Renovations for Daly City Youth Health Center: City of Daly City

Important note: the following recommendation was approved by the Board of Supervisors on Dec. 6, 2016:

To: Honorable Board of Supervisors

From: John L. Maltbie, County Manager; Louise F. Rogers, Chief, San Mateo County Health

Subject: Measure A: One-time grants totaling $1,700,000 for the renovation and improvement of 350 90th Street, Daly City, to support the relocation of the Daly City Youth Health Center

RECOMMENDATION:

Measure A: Adopt a resolution:

A) Authorizing a one-time $1,423,000 grant of Measure A funds (including $423,000 of district-specific funds) for the renovation and improvement of 350 90th Street, Daly City, to support the Daly City Youth Health Center; and

B) Authorizing a one-time $277,000 grant of district-specific Measure A funds to the City of Daly City for Exterior Renovation of 350 90th St., Daly City, to address ADA Compliance Issues.

BACKGROUND:

For the last 26 years, the San Mateo County Health (Health System) has relied upon its unique partnership with the Daly City Youth Health Center (Center) to serve underserved, high-risk adolescents and young adults (collectively referred to as “youth”) in northern San Mateo County (North County). San Mateo County Health staff are embedded in the Center, providing North County youth a diverse array of primary care services as a school-linked program of the Jefferson Union High School District (JUHSD). Since 1990, the Center has helped more than 52,000 underserved youth, with a majority living in Daly City, Broadmoor, Pacifica, Colma, Brisbane, South San Francisco and San Bruno. Six zip codes from the latter cities are considered high-risk, i.e. these zip codes have the largest populations of children and youth ages 0-17 in the probation, behavioral health and child welfare services, according to a joint analysis performed by the County’s Probation Department, Human Services Agency, and the San Mateo County Health.

Adolescence is a challenging time, especially for youth that are low-income, learning English, or struggling with complex medical or mental health needs. Past surveys show disturbing behavioral health illness of youth enrolled in local high schools. The California Health Kids Survey results from the 2011-13 school years indicated that 17.5% of 11th grade students seriously considered attempting suicide, 23.7% had used marijuana, and 31.4% had alcohol seven or more times.

Young people are challenging to engage in medical and mental health care, so the Center has tailored its approach and partnered with schools to engage youth on their own terms. For example, since the youth population has challenges with making appointments, traveling to appointments, and appearing for appointments, the Center provides each youth client a broad array of services during a single visit, including insurance enrollment, primary care, reproductive health care, and counseling as needed. The Center offers prevention programs, using peer educators to educate and empower the youth to make decisions in line with their goals and values. Over the years, the Center has grown into a community wellness center providing primary health care, insurance enrollment, counseling services, vocational internships, and comprehensive sexual health education for youth ages 12-24.

The Center expects to see a 37% increase in youth they serve over the next five years and a 12% increase in the primary care and behavioral health utilization. This is due in large part to the fact that the Center’s tailored approach to meeting youth needs is not offered anywhere else in North County, by either the San Mateo County Healthor other North County providers.

Given the inadequacy of the Center’s existing location / facility, the Center and its partners (including the San Mateo County Health) have identified a larger, more modern space at 350 90th Street in Daly City, owned by the City of Daly City. JUHSD’s board recently agreed to lease the property from Daly City for ten years with two five-year options, on behalf of the Center and its partners, who envision the new location to be the Center’s new long-term home.

DISCUSSION:

As the San Mateo County Health looks to the future and the array of services that will be needed by low-income residents in North County, the Center’s logical role is to be North County’s designated youth health center, based on the Center’s proven innovative approach, its current client base, and its strong relationships with North County schools and community-based organizations.

The Center’s leadership have been in discussions about the need to rebrand, as part of this recognition of the role they play in the continuum of services available across North County, not just Daly City.

The opportunity afforded by the new space at 350 90th Street has an additional benefit for the San Mateo County Health, as some of the youth-focused Behavioral Health and Recovery Services (BHRS) provided next door at the Mike Nevin Daly City Clinic (Clinic) can be co-located in the new building. Moving these BHRS youth services to 350 90th Street frees up valuable space for other medical and behavioral health services that are best located in the Clinic. With the co-location of BHRS as the Center’s long-time partner, the 350 90th Street location will become a hub for family services and partnerships with schools and other youth and family-focused nonprofit organizations in North County.

Measure A is the ten-year half-cent general sales tax approved by San Mateo County voters in November 2012. The Board and County staff have conducted study sessions and community outreach efforts to inform priorities for Measure A spending. On March 17, 2015, the Board adopted the Measure A allocation plan for the FY 2015-17 budget, during which the County anticipates Measure A receipts of approximately $80 million annually. The plan included $5 million in one-time loans or grants for FY 2015-16, and

$1 million each year for FY 2015-16 and 2016-17, divided equally among the five Board districts, for entities that submitted Letters of Intent which were not funded or, in cases of emergencies or unforeseen circumstances, other one-time projects for entities that did not submit a Letter of Intent. On April 28, 2015, the Board approved the criteria and process for staff to utilize in administering these funds. In accordance with such criteria, District 5 has submitted a request to use Measure A funds as shown below and in the attachment hereto.

