Commissioners kickstart county’s dialysis clinic project

$3.3M facility should be built by next spring

BUILT WITHIN A YEAR? – An architect’s rendering of the proposed La Salle County Dialysis Clinic presented by Paul Rheinlander to county commissioners Monday, March 9, shows a building of approximately 7,500 square feet with an estimated construction price of $3.3 million, towards which the county hopes to receive a half-million-dollar grant from the Texas Department of Agriculture. In order to qualify for the funding, however, La Salle must finish the building and have it inspected and ready to receive its first patient by the last day of April, 2021. The project site is adjacent to the La Salle County Elderly Nutrition Center on North Baylor Street in Cotulla.

Kidney dialysis patients in La Salle County may soon have a new facility closer to home in which to receive lifesaving treatment, following a commissioners’ decision Monday, March 9, to accelerate the construction bid process and apply for a grant.
The county’s new dialysis clinic is planned for a site adjacent to the present Elderly Nutrition Center on North Baylor Street and is expected to be complete by April 2021.
Half a million dollars in federal funding towards the facility will come from the US Department of Housing and Urban Affairs and is being channeled through the Texas Department of Agriculture. La Salle County has a short window of opportunity, however, to secure the funds, and must be able to begin serving patients at the facility by the spring deadline, according to County Judge Joel Rodriguez.
In a presentation to commissioners Monday, architect Paul Rhenlander said the 7,500-square foot facility is expected to cost $3.3 million but will require building contractors who are experienced in the construction of a specialized commercial facility.
The square-foot price of the new center approximates $300, a price at which Commissioner Raul Ayala expressed concern.
“A regular home costs $65 a square foot, or so, to build,” the commissioner said before voting with Comms. Erasmo Ramirez and Jack Alba to begin the process of attracting bidders. Comm. Noel Niavez was absent from the meeting.
Judge Rodriguez said he believes the facility is much needed in La Salle County and that he has been approached often by local residents wanting updates on whether or when the county will build a dialysis clinic.
Commissioners viewed a rendering of the proposed building and learned that the steel structure will be sheathed in stucco and stone, features a waiting room and reception area, up to twelve patient beds and an isolation room for patients diagnosed with hepatitis.
Rheinlander said electrical and plumbing at the facility will meet or exceed requirements laid out by the state, and a $100,000 water filtration system is a necessary component.
The architect also said he believes commissioners should expect an eight-month construction schedule that will culminate in the first patient being served on or before April 30 next year. That schedule, he said, will include a series of mandatory inspections, with state authorities examining the facility at 80 percent and 100 percent completion. A fire marshal’s inspection will also be required before the first patient can be served in the new facility, Rheinlander added.
Commissioners agreed Monday to set a one-month bidding opportunity for potential contractors but have stipulated that all those vying for the contract attend a pre-bid conference to ensure they are familiar with the advanced design and the state’s requirements for the equipment, fixtures and fittings.
“We expect to attract builders with experience in building renal facilities,” Rheinlander said. “Right now, we are waiting on the commissioners’ court to approve the design and to move forward on the timeline.
“Ideally, we will attract contractors who have subcontractors with experience in these facilities,” the architect said. “The specialized electrical, water and other systems have to be in place for these [dialysis] machines to work.”
“If we can’t build this in time, we can’t get the funding,” the county judge said. “There is such a need for dialysis here.”
“That’s why the pre-bid conference is so important,” Comm. Jack Alba said. “We can’t just have someone show up with a hammer.”
“You can’t pre-qualify a contractor,” Rheinlander cautioned the court. “If you advertise this thing nationwide, you’re going to get every Tom, Dick and Harry out there.”
Judge Rodriguez said he believes consultation with several knowledgeable sources in La Salle County has enabled the project to reach its present point, and thanked Alfredo Zamora Jr. for his service to the county in helping the dialysis center reach a stage at which a viable design meets local demand and meets state requirements for licensing.
“We have the manpower to do the screening pretty fast, once they bid,” the county judge said. He also indicated that the county may be prepared to proceed with the project under its own steam, should it fail to earn the Texas Department of Agriculture funds. “We still have the CERTZ [tax reinvestment zone] funds. We need to make every effort to hit that deadline, but there are circumstances we can’t control. Will there be a hurricane?”
The county judge added that recent news related to oil prices may directly affect La Salle County’s economy in the immediate future.
“The Saudis have flooded the market with oil, forcing oil prices down, and our tax base will go down,” Rodriguez said. “This will limit the number of projects in the area. Locally, that is a factor affecting us.
“The best thing we can do now is plan,” Rodriguez told commissioners. “Advertise, place notices, send out letters to contractors.
“The state told us that they don’t think we can do it in time,” the county judge said. “We are the only one in the state being treated this way. Alfredo Zamora has done a lot of work on this. This thing couldn’t be here today if it wasn’t for his work.”
Commissioners learned that dialysis equipment in the new facility may be leased, and that a majority of the patients receiving treatment at the clinic are likely to be covered by Medicaid or Medicare.
“Today is the day that we cancel or move forward,” the county judge said. “We could lose five hundred thousand dollars.”
Commissioners agreed to set a May 15 deadline for the next step in the bidding process, gave Rheinlander the green light on the building’s design with an option to include a single-pitch metal roof; and ordered SNB Infrastructure representative engineer Jorge Martinez to begin the process of replatting the property and clearing easements in the construction site.
“This is such a big deal,” the county judge said. “There are people who have asked, and we can show them that.”