 12 4. Project Team MEP Engineering Founded in 1983, RMF Engineering (RMF) has been on the forefront of complex Mechanical, Electrical and Plumbing engineering solutions since before terms like efficiency, sustainability, LEED and green requirements were common terminology. In our 39 year history, we have become nationally recognized for our quality analysis, planning, design and commissioning of buildings, as well as campus utility generation and distribution systems. With over 260 staff in 11 offices, RMF is a client- focused practice routinely ranked as one of the top MEP firms in the country. We are proud of our prompt responsiveness, industry-leading tech savvy and project teams who have extensive history of working together as specialized units. As a result, you can expect to receive the highest quality contract documents, the most intelligent engineering solutions and a team that is known for seeing every project through to completion. Full Service Engineering We provide our clients a full range of engineering services to provide maximum energy efficiency and sustainability across their entire operational portfolio. Starting with Energy Master Planning all the way through to Commissioning, our focus is to provide technical expertise and a high level of service that leads to long-lasting relationships. Behavioral Health Crisis Services Provider Incorporated in 1987, RHA is a behavioral health organization that provides outpatient, community- based, and residential services in North Carolina, Tennessee, Georgia, Florida, and Pennsylvania. With headquarters in Asheville, NC and affiliations in several other states, RHA has over 5,300 employees serving over 40,000 individuals annually. RHA has become one of the largest providers in North Carolina of mental health, substance use, and intellectual/development disability services by consistently demonstrating expertise in clinical, operational, and management aspects of service provision. Accredited by the Council on Quality and Leadership (CQL) and CARF (Commission on Accreditation of Rehabilitation Facilities), RHA Health Services is comprised of three cross-disability divisions, specializing in outpatient, community based and residential programs for children, adolescents, and adults with behavioral health and/or intellectual/ developmental disability needs. RHA accomplishes success as a state-wide provider in North Carolina by developing strong community partnerships and adapting to the ever-changing needs within each community. RHA demonstrates success with a continuum of behavioral health programming and utilizes the System of Care (SOC) philosophy. Our Valued Consultants DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 | 13 4. Project Team Site/Civil Engineering & Landscape Architecture Timmons Group boasts over 60 years of Site Engineering and Planning experience for hundreds of projects throughout the eastern United States. We understand successful site design integrates all the technical disciplines with a comprehensive knowledge of the specific project envisioned by our client. Because Timmons Group professionals specialize within specific market sectors, projects are always led by a seasoned professional who fully understands what will make each client’s business successful. In the preliminary phase of a project, Timmons Group personnel utilize SITEOPS, a conceptual design software that allows for a comparison of numerous site design options. This approach saves our clients valuable time in the review process, and considerable money during the construction phase: seamlessly integrating architect’s design into the site plan from the very beginning; contractors know we will consider a wide variety of alternatives before specifying an approach and construction sequence; review agencies know the documents submitted by Timmons Group will consider all local, state, and federal requirements on the very first submittal; and clients know they will get the best, most efficient site designs from our team of Timmons Group professionals. The Landscape Architecture team at Timmons Group understands how landscapes work: site designs that respond to the environmental context and needs of the community will endure change and succeed in connecting people with place. We seek to create dynamic places that achieve timeless appeal and are tailored to our clients’ goals and the appropriate user groups. Grounded in the art and science of our discipline, we deliver the combination of beauty, economy, and performance that clients expect in designs. Cost Estimating (HUB, SDVOSB, SWaM) 35 North is a full-service program and project management firm with wide-ranging project experience focused in the areas of construction management, cost estimating, scheduling, and compliance. Working on a variety of project sizes and types, we can turn challenging situations into actionable and realistic solutions. We are a North Carolina HUB-certified firm and a Service-Disabled Veteran-Owned Small Business (SDVOSB) that offers a host of construction support services to clients nationwide. Accurate and detailed project costing is the foundation of any successful project. 35 North provides comprehensive cost estimating and cost planning models from a project’s inception through closeout. We achieve this through a proactive approach to cost management, one in which we seek to constantly provide thorough, accurate, and timely information about a project’s development. By looking forward and minimizing the need to react to unforeseen project conditions, we have a proven track record of saving our clients time and money while preserving project quality. Our proactive approach is supplemented by forward-looking solutions, constantly updated market information and metrics, and state-of-the- art technology and tools, all of which combine to provide accurate data that ensures your project will remain on budget through completion. 35 North has a strong local presence in North Carolina. Our headquarters are located in Durham, NC, and we are very familiar with the construction market conditions, trends, and cost analysis of materials and labor specific to the state. We have worked on over 300 Public and State or Government-Funded Projects. In 2020, we have estimated in excess of $2 billion worth of construction costs for projects across the country. DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 | 14 Adam Chahulski AIA, NCARB, LEED AP Principal in Charge CPL – Charlotte, NC Adam has over 17 years of design experience specific to the healthcare market sector working on projects ranging from one room renovations to 500,000 sf bed tower additions. As a healthcare planner, Adam is responsible for developing innovative programs to meet client needs and budgets of all types and complexities. RHA Health Services, Asheville, NC • Caldwell County Facility Based Crisis Center • Wilmington Facility Based Crisis Center • Burlington Facility Based Crisis Center Wake Forest Baptist Health, Winston Salem, NC • Adolescent Behavioral Health Unit Renovation • New Care Tower ED Expansion and renovation - includes 10-bed Behavioral Holding Unit Mission Health, Asheville, NC • St. Joseph Behavioral ED Renovation • Main Campus Emergency Department Behavioral Health Holding Unit Wayne UNC Healthcare, Goldsboro, NC • Behavioral Health Addition Master Plan • Inpatient Behavioral Health Unit Renovations • Emergency Department addition for 12 bed Behavioral Holding Unit Caldwell Memorial Hospital, Lenoir NC • Behavioral Health Masterplan Cone Health Alamance Regional Medical Center, Burlington, NC • Behavioral Unit Renovation Vaya Health Wilkesboro, Wilkesboro, NC • Facility Based Crisis Center EDUCATION • Master of Architecture, Kent State University • Bachelor of Science, Kent State University PROFESSIONAL REGISTRATION • Registered Architect: NC • National Council of Architectural Registration Boards (NCARB) • Leadership in Energy & Environmental Design (LEED AP) PROFESSIONAL AFFILIATIONS • American Institute of Architects (AIA) DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 | 15 Sandy Feutz LCSW Chief Operating Officer RHA – Asheville, NC Sandy has over 25 years of experience as provider and leader of behavioral health services in North Carolina. Sandy is passionate about designing, developing, and implementing new programs that remove barriers and ensure access to care for those most in need. Sandy builds strong partnerships with community stakeholders to ensure that services are responsive and meet community needs. Relevant Program Development Experience C3356 – Comprehensive Care Center, Asheville, NC • Full continuum of care under one roof, to include: –16 bed Facility-Based Crisis/Non-hospital Medical Detox (FBC/ Detox) –Behavioral Health Urgent Care (BHUC) –Peer Living Room (PLR) –Outpatient and Community-based Treatment Teams –On-site Pharmacy –Local National Alliance on Mental Illness (NAMI) Mobile Crisis Management • Eleven Counties throughout Western NC Foothills Regional Treatment Center, Lenoir, NC • 12 bed FBC/Detox, located at same site as outpatient/ community-based services Outpatient Behavioral Health Offices • Implemented Outpatient clinics and developed clinical programs in multiple communities; providing access to services that was not previously available EDUCATION • Master of Social Work, University of Maryland Baltimore • Bachelor of Social Work, Appalachian State University PROFESSIONAL REGISTRATION • Licensed Clinical Social Worker – NC DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 | 16 Robin Washco AIA, NCARB Project Manager CPL – Charlotte, NC Robin has over 13 years of experience in architectural design services, primarily focused on healthcare facilities. She is experienced in all aspects of project implementation including early planning and conceptual design, project team and drawing coordination, production of construction documents and construction administration. She has a high proficiency in BIM software, allowing conceptual design ideas to become reality. RHA Health Services, Asheville, NC • Caldwell County Facility Based Crisis Center • Wilmington Facility Based Crisis Center Caldwell UNC Healthcare, Jonas Hill Behavioral Health Facility, Lenoir, NC Project Manager for a 27-bed psychiatric facility is the first of its kind for the region provides desperately needed care, treatment and support for a wide range of adult behavioral health services. Caldwell UNC Healthcare, Lenoir, NC • Facility Master Plan • ICU Room renovation • ED Behavioral Holding Unit Alamance Regional Medical Center, Burlington, NC • Project Manager for 34,000 sf Heart and Vascular Expansion and Renovation FirstHealth of the Carolinas, Moore Regional Hospital, Pinehurst, NC Project Manager for the following projects: • New 120,000 sf Comprehensive Cancer Center • Women’s & Children’s Services Renovation EDUCATION • Bachelor of Architecture, Virginia Polytechnic Institute and State University PROFESSIONAL REGISTRATION • Registered Architect: NC • National Council of Architectural Registration Boards (NCARB) PROFESSIONAL AFFILIATIONS • American Institute of Architects (AIA) DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 | 17 Danielle Scesney AIA, NCARB Project Architect CPL – Charlotte, NC Danielle is involved in all aspects of the design and construction phases of healthcare projects, ranging from small renovations to 120,000 sf new builds. Her attention to detail and eagerness to collaborate results in effective yet creative designs. Danielle is continuously involved in the design from programming to 3-D imagery, building construction documents and coordinating with consultants. Caldwell UNC Healthcare, Jonas Hill Behavioral Health Facility, Lenoir, NC Design Architect for a 27-bed psychiatric facility is the first of its kind for the region provides desperately needed care, treatment and support for a wide range of adult behavioral health services. Caldwell UNC Healthcare, Lenoir, NC • ED Behavioral Holding Unit RHA Health Services, Asheville, NC • Caldwell County Facility Based Crisis Center Cabarrus County, Mt Pleasant, NC • Design Architect for 12,000 sf Library & Senior Center Alamance Regional Medical Center, Burlington, NC • Design Architect for 34,000 sf Heart and Vascular Expansion and Renovation Wayne UNC Healthcare, Goldsboro, NC • Design Architect for Surgery Addition and Renovation - 42,500 sf addition, 58,700 sf renovation • Emergency Department addition for 12 bed Behavioral Holding Unit Vaya Health Wilkesboro, Wilksboro, NC • Facility Based Crisis Center EDUCATION • Bachelor of Architecture, University of North Carolina at Charlotte PROFESSIONAL REGISTRATION • Registered Architect: NC • National Council of Architectural Registration Boards (NCARB) Certified PROFESSIONAL AFFILIATIONS • American Institute of Architects (AIA) DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 | 18 Sara Huffman LCSW, LCAS Regional Director of Operations RHA – Burlington, NC