Located near the legendary Black Hills of South Dakota, the new Rapid City Health Center is designed to treat multigenerational members of the Cheyenne River Sioux, Oglala Sioux and Rosebud Sioux under one roof in a uniquely tribal health care concept.

The largest design-build effort to date for Indian Health Services (IHS), the center consolidates 10 existing clinic-based buildings into a 200,000-sq-ft, state-of-the-art medical facility, incorporating traditional healing, modern medicine and sustainable design features.

The Flintco/Scull joint venture team is partnering with Childers Architect, serving as architect of record, and HKS, which is serving as consulting architect and medical/interiors planner on the $120-million project. The partners bring a depth of experience to the project: Flintco has completed $2.8 billion in regional Native American projects and approximately $590 million of that has been with Childers.

The form of the building’s facade references the buttes of the Black Hills, and a stone base grounds the building. Glazing was selected to express the grasslands, and the exterior color is inspired by mineral banding found in the Badlands area.
Image courtesy of Flintco

“设计团队的一个具体挑战是平衡印度卫生服务计划标准与部落的需求。我们试图提供一个现代的医疗保健机构，也支持传统的康复。”七代建筑与工程总裁Karl Kowalske说。

A tribally owned firm, Seven Generations created the project’s bridging documents before handing them off to the Flintco/Scull design-build team to complete the design and construct the project. Upon completion, IHS will turn the building over to the three tribes to manage its operations.

In-house services include audiology, dental, eye care, primary care, podiatry and specialty care in addition to diagnostic imaging, laboratory, pharmacy, physical therapy, health education and a center for wellness and nutrition.

卫生中心建于19世纪后期是拉皮德城印度学校所在地的土地上，美国政府将一所美国原住民儿童的寄宿学校从其家人那里撤离。该学校于1930年代关闭，该地点的诊所大楼是为美洲原住民的结核病医院建造的，其中许多人从该疾病中丧生。

“There is an enormous richness to this project and story—balancing the gravity of the history while providing modern health care, modern medicine and sustainable design,” Kowalske says.

It was a complex project from every aspect, adds Seven Generations COO Jeremy Berg. When conceived, the project was the first multitribal health clinic for IHS. Seven Generations worked to build consensus among IHS and the multiple sovereign tribes, bringing them all together into one large-scale health center with bridging documents that took the project from initial concept through schematic design.

伯格说：“我们想承认网站上发生的事情，并使[该项目]成为前进的方式。”“每个部落都是独一无二的，我们正在寻找组织代表所有这些建筑物的方法。”

The design takes its cues from South Dakota geography: The eastern portion of the state is vast grasslands, the west has rocky cliffs and timberland and the Missouri River runs between them. The public entrance features a Lakota star skylight that floods the building with daylight to create a uniquely tribal space. From there, the main corridor, designed to mimic the river, divides the east and west portions of the building, which is further divided into four subregions that house different departments and feature colors, images and symbolism specific to each tribe. A healing garden is included in the outdoor landscape.

根据医疗家庭模式，健康中心将成为一站式商店，适合聚在一起为各种服务和程序聚集在一起。“该诊所是部落成员将访问并停留多个小时的地方。这是一次多代体验。“一个祖母可能会和她的孙女一起来，并为每个人有多次约会。部落成员还会旅行几个小时来获得医疗保健，一旦他们来到这里，提供者就会尝试为他们提供尽可能多的服务。”

该建筑的主要入口设有44英尺二木，钢框，玻璃圆形圆形大厅距地板40英尺。它充满了日光。
Image courtesy of Flintco

Complex Challenges

“It’s the type of project we enjoy in terms of coordination on an existing campus that had been in the making for several years,” says Flintco project manager Harry Knight. The campus encompasses approximately 40 acres, 30 of which were redeveloped to create the new health center. Flintco worked with Ferber Engineering Co., the civil engineer, to mastermind a phasing plan that ensured the existing facilities stayed open and operating while the new building was being built. “It’s a dance with all the pieces moving along together,” Knight says.

The project broke ground in summer 2020, and crews worked to pour foundations during South Dakota’s harsh winter weather in temperatures that with the windchill felt like 30 to 40 degrees below zero. The building required completely new infrastructure—from power and water to sewer and fiber optics. Crews worked around the older buildings, navigating unforeseen site conditions like buried foundations from the old Sioux San campus that were not documented on the plans and dealing with cultural heritage issues that required they stop work to document buildings, provide historical records and protect archaeological artifacts.

“We encountered a system of underground concrete tunnels with steam pipe running through it. Asbestos materials in the 274 linear ft of pipe network had to be managed and abated. This was a cost driver that no one could have foreseen,” Knight says. “Those are the kind of things you want to avoid.”

Sustainable Design

IHS项目要求中方设计指导方针18luck官网lding’s energy efficiency and performance be 30% better than the baseline energy model requirements. An underground cooling system creates ice during the night that is used to cool the building during the day. A stormwater system allows water to infiltrate into parking island bioswales and irrigate plants and trees.

内部饰面具有材料，具有前和消费后的回收含量，没有挥发性的有机化合物，本地采购以及环境和健康产品认证。室内储水装置，地面安装的光伏系统和预定的照明控件也是LEED黄金设计的关键。

机组人员放置圆形圆顶圆顶的钢结构。200,000平方英尺的健康中心取代了10座基于诊所的建筑物，这些建筑在项目期间保持开放和运营。
Image courtesy of Flintco

先进的医疗系统ems include a large imaging suite with CT, X-ray, MRI and ultrasound technology. “As the design-builder, it has been a privilege to sit down and interview each medical department to figure out what the equipment list should be,” Knight says.

“Other challenges came from the technical side; for instance, designing for a colder region where the freeze line is lower,” says Breck Childers, managing principal at Childers Architect.

他说，圆形大厅中的落地灯很好地挑战了生命安全和防火设计，并且随着Covid-19的发作，团队开始重新思考“良好”设计。“这是从打开和通风到接待台周围滑动玻璃门的能力，以使机载病毒剂的传播在另一个大流行的情况下保持蔓延，从而保持平衡。我们不断地与建筑美学平衡安全，”他说。

With several entities involved, communication throughout the design phase was key. “Having the trade partners involved in the design process helped us issue a well-coordinated set of drawings,” says Childers project manager Mathew Thomas. “One challenge was to be sure we met exactly what was included in the bridging documents. There was a lot of back and forth to ensure everything in the bridging documents was covered while also ensuring we were code compliant and within the costs that Flintco had bid for the project.”

奈特补充说：“设计构建模型为客户提供了更好的价值；您可以设计其预算和目标成本。18luck.cub[这个项目]很不寻常，因为他们非常开发了桥接文件。我们为它们的结合在一起做了很多详细的详细信息，同时还可以在客户的预算范围内使用这些桥接文档中的材料。它使Flintco的责任使高水平的高价值项目。”

Knight says Flintco will pursue this model with future projects when the client sees the benefits of design-build. “It has been rewarding to see it all come together—making what has been conceptualized manifest in reality. Getting them into the facility is a huge health care driver for the tribes, which is much needed and long overdue,” he says.