MP Sabrina Turner Says Current Cost Of Unopened Poinciana Mental Health Facility Is $22 Million. Points To COVID-19 & Public Works Department For Delays In Opening

By Alric Lindsay

In response to questions raised by MP Barbara Conolly in Parliament yesterday, October 10, 2024, MP Sabrina Tuner, the Honourable Minister of Health and Wellness and Home Affairs, confirmed that $22 million had been spent to date on the Poinciana Mental Health Facility which remains unopened and unavailable to mental health patients. Not wishing to avoid accountability, the Health Minister indicated that while her ministry holds the budget for the facility, the Public Works Department is responsible for the operational arm and any delays.

The $22 million price tag explained

Providing a breakdown of the $22 million price tag, the Health Minister said:

Mister Speaker, the total building and outfit cost to date for the Poinciana Rehabilitation Centre is CI $22,960,000.  The original project cost was estimated at CI $16,241,000 and the outline business case (OBC) stage in 2016, meaning there is a change of 6.4 million to date for building and fit out costs.

The modification is largely attributed to changes in scope which improved and increased capacity at the centre.

She added:

The original outline business case expected the Poinciana Rehabilitation Centre to be constructed to residential facility building standards. It was later agreed to increase construction standards so that the structures will gain higher hurricane ratings than would normally be required for a standard residential facility. Also, this also saw an increase in the size of the administration building.

Additionally, specialized equipment and custom fit outs were required to increase operational capabilities and efficiencies with regards to the cottages.

She continued:

The original OBC in 2016 call for seven cottages. It was later agreed to bill nine to increase the number of patients the centre can care for.

In March 2020, the entire construction sector stood down in response to the pandemic. The sector did not resume for months, thereby pushing out the deliverable date as work could not continue. When the sector resumed, there were significant challenges in supplies, chain reimporting labor and pressures caused by the industry wide backlog. Covid-19 also triggered a large inflation and price increases globally.

Minister explains why accountability for delays lies with Public Works

After the COVID-19 pandemic, several dates were estimated for the opening of the Poinciana Rehabilitation Centre.  However, the opening has been subject to constant delays.

Explaining where accountability lies for delays, the Health Minister said:

The funding of this project has been shared between two governments. That means it has a root, and that root is not me, not this ministry.

Because the Ministry of Health and Wellness is one thing, but the completion and the occupancy of that building and its completion relies on the successfully passing of all planning inspections conducted by the Department of Planning. This is a position that’s called for a project manager or a project management team. And for this project, it is not, as never has been, the Ministry of Health and Wellness, nor has it been the responsibility of myself as the minister with any project.

She added:

The elephant in the room, Mister Speaker, is who has the responsibility to the overall oversight and the project and the entire project. Let me make it clear, Mister Speaker, please. It is not the Ministry of Health and Wellness. Mister Speaker. When you have a project, you will have a project manager. If you have multiple entities dealing with it, the project manager is responsible for given timelines, leading updates for the completion of the project.

In addition to naming the project manager as a responsible party, the Minister said that the mental health facility “remains in the hands of the Public Works Department as construction continues and to head towards the completion.”

She emphasized that the Ministry of Health will only be an end-user upon the opening of the mental health facility, and, in the meantime, the Public Works Department is responsible for the “operational arm of the entire project.”

She doubled down by saying that “project management and responsibility for the completion of this project has always been in the hands of PWD and not the Ministry of Health and Wellness.”

Emphasizing that she was not passing the buck, she said:

It is not a matter of the blame game. This is. This is a matter of just stating the facts. And it is my duty to inform the public, because this is the public’s money we’re talking about here. And I too am very concerned at the time.

We’re in this role, we have this constitutional responsibility and the public is holding us responsible for deliverables. We can only work cohesively with the civil service arm in hoping that they can bring out our broad outcomes in a timely manner.

How the delays affect the revised, estimated opening date

After pointing out where accountability lies, the Health Minister was pressed by Opposition members to provide an approximate opening date for the mental health facility.

Regarding this, she said:

The ministry and Poinciana teams continue to work to prepare the centre for its opening so that it is ready to receive patients when the facility is handed over.

Mister speaker, as per report from Public Works Department’s project manager, the construction of both the main buildings and cottages have been completed and progressing through final building inspections and the handover phase.

A special permission occupancy was granted for the main building on July 22, 2024, and the PRC staff have since occupied its facilities. The SPO has enabled PRC staff to access the buildings in order to commence preparation work to receive residence, including, but not limited to, setting up offices and equipment, conducting training and onboarding.

She added:

Mister Speaker, for the sake of clarity, the certificate of occupancy and the special permission of occupancy are both official permits related to building occupancy that served different purposes to have distinct conditions. The CO is the final approval that will allow full permanent occupancy of the building. It confirms that the building is in full compliance with all building code requirements and any planning conditions imposed by the Department of Planning. On the other hand, the SPO is a temporary authorization that allows occupancy of the building, or a portion of it, before the co is issued.

It is typically granted when the building is substantially complete, but some minor non-safety related work remains. According to the Department of Planning, an SPO may be issued prior to a CO.

Mister speaker in addition to delays caused by COVID-19 and other unforeseen factors, the project has recently encountered challenges in securing occupancy permits due to a prolonged inspection process.

She continued:

The project team at PWD aims to hand over the first cluster of cottages, example three cottages, to prioritize the repatriation of overseas persons by the 15 July 2024. This is dependent upon continued engagement and quick turnaround by BCU and no severe inclement weather.

She concluded:

Mister Speaker, through you, I give this House and this entire country my word that I am comfortable, that I will, and I’m getting the response that I’m satisfied now at this juncture to be able to at least deliver a certificate of occupancy date.

Impact of delayed opening

While the public waits for the Health Minister to deliver a certificate of occupancy date, it may be challenging for Caymanian patients overseas to return as not all parts of the facility are ready to treat them.

Additionally, the delay ties the hands of the judges in the Cayman Islands judiciary when they need options under section 159 of the Criminal Procedure Code when deciding on how to deal with mentally insane criminals.

This was recently illustrated in the case of Akeme Dominick Burke, a Jamaican man who was found not guilty on October 8, 2024, of aggravated burglary and indecent assault because of insanity.  With limited options available, the Honourable Justice Richards ordered Burke to be treated by the George Town hospital until Her Excellency The Governor orders otherwise.

The above Court case is mentioned to illustrate that kicking the can down the road for the full opening of the Poinciana mental health facility has wide-ranging impacts. That is, the opening delay is not confined to one Government department or one group of stakeholders. Instead, it affects all arms of the Government, including the judiciary.

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