Sara Huffman is the Regional Director of RHA Health Service’s in Central NC. She has over 15 years of experience serving individuals and communities with Mental Health and Substance use treatment and programming. Sara is a strong clinical and compassionate professional dedicated to the well-being of all she and her team serve. She is a staunch and powerful voice in a large, vibrant, multi-pronged behavioral health provider who seeks the best for her total community every day. Sara’s impact can be felt through the programs she leads and has developed. Sara has lead projects with County Government and Community Stakeholders to create public/private funded programs for: Hospital Peer Bridger Programs • Alamance Regional Medical Center, 2015 • High Point Regional, 2018 Law Enforcement Co- Responder and Quick Response Teams • Burlington Police Department, 2015 • New Ber Police Department, 2020 • Alamance County wide, 2021 • Alamance County QRT, 2017 Detention Center Behavioral Health Teams • Alamance County Detention Center, 2016 Family Justice Center Behavioral Health Programming • Alamance County Family Justice Center, 2021 Behavioral Health Urgent Care Centers • Alamance County, 2015 • Guilford County (High Point), 2015 EDUCATION • Bachelor of Social Work, Appalachian State University • Master of Social Work, East Carolina University PROFESSIONAL REGISTRATION • Licensed Clinical Social Worker (LCSW) • Licensed Clinical Addiction Specialist (LCAS) DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 | 19 Molly Livingstone CHID, NCIDQ, LEED AP BD+C Senior Interior Designer CPL – Charlotte, NC As a Senior Interior Designer with 16 years of experience, Molly is proficient with many diverse project types. Specializing in healthcare design, she works with clients to develop innovative interior designs and palettes each of which reflect and complement the architectural details and feeling of the space. Molly guides clients through our innovative design process providing her expertise to implement the project vision. Caldwell UNC Healthcare, Jonas Hill Behavioral Health Facility, Lenoir, NC Senior Interior Designer for a 27-bed psychiatric facility is the first of its kind for the region provides desperately needed care, treatment and support for a wide range of adult behavioral health services. Wake Forest Baptist Health, Winston Salem, NC • Adolescent Behavioral Health Unit Renovation • New Care Tower ED Expansion and renovation - includes 10-bed Behavioral Holding Unit RHA Health Services, Asheville, NC • Caldwell County Facility Based Crisis Center Cone Health, Alamance Regional Medical Center, Burlington, NC • Behavioral Unit Renovation • 34,000 sf Heart and Vascular Expansion and Renovation Wayne UNC Health Care, Goldsboro, NC • Emergency Department addition for 12 bed Behavioral Holding Unit Caldwell UNC Healthcare, Lenoir, NC • ED Finishes Renovation • ED Behavioral Holding Unit EDUCATION • Bachelor of Science, Pre- Architecture, University of Connecticut • Associate of Applied Science, Interior Design, Art Institute of Charlotte PROFESSIONAL REGISTRATION • Certified Healthcare Interior Designer (CHID) • National Council for Interior Design Qualifications (NCIDQ) • LEED AP BD+C PROFESSIONAL AFFILIATIONS • International Interior Design Association (IIDA) • American Academy of Healthcare Interior Designers (AAHID) DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 | 20 Jose Torres PE Principal – MEP Engineering RMF – Raleigh, NC Mr. Torres is a mechanical engineer with experience in the design and analysis of HVAC systems serving healthcare, educational and government facilities. He has worked on over 110 healthcare projects in the past 10 years. Mr. Torres has a thorough understanding of the critical system requirements of healthcare facilities. He has working knowledge of the “Green Guide for Healthcare Design.” He has significant project experience in the design of air and hydronic piping systems for assignments involving renovation and new work, as well as equipment selection, preparation of project specifications and CA. Wake County Government New Mental Health Continuum of Care Wake County Government Mental Health LME Revisions UNC Health 12 IP Psych Beds - Wakebrook Psychiatric Hospital Inova Health System - Loudon County Cornwall Medical Center Renovation Duke Health New Green Level Medical Office Building Core and Shell UNC REX Healthcare New Sleep Center Cape Fear Valley Health New Harnett Health Medical Office Building and Cancer Center Upfit WakeMed Health & Hospitals New Ambulatory Surgery Center and Medical Office Building UNC Health New Eastowne Medical Office Buildings & Parking Deck Bebe Rose Properties New Surgical Center For Dental Professionals UNC REX Healthcare Holly Springs Medical Office Building II Expansion Maria Parham Medical Center Medical Office Building Condition Assessment EDUCATION • MBA, Wake Forest University • BS, Mechanical Engineering, 1998, North Carolina State University PROFESSIONAL REGISTRATION • Professional Engineer: NC #031493 DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 | 21 Kirsten Nugent PE, HFDP Project Manager – MEP Engineering RMF – Raleigh, NC Ms. Nugent brings a fresh perspective to the projects she works on. Her experience focuses on designing mechanical, plumbing, fire protection and category 1 and 2 medical gas systems, predominantly for healthcare projects. She is experienced in designing airborne infectious isolation rooms, protective environment rooms, operating rooms and hazardous compounding pharmacies. Many of these projects have been for new construction but is also dedicated to energy modeling and air handler replacement / renovation projects. She has worked on over 45 healthcare projects in the past 8 years. National Institute of Health Neurobehaviroal Study Animal Research Core Cape Fear Valley Health New Harnett Health Medical Office Building and Cancer Center Upfit UNC Health New Eastowne Medical Office Buildings & Parking Deck UNC Health New Alternative Care Site UNC Health New Hillsborough Campus Bed Tower Addition UNC REX Healthcare Neuro Surgery ICU 2 Anderson Renovation UNC REX Healthcare New Outpatient Cancer Center & Medical Office Building UNC REX Healthcare Holly Springs Medical Office Building II Expansion UNC REX Healthcare New Holly Springs Hospital Duke Health New Green Level Medical Office Building Core & Shell Duke Health Arringdon Ambulatory Surgery Center and MOB Tenant Improvements Duke Health New Central Tower EDUCATION • BS, Mechanical Engineering, Clemson University PROFESSIONAL REGISTRATION • Professional Engineer: NC #048869 • Healthcare Facility Design Professional DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 | 22 Jack Grabowski PE, LEED AP, HFDP Lead Electrical Engineer RMF – Raleigh, NC Mr. Grabowski is an electrical engineer with over 22 years of healthcare expertise, working directly with clients and contractors to solve complex electrical problems. He is adept at effectively training and leading comprehensive teams, master planning, assessing aging facilities to replace their infrastructure, and coordinating site utilities. Mr. Grabowski graduated from the University of Maryland, College Park with a Bachelor of Science in Electrical Engineering with a power engineering focus. He is a Professional Engineer, LEED Accredited Professional, and is active with IEEE for which he has taught classes since 2008. Cape Fear Valley Health New Harnett Health Medical Office Building and Cancer Center Upfit Hopkins Sibley Memorial Hospital New Medical Office Building* LifeBridge Health Carroll County Memorial Hospital Nursing Administration Office Suite Renovation University of Maryland Medical Center New Laurel Medical Facility University of Maryland Medical Center New Capital Region Medical Center Calvert Health Emergency Department Triage Renovation Beebe Healthcare New Outpatient Surgery Center* MedStar Health Mary Washington Healthcare Cancer Center Transformers Hopkins Sibley Memorial Hospital New Patient Tower* Beebe Healthcare New Beebe Surgical Hospital* Doctors Community Medical Center Surgical Department Renovations* UNC REX Healthcare Heart and Vascular Equipment Fit Out *Completed with prior firm EDUCATION • BS, Electrical Engineering, University of Maryland, College Park PROFESSIONAL REGISTRATION • Professional Engineer: MD #29246 • LEED Accredited Professional • Healthcare Facility Design Professional DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 | 23 Benjamin Grobe Electrical Designer RMF – Raleigh, NC Mr. Grobe has over eight years of experience in the industry focusing on electrical design for building and distribution systems. His experience spans multiple markets including state, federal, healthcare, science and technology. Mr. Grobe takes time in designing energy efficient systems to benefit each client and their unique requests, and is always deeply involved in a project through completion.. Duke Health 710 West Main Street Level 1 and 2 Renovation UNC Health Women’s NICU Conversion Vidant Health Duplin Kitchen AHU Replacement North Carolina Department of Agriculture and Consumer Services Donald W. Eaddy Building HVAC Lab Exhaust Upgrades and Repairs Labcorp 6692 Columbia Gateway Drive Renovation North Carolina Department of Health and Human Services State Lab Three Story Building Addition North Carolina Department of Health and Human Services State Lab Molecular Lab Renovations Invitae New Office and Laboratory Facility East Carolina University Howell Hall South Renovation UNC Greensboro Taylor Theater Infrastructure Renovation EDUCATION BS, Electrical Engineering, Binghamton University DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 | 24 Brian Cooney PE Sructural Engineer CPL – Rochester, NY Brian is a licensed professional engineer with over 20 years of experience. His experience runs the gamut of structural engineering design, utilizing many types of building materials such as structural steel, timber, reinforced concrete, and masonry. FirstHealth of the Carolinas, Hoke Community Hospital, Raeford, NC Structural Engineer for design-build (with Rodgers Construction) project for a new 62,000 sq. ft. freestanding community hospital and ambulatory care center for FirstHealth of the Carolinas. The new Hospital features an 11,000 sq. ft. Emergency Department with eight treatment bays with decontamination area and eight bed observation unit. This project also included a freestanding MOB. Center for Nursing & Rehabilitation, Cooling Tower Replacement, Livingston County, NY Structural Engineer for this project to replace the cooling tower, condenser pump and VFD. The project also included upsizing the electrical power for the larger pump and VFD. University of Rochester Medical Center, Imaging Center, Rochester, NY Provided structural design for this three-story, structural steel famed, medical office building. This design-build project was led by LeChase Construction. The new 3 story outpatient Imaging Center features Medical Office space on the top floor. The new imaging center has MRI & CT functions and was planned as part of a new medical campus on East River Road. Livingston County Center for Nursing and Rehabilitation, Mount Morris, NY Structural Engineer for a new four-story building featuring resident unit areas, functional service areas and a Street of Services. Each Household Area contains 24 resident sleeping rooms, a shower room and activity spaces. EDUCATION • Bachelor of Science, Civil Engineering Technology Rochester Institute of Technology • Structural Design Certificate Rochester Institute of Technology • Associate of Applied Science, Civil Engineering Technology Monroe Community College • Associate of Occupational Studies, Building Construction, Alfred State College PROFESSIONAL REGISTRATION • Professional Engineer: GA, NC, NY, PA PROFESSIONAL AFFILIATIONS • American Institute of Steel Construction DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 | 25 Blake Hall PE, PLA Principal Civil/Site Timmons Group – Raleigh, NC With 19 years under his belt, Blake is an experienced Civil Engineer and Landscape Architect in our Raleigh, NC office. He has a strong record of meeting/exceeding aggressive schedules and standards of quality through successful teamwork. Blake has participated in the design and construction management for several LEED and sustainable LID projects throughout North Carolina. Atrium Health, Wadesboro, NC. As part of a Design- Build team, Timmons Group provided all civil engineering, landscape architecture, surveying, and site permitting for the new Atrium Health Anson Hospital. The project is located on Highway 74 in Wadesboro and serves as the replacement facility for the existing Anson Community Hospital. The site consists of 10 acres and includes an emergency room drop off, helipad, and healing garden. This project was awarded an Excellence in Construction Award by the Associated Builders and Contractors Carolinas Chapter. Healthpark