AP Partnerships Build Opportunities for Better Lives

By Addisu Negash, AP Gulf States, Project Executive

The need for behavioral health facilities in the U.S. continues to grow year after year, as limited options and long waits are in place right now. Challenges exist to getting care; some 38% of Americans have to wait longer than one week for face-to-face services, and 46% have driven more than an hour roundtrip to seek treatment or have someone close to them who has experienced this, according to the National Council for Mental Wellbeing.

It’s one of the many reasons Adolfson & Peterson Construction (AP) is so grateful to have a long history of working with Tennessee-based Acadia Healthcare. Acadia develops and operates a network of behavioral health facilities nationwide providing psychiatric and chemical dependency services through inpatient psychiatric hospitals, specialty treatment facilities, residential treatment centers, outpatient clinics and therapeutic school-based programs. Part of the company’s growth strategy is to increase the size of existing facilities across the country.

We treasure the role AP has been able to play in Acadia’s five-year plan to double all of its beds across the U.S., to bring their total to 22,000 beds. Last year, AP completed Acadia’s Rio Vista Behavioral Health Hospital in El Paso, Texas. The Rio Vista hospital started around 2017 with 80 beds and within just five years, there was a need for more. AP expanded the facility to add another 52 beds in 2023.

Mental health services in the U.S. are insufficient despite more than half of Americans (56%) seeking help. Limited options and long waits are the norm, but there are some bright spots, with 76% of Americans now seeing mental health as important as physical health.

~ National Council for Mental Wellbeing

Our latest project for the company is Cedar Crest Hospital & Residential Treatment Center at 3500 I-35 Frontage Rd. in Belton, Texas. The existing facility will double in size with a new 79,000-square-foot, two-story addition, bringing 96 beds and space for activity therapy, an outpatient clinic, a gym, activity yards and a kitchen. AP will also renovate the existing hospital kitchen. The renovation and construction kicked off in late 2023 with a planned completion in spring 2025.

This project is much needed as Bell County (for which Belton is the county seat) statistically has significantly higher experience with poor mental health days than other Texas communities, according to the Seton Medical Center Harker Heights 2022 Community Health Needs Assessment of Bell County, Texas.

The study states Bell County’s suicide rate is higher than other regions across Texas, and community members report that mental and behavioral health is a significant barrier to a healthier community. According to a U.S. News and World Report analysis, Bell County residents have a slightly higher experience with Medicare beneficiaries with depression.

These numbers point to why this project is so crucial for this community.

The need for behavioral health facilities is tremendous across the country, evidenced by how AP is also working with Acadia on renovation and expansion projects in Tucson and outside Phoenix, as well as constructing a new behavioral health facility in Mesa, Arizona.

What we bring to the projects with Acadia is a partnership. We are a trusted part of their team. They have the expertise to provide treatment, and we have the experience and knowledge to build the facilities. To start a project on the right note, we connect with a variety of Acadia departments from compliance to HR, and real estate to design. At the end of the day, we are trusted to advise them on a variety of topics from the pricing of the project to the labor market.

Building a behavioral health facility requires specific construction expertise. Case in point, all hospitals have life safety components, as well as patient safety and architectural aspects and aesthetics. Life safety is the same for all healthcare projects with access control and fire alarms etc.

But, patient safety is different for behavioral health. It has a bit of a justice-style component to it with various kinds of hardware to protect patients who may try to hurt themselves. There are suicide prevention doors in the bathrooms, for instance, which are cushioned doors that use hook and loop fasteners into the wall so no weight can be put on them. There are anti-ligature hardware and even several specific types of screws are required.

Additionally, there are a couple of different behavioral health construction types: direct supervision and indirect supervision. For the direct supervision, a nursing station is in the center of the area with the rooms surrounding it like a hub and spoke design. For indirect supervision, a master control center has 24/7 camera access, but this is being used less frequently today because of privacy concerns.

Architecturally, there are some design features Acadia incorporates to assist in healing. For instance, every bed has a courtyard view, providing a soothing effect and moving away from an institutional feel. The colors and finishes are designed for safety and calming to assist in the healing process. The goal of constructing these facilities is always to help improve safety and enhance patient outcomes.

While most construction projects are construction manager at-risk (CMR), Acadia and AP engage each project from the planning stages. Acadia has its own facility models with two or three design teams that are routinely contracted within the different market areas in which the company operates. This is the third project that AP is partnering with Stengel-Hill Architecture as the design partner.

We take all of those external operations and serve as lead coordinators from the start. We have our kick-off meeting up front and get everyone engaged from beginning to end, so everyone involved understands when and where they fit in. That communication is key from the start.

We really understand how Acadia operates and when we partner with the firm, we come in and quarterback the entire project. We are leading the construction while hiring vendors for their signage, ordering the kitchen equipment and furnishings. It is one of the many benefits we bring to the project; we understand their structure.

When you expand a facility, you’re not just adding beds. There are a lot of moving parts for the facility and around 90 to 120 days before they have the beds and rooms move-in ready, we help them plan to make sure they have the needed nurses, a facility manager and IT capacity. We make sure they have the infrastructure in place, even though it is not really in the scope of our work-

After all, we could all use a great coach to direct the team on the field. And, knowing we are helping a population of our neighbors in need with additional behavioral health resources makes it all worthwhile.

Multiple key indicators reveal significant and growing concerns over mental and behavioral health needs across the region, the state and the country. Facilities like these provide services to address those concerns and improve outcomes for many individuals, and we are pleased to play a role in those solutions.

Addisu brings over 20 years of expertise in the construction industry, showcasing a rich and varied project portfolio. With a track record of successfully managing projects totaling more than $580 million, his career reflects a commitment to diversity in both scope and scale.

He is an integral part of AP’s success when it comes to generating work with repeat clients in Central Texas. Serving as a Project Executive, Addisu offers executive-level leadership to projects in Central Texas, fostering an inclusive approach that supports the entire project team. His responsibilities span strategic planning, risk management, and operational decision-making, contributing to a dynamic and culturally diverse construction landscape.

Addisu holds a bachelor’s degree in mechanical engineering from Bucknell University and a masters degree in operation management from the Robert H. Smith School of Business at the University of Maryland.

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