It's all about Pima County's record on fiscal accountability. "There's no truth in this bonding," says Schuh, former leader of the Pima Association of Taxpayers. "It's almost duplicitous."
Question 3 asks for $18 million in bond funds to construct a 60,000-square-foot psychiatric urgent-care facility near Kino Hospital on Ajo Way. If Question 4 is passed, it would supply $36 million to build an 80- to 100-bed psychiatric hospital next door.
Two years ago, voters approved $12 million in bonds to construct a new, 50-bed psychiatric hospital at Kino (See "Bond Potpourri," May 6, 2004), but that money has not been spent. Because of that, Schuh wonders how things could have changed so much, and whether the first vote intentionally misled the public.
Pima County Administrator Chuck Huckelberry has an explanation. He says the 2004 bond question was developed before the Kino complex was leased to University Physicians Healthcare. Once that controversial agreement was finalized, it called for a master plan to be formulated for the hospital campus.
"The master plan consultant told us the $12 million was an ill-advised expenditure," Huckelberry recalls. Emphasizing that the 2004 bond money will be combined with the proposed hospital bonds to build a $48 million psychiatric hospital, Huckelberry adds about the previous vote, "We thought it best at the time."
The expense of the new hospital also concerns Schuh, who labels it "appalling" and "outrageous." She points out it will cost approximately $500,000 per bed, and refers to a December commentary in the Weekly's sister publication, Inside Tucson Business.
In the article, author Lionel Waxman compared the local proposal with a number of other facilities, and found Pima County's anticipated construction costs are far higher. Including five projects in his review, Waxman discovered their price per bed ranged from $133,333 to $358,695.
Firing back in a January letter, Huckelberry strongly disputed Waxman's analysis, including the lack of information on the dates of construction of the comparison facilities. Following up, last week, Huckelberry cited the extreme security needed in psychiatric facilities as one factor in determining the price.
"Two years ago," Huckelberry says, "it cost $500,000 per bed for a new facility at the Arizona State Hospital in Phoenix. That's what they cost!" In his response to Waxman's column, though, Huckelberry had stated the price of the 200-bed facility built in 2003 was $400,000 per bed.
For her part, Schuh stresses voters have been given no information about who will lease the new facilities, or who will pay their operating and maintenance costs.
Huckelberry indicates the urgent-care facility will most likely be leased for $10 a year to Community Partnership of Southern Arizona after a formal bidding process is completed. The hospital, he adds, would probably be operated by University Physicians Healthcare.
Neal Cash, CEO of CPSA, believes that since his agency has the funding and legal mandate to provide behavioral health services in Pima County, CPSA will operate the urgent-care facility. But Cash doesn't have answers to Schuh's financial questions. He can't say whether new staff members would have to be hired to operate the facility, nor what the operating and maintenance costs would be and how they would be paid for.
But Cash firmly believes the bond issues should be approved. "It will allow co-locating provider networks, such as La Frontera and COPE," to the new facility he says. "Plus, it will create some synergy with Kino Hospital.
"I see this as a community facility," Cash continues. "All hospitals will divert (psychiatric) patients there, as will law enforcement."
Supporters of the measures list several other benefits of the two proposals. By separating psychiatric patients from the existing hospital, they say, potential security problems can be prevented, while more bed space for medical patients would be made available.
Proponents also believe construction of the two facilities will reduce current burdens on hospital emergency rooms across Tucson, since psychiatric and substance-abuse patients who presently use them can utilize the Kino facility instead. Huckelberry estimates this alone could save more than $3 million a year in medical expenditures.
Freeing jail beds now occupied by those suffering from psychiatric or substance-abuse problems is also listed as an advantage of the ballot measures. Police officers dealing with the mentally ill will additionally benefit, supporters insist, because they will know where to transport these people.
From her perspective, Schuh remembers the existing Kino Hospital was supposed to accommodate psychiatric patients, and it now has 64 beds for that purpose. She wonders why that plan wasn't followed instead of proposing an entirely new facility.
Referring to the master plan for the Kino complex, Huckelberry says the change was the consultant's idea. "They recommended building separate psychiatric facilities, and we said OK," he offers.
Schuh also believes it is time Pima County voters start saying no to bond questions which drive up already high property taxes. "They're out of control with bonds," Schuh declares.
According to these officials, passage of both Questions 3 and 4 would increase the property taxes on a residence assessed at $100,000 by $6.05 per year, while the increase would be greater for commercial properties.
That relatively small cost doesn't sway Mary Schuh. "The credibility gap is just too large," she says.