at 42 West, Garner, NC. Timmons Group provided traffic, extension of the public water and sewer lines, new road construction, grading and utilities, site lighting, and landscaping for the new medical office park. Alamance Medical Site Design, Town of Gibsonville, NC. Civil design lead for control and boundary survey, parcel and plat mapping, as well as recombination mapping. Timmons group also provided permitting and stormwater services, including a stormwater pond and culvert design. We provided fire flow testing and utility hydraulic analysis to determine the needs for on-site water distribution. Six Forks Medical Office, Raleigh, NC. Timmons Group provided civil engineering, surveying and environmental services for the development of a new, two-story, 18,600 sf medical office. Wayne County Health & Social Services Facility, Goldboro, NC. EDUCATION • BS, Landscape Architecture, Virginia Tech PROFESSIONAL REGISTRATION • NC Professional Engineer • NC Landscape Architect DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 | 26 Chris Glass PLA Project Manager Civil Timmons Group – Raleigh, NC Having 11 years experience, Chris is a Landscape Planner for Public Land Development in our Raleigh office. Chris has experience in assisting with site selections, producing construction drawings, and designing landscape plans. He is one of the firm’s leading experts on civil engineering technology and routinely uses programs such as SiteOps, ArcGlobe, ArcMap GIS, and SketchUp to advance the firm’s capabilities. New Hope EMS Station Site Selection and Due Diligence, Wake County, NC. Timmons Group provided geotechnical engineering for Wake County’s New Hope EMS Station on Louisburg Road in Wake Forest, NC. The site is approximately 1.78 acres of undeveloped woodlands. The borings encountered approximately 3 to 7 inches of surficial topsoil (or a combination forest litter and topsoil). Below topsoil, “undisturbed” residual soils were encountered to boring termination depths up to approximately 15 feet. Timmons Group also recommended that site grading be conducted during the typically warmer summer months. UNC Health Chapel Hill, Outpatient, Chapel Hill, NC. Timmons Group is currently providing civil engineering for the UNC Health Outpatient facility. Economic Development Site Related SWOT Analysis, Orange County, NC. Timmons Group completed an in depth analysis of each of these areas and the surrounding properties to develop a list regarding next step recommendations for short and long term goals in order to help better position the County for economic development wins. Friendship Innovation Park, Holly Springs, NC. Timmons Group is working on the master plan development for this manufacturing facility. Services provided include civil engineering, transportation engineering, CMT, and survey. EDUCATION • BS, Landscape Architecture, Clemson University PROFESSIONAL REGISTRATION • NC Landscape Architect DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 | 27 4. Project Team Team Availability Business DevelopmentAHWFB - Care Tower, Winston-SalemAH - Concord Free Standing EDCH - Alamance, Heart & Vascular ExpansionFHOTC - Moore Regional, Cancer CenterCabarrus County, Library & Senior CenterMiscellaneous Projects Not Listed6-12 Month OutlookCPL Arch/Interiors Current Project & Projected Workload Adam Chahulski 20 35 5 20 5 --15 Robin Washco 5 --40 15 -15 25 Danielle Scesney 5 --20 -20 15 20 Molly Livingstone 15 35 -20 5 -5 20 Brian Cooney 10 ---5 -65 20 State Lab 3 Story, Building AdditionNC Dept. of Health and Human ServicesDabney Hall, Renovation Phase 3North Carolina State University710 West Main, Street Level 1 and 2Renovation Duke HealthTaylor Theater Infrastructure RenovationUNC GreensboroNew Harnett Health, Medical Office Building and Cancer Center UpfitCape Fear Valley Health SystemRMF Engineering Current Project & Projected Workload Jose Torres 20 10 10 10 20 Kirstie Nugent -15 15 15 30 Jacek Grabowski ----- Benjamin Grobe 20 -10 15 -UNC Health Chapel Hill – Outpatient Yield North – Holly Springs UNC Health Garner ASC Friendship Innovation Park, Holly Springs NCEC Cooperative Ready Sites County ProgramWayne County Jail Expansion GeneSuites – Holly Springs Administration / OverheadTimmons Group Current Project & Projected Workload Blake Hall 10 15 5 10 5 10 10 35 Chris Glass 20 20 10 10 10 15 15 -ECSU-Dining Facility VAMC Replace MRIVAMC Fayetteville D WingUNC Carrington School of Nursing6-12 Month Outlook35 North Current Project & Projected Workload Ron Deckman 20 10 10 20 40 Based on review of our current workload, CPL + RHA has the available capacity to accomplish the work outlined in the Request for Qualifications for the Construction of a Behavioral Health Crisis Diversion Facility in Orange County. We are accustomed to producing multiple concurrent contracts and are organized to do so—with adequate reserve staffing to cover any contingencies. DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 | 28 5. Similar Projects Caldwell UNC Health, Jonas Hill Hospital and Behavioral Health Clinic Lenoir, NC CPL provided architectural and interior design services for a new Caldwell UNC Behavioral Health Facility in Lenoir, North Carolina. The facility was opened in 2020 and provides support for mental health, substance abuse and developmental disability outpatient programs. Our team also provided detailed landscape design for the outdoor patient area. Located on a rolling site adjacent to Caldwell UNC Health, the Jonas Hill Hospital and Behavioral Health clinic is a community-minded facility combining both inpatient and outpatient services in a setting that supports healing, and promotes community awareness and involvement. A New Community-Minded Behavioral Health Facility DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 | 29 5. Similar Projects Caldwell UNC Health, Jonas Hill Hospital and Behavioral Health Clinic (continued) PROJECT DETAILS Size: 21,680 sf Completion Date: 2020 Construction Cost: $8,100,00 Design Team: R. Washco, D. Scesney, M. Livingstone Client Reference: Laura Easton – President and CEO, Caldwell UNC Health Care, 321 Mulberry St. SW, Lenoir, NC; 828.757.5100 Complete with 27 beds for adult inpatient behavioral health hospitalization, Jonas Hill is equipped to treat a variety of conditions including anxiety, depression, bipolar disorder, schizophrenia, post-traumatic stress disorder (PTSD), and substance abuse. The facility’s integrated outpatient clinic will provide additional education and resources to patients and their families including behavioral health evaluations, medication management, and therapy/counseling. DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 | 30 5. Similar Projects Caldwell County, Facility Based Crisis Center Lenoir, NC CPL was hired by Caldwell County, in conjunction with RHA Health Services, to provide architectural and engineering design services for a new Facility Based Crisis Center (FBC) that will serve local residents of Alexander, Caldwell, and McDowell Counties. The FBC was an approximate 5,200 square foot addition to an existing outpatient facility that has 12-beds to serve adults with mental health issues, substance abuse issues, and developmental disabilities. It will offer 24hr care to those in need, and combined with the outpatient center, will provide a continuum of care offering counseling and medication management for long-term recovery. During the design process CPL worked closely with PROJECT DETAILS Size: 5,200 sf Completion Date: 2017 Construction Cost: $1,100,00 Design Team: A. Chahulski, R. Washco, D. Scesney, M. Livingstone, R. Nilson Client Reference: Sandy Feutz – Chief Operating Officer, RHA Health Services; 828.775.1264 A Landmark Addition to the Continuum of Behavioral Healthcare in Caldwell County RHA to ensure proper materials, fixtures, and finishes were specified for the safety of patients and staff, but also collaborated on making the space a healing environment void of an Institutional feel. Incorporation of universal room sizes allowed for future expansion from single to double occupancy rooms to expand capacity without the need for horizontal expansion. DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 | 31 5. Similar Projects Wake Forest Baptist Medical Center, Behavioral Unit Renovations – Sticht Center Winston-Salem, NC Dynamic renovations made to Atrium Health Wake Forest Baptist’s Sticht Center made way for a complete relocation of their Pediatric and Adolescent Behavioral Health Unit. Now located on the Hospital’s main campus, under the same roof as their adult mental health services, the child and teen unit greets patients and their families with a new friendly, inspiring feel. Throughout the 16,000 sq. ft. space, colorful, bright finishes and furnishings enhance every square inch of new patient classrooms, dining and activity areas, therapy and exam rooms, overnight space, and staff support areas. PROJECT DETAILS Size: 16,000 sf Completion Date: 2020 Construction Cost: $1,200,000 Design Team: A. Chahulski, M. Livingstone, S. Epps Client Reference: True Morse – Director Facilities Planning and Construction, Atrium Health Wake Forest Baptist; 743.999.1769 Adolescent and Pediatric Behavioral Health Unit DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 | 32 5. Similar Projects RHA Health Services, Burlington Facility Based Crisis Center Burlington, NC CPL was approached by RHA Health Services to assist with planning and design efforts on a new 16-bed Facility Based Crisis Center located in Burlington, NC. The FBC is going to occupy three spec office buildings totaling 20,000 square feet currently under construction. The largest of the buildings will house an Adult/Adolescent Urgent Care, support service areas, and the 16-bed unit consisting of single and double occupancy rooms. CPL worked closely with the developer to ensure the building’s construction type and structural systems would meet all applicable codes for an I-2 occupancy, as well as all DHSR licensure requirements. The other buildings will provide outpatient counseling, education, and an on-premise pharmacy. The campus will serve as a hub to provide the needed behavioral healthcare to the local community, while at the same time reduce the burden put on local hospitals emergency departments and law enforcement agencies. PROJECT DETAILS Size: 20,000 sf Completion Date: 2021 (Concept Design only) Construction Cost: $5,000,000 Est. Design Team: A. Chahulski Client Reference: Sandy Feutz – Chief Operating Officer, RHA Health Services; 828.775.1264 SCALE:7/1/16 WILKES FBC PERSPECTIVE Vaya Health (Formerly Smoky Mountain Center), Wilkesboro Facility Based Crisis Center Study Wilkesboro, NC CPL worked with Vaya Health to raise awareness in North Wilkesboro through community engagement sessions for the purposes of obtaining funding to construct a new Facility Based Crisis Center. The proposed plans were for a 20-bed facility that would be an addition to an existing outpatient behavioral facility, as well as Adult Urgent Care. PROJECT DETAILS Size: 9,000 sf Completion Date: 2016 Construction Cost: 2,700,000 Est. Design Team: A. Chahulski, D. Scesney Client Reference: Genny Pugh – Senior Director of Community Collaboration, Smoky Mountain Center; 828.275.1034 DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 6-10. Required Information Addendum Acknowledgement Form Firms must acknowledge receipt of addendums posted by Orange County before the RFQ deadline. Please initial for Addendums received. Addendum No 1 ________________ Addendum No 2 ________________ Addendum No 3 ________________ DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 6-10. Required Information Section I: General Government and Administration Policy 10.0: Living Wage Contractor Policy Reviewed by: County Attorney/County Manager Approved by: County Manager Original Effective Date: April 21, 2016 Revisions: August 1, 2016 Policy Statement It is the policy of Orange County to ensure its employees, and all individuals who provide services for Orange County, are paid a living wage. Purpose To encourage all vendors and contractors to pay a living wage to all employees who perform work pursuant to a contract with Orange County. Applicability Applies to all Orange County contracts and purchases. Policy 10.1 Living Wage 10.1.1 Orange County is committed to providing its employees with a living wage and encourages all contractors and vendors doing business with Orange County to pursue the same goal. Orange County’s living wage is as reflected in the adopted Orange County Budget and as that budget document is amended from time to time. To the extent possible, Orange County recommends that contractors and vendors seeking to do business with Orange County provide a living wage to their employees. 