Collin County 

Recovery Plan 

State and Local Fiscal Recovery 

Funds 

2021 Report 

 
Collin County 2021 Recovery Plan Performance Report 1

Collin County 

2021 Recovery Plan 

Table of Contents 

General Overview ........................................................................................................................ 2 

Executive Summary .................................................................................................................. 2 

Uses of Funds and Promoting Equitable Outcomes ................................................................. 3 

Community Engagement ......................................................................................................... 12 

Labor Practices ....................................................................................................................... 12 

Use of Evidence ...................................................................................................................... 13 

Table of Expenses by Expenditure Category .......................................................................... 14 

Project Inventory ....................................................................................................................... 15 

Project 1: Adult Detention Center Medical/Mental Health Infirmary ....................................... 15 

Project 2: Health Care Services Building & Parking Garage ................................................... 17 

Project 3: Medical Examiner Building ...................................................................................... 19 

Performance Report ................................................................................................................. 21 

 
Collin County 2021 Recovery Plan Performance Report 2

GENERAL OVERVIEW 

EXECUTIVE SUMMARY 

The American Rescue Plan Act (“ARPA”) State and Local Fiscal Recovery Funds (“SLFRF”) totaling

$200,984,172 were approved by the Commissioners Court to be used for specific county infrastructure

projects that support public health and mitigate the spread of COVID‐19.   These projects represent a

holistic public health approach to supporting high risk individuals across the entire county by building

community capacity, while also serving people with barriers to services, including people of color,

people with low incomes, limited English proficiency populations and other traditionally underserved

groups.  In order to comply with CDC COVID‐19 infectious disease prevention and containment

directives that support public health and mitigate the spread of COVID‐19, the goal of these projects is

to increase the community public health capacity within the county’s three facilities involved in public

health ‐ Adult Detention Center, Health Care Services building and Medical Examiner building.  

These capital investment projects support the recovery and resiliency of Collin County and are

delineated in the projects below.

PROJECT 1: Adult Detention Center Medical/Mental Health Infirmary

The Collin County Commissioners Court has approved the use of ARPA funds for construction of a

specialized medical and mental health infirmary of approximately 450 beds at the Collin County Adult

Detention Center and for capital investments in directly related ancillary infrastructure, such as the

central plant.  In order to respond to the COVID‐19 public health emergency, the strategies of physical

distancing, segregation, cleansing and de‐contamination have proven necessary for preventing the

spread of this virus and its existing and future variants.  In addition to the increased space needed to

provide for these public health strategies, the specialized housing areas will also address the growth in

substance abuse resulting from the public health crisis, as well as other COVID‐19 long‐term medical and

mental health side effects.   The increase in mental health stress and breakdowns as a result of both the

pandemic and its restrictions is impacting our most high risk and under‐served communities.  Those

incarcerated, even for a short time, in a detention setting are typically among the highest risk and most

under‐served.   

Goal:  Increase the community public health capacity of the Collin County Adult Detention Center

infirmary.

Project Status:  A Request for Qualifications (“RFQ”) is being compiled to ensure competitive

solicitation.  No funds have been expended to‐date.

Noteworthy Challenges or Opportunities Identified:  Increasing supply chain costs and long lead times

make budgeting this construction project a challenge.

PROJECT 2: Health Care Services Building & Parking Garage

The Collin County Commissioners Court has approved the use of ARPA funds for construction of a new

Health Care Services building and parking garage to establish the capacity for a vaccination hub and

provide the ability to meet the incremental needs of our community resulting from the COVID‐19

pandemic.   While Collin County Health Care Services is dedicated to protecting the health of all people

and communities within Collin County, the onset of COVID‐19 has required more extensive involvement

in a direct care role to support those with the greatest needs and impact from this public health crisis.   
Collin County 2021 Recovery Plan Performance Report 3

In order to respond to the COVID‐19 public health emergency, this infrastructure project will enable the

County to:  

 execute the Center for Disease Control and Prevention (“CDC”) mandated strategies of physical

distancing and segregation of staff, patients and other clientele

 plan, prepare for, promote, distribute, administer and track COVID‐19 vaccines, and to carry out

all other vaccine‐related activities

 detect, diagnose, trace and monitor COVID‐19 infections and related activities necessary to

mitigate the spread of COVID‐19  

 provide additional medical treatment areas and examination rooms, as well as laboratory test

analysis space and storage for additional equipment and supplies purchased to combat the

COVID‐19 pandemic now and in the future

 sustain the health care workforce to prevent, prepare for and respond to COVID‐19, and to carry

out other health workforce‐related activities

Goal:  Increase the community public health capacity of Collin County Health Care Services.

