Submitted Application for a 2013 CIP Project

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AppID3279
I. Administrative Section 
Project Name: Southern Forensic Facility
Project Description (One Sentence): The purpose of this project is to complete construction of a maximum security facility in Southern Nevada for mentally disordered criminal offenders.
Project Location: County: Clark
Project Location: City: Las Vegas
Department (department requesting project): DHHS
Division (division requesting project): MH/DS
Agency (agency requesting project): Lake Crossing
Agency contact person: Al Kenneson, ASO II
Contact phone: 775-688-2033
Contact email: al.kenneson@nnamhs.state.nv.us
At the Department level ranking of this project:
The Department will rank their projects 1 through the lowest ranked project (i.e., If 5 projects were submitted by the Department a ranking of 1 would be assigned to the most important or most needed project and a ranking of 5 would be the least needed project).
Has this project been previously requested in a prior CIP? Yes
SPWD 4 digit Building No. (for existing buildings)
Facility Condition Analysis Project No. (if recommended)
II. Narrative Section 
Project Justification (Essay)
Project Description: For many years, Lakes Crossing Center (LCC) has been the only facility in the state of Nevada available to provide services to mentally disordered offenders. The staff serves clients from all 17 counties from the facility located in Sparks. The services this facility provides include competency to be adjudicated assessments, treatment to competency, criminal responsibility assessments and treatment for individuals acquitted Not Guilty by Reason of Insanity (NGRI). The facility may also be the site of commitment for individuals who cannot be restored to competency and have been charged with very serious crimes. The facility delivers these services both inpatient and outpatient as meets the national standard of least restrictive setting and Nevada statutory requirements. This latter service of outpatient assessment and treatment has been virtually impossible to provide in the southern part of the state due to the lack of infrastructure for those types of services in that location. One of the legal issues that will be resolved by building a facility similar to Lakes Crossing in the south is the ability to meet the standards and statutes that require the opportunity for outpatient assessment and treatment if a person is not a danger to the community and can benefit from that type of care. Other legal issues that are at the fore in completing this project relate to the requirement that came out of a recent federal lawsuit against the agency. Lakes Crossing was the subject of a suit similar to such suits in many other states that require an individual who is found incompetent and in need of treatment to be transferred to a psychiatric facility for treatment within 7 days of the filing of the judge’s order. Since clients from Clark County have to be transported by plane across the state to LCC, it is very difficult to meet this requirement within the seven-day time frame. This transportation is accomplished at great cost to the community because the plane must be chartered to fly sometimes with only one or two individuals. Ground transportation is not feasible because of the long timeframe an acutely mentally ill person would have to be confined in a car. Both of these types of transportation are also dangerous and pose a risk to the health and safety of both the transporting officers and the clients. On a number of occasions, officers have had to restrain clients while in the air. Having a facility available within the southern community would relieve these additional legal problems and threat to the safety of the staff and clients who are involved in these services. The population in the state of Nevada has slowed in its growth, however, the admissions to LCC have continued to exceed its original bed capacity. In addition, the acuity level (the seriousness of the client’s disorder) has increased. At present, these problems, which affect the health and safety of both clients and staff, have been resolved by taking over an unused pod at the civil hospital in the North and adding some beds at the main facility. For the moment, this resolution is satisfactory and has kept the density of the client population down reducing staff injuries and altercations as well as providing more adequate space for programming. The forensic facility in the North is currently at capacity, however, in recent months referrals have picked up. We are receiving six new clients from the southern area every two weeks, which will probably continue until at least mid-May. The courts need a means of providing outpatient as well as inpatient services for forensic clients. It will be necessary to have this service provided in the south to meet with the growing increase in client demand and infrastructure needs of the courts in the southern region of the state and to reduce the liability of flying clients back and forth between two ends of the state. This project is proposed to provide a 65,000 square foot facility for mentally disordered offenders in the southern region of the state. The land purchase and building design portion of the project have already been funded and are complete. For many years, these individuals have had to be flown from Clark County to the Northern end of the state for treatment to achieve competency or to be treated as NGRI or as Incompetent with no potential to be restored to competency. This project would provide 50 beds in Clark County for individuals who need inpatient treatment to competency as well as other treatment in a forensic setting. It would also provide beds for individuals who are adjudicated NGRI or who are committed through the criminal justice system as Incompetent and have committed certain designated felonies. This facility would provide inpatient evaluation of competency for individuals who cannot be evaluated outpatient due to a lack of appropriate examiners in the rural counties or are incapable of complying with outpatient treatment. Additionally space will be provided to support some outpatient services for the Southern region. The project will be designed that it can be expanded in the future to accommodate as many as 100 clients. The level of completion being requested at the present time is construction as well as funding for the furniture, fittings and equipment.