10.1.2 Prior to final execution of a contract with Orange County all contractors and vendors seeking to do business with Orange County shall submit to the County’s representative a statement indicating whether those employees who will perform work on the Orange County contract are paid at least the living wage amount set out above. If such employees do not make at least the living wage amount set out above the contractor or vendor shall indicate in the statement the actual amount paid to such employees. For bid projects this statement should be submitted as part of the bid packet. This policy may be reviewed annually and updated as needed by the Manager’s Office Acknowledged Receipt by: ____________________________________________________ Company Name: ____________________________________________________________ Date: ___________________________________________________________________ Adam M. Chahulski, Principal CPL Architects and Engineers, P.C. 7/20/22 DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 6-10. Required Information DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 6-10. Required Information ORANGE COUNTY NONDISCRIMINATION CERTIFICATION The undersigned bidder or proposer hereby certifies and agrees that the following information is correct: 1.In preparing its enclosed bid or proposal, the undersigned bidder or proposer has considered all bids and proposals submitted from qualified, potential subcontractors and suppliers, and has not engaged in discrimination as defined in Section 12-52 of the Orange County Non-discrimination Ordinance. 2.Without limiting any other remedies that Orange County may have for a false certification, it is understood and agreed that, if this certification is false, such false certification will constitute grounds for Orange County to reject the bid or proposal submitted with this certification, and terminate any contract awarded based on such bid or proposal. It shall also subject the bidder or proposer to disqualification from participating in county contracts or bid processes for up to two years. 3.As a condition of contracting with Orange County, the undersigned bidder or proposer agrees to promptly provide to Orange County all information and documentation that may be requested by Orange County from time to time regarding the solicitation and selection of suppliers and subcontractors in connection with this solicitation process. Failure to maintain or failure to provide such information constitutes grounds for Orange County to reject the bid or proposal and to terminate, without penalty to Orange County, any contract awarded on such bid or proposal. All such information and documentation shall be maintained for a period of three years after the expiration of the contract. 4.As part of its bid or proposal, the undersigned bidder or proposer shall provide to Orange County a list of all instances within the past ten years where a complaint was filed or pending against bidder or proposer in a legal or administrative proceeding alleging that bidder or proposer discriminated against its subcontractors, vendors, suppliers, or commercial customers, and a description of the status or resolution of that complaint, including any remedial action taken. 5.As a condition of submitting a bid or proposal to Orange County the undersigned bidder or proposer agrees to comply with the Orange County Non-discrimination Ordinance. Falsification of this certification shall constitute a violation of the Orange DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 6-10. Required Information County Non-Discrimination Ordinance and shall be grounds for rejection of the bid or proposal or termination of an existing contract, without fault or further obligation to Orange County. 6.As a condition of submitting a bid or proposal to Orange County the undersigned bidder or proposer agrees that Orange County may consider the information submitted as part of this certification in its determination of the responsibility of the undersigned bidder or proposer. The undersigned bidder or proposer, as the case may be, waives the right to challenge the rejection of a bid or proposal when such rejection is based, in its entirety, on information submitted as part of this certification. The bidder or proposer certifies the undersigned has full authority to sign on its behalf. By:________________________________________ ___________________________________________ Printed Name and Title On behalf of _________________________________ ___________________________________________ Company or Corporate name Adam M. Chahulski, Principal CPL Architects and Engineers, P.C. DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 6-10. Required Information 1 Supplemental Vendor Information: HISTORICALLY UNDERUTILIZED BUSINESSES Historically Underutilized Businesses (HUBs) consist of minority, women and disabled business firms that are at least fifty-one percent owned and operated by an individual(s) of the categories. Also included in this category are disabled business enterprises and non-profit work centers for the blind and severely disabled. Pursuant to G.S. 143B-1361(a), 143-48 and 143-128.4, the County invites and encourages participation in this procurement process by businesses owned by minorities, women, disabled, disabled business enterprises and non-profit work centers for the blind and severely disabled. This includes utilizing subcontractors to perform the required functions in this RFP/RFQ. Any questions concerning NC HUB certification, contact the North Carolina Office of Historically Underutilized Businesses at (919) 807- 2330. The Vendor shall respond to question #1 and #2 below. a) Is Vendor a Historically Underutilized Business? Yes No b) Is Vendor Certified with North Carolina as a Historically Underutilized Business? Yes No If so, state HUB classification: ____________________________________________________________ X X DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 CPL 6302 Fairview Road, Suite 102 Charlotte, NC 28210 www.CPLteam.com Primary Contact Adam M. Chahulski, AIA Principal in Charge 704.770.8999 AChahulski@CPLteam.com Passionate People. Transformative Solutions. DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 1 Financial Services Department – Purchasing Division RFQ No 367-OC5359 Request for Qualifications (RFQ) to Provide Preliminary/Advanced Planning Services for the Construction of a Behavioral Health Crisis Diversion Facility serving Orange County, North Carolina I. Purpose: The intent of this Request for Qualifications (RFQ) is to obtain the necessary information to identify a qualified consultant to assist Orange County with preliminary/advanced planning services necessary for the development of a Crisis Diversion Facility serving the residents of Orange County. The work will include a review of existing planning and development information regarding this proposed facility, and the development of programming documents, a preliminary/schematic design, site requirements and budget estimates. Firms submitting proposals must have significant experience with projects of similar scope in terms of behavioral healthcare, urgent care, and facility-based crisis management. The project is anticipated to take between three and four months. The selected consultant will be required to provide a specific timeline for all tasks that will be mutually agreed upon by the County, within 30 days of award. II. General County Background: Nestled in the hills of the North Carolina Piedmont, Orange County is located between the Research Triangle Park and the Triad cities of Greensboro, Winston-Salem and High Point. With more than 140,000 residents, Orange County includes historic Hillsborough, the county seat; Chapel Hill, home of the University of North Carolina; and Carrboro and Mebane, former railroad and mill towns. The County encompasses 400 square miles of rolling farms and forest, vital urban centers and small towns. Orange County combines the best of cosmopolitan and rural values with an abundance of historical, social and cultural resources. Orange County’s estimated population DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 2 in 2020 is 143,960 with a growth rate of 0.68% in the past year according to the most recent United States census data. III. Crisis Diversion Facility Development: The Orange County Behavioral Health Task Force (BHTF), and its Crisis Diversion Facility Subcommittee, were established in November 2019. The Crisis Diversion Facility Subcommittee is comprised of subject matter experts in behavioral health clinical services, emergency services, law enforcement, and criminal justice, in conjunction with Orange County government. The missions of the subcommittee and of the proposed facility are: To enhance Orange County crisis services to best facilitate deflection/diversion of individuals experiencing a Behavioral Health crisis (MH and SUD) from either hospital-based emergency department or the criminal justice system. The subcommittee has worked diligently over the past two years in support of its mission. Among its many accomplishments, the group has: • Performed a literature review and review of existing U.S. and N.C. programs and facilities in order to identify best practices in this area. • Met with local stakeholders and performed a gap analysis that helped identify needed services. • Received approval of a recommendation for the development of a Crisis-Diversion Facility by the Orange County Board of County Commissioners (BOCC) in April 2021. • Received funding for additional implementation planning from the BOCC in November of 2021. • Developed a detailed project description, including a scope, function and statement of expected results (Attachment #1) • Developed a list of 50 items to help define the scope/function of the new facility (Attachment #2). • Developed preliminary/general design specifications for the Crisis Diversion Facility (Attachment #3). • Developed an estimate of Projected Demand for Service (Attachment #4). Note: The preliminary planning/scope development documents prepared by the subcommittee are provided for reference. The firm selected for this work will review this information and apply their professional experience and judgement in the development of requested work products. DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 3 IV. Required Services Services required to be provided by the selected firm include: • Further scope refinement and development, to include clarification of space requirements and growth/use projections. • Programming spaces of the facility. • Development of site requirements. • Review of potential building sites and development of a site recommendation. • Development of cost analysis/project budget. • Preliminary Schematic Design Development. V. Service Provider Requirement Firms submitting proposals must include as part of their team, a qualified behavioral health crisis service provider, who is capable of managing urgent and emergent clinical needs for assessments, crisis de-escalation, and discharge planning during hours of operation. The role of the service provider shall be to act as a consultant to assist with preliminary/advanced planning efforts necessary for the development of the new Behavior Health Crisis Diversion Facility. Specifically, the service provider is expected to assist in the process to establish/clarify space needs, bed and chair allowances, requirements and licensing and input on design specifications to ensure the best practices for service delivery. VI. Procedures – Submitting Response: IMPORTANT NOTE: This is an absolute requirement. Firms shall bear the risk for late submission due to unintended or unanticipated delay. Any proposal submitted after the proposal deadline will be rejected. Electronic Responses only will be accepted for this solicitation. Firms should enter “RFQ#: 367-OC5359: to Provide Preliminary/Advanced Planning Services for the Construction of a Behavioral Health Crisis Diversion Facility serving Orange County, NC., Company’s name”: as the subject for the email. Electronic (PDF Format) submittals should be less than 15MB in size and submitted by 3:00 p.m. EST on August 12, 2022. PDF files should include bookmarks that link to sections to allow easy document navigation. Electronic submittals shall be emailed to Jovana Amaro, Purchasing Agent, jamaro@orangecountync.gov by the date specified above. Critical updated information may be included in Addenda to this RFQ. It is important that all Firms proposing on this RFQ periodically check Orange County’s website for any Addenda that may be issued prior to the RFQ deadline. All Firms shall be deemed to have read and understood all information in this RFQ and all Addenda thereto. DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 4 RFQ Schedule: The table below shows the intended schedule for the RFQ. Orange County will make every effort to adhere to this schedule Event Responsibility Date and Time Issue RFQ Orange County July 11, 2022 Submit Written Questions Firm August 1, 2022 Provide Response to Questions Orange County August 5, 2022 Submit Proposals Firm August 12, 2022 Onsite Presentation (Finalists) Firm TBD Contract Award Orange County TBD Contract Effective Date Orange County TBD Proposal Questions: 1. Proposal Questions Upon review of the RFQ documents, firms may have questions to clarify or interpret the RFQ in order to submit the best proposal possible. To accommodate the Proposal Questions process, firms shall submit any such questions by the above due date. Written questions shall be emailed to jamaro@orangecountync.gov copying sarndt@orangecountync.gov by the date specified above. Firms should enter “RFQ No 367- OC5359: Questions” as the subject for the email. Questions submittals should include a reference to the applicable RFQ section. Answers to these questions and any additional terms deemed necessary by Orange County will be posted in the form of an addendum to the Orange County Website http://www.orangecountync.gov/Bids.aspx, and shall become an addendum to this RFQ. No information, instruction or advice provided orally or informally by any Orange County personnel, whether made in response to a question or otherwise in connection with this RFQ shall be considered authoritative or binding. Firms shall rely only on written material contained in an Addendum to this RFQ. VII. Submittal Response Requirements: 1. A cover letter identifying the firm, or firms proposed for a team approach for the project. (Maximum of one page in length.) 