Project Status:  No activities have been performed on this project beyond approval of the use of funds

for this purpose.

Noteworthy Challenges or Opportunities Identified:  Increasing supply chain costs and long lead times

make budgeting this construction project a challenge.

PROJECT 3: Medical Examiner Building

In response to the COVID‐19 public health emergency, the Collin County Commissioners Court has

approved the use of ARPA funds for construction of a new Medical Examiner building.  The Medical

Examiner is directly engaged in matters related to public health and provides a public health support

service that is essential for patient care.  In order to respond to the COVID‐19 public health emergency,

the strategies of physical distancing, segregation, cleansing and de‐contamination have proven

necessary to preventing the spread of this virus and its existing and future variants.  In addition to the

increased space needed to provide for these public health strategies, the additional square feet will also

address the incremental needs of our community resulting from the COVID‐19 pandemic by growing the

capacity of medical examiner operational areas, such as autopsy rooms, meeting rooms and body

storage.  These operational areas have been severely impacted by the COVID‐19 protocols for isolation

and segregation.  Currently, a portable morgue trailer is being used to hold COVID‐19 bodies.

Goal:  Increase the community public health capacity of the Medical Examiner’s building.

Project Status:  No activities have been performed on this project beyond approval of the use of funds

for this purpose.

Noteworthy Challenges or Opportunities Identified:  Increasing supply chain costs and long lead times

make budgeting this construction project a challenge.

USES OF FUNDS AND PROMOTING EQUITABLE OUTCOMES 

The Commissioners Court approved ARPA funds to be used for specific county infrastructure projects

that support public health and mitigate the spread of COVID‐19.  The projects selected were chosen to

support a strong and equitable recovery from the COVID‐19 pandemic and economic downturn.  By

increasing public health capacity through investment in county infrastructure and providing jobs for
Collin County 2021 Recovery Plan Performance Report 4

many of our residents while serving those on its community margins, Collin County is investing in our

future.

These projects represent a holistic public health approach to supporting high risk individuals across the

entire county by building community capacity, while also serving people with barriers to services,

including people of color, people with low incomes, limited English proficiency populations and other

traditionally underserved groups.  In order to comply with CDC COVID‐19 infectious disease prevention

and containment directives that support public health and mitigate the spread of COVID‐19, the goal of

these projects is to increase the community public health capacity within the county’s three facilities

involved in public health ‐ Adult Detention Center, Health Care Services building and Medical Examiner

building.  

Awareness of and access to the additional capacity, including increased capability for physical

distancing, will be self‐evident with equal opportunity for those who qualify within each facility.  The

intended outcomes of these projects are to better serve residents requiring services at these facilities

and comply with CDC COVID‐19 infectious disease prevention and containment directives.   By

increasing the health care capacity of these three facilities, Collin County is able to better care for its

most at‐risk and marginalized residents for many years to come.   

To understand the impacted population, it is useful to know some Collin County population

demographics and statistics.   Per 2019 United States Census Bureau data at

https://www.census.gov/quickfacts/collincountytexas, these include:
Collin County 2021 Recovery Plan Performance Report 5

As one of the fastest growing counties in the United States, any COVID‐19 public health impacts

currently being experienced will only increase in the coming years as the county’s population grows,

resulting in even greater demand on our public health facilities.  In this way, using these ARPA funds to

increase capacity of public health infrastructure not only addresses today’s COVID‐19 impacts, but also

ensures the county can handle future demand.

As can be seen in the Census Bureau charts above, 11.3% of the county is in a high‐risk age group for

getting COVID‐19, while people under age 65 who don’t have health insurance account for 12.5% of the

county’s population.  Black and Hispanic people, who are more susceptible to severe disease from

COVID‐19 due to higher incidences of chronic illnesses and comorbidities like diabetes and

hypertension, make up more than 26% of the population.   Finally, 6.1% of residents lived in poverty as

of 2019.   

According to a CDC COVID‐19 Science Update released on August 6, 2021

[https://www.cdc.gov/library/covid19/08062021_covidupdate.html] based on a study performed by

Miller et al. as published on July 21, 2021 in Health Affairs, working‐age adults in the United States

without health insurance, with lower household income, with limited remote work options, living in

detention facilities, or living in health‐related group facilities had a higher all‐cause mortality rate during

the COVID‐19 pandemic.  Also noted within this Science Update, the mortality rate was higher among

non‐Hispanic Black adults, regardless of health insurance status, household income or remote work

options.  The mortality rate was also higher among Hispanic adults, those with lower incomes and those

in essential industries.  