Project Justification: Client numbers at Lakes Crossing over the last five years have periodically exceeded what the original facility can accommodate. The facility serves the entire State of 17 counties with no other comparable facility available. The facility cannot allow clients to wait longer than seven days in the jail and therefore adequate space to accommodate all referrals must be available within that time frame. The average length of stay for clients at this time is approximately 100 days but under new laws (AB193 and SB 380) passed in the last legislature some clients fall into categories where the length of stay may be extremely lengthy (up to ten years or longer). As these long term clients are committed to the facility fewer beds will turn over to accommodate the shorter term pre-trial commitments. Therefore, the state will need to provide sufficient beds in both the northern and southern regions of the state to meet the demands over the coming years. Please also refer to the health, safety and legal issues outlined in note #1 for explanation of why this project needs to be completed in the South where the largest number of defendants are housed and the largest number of courts operate to adjudicate them. The numbers for Not Guilty by Reason of Insanity (NGRI) commitments are somewhat unpredictable because the law is only recently beginning to be used by attorneys since it was reinstated in 2003 and rewritten in 2005. We have figures for Arizona and Ohio which are much larger states than Nevada. Arizona currently has 24 beds devoted to NGRI and 102 beds to Guilty Except Insane (a similar statute that Nevada does not have) for a population of a little over 6 million. In May 2005, Ohio had 294 persons in NGRI status in all of its inpatient sites for a state population of 11 million. It is noted in the Ohio Forensic Newsletter that the average length of stay for these individuals was 5.7 years. Given that Nevada has a population of 2.6 million and tends to be conservative, the numbers committed under NGRI status is likely to be much reduced proportionately. Nonetheless, it is possible that we may have one or two a year that stay for fairly long periods of time. Statewide it would seem wise to plan that two to four beds may need to be used for this purpose at any given time. Given the numbers we have experienced and believe them to be reasonable despite the fact that other states have a higher commitment rate. We are continuing to research data from the other states. The projection for SB 380 should be based on the numbers of individuals that are found Incompetent Without Probability and have committed very serious crimes. About 10 to 15% of inpatient commitments for competency treatment are found Incompetent Without Probability. That would mean about 20 plus per year. Of those, about 30% are crimes serious enough to be committed under this law. At the present time we have one individual who was charged with a triple murder committed under this statute. It is unlikely the court will ever see fit to discharge him unless he so dramatically recovers from mental illness that there is no choice. Consequently, this bed is gone for at least ten years. There are two more very serious offenders waiting for adjudication under this statute. Thus, a rate of four to six commitments a year seems reasonable. However, these are likely to accumulate gradually taking more and more beds off line. A total of ten beds a year devoted to these types of commitments would quickly fill the 66 beds we currently have available since the facility is running at about 50 to 65 census wise.
Project Background Information: This project has been requested on several other occasions. In anticipation of the state’s expanding needs a request was made in 2003 based on observations in the preceding years after opening of the Lakes Crossing addition early in 2000 that the facility was frequently at capacity or over and it did not appear that this demand would remit. The request was made again in 2005 and again in 2007. In 2005 a lawsuit was filed against the Division of Mental Health and Developmental Services because a waiting list was generated that caused defendants committed to the facility to wait long periods in the jail. In part this occurred because the facility would not exceed its designated capacity out of concern for the health and safety of clients and staff. Additionally, exceeding the capacity violates licensure regulations which the facility had begun seeking at that time. In 2007 funding was granted for Nevada State Public Works Board project #07-P31. The architectural design was completed prior to the last legislature.
Mechanical and/or Electrical Equipment Replacement Projects:
Type of equipment to be replaced: NA
Year existing equipment was installed: NA
Manufacturer of existing equipment: NA
Model of existing equipment: NA
Hazardous Materials (Asbestos, Lead Paint, etc.):
Will this project require any hazardous material abatement? No
Ramifications if the Project is not Approved
(Short Essay): If this project is not approved, it is likely that the current facilities will not be able to respond to the demands for forensic mental health services in the state and waiting lists will develop causing complaints against the state. A waiting list for inpatient services for court referrals is likely to generate more lawsuits claiming defendants civil rights are being violated because they are not being transferred in a timely manner from detention centers into a mental health facility for evaluation and treatment. Lakes Crossing Center would become overwhelmed very quickly if the number of clients increased by even ten referrals a month more than what are presently being committed. It is important to note that that may mean only two or three referrals from the larger counties as the admissions from the rural counties are also increasing. The greatest concern is the specter of mentally ill clients waiting in growing numbers in the county detention centers for treatment space to be available and the violation of their constitutional rights. Additionally, if the courts are pressed to provide outpatient forensic services in Clark County there would be considerable difficulty and expense without the local infrastructure to provide these services. It is anticipated that staff to meet this need would be housed at the new southern facility where presently any such services have been provided by transporting staff from LCC to Las Vegas.