2. Qualifications of the firm. Maximum of 10 pages total. Submittals must include a firm overview and brief description of the firm’s history. A project organizational chart and description may be included. Key members of the project team should be included in the organizational chart. Clearly identify the prime contractor and any sub-contractors, if relevant, and the general roles of each on the project. List any and all MBE and HUB participation in this project. DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 5 3. An explanation of how the firm will adhere to the scope of work including a proposed work timeline that appropriately meets the goals of this project. This narrative should include an explanation of the following: a. An indication of your understanding of the project, b. Descriptions of similar projects that the firm has completed. 4. Identification of the roles and responsibilities of all team members with the firm including: a. Team organization including an identification of the lead consultant and project manager, key personnel that will be working on the project, the role of any proposed consultants, etc., b. A statement of qualifications for all team members including resumes and educational background. One-page resumes of all key personnel should be provided (one page per person). The office locations of each team member should be specified on the résumés. The submittal should, as a part of the information provided for subcontractors, include the names, locations, and general roles of the project team members. c. A description of the current workload for identified individuals. 5. A minimum of three references for similar projects (Maximum of 5 pages total; includes both front and back for no more than 5 pages) including: a. The name and date of the project, b. The location of the client, and c. A contact name including relevant contact information. d. At least one of these references should be able to describe the proposed project manager’s experience and qualifications. Orange County may contact these references and the information obtained may be considered in the evaluation of the proposal. 6. Acknowledgment of receipt of any addendum 7. Living Wage: Orange County is committed to providing its employees with a living wage and encourages agencies it funds to pursue the same goal. Acknowledgement of receipt of Orange County’s Living Wage Contractor Policy. 8. E-Verify: HB789 imposes E-Verify requirements on contractors who enter into certain contracts with state agencies and local governments. The legislation specifically prohibits governmental units from entering into certain contracts “unless the contractor and the contractor’s subcontractors comply with the requirements of Article 2 of Chapter 65 of the General Statues.” (Article 2 of Chapter 65 establishes North Carolina’s E-Verify requirements for private employers.) It is important to note that the verification requirement applies to subcontractors as well as contractors. 9. Orange County Non-discrimination Certification Form. 10. Supplemental Vendor Information: HUB form DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 6 All submittals, exhibits, responses, attachments, reports, charts, schedules, maps and illustrations shall become the property of Orange County upon receipt. Since qualification packages can be submitted electronically, page limitations in this RFQ refer to pages of content. The page limitations do not include front cover, back cover, section dividers, or table of contents, if included. Proposals may not use less than 12 point font. Orange County shall review all firms’ responses to this RFQ to confirm that they meet the specifications and requirements of the RFQ. All Statements of Qualifications must be received by Orange County not later than the date and time specified in Section VI of this RFQ. All submittals received will be reviewed against the submittal response requirements set forth in this RFQ by a selection committee composed of County staff. A short list will be developed. The short-listed firms may be invited to interview with the County. VIII. Selection Criteria: All submittals will be ranked based on qualifications. Orange County will establish a short list of candidates and schedule interviews accordingly. The following criteria will be the basis on which consultants will be evaluated (in no particular order): • Past performance of the lead consulting firm on similar planning projects • Adequate and experienced staff and proposed team for the project • Recent experience with successfully coordinating and maintaining project schedules • Current workload and firm capacity • Understanding of the area where the project is located • Working arrangements with necessary consultants • Other factors that may be relevant to the project. DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 ATTACHMENT #1 PROJECT DESCRIPTION: SCOPE, FUNCTION AND EXPECTED RESULTS 1. Clinical Services  Offer Behavioral Health Urgent Care services for assessment, stabilization, and treatment for patients experiencing BH crisis: mental illness and substance use disorders for patients 4 years old and older.  Provide Facility Based Crisis services for adults including security required for some patients and for justice-involved individuals. Includes initiation of MAT in anticipation of transfer to a third-party facility and sobering services for routine and surge demand.  Provide BH crisis services to walk-in patients on a 24/7/365 basis.  Medical urgent care to lower medical clearance barriers. 2. Criminal Justice Services  Provide law enforcement and emergency medical services with a default no wrong door destination. Answer the question: Divert to Where?  Provide criminal justice stakeholders with clinical assessment services and a facility to offer the most appropriate care for justice-involved individuals in the least restrictive setting possible. 3. Community Treatment Networking  Make referrals to community treatment with warm handoff supported by case manager and/or peer specialist. Facilitate transitioning individuals to from crisis care to community-based treatment.  Provide information about community treatment services available to Orange County residents for a wide variety of BH problems. Cut through the fog of obtaining BH services so often experienced by individuals, families, and friends trying to get help. 4. Social Services Networking  Warm handoff regarding referrals to necessary social services and resources with case manager/peer specialist to facilitate discharge and follow up.  OC Partnership to End Homelessness Access (via OC Connect).  Liaison for NAMI programs.  Health insurance enrollment liaison including legal representation.  Transportation assistance. DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 EXPECTED RESULTS  Meets Objectives. Enables and works with local programs to facilitate deflections toward community treatment and social services and away from ED or criminal justice involvement.  Fills Identified Gaps. Fills identified gaps in existing crisis response capabilities.  Aligns with Public Safety and Social Justice. Aligns with current public safety reform and social justice objectives.  Offers No Wrong Door. Provides a default destination and no wrong door access for law enforcement and emergency medical services by removing restrictive entry or exclusion criteria and provides access by general public.  Provides Least Restrictive Setting. Offers the least restrictive setting for crisis care in a calming environment with case managers and peer specialists that can safely engage the individual in crisis.  Facilitates Collaboration. Is well integrated into the existing network of community treatment services and social services thus multiplying the Facility’s impact. Avoids a silo effect.  Reduces Costs. Reduces burden and costs for law enforcement, emergency services, and hospital-based services (ED and inpatient beds), and jail. Improves outcomes for all involved. DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 ATTACHMENT #2 LIST OF 50 ITEMS TO HELP DEFINE SCOPE/FUNCTION/DESIGN OF FACILITY  Behavioral Health (BH) urgent care (24/7).  Serve short-term Involuntary Commitment (IVC) patients.  Emergency Substance Use Disorder (SUD) treatment services (24/7).  Non-hospitalization detoxification services.  Urgent Medical Care Services (to allow non-life-threatening conditions to be treated at Facility)  On-site pharmacy services to support stabilization and initial treatment. Serve patients in Facility.  Point of Care Testing (quick turnaround laboratory services). Serve patients in Facility.  Capacity to manage individuals who are agitated, but do not require secured space and restraints.  Referral and transportation to hospital and other treatment facilities (after dropping off by Law Enforcement/ EMS)  Serve individuals with special needs (e.g., IDD).  Peer support specialists.  Multi-day temporary boarding while waiting for transfers: that is, a bridge between crisis management and community treatment.  On-site pharmacy services to allow patient to be discharged with medication.  Third-party laboratory with available, expedited courier service. Serve patients in Facility.  Child services for ages 4 – 17.  Walk-in Services for general public (24/7/365).  Short-term ambulatory treatment services (e.g., non-medical detox) to facilitate stabilization prior to discharge.  Initiate MAT treatment in anticipation of transfer to community treatment provider.  Sobering and adjunct outpatient services.  Dual entry (dedicated entry) for Law Enforcement and EMS.  Calming area or living room setting.  Rooms/beds for agitated patients.  Space for law enforcement and emergency medical personnel. DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4  Video conference facility to provide access to magistrate.  Video conference room for robust link between Facility and Magistrate, Courts, District Attorney.  On-site criminal justice space to support criminal justice stakeholders.  Short-term boarding for patients awaiting transfer to third party community service.  Dedicated space/rooms for patients housed in Facility in lieu of jail.  Short-term boarding for patients awaiting IVC or other hearing.  Clinical space for minors (4 years old and older).  Call center coordination including 911/988, EMS, LE/Crisis Units, Hospitals. Community Treatment Services Networking  Serve as community hub with information about all community treatment services (for all conditions) where Facility is well integrated with community providers.  Referral to out-patient/in-patient BH treatment services.  Referral to out-patient/in-patient SUD treatment services (e.g., MAT, ADATC).  UNC Hospital referral liaison (facilitate transfer of patients needing higher level of care without involvement of LE or EMS who may have brought patient to Facility).  Patient transfer to other treatment facilities (e.g., UNC Hospitals, detox facilities).  LME/MCO liaison.  Warm handoff to community treatment services with support from peer specialist and/or case manager. Social Services Networking  OC Partnership to End Homelessness Access (via OC Connect).  Liaison for NAMI programs.  Health insurance enrollment liaison including legal representation.  Warm handoff regarding referrals to social services/peer specialist.  Transportation assistance. DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 Facility Related Criminal Justice/Security Issues  On-site Law Enforcement personnel to maintain facility security.  Locked, secure facility space.  