2006 Bond Election
On May 16, 2006, Pima County voters approved
the sale of $54 million in general obligation
bonds to fund the construction of psychiatric
facilities. Below is a link to the Bond Implementation
Plan Ordinance that governs the spending of
these bond funds. Also on this site is additional
information provided to the public prior to
the election.
Psychiatric Care
Facilities
Question No. 3: Psychiatric Urgent Care Facilities $18,000,000
For the purpose of acquiring, developing, improving and equipping psychiatric urgent care facilities for the County, shall Pima County, Arizona be authorized to sell general obligation bonds of the County in an aggregate principal amount not exceeding $18,000,000?
Question No. 4: Psychiatric Inpatient Hospital Facilities $36,000,000
For the purpose of acquiring, developing, improving and equipping psychiatric inpatient hospital facilities for the County, shall Pima County, Arizona be authorized to sell general obligation bonds of the County in an aggregate principal amount not exceeding $36,000,000?
May 16, 2006 Special Bond Election
NOTE: Questions 1 and 2 on the May 16, 2006 election ballot will be associated with the Regional Transportation Plan, which is separate from these Psychiatric Care Facilities questions.
Emerging Kino Campus
Kino Hospital Transition to University Physicians
Pima County currently has a 25 year lease with University Physicians Healthcare (UPH), a private non-profit health care organization associated with the University of Arizona College of Medicine, to operate the former Kino Community Hospital now known as University Physicians Hospital at Kino Campus. The purpose of this unique public/private partnership is to transition the hospital from one focused mainly on psychiatric services to a full-service hospital that provides comprehensive medical services to an underserved population, and to reduce taxpayer support of the hospital. This transition has been successful. Surgical cases have grown from 3 cases per month to 130 cases per month. UPH has expended over $10 million in new medical equipment. The 13-bed intensive care unit has been reestablished, and there are now 276 credentialed physicians at the hospital.
Kino Campus Master Plan
Pursuant to the lease agreement with UPH, a master plan for the 70-acre Kino health campus was completed in May 2005. The primary concept for the master plan was to develop a plan for an academic research and healthcare campus to support excellent, full-service healthcare for the Tucson community, and state-of-the-art research and teaching programs. Future facilities discussed in the master plan include a research institute and training facility, a Pima Community College of Nursing facility, long-term care facilities, a children and womenÕs center, and an upgraded and expanded psychiatric facility.
In May of 2004, voters approved $25 million for the development of a Kino Public Health Center on the Kino health campus, to consolidate public health, medical, and administrative services in one location. This building is currently under construction, and is scheduled for completion by the end of this year.
At the same election, voters also approved $12 million to expand existing psychiatric facilities at Kino Hospital, now known as University Physicians Hospital at Kino Campus, by beginning the development of a psychiatric inpatient hospital adjacent to the current hospital. The majority of psychiatric inpatient beds in the hospital are currently located in areas designed as medical/surgical units and are inefficient from an operations and safety standpoint. During the master planning process, it was determined that simply expanding existing psychiatric facilities was not in the taxpayersÕ best financial interest. Instead, the master plan, which balances optimal patient care delivery as well as public expenditures, concluded that a larger facility for psychiatric services on the Kino health campus was needed. The multiple story facility, as proposed, will be part of University Physicians Hospital and will be constructed adjacent to the existing facility, allowing patients access to secure, ground level outdoor areas, and medical care. This project will completely relocate psychiatric inpatient beds from the present medical/surgical units returning that space to its originally designed purpose. This plan is much more cost effective than leaving the existing psychiatric units in place and constructing new medical surgical beds.
The Need for Psychiatric Care Facilities
The Community Partnership of Southern Arizona, our regional behavioral health authority, reports that over 30,000 individuals are presently receiving some sort of publicly funded mental health service in Pima County, most with diagnosed mental health disorders. Quite likely, there is an equal number in the community who have not been diagnosed or are not receiving any form of treatment. Up to 25% of the 2,000 detainees in the Pima County jail are mentally ill or require mental health or substance abuse treatment. Moreover, the use of methamphetamine and the crime associated with such use in Pima County has reached crisis levels, and methamphetamine use by individuals with behavioral health problems is a growing concern.
This is a regional issue that impacts not only mental health service providers, but also hospital emergency rooms and law enforcement personnel throughout Southern Arizona. Many of these individuals end up in a medical emergency room, jail, or juvenile detention facility because there is no other place to take them. The co-location of medical patients in hospitals and emergency rooms with individuals with behavioral health and substance abuse problems causes delays and disruptions in treatment for both groups of patients and jeopardizes patient safety.