A one-time $1,423,000 Measure A grant to DCYHC, which includes $423,000 in district-specific funds, will be applied towards the approximately $3.2 million in estimated tenant improvements at the new location. Tenant improvements will include overhaul of the new space’s electrical infrastructure and heating, ventilation, and air conditioning systems, as well as the creation of exam and counseling rooms. Another one-time $277,000 grant of district-specific Measure A funds will be made to the City of Daly City to address ADA compliance issues relating to the building exterior at the same location. Project summaries for the two district-specific grants are attached.

In addition to these Measure A funds from the County, JUHSD’s Board has already approved a $1.5 million loan to finance DCYHC’s tenant improvements. DCYHC has initiated a capital campaign in order to raise funds from institutional and individual donors to both repay the JUHSD loan and fund tenant improvement costs not covered by these Measure A funds or JUHSD.

PERFORMANCE MEASURES:

Measure	FY 2016-17 Estimated	FY 2016-17 Projected
Number of primary care clients receiving care at the Center	1706	1810

FISCAL IMPACT:

There are sufficient Measure A funds budgeted in the FY 2016-17 Adopted Budget for this purpose.

DISTRICT 5 (Supervisor Adrienne J. Tissier) FYs 2016-17 Measure A Request

Daly City Youth Health Center: Daly City Community Services Building Third Floor Tenant Improvements $423,000 One-Time Grant

This is a request for a one-time grant totaling $423,000 that will provide funding to the Daly City Youth Health Center (DCYHC) for tenant improvements to the third floor of the Daly City Community Services Building where DCYHC will be relocating. The tenant improvements will bring the Community Services Building.

The DCYHC is a trusted, comprehensive service provider in northern San Mateo County, serving over 3,000 low income, high-risk youth ages 13-25, each year with a majority of the youth residing in Daly City, Brisbane, Broadmoor, Pacifica, Colma, South San Francisco and San Bruno. The DCYHC offers primary health care, insurance enrollment, behavioral health counseling, health education and career services.

Through a strategic planning process in 2014-15 involving staff, community leaders and youth, it has been determined that the DCYHC has considerably outgrown its location. The DCYHC is currently sprawled over three floors and five suites, creating confusion for clients, guests and those with disabilities to navigate. There is currently no space for blood draws or performing vital checks, the rooms are too small for exams and procedures, and only one bathroom is available for all medical patients and staff. In connection with the strategic planning process, the community spoke about the need to have an appropriate, inviting, youth-oriented secure space for teens to receive health services and participate in health programming such as sex education.

Since 2014, the San Mateo County Real Property Division has assisted the DCYHC in their search for a new and larger facility. In the summer of 2015, two floors of the Daly City Community Services Building became available for lease and deemed, by Real Property and the staff of the DCYHC, an appropriate use for an expanded health facility. Each floor has approximately 7,000 square feet and it was determined that the third floor of the building would be the most appropriate based on the existing floor plan. The current cost estimates for the identified tenant improvements are approximately $3.2M and the DCYHC has initiated a capital campaign to pay for such improvements, of which the County’s $423,000 grant would be a part.

The County Manager’s Office will work with the DCYHC on the tenant improvement performance objectives for the County’s Measure A funds in this agreement.

Total Measure A Request: $423,000

DISTRICT 5 (Supervisor Adrienne J. Tissier) FY 2016-17 Measure A Request: Daly City Community Services Building – Exterior Renovation ADA Compliance $277,000 One-Time Grant

This is a request for a one-time grant totaling $277,000 that will provide funding to support the exterior renovation of the City of Daly City’s Community Services Building in order to bring the building into compliance with current ADA compliance standards.

Such renovations will facilitate the relocation of the Daly City Youth Health Center (DCYHC) to the building.

Through a strategic planning process in 2014-2015 involving staff, community leaders and youth, it has been determined that the DCYHC has considerably outgrown its location.

Since 2014, the San Mateo County Real Property Division has assisted the DCYHC in their search for a new and larger facility. In the summer of 2015, two floors of the Daly City Community Services Building became available for lease and were determined, by Real Property and the staff of the DCYHC, to be an appropriate use for an expanded health facility. In order for the DCYHC to move into the Daly City Community Services Building, however, the exterior front of the building including the parking lot, the ramp leading up to the building and other issues must be addressed and comply with new ADA standards. The cost estimates for the ADA updates by the City of Daly City will cost approximately $277,000.

The release of funds will be contingent on the execution of a Grant Agreement providing for the County’s confirmation the funds are expended for the purposes stated herein.

The County Manager’s Office will work with the City of Daly City on the negotiation and development of the grant agreement, including performance objectives for the County’s Measure A funds in this agreement.

Total Measure A request: $277,000.

Important note: this is a copy of the official report -- item 6 on the Board's agenda.