On-site security personnel to maintain safe environment and provide readily available transportation for patients in custody, act as courier for IVC and other court paperwork to and from Facility.  On-site presence (or video conference link) for criminal justice stakeholder (e.g., Magistrate, District Attorney, public defender, courts/judges, forensic social worker).  On-site security to temporarily board patients who are in custody (e.g., transfers from jail).  FIT (Formally Incarcerated Transitions) program liaison.  Readily available transportation for IVC patients.  Forensic assessment services for Magistrate & court processes.  Clinical services for individuals who are in custody (temporary transfers from detention facility) or awaiting other court processing/hearing.  No refusal admission for law enforcement and emergency medical services (24/7/365) including individuals who are agitated or under an IVC order. DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 1 ATTACHMENT #3 Orange County Crisis-Diversion Facility (working title) Physical Design Specifications This document presents specifications for the OC Crisis-Diversion Facility physical floorplan and infrastructure 1. All services supported by this Facility are expected to be covered under BHUC-4 and FBC regulations2. This document is organized as follows: A. Front Entrance/Waiting Areas. B. Rear Entrance. C. BHUC Clinical Areas. D. Adult FBC Areas. E. Medical Areas. F. Facility Security. G. Outpatient Service Areas. H. General Purpose Areas. I. Community Partner Offices/Workspace. J. Communications Infrastructure. Note. The text below describes a facility that can be a one story or two-story building. If a two-story building, considerations should be given to separating a BHUC facility on the first floor and FBC/secure space on second floor with direct access to rear entrance. Main pharmacy could also be placed on second floor with a means to support the outpatient pharmacy on the first floor. A. Front Entrance/Waiting Areas • Front entrance provides access point for general public on a 24/7/365 basis. This is the initial point of contact for access to BHUC services. • Reception, waiting areas, and clinical space have a “living room” environment for a calm reception of patients and initial contact with peer specialists and clinical staff. • Beyond front door reception area, path splits into separate routes for adults and minors. Each includes in sequence: o Security check and storage of personal belongings not allowed into Facility. o Triage and central administration. o Waiting rooms, which lead to clinical areas for patients. 1 The April 22, 2021 report prepared by the Orange County Behavioral Task Force Crisis-Diversion Facility Subcommittee contains specific recommendations for needed services. This document describes a Facility physical layout and infrastructure for delivering those services. It has been developed by the Crisis-Diversion Facility Subcommittee and an associated Design Workgroup comprised of subject matter experts in Facility design and operation. 2 BHUC-4: Behavioral Health Urgent Care, Tier 4. FBC: Facility Based Crisis. DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 2 • Waiting areas are separate for adults and minors (cohorts of interest: adults, adolescents, children 15 years of age and younger). May need visual separation between adolescents and children under 15 years of age in waiting area for minors. • Adjacent to the public access reception area are outpatient pharmacy (see details in Section E) and resource center (see details in Section G). Access to general office space is also available via front entrance (see Section H). B. Rear Entrance • Rear entrance will require easy access from street for EMS, LE, other emergency services. • Secure rear entrance with two Sally Ports and a separate entry door for access to Facility in lieu of Sally Port. • Supporting security measures include (also see facility security, Section F): o Two seclusion room with restraints. o Area for secure patient handoff to clinical staff. o Search area. o Area for storage of personal belongings and contraband. • Office and break areas for EMS and LE personnel with access to drink and snack food. • Laboratory sample pick up (see Item E). C. BHUC Clinical Areas • Clinical areas for observation, assessment, stabilization (living room/calming environment). • Centrally-located nursing center from which oversight and services support both adult and minors. • Space for non-hospitalization detox. Includes space to initiate emergency SUD treatment/MAT in anticipation of transfer: multi-day stays are anticipated (See Section D). • Area to support sobering services. (Also see G. General Purpose Areas, Multi-use Room.) • Offices for clinical staff to confer with patients and arrange referrals to third-party facilities including open referral to UNC Hospitals. • Specially designed sensory space to best serve IDD or ASD patients. • Space for case managers/peer support specialists to work with patients, arrange for a discharge plan, and follow up after discharge including peer support day area and small group meeting room(s). • Because Facility Based Crisis (FBC) space cannot be used for minors, space is required for patients under age 18 who may be awaiting transfer to third-party services but cannot be transferred within 23-hour service interval. Note: Above assumes detox can be started in BHUC (instead of FBC area) for adolescents in anticipation of transfer to third-party facility. D. Adult FBC Areas • FBC patient rooms (beds) for patients who may require multi-day stays, no patients <18 years of age. Distinct uses include: o Multi-day stays for respite and awaiting transfer to third-party facilities. DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 3 o Rooms for IVC patients. (Assume minors will be served in BHUC until transfer to third-party facility, if necessary.). o Patient rooms for short-term services including initiation of services that will be continued after transfer to third-party facilities (e.g. MAT). o Secure patient rooms for patients who are agitated. o Secure patient rooms for justice-involved individuals including adjacent space for LE personnel who may need to accompany these patients 3. Includes those patients awaiting forensic assessments and those transferred from OC Detention Center. • If need cannot be supported in BHUC area and if allowed by regulation, space for holdover of minors who cannot be transferred due to lack of beds in third-party facilities within the 23-hour service interval (See Section C). • Nurses station to serve and observe FBC patient rooms. • Secure rooms are visually separated from other patient beds to maintain a safe and calm environment for patients not requiring higher level of security. E. Medical Areas • Medical Examination and Treatment. Space for examination rooms and small medical staff to provide “urgent care” type medical services, conduct point of service laboratory tests, and take samples for analysis by outside laboratory. Accessible directly from rear entrance area and accessible from clinical areas within Facility. • Inpatient Pharmacy. Pharmacy located in the facility to serve patients and provide medicines upon discharge from Facility. Support outpatient pharmacy (see below). Space for pharmacy staff and secure storage. • Outpatient Pharmacy. Outpatient pharmacy (pick up window) located near and accessible from front entrance to support patients on an outpatient basis. Outpatient pharmacy supported by inpatient pharmacy located elsewhere in Facility (maybe adjacent). • Laboratory Services. Point of service testing and sample collection conducted in medical area. Sample pick up by third-party laboratory courier is located at rear entrance. F. Facility Security • The workgroup believes security personnel located in the Facility is a necessary and reasonable. To the extent that security personnel are present, keeping a low profile to maintain a calming, safe environment for all patients is desirable. • Locate most of security personnel away from eyes of general population entering via front entrance and those in BHUC clinical areas to achieve a balance that provides safety and presents a calming environment for all patients and the public. • Space for Facility security personnel should be located such that security personnel can observe entire space via security video and sound. o For example, this may be space located adjacent to the front desk but not within the front desk area. 3 Details about accompanying LE personnel for justice-involved individuals vs. transfer to Facility security has yet to be determined. DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 4 o Located to maintain a capability for immediate response at front desk, waiting areas, clinical areas (open and secure areas), and rear entrance. • Facility staff must have capability to call security for immediate response at all locations. • Area for security staff breaks (with coffee, snack food, and drinks) can be shared with other staff break areas. Security staff space also includes lockers for personal belonging and storage for supplies including weapons storage as necessary. • Direct access to secure space (see Section D) from rear entrance without traverse of other clinical and public areas of the facility. When security personnel are working in the rear entrance area space should accommodate safe transfer of patients to Facility clinical staff in either the FBC or BHUC areas. Note: To date, Facility security staffing and operational plans have not been finalized. In keeping with the idea of having a low-profile security presence in the Facility, maintaining a safe environment will incorporate a peer specialist first approach. That is, using peer specialists who are trained to work with agitated patients and who can employ de-escalation methods. These peer specialists are expected to work closely with patients at point of arrival, during their stay in the Facility, and upon discharge and follow-up. The level of Facility security that will be necessary to back up the peer specialists is yet to be determined. G. Outpatient Service Areas • Separate space to provide outpatient services with a focus on child outpatient services. • Outpatient services may include partial hospitalization program (PHP) and Intensive Outpatient Program (IOP) services. • These programs are intended to bridge gaps in services especially for minors with a focus on community-based services. Note: Inclusion of outpatient services to augment crisis services have yet to be made final. This space is generally considered to be adjacent to but not within the BHUC/FBC space. H. General Purpose Areas • Multi-use Room. A large multi-use room for general use and to support training programs for Facility staff and other closely aligned stakeholders. Space capable of being partitioned for separate, simultaneous use by multiple groups. Need to be able to convert into space for use as sobering center to handle periodic surge in demand for this service. • Outdoor space or courtyard for patients. • Recreational space for social activities. • Resource Center/Call Center accessible from front entrance and serves as a library/resource center for general public. Resource Center may be staffed by volunteers or paid staff who provide literature and contact information for all BH-related services and support programs that are available to OC residents including County services, UNC Services, private services and clinics, and residential treatment options whether or not they are located in Orange County. Resource center may include access to legal services (e.g., legal aid) regarding insurance, psychiatric advanced directives (PADs), or other matters. • Staff area for breaks, storage of personal belongings, and provides coffee, drinks, and snacks. DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 5 • Storage areas for clinical supplies. • Food service and laundry services for FBC patients and others with overnight stays. I. Community Partner Offices/Workspace • General office space for community groups and other stakeholders including, for example, school liaison, DSS, NAMI, FIT program, homeless programs coordination. • Office space for Alliance Health representative(s) for collaboration and to provide patient access to services and insurance. • Shared space for use by multiple groups (office hoteling). • Space for other service providers (e.g., ACT team). J. Specialized Communications Infrastructure • Two secure and private Video Conference Rooms with video conferencing equipment, printers, and fax machines. o One room primarily for clinical use including telemedicine and consultation with other stakeholders and community services. o One room primarily for criminal justice use with courtroom like set up to support criminal justice processes and access to magistrate. • Separate entrances to video conference rooms from both secure and open areas