Health, Life Safety, and/or Legal Issues
Please describe any health, life safety, and/or legal issues that will be resolved by completing this project (Short Essay): Please see question 9
Proposed Project Schedule Impacts/Issues
1. Will this project require relocating personnel or vacating the building for any period of time? No
Explain: This is a new facility and an entire staff has to be hired.
Has any design work been completed on the proposed project? Yes
What is the latest date this project could be completed without disrupting your program?
What is the driving proposed completion date?
III. Cost Estimate Section 
Preliminary Cost Estimate and Funding Sources (The SPWD will prepare all final cost estimates. This schedule is for preliminary purposes only.)
1. Land Cost (if land must be purchased): 0.0000
2. Off-site construction cost:
3. On-site connection fees:
4. Utility connection fees:
5. Water rights deeded:
6. Furniture, Fixture and equipment costs:
7. Specialty equipment costs
8. Data and network equipment costs:
9. Telephone equipment costs:
10. Moving costs:
11. Costs for renovation of vacated space:
12. Costs for correction of known deficiencies:
(describe deficiencies)
13. Costs of any known commitments:
(describe commitments)
14. Costs of any hazardous material abatement:
(describe hazardous materials)
15. Total project costs: 0.0000
NOTE: COSTS FOR EXTENDED LEASE AGREEMENTS MUST BE INCLUDED IN YOUR OPERATING BUDGET
16. Proposed funding of total project cost:
a. Agency:
b. Federal
c. Other/Donor
d. State 40050000
(describe source of 'Other' funding): General Funds
Total: 40050000
17. Agency point of contact for outisde funding if 16a, 16b, or 16c funding sources are providing funds.
a. Name
b. Phone Number
c. Email Address
IV. Analysis Section 
Site Analysis (New construction only)
1. Estimated land area to be acquired (acres) 10
2. Will this project require new parking spaces? Yes
3. Are utilities available to site? Yes
4. Will project require relocation of existing utilities? No
5. Are there any required off-site improvements (or right-of-way dedications)? Unknown
6. Is the site in a flood plane? No
7. Is the site in an airport impact zone? Yes
8. Does the site contain any underground storage tanks? Unknown
9. Does the site contain any adverse soil conditions? Unknown
10. Will the site require an environmental assessment? Unknown
11. Will rezoning or a special use permit be required? No
12. Will any connection fees need to be paid? Yes
13. Will any water rights need to be deeded? Unknown
14. Will construction traffic degrade existing access or facilities? Unknown
15. Will the site require any hazardous material abatement? Unknown
16. Other site considerations affecting cost? (describe): Unknown
V. Programming Section 
Programming (New construction, building remodels, and building additions only)
1. Has any architectural programming occurred? Yes
(Programming is an architectural definition of the needs/problems that must be addressed by the project) Yes
2. Has any advanced planning occurred in previous CIPs? Yes
3. Net Square footage required (including storage space)
New Construction SF: 65000
Remodel/Renovation SF:
Addition SF
Total project SF:
4. Occupancy type (Assembly, business, educational, factory/industrial, high hazard, institutional, mercantile, residential, storage, utility/miscellaneous) : Institutional
5. Approximate quantity of staff to occupy facility: 130
6. Approximate number of visitors per day: 5
7. Will this project require funding for any furnishings, fixtures and equipment? Yes
8. For existing facilities, are there any known hazardous materials? (i.e., Asbestos, lead paint or underground storage tanks): No
9. How many years of future growth will this project accommodate? 5
10. List of required facilites (laboratory space, classroom space, office space, conference rooms, cafeterias, maintenance shops, garages) and any unusual related equipment required for your project: Included but not limited to facilities within this CIP request is office space; security systems; control room and storage; client intake, showers, processing, laundry; service kitchen and storage; client housing blocks; janitorial closet and linen rooms; seclusion rooms; multi purpose rooms; recreation rooms and storage; fitness rooms; courtyard; gymnasium; creative arts room; barbershop; canteen; library; conference room; staff lounge; staff showers, rest rooms, lockers; family conference room; therapy rooms; reception area; visiting room; mail and receiving area; public phones area; maintenance work shop; mechanical room; vehicle garage; and sprinkler riser room.
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