Psychiatric Urgent Care Facilities $18,000,000
Scope: To construct a psychiatric urgent care center to complement existing and proposed psychiatric facilities on the Kino health campus. The urgent care center will be approximately 60,000 square feet in area and will be located in close proximity to University Physicians Hospital at Kino Campus, including the proposed psychiatric inpatient hospital facility. The psychiatric urgent care center will be leased to and operated by the regional behavioral health authority designated in statute by the State to provide publicly funded urgent care and crisis services for Pima County.
Benefits: Development of a psychiatric urgent care center will fill a significant gap in the mental health delivery system in Southern Arizona. It will substantially reduce the number of mental health and/or substance abuse patients currently being seen in local emergency rooms, freeing the emergency rooms to provide emergency medical care. The psychiatric urgent care center would coordinate services with all hospitals in Pima County, not only University Physicians Hospital at Kino Campus. The advantage of being located on the Kino health campus is the proximity to medical services in the event a patient requires more intensive medical evaluation or stabilization of medical emergencies. The development of a psychiatric urgent care center will also benefit law enforcement personnel and other first responders who now often respond to these individuals in crisis, by providing a location to take these individuals and a plan for streamlining the process.
Psychiatric Inpatient Hospital Facilities $36,000,000
Scope: To construct an 80 to 100-bed psychiatric inpatient facility and expanded psychiatric emergency department on the Kino health campus. The proposed facility will be part of University Physicians Hospital at Kino Campus and will be constructed adjacent to the existing hospital and within close proximity to the proposed psychiatric urgent care center. The proposed $36 million in bond funds would be combined with the $12 million of bond funds authorized in May 2004 for a total of $48 million.
Benefits: The majority of psychiatric inpatient beds in the University Physicians Hospital at Kino Campus are currently located in areas originally designed as medical/surgical units and are inefficient from an operations and safety standpoint. Medical patients as well as patients with behavioral and substance abuse issues are treated in an emergency department that is too small, causing delays and disruptions in treatment for all patients and jeopardizing patient safety. The proposed psychiatric impatient hospital and expanded emergency department with space specifically designed for psychiatric patients, will improve security, operational efficiency and treatment opportunities.
One Community's Experience with Crisis Intervention Teams (CIT)
Encounters between law enforcement officers, individuals in behavioral health crisis, and bystanders can be dangerous for all involved. The Crisis Intervention Team (CIT) program is a model program successfully implemented in over 100 communities across the country. The program gives officers additional skills to make safer interventions for themselves, the person in psychiatric crisis and the community. Besides training officers and dispatching them to behavioral health crisis calls, an essential part of the programÕs success is the availability of a psychiatric urgent care center. The Pima County SheriffÕs Office, the Tucson Police Department, and other law enforcement agencies in Pima County are implementing CIT training.
The CIT model was first developed and implemented in Memphis, Tennessee in 1988. During the first 10 years of the program, the following successes were reported:
*Officer involved shootings of individuals with mental illness dropped significantly.
*Injury rates for officers were 7 times higher before the program.
*Costs to the criminal justice system were significantly reduced.
*The number of individuals with mental illness in jail was significantly lower than the national rate.
*Arrest rates were very low compared to the national average, with very few individuals with serious mental illness arrested during interventions.
*SWAT callouts dropped significantly.
*Clinicians report improved treatment of individuals with mental illness by law enforcement.
*Officers were usually back on patrol within 15 minutes of bringing an individual with mental illness in to a medical center, whereas before, officers spent 4 to 6 hours in emergency rooms.
Impact of Issuing New General Obligation Bond Debt
The total value of general obligation bonds being submitted to the voters for approval is $54 million. If voters authorize the sale of these bonds, the actual sale will be scheduled over 2 years, with projects scheduled to be completed in 3 years. The County will pay off general obligation bond debt through an annual levy of a secondary property tax assessed against the value of all taxable property in Pima County. Voting for bonds at the May 16, 2006 election does not incur debt, but only authorizes the County to sell bonds at a later date and incur new debt.
Secondary Tax Rate Will Not Increase
The current secondary tax rate is $0.7150 per $100 of assessed value. In order to remain at this rate and to not cause significant year-to-year variation in the secondary property taxes paid for debt service purposes by Pima County property owners, the Board of Supervisors pledges that the secondary property tax rate shall not exceed $0.7150 per $100 of assessed value during the term of debt retirement for general obligation bonds authorized at the May 16, 2006 election.
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