to extent possible. • Secure computer equipment with access to: o E-Warrants (replaces NC AWARE) for criminal justice processes. o OC Housing Helpline for housing assistance as part of discharge plan. DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 1 ATTACHMENT #4 Crisis-Diversion Facility Estimate of Projected Demand for Service To support the design of the Orange County crisis-diversion facility (Facility), the subcommittee has undertaken a task to estimate the number of individuals who are expected to be served by the Facility. Herein we document our approach to developing these estimates. This report is organized into seven sections: • Executive Summary, • Overview, • Current Episodes, • Deflection Potential, • Results, • Demographic Breakdown, • Uncertainties. Executive Summary The Orange County Behavioral Health Task Force Crisis-Diversion Facility Subcommittee put forth recommendations for a BH crisis-diversion facility for Orange County. The subcommittee has described the services to be provided by the Facility, its alignment with various stakeholders in Orange County, and the number of individuals expected to be served by the Facility. Data have been compiled by the subcommittee working with various stakeholders who currently respond to BH crisis daily. These data have been used to quantify the number of cases expected to be served by the Facility. The current estimate is that the Facility will serve approximately 400 BH crisis cases per month. The facility will serve minors as well as adults and the current estimate is that cases involving minors will be approximately 23% of total cases or about 90 cases per month. While care has been taken to base these projections on hard data, the estimate also relies on professional judgement of subject matter experts where necessary. This report documents the data compiled and the approach used to make these projections. Overview In November 2019 the Orange County Behavioral Health Task Force (BHTF) formed a subcommittee to lead the process of developing a BH crisis center for Orange County. The first step in the subcommittee’s work was determining the scope of services that need to be provided to fill the gaps in Orange County’s current crisis response system. This process involved engaging all stakeholders who currently are involved in crisis response and asking what services are missing and, if available, would enable better responses and better outcomes for individuals in crisis. The subcommittee’s work led to the current plan for clinical and criminal justice services within a new crisis-diversion facility and plans for networking with community treatment and social services providers. The assessment described above asked stakeholders how and when they would use the Facility. To develop an estimate, or projection, of the number of individuals who are expected to be served by the Facility, these same stakeholders were asked to quantify their expectations. That is, how many individuals with whom they engage routinely do they believe could be deflected to the Facility in lieu of the current default approach, which often involves transport to the UNC Emergency Department. DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 2 Current Episodes The first step toward determining the potential number of episodes that could be served by the new Facility, is determining how many BH episodes currently occur in Orange County each month. This information is displayed in Table 1. The episode types make up the column headers in Table 1. The term episodes includes various types of BH cases (mental health and substance use disorders) and includes: • Cases involving Mental Health (non-violent and potentially violent episodes), • Cases involving suicide or substance use disorders, • Involuntary Commitments (IVC) pursuant to Magistrate review and issuance of orders, • Nuisance and trespass cases involving homeless individuals, • Cases involving justice-involved individuals (court processes and detention center). Stakeholders make up the rows in Table 1. Stakeholders are the entities currently responding to BH episodes and provide services to help individuals in crisis. These stakeholders are the sources for the data shown in Table 1. These data sources are discussed in the Appendix along with notes about the information provided and how the data are is used to estimate the number of BH episodes currently occurring in Orange County. Table 1. Current Orange County Behavioral Health Episodes per Month (without Facility). Deflection Potential The next step in the process of determining the number of episodes that could be served by the new Facility is estimating the Deflect Rate. That is, of the number of episodes that currently occur, what percent could be deflected to the new Facility in lieu of being transported to the emergency department or magistrate/detention center. MH-NV MH-V Suicide SUD IVCs Homeless Courts Det Ctr Total EMS 17.0 52.0 69.0 CHPD 8.3 4.9 3.0 5.9 22.1 CPD 2.3 1.7 0.9 1.8 6.7 HPD 2.4 2.1 0.3 0.5 5.3 OCSO 2.3 2.2 2.3 4.5 11.3 UNCP 0.2 0.0 0.2 All Orange County 10.9 10.9 OCSO Detention Center 15.0 15.0 Courts (assessments, etc.)20.0 20.0 Juvenile Justice 4.0 4.0 Magstrate - IVCs 20.0 20.0 OC DSS 9.1 9.1 CHCCS 48.0 48.0 OC Schools 31.0 31.0 UNC ED/PES (Routine Caes) 100.0 100.0 UNC CAPS 0.0 Sobering Diversions 65.0 65.0 Walk-ins 88.0 88.0 Mobile Crisis (FH)13.4 13.4 UNC (Urgent/Emergent)353.0 353.0 Totals >>675.0 10.9 6.5 129.7 20.0 10.9 24.0 15.0 892.0 Stakeholder Number of Episodes (Current Status No Crisis Facility) DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 3 Table 2 presents the deflection rates estimates provided by the stakeholders. There are two estimates for each stakeholder/episode type: a high deflection rate and a low deflection rate. The high and low values are used to bracket the possible outcomes and account for uncertainty in projecting how the new Facility will be integrated with stakeholder practices. It should be noted that for some stakeholders the deflection rate applies to the total number of episodes estimated to occur in Orange County each month. For other stakeholders, the deflection rate applies to the episodes most likely to be deflected to the new Facility. The notes for Table 2 add some of this explanation to the raw numbers. Figure 2. Deflection Estimates by Episode Category and Stakeholder. Notes 1. The nature of most IVC cases is that many could be deflected to the new Facility. However, of approximately 263 IVC cases occurring in Orange County each month (average of 2020 and 2021), 80% originate from within UNC. This leaves at most about 52 who could be deflected. Other factors further reduce this number (e.g., double counting, multiple orders per episode). Therefore, based on reconciling IVC data with UNC ED/PES data, we estimate that only about 20 IVC cases may be deflected (see Table 1) and of these we assume 100% are deflected to the Facility. 2. Chapel Hill Carrboro City Schools and Orange County Public Schools estimated episodes to be 5% and 4% of student enrollment, respectively. So, the 100% represents the 5% value (the CHCCS estimate) and 80% represents the 4% value (the OCPS estimate). The 5% value is shown in Table 1. 3. Routine patients appearing at the UNC Emergency Department do not require a psychological assessment and are discharged from ED without being admitted. Diversion assumption is that they could be provided with a reference to the Facility where they may obtain services in the future. These cases are assumed to be include in the walk-in category and are not counted separately, thus a zero deflection rate. 4. For sobering cases, we only included sobering cases that appear before the Magistrate. Did not include deflections from ED as those likely are included in the EMS/LE categories. See Appendix for more detail. 5. Walk-in cases are scaled from Durham County number to OC population. OC population is about 52% of Durham County (150,000 vs 291,000). So, 100% represent the assumption that OC will experience same walk-in rate as Durham. 110% assumes that OC walk-in episodes in OC will be at a somewhat higher rate than Durham. 6. Of the ED cases not otherwise diverted, a percent could be stepped down to C-D Facility in lieu of inpatient admittance. Data from UNC ED suggest that this number could be as high as 25%. This HIGH LOW HIGH LOW HIGH LOW HIGH LOW HIGH LOW HIGH LOW HIGH LOW HIGH LOW EMS 90.0%80.0%100.0%95.0% CHPD 80.0%70.0%80.0%70.0%95.0%80.0%95.0%80.0%95.0%50.0% CPD 80.0%70.0%80.0%70.0%95.0%80.0%95.0%80.0%95.0%50.0% HPD 80.0%70.0%80.0%70.0%95.0%80.0%95.0%80.0%95.0%50.0% OCSO 80.0%70.0%80.0%70.0%95.0%80.0%95.0%80.0%95.0%50.0% UNCP 80.0%70.0%80.0%70.0%95.0%80.0%95.0%80.0%95.0%50.0% All Orange County 35.0%25.0% OCSO Detention Center 100.0%80.0% Courts (assessments, etc.)100.0%75.0%100.0%80.0% Juvenile Justice 100.0%67.0% Magstrate - IVCs 100.0%100.0%1 OC DSS 100.0%80.0% CHCCS 100.0%80.0%2 OC Schools 100.0%40.0% UNC ED/PES (Routine Cases) 0.0%0.0%3 UNC CAPS Sobering Diversions 95.0%65.0%4 Walk-ins 110.0%100.0%5 Mobile Crisis (FH)0.0%0.0% UNC (Urgent/Emergent)10.0%5.0%6 NotesHomelessCourtsDetention Ctr.Stakeholder MH-NV MH-V Suicide SUD IVCs DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 4 number may decrease if patients are deflected to Facility in lieu of transport to the ED and received initial care at the Facility instead of the ED. There is limited analysis of this category at this time, the high and low deflection rates for this category, therefore, are conservatively set at 10% and 5%, respectively. Results The final step in the process of determining the number of episodes that could be served by the new Facility each month is generating a mid-point estimate. The mid-point estimate that results from this process is approximately 400 episodes per month. The mid-point estimate is derived by multiplying the number of episodes from Table 1 by the deflection rates in Table 2. This results in two estimates: a high estimate and a low estimate. Combining these estimates produces a mid-point estimate that is shown in Table 3. It should be noted that the mid-point estimate is not the average of the total numbers. The reason for this is that the high and low deflection rate values are applied to each stakeholder/episode type and the result then summed across all categories. Table 3 presents the mid-point estimates in detail for each stakeholder/episode type. The two right-most columns of Table 3 show the high and low value for each stakeholder. Totals for all stakeholders are presented at the bottom of the columns. Figure 3. Midpoint Estimate Totals and Breakdown by Episode Type and Stakeholder. Demographic Breakdown The above data presents the total number of episodes. It is important to gain an understanding of the demographic breakdown by age, gender, ethnicity, and race. We tried to develop such a breakdown. However, data were lacking or simply required too much analysis for our purposes. The most complete data we could compile was data by age. The age breakdown is critically important to the design of the new Facility because separate accommodations need to be provided for minors and adults. MH-NV MH-V Suicide SUD Comm*Homeless Courts Det Ctr 14.5 0.0 0.0 50.7 0.0 0.0 0.0 0.0 65.2 63.0 67.3 6.2 3.7 2.6 5.1 0.0 0.0 0.0 0.0 17.7 16.3 19.0 1.7 1.3 0.8 1.6 0.0 0.0 0.0 0.0 5.4 5.0 5.8 1.8 1.6 0.2 0.5 0.0 0.0 0.0 0.0 4.1 3.8 4.4 1.7 1.7 2.0 3.9 0.0 0.0 0.0 0.0 9.3 8.6 10.1 0.2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.2 0.0 0.0 0.0 0.0 0.0 3.3 0.0 0.0 3.3 0.0 3.8 0.0 0.0 0.0 0.0 0.0 0.0 0.0 13.5 13.5 12.0 15.0 0.0 0.0 0.0 0.0 0.0 0.0 17.5 0.0 17.5 15.0 20.0 0.0 0.0 0.0 0.0 0.0 0.0 3.3 0.0 3.3 2.7 4.0 0.0 0.0 0.0 0.0 20.0 0.0 0.0 0.0 20.0 20.0 20.0 8.2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 8.2 7.3 9.1 43.2 0.0 0.0 0.0 0.0 0.0 0.0 0.0 43.2 38.4 48.0 21.7 0.0 0.0 0.0 0.0 0.0 0.0 0.0 21.7 12.4 31.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 52.0 0.0 0.0 0.0 0.0 52.0 42.3 61.8 92.4 0.0 0.0 0.0 0.0 0.0 0.0 0.0 92.4 88.0 96.8 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 0.0 26.5 0.0 0.0 0.0 0.0 0.0 0.0 0.0 26.5 17.7 35.3 218.0 8.0 6.0 114.0 20.0 3.0 21.0 14.0 403.0 352.0 451.0 Episodes Diverted to Crisis Facility Total (Midpoint) Total (Low) Total (High) Sobering Diversions Walk-ins Mobile Crisis (FH) UNC (Urgent/Emergent) Totals Magstrate - IVCs OC DSS CHCCS OC Schools UNC ED/PES (Routine Cases) UNC CAPS OCSO UNCP All Orange County OCSO Detention Center Courts (assessments, etc.) Juvenile Justice Stakeholders EMS CHPD CPD HPD DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 5 Breakdown of episodes by age (percent under 18 years of age) is available: • EMS (8.4%) • Juvenile Justice (100%) • IVCs (18%) • OC Department of Social Services (100%) • Chapel Hill Carrboro City Schools (100%) • Orange County Public Schools (100%) • UNC - urgent/emergent step down (25%). Of course, for some categories 100% of the projected episodes are minor because the population served by the stakeholder is 100% minors (e.g., schools). Across all categories 23% of possible deflections to the new Facility are expected to be individuals under age 18 or about 90 episodes per month. Uncertainties We have focused on the need to base an estimate of the number of BH episodes that could be served at the Facility on hard data wherever possible. In many categories, data have been extracted from stakeholder databases by subject matter experts who understand the data and its limitations. In other categories, where no hard data exist or where the level of effort required to compile hard data is excessive, we relied on best professional judgement. The sources of the data used is presented in the Appendix to this report. Most of the data available represent BH episodes that currently result in transport to the UNC Emergency Department. Deflection of individuals experiencing a BH crisis from the emergency department is an important part of the Facility’s mission. There is less information about potential diversion or deflection from criminal justice entanglement. This lack of data does not reflect a lack of interest on the part of stakeholders in Orange County, but rather a lack of readily available data. Efforts will continue to develop these data as deflection from criminal justice also is an important part of the Facility’s mission. Finally, the projects are based on 2021/2020 data. Currently, we do not attempt to project growth in the number of cases served by the Facility. Growth in the number of cases will occur due to growth in Orange County population, trends in BH cases requiring services, and increased awareness and, therefore, use of the services available to stakeholders and Orange County residents. DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 6 Appendix Data Sources Used for Projecting Episodes Served at the Facility Previously the Crisis-Diversion Subcommittee prepared estimates of the projected usage of the Crisis Diversion Facility (Facility). A summary of these projections is contained in the subcommittee report provided to the BOCC on April 22, 2021. The Subcommittee updated its estimate of Facility usage in early 2022. This 2022 update is based on: • data for all of 2021, • refining data previously collected, and • adding several new categories not previously included in the projection of Facility usage. Most of the new categories were added because it is now clear that the Facility will provide BHUC services for individuals 4 years old and older. Table 1 presents the data categories and data sources used for the 2022 update of projected Facility usage. Endnotes provide details about sources of data and how the data were used. Exhibit A presents a reconciliation of data collected from various sources with data provided by UNC Emergency Department/Psychiatric Emergency Services (ED/PES). Table 1. Data Categories and Data Sources used in Projecting Facility Cases Data Category/Data Source Data Source 911 datai ii Orange County 911 Call Center Municipal Police Dataiii Chapel Hill Police Department Emergency Medical Servicesiv Orange County EMS UNC Hospital ED v (also see Exhibit A) UNC ED/PES Courts vi Orange-Chatham District Courts Magistratevii Chief Magistrate, Clerk of Court Detention Centerviii Orange County Criminal Justice Resource Department Juvenile Justiceix Orange County Criminal Justice CHCCS x Chapel Hill Carrboro City Schools OC Public Schools xi Orange County Public Schools OC DSS xii Orange County Department of Social Services Sobering Casesxiii Stakeholder meeting (22SEP2022) Walk-ins xiv Alliance Health i Mental Health calls to 911 are taken from Orange County 911 records and reported separately for each Orange County law enforcement agency. Two types of episodes are included: those coded as MH- nonviolent and those coded as MH-violent. Examination of the potentially violent descriptions suggested that most of these episodes could be addressed at the recommended Crisis-Diversion Facility. Response by LE based on CHPD data indicates that about 80% of the MH calls result in voluntary transport (i.e., transport to the ED without IVC). Data were compiled for the last nine months of 2020 and all of 2021 and included jurisdiction data (e.g., CHPD, HPD, CPD, UNC-PD, OCSO). Few changes in number of episodes were identified between 2020 and 2021, so the 2021 data were used in the projections. Note: DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 7 Most commitment episodes reported for LE agencies are voluntary commitments: that is, voluntary transports to the ED. All IVCs data compiled from the Magistrate’s office are entered separately in our projections under the Magistrate. ii Disturbance/Trespass 911 calls associated with homelessness are recorded separately. Virtually all these calls involve Chapel Hill (87%) and Carrboro (8%). A small percentage of these may be transported to Crisis-Diversion Facility. These diversions may grow as programs to address homeless population evolve. Data were compiled for the last nine months of 2020. No data for 2021 were compiled. The 2020 data are used for the 2022 projections without update. iii In addition to the 911 call data, CHPD records were reviewed: data was compiled from Chapel Hill Police Records Management System (RMS) for 2015 – 2020. Although the RMS records are not designed to support a rigorous enumeration of cases and case types, these records do provide some insight on suicide and SUD episodes. The CHPD data are used to make inferences for episodes in the other Orange County municipalities based on population. Currently, most of these calls result in transport to the UNC ED. Note: Most commitment episodes reported for LE agencies are voluntary commitments or voluntary transports to the ED. All IVCs reported by the Magistrate are entered separately in our projections under the Magistrate. iv EMS 911 calls were compiled from ESO data for three categories: MH-related (includes suicidal ideation), opioid-related, and alcohol-related for 2018 – 2021. Data for 2018, 2019, 2021 were used for the BH category because 2020 data appear to be outliners from the other years on the high side. Most episodes labeled as transported without sirens or lights can be diverted to Facility: less than 3-4% are too agitated to receive care at the Facility. These episodes do not include treated and released or AMA situations. Alcohol (ETOH) cases included data from 2018 – 2021. Opioid data from 2021 are used in the projections instead of 4-year average because cases are increasing year over year. Minors account for about 8.4 percent of BH cases and zero percent of opioid cases. Percent of alcohol related cases that involve minors is not available. v UNC ED data were compiled for the first eleven months of 2021. Cases were categorized as routine and emergent/urgent. These data were not used directly, but served to evaluate data from other stakeholders currently transporting individuals to the UNC ED. vi Requests for clinical assessment and support services provided to individuals and their families involved with Community Resource Courts may result in approximately 5 – 10 cases per month with additional demand from individuals enrolled in Community Resource Court accessing the facility as walk in patients. These estimated are based on best judgement by professionals involved in resource court proceeding. Additionally, various outreach programs (e.g., SORAD, Lantern) may result in an additional 8 patients per month. Also see Endnote viii. Total for this category is estimated to be 10 – 20 patients per month. These estimates do not include any additional deflection efforts by local LE agencies. vii IVCs. Magistrate records were compiled to identify IVCs initiated in Orange County for 2018 – 2021. IVCs have been increasing year over year and this is true for minors as well. The average of 2020 and 2021 is used for the January 2022 projections. The 2020/2021 IVC data also provided breakdown by age and these data are used to estimate the percent of total IVC cases that are under 18 years of age (18.4% – 19.8%). All IVC episodes are included in the Magistrate account and not under law enforcement. Of the approximately 250 IVCs per month, approximately 80% are generated from within UNC Hospital and so are not eligible for deflection to the Facility. Additionally, not all IVCs issued by the OC Magistrate actually involve an Orange County resident. Moreover, do to process issues some individual episodes result in more than one IVC order (e.g., patient cannot be located within 24 hours thus requiring a second DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 8 IVC for the same episode). So, 20% of 250 per month is 50 IVC episodes per month. After accounting for cases that require a higher level of service than provided by the Facility, non-OC residents (40% of UNC ED/PES patients are OC residents), and multiple IVC orders for a single episode, the number of IVC potentially deflected to the Facility per month is estimated to be about 20 per month. This estimate is consistent with a review of UNC ED/PES data. viii Referrals from the Detention Center population for treatment or observation in the Crisis-Diversion Facility are estimated based on best judgement by professionals experienced in providing BH services to this population. Not counting IVCs from Detention Center, approximately 5 patients per month could benefit from Facility to assess and stabilize BH episodes. Additionally, approximately 10 patients per month could be evaluated at the Facility associated with court appearances (e.g., first appearance). These estimates do not account for possible use of the Facility for Safe Keeping, which now requires transfer to Central Prison. No Safe Keeping estimates have been provided. Total for this category is approximately 15 patients per month. ix Best professional judgement is that the number of minors who might be referred to the Crisis-Diversion Facility (Facility) from juvenile justice is 10 – 15 per year (1 – 2 per month). This is represented in the projections as 15 episodes per year with a probability of diversion at 100% for the high value and 67% for the low value. Additionally, based on professional judgement, the number of minors/families who could be diverted to the Facility instead of Secure Custody and involvement in the CJ system is perhaps an additional 10 – 15 cases per year (1 – 2 per month). This is represented in the projections as 15 diversions from CJ per year with a probability of diversion at 100% for the high value and 67% for the low value. x CHCCS provided high level professional judgement and concluded the following. CHCCS population is approximately 11,500 students. Approximately 5% of 11,500 or 575 students a year (about 48 per month) potentially could either have indirect/direct contact with the Facility via staff calling for consultation, safety and risk assessments, substance use/abuse evaluation/assessments, mobile crisis visits to school and/or actual visits. xi Best professional judgement is 10 – 25 students per month diverted to the Facility. Demographic breakdown is estimated to be: 1) 65 – 70% white, 2) 30 – 35% Hispanic/black leaning toward Hispanic and 1) 35% female/65% male (maybe 75% male). For comparison to the CHCCS estimate (see Endnote x) the Orange County Public School system estimate is about 10 – 25 episodes per month represents or 1.6% - 4.0% of total enrollment (7430). xii OC DSS provided data based on 2021 calendar year. Data fall into two categories: 1) In-home and Foster Care cases and 2) work with families not involved in in-home or foster care services. Demographic data provided for first category. xiii Data from Stakeholder Workgroup (22SEP2021) indicated that about 10 – 15 cases per week are transported to ED and same number per week to the Magistrate. The ED cases mostly are covered by EMS data and so are not counted under this category. The magistrate data are additions to the 2021 projection. For the 2022 projections it is assumed that 95 % (high estimate) can be diverted to the Facility based on an assumption that 5% are too agitated for the Facility, which is conservative (the facility is staffed and designed to likely handle 100% of these cases). The low estimate simply reflects the lower end of the range of the estimated number of cases per month. xiv Alliance Health gathered data from Durham’s RI facility. The number of walk-in cases per month is 161 in 2021. Scaling this number to population of Durham County vs Orange County (52%) yields about 84 per month, which is the basis for the value used in the projections. These cases are also assumed to DocuSign Envelope ID: 1920B089-58AA-4E97-8225-7BCF8DEBAAD4 9 account for the routine discharges from UNC ED who may later be part of the walk-in cases served by the Facility. So, no separate transfers or routine cases from UNC ED are counted. 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