These statistics weighed heavily in the selection of the approved projects, which inherently support

high‐risk, under‐served and disadvantaged residents across the entire county.  Collin County’s projects

maximize the impact of the ARPA funds in an effective and efficient way to achieve an equitable

outcome for our population.    

Besides SLFRF, no other federal recovery funds provided under the American Rescue Plan were received

by the county.

PROJECT 1: Adult Detention Center Medical/Mental Health Infirmary

This project can be classified into Expenditure Category 1 “Public Health”, subcategory 1.4, which is

“Prevention in Congregate Settings” including jails.   

This project provides for construction of a specialized medical and mental health infirmary of

approximately 450 beds at the Collin County Adult Detention Center and for capital investments in

directly related ancillary infrastructure, such as the central plant.  In order to respond to the COVID‐19

public health emergency, the strategies of physical distancing, segregation, cleansing and

decontamination have proven necessary for preventing the spread of this virus and its existing and

future variants.  In addition to the increased space needed to provide for these public health strategies,

the specialized housing areas will also address the growth in substance abuse resulting from the public
Collin County 2021 Recovery Plan Performance Report 6

health crisis, as well as other COVID‐19 long‐term medical and mental health side effects.  The increase

in mental health stress and breakdowns as a result of both the pandemic and its restrictions is impacting

our most high risk and under‐served communities.  Those incarcerated, even for a short time, in a

detention setting are typically among the highest risk and most under‐served.   

The current Collin County Adult Detention Center infirmary area contains 24 medical cells and

encompasses 12,430 square feet of space.   Current overall detention staffing is 359 and medical staffing

through a contracted provider has 64 personnel.  Since the beginning of the COVID‐19 pandemic, these

medical cells have been used almost exclusively for mental health and COVID‐19 isolation purposes.   

Even with this dedication of existing medical space, standard housing areas have had to also be utilized

to address the high demand for additional space needed for these two purposes.   

As a comparison to the County’s population statistics included above, below are 2019 inmate statistics

compiled from Collin County Adult Detention Center data.  It is only through understanding Collin

County’s existing demographics and gaps in current capacity that the county can best fill the

community’s public health needs.
Collin County 2021 Recovery Plan Performance Report 7

As is evidenced in the charts above when compared to the county’s population demographics, it is clear

that our most at‐risk and under‐served are over‐represented in the incarcerated population.   By

addressing the needs of inmates as a population subgroup, racial and economic equity is prioritized.   

According to the Journal of the American Medical Association [Saloner B, Parish K, Ward JA, DiLaura G,

Dolovich S. COVID‐19 cases and deaths in federal and state prisons. JAMA. 2020;324(6):602‐603],

“COVID‐19 outbreaks are also growing faster in carceral facilities: The average daily growth rate of cases

between March 1, 2020, and June 6, 2020, was 8.3% in prisons compared to 3.4% in the general US

population.”  According to the Johns Hopkins Center for Health Security and the Johns Hopkins

Bloomberg School of Public Health [https://www.centerforhealthsecurity.org/our‐

work/pubs_archive/pubs‐pdfs/2020/20201015‐covid‐19‐criminal‐justice‐system.pdf], “the US criminal

justice system is highly susceptible to the spread of COVID‐19 because of the structure of carceral

facilities, which propagates the spread of respiratory infections, and the comorbidities of many

incarcerated individuals.”

The addition of approximately 450 specialized medical and mental health infirmary beds at the Adult

Detention Center will provide quarantine space for inmates who have been exposed to or are known to

have COVID‐19, as well as provide the ability to house inmates with preexisting and chronic medical

conditions (such as heart disease, diabetes and lung disease) separately.   Consideration must be given
Collin County 2021 Recovery Plan Performance Report 8

to these high risk inmates in terms of preventing exposure and providing timely diagnosis and treatment

if signs of a COVID‐19 infection appear.  Infectious disease design concepts, including modern HVAC and

filtration systems, will be a part of this project as well.

Approximately 75 of these new medical beds will address inmates requiring detoxification from alcohol

and substance abuse or addiction.  Given the impact of social isolation brought on by safety measures

implemented to mitigate the public health emergency, the unprecedented escalation of the opioid crisis

in 2020 is almost certainly linked to the COVID‐19 pandemic [https://www.ama‐

assn.org/system/files/issue‐brief‐increases‐in‐opioid‐related‐overdose.pdf]. This crisis not only burdens

the families and individuals of those suffering from an addiction disorder, but it also overwhelms the

treatment capacity of the Adult Detention Center infirmary when these individuals are brought to jail.

An analysis of the Collin County Adult Detention Center mental health population, which included those

inmates on court‐ordered medications, on any level of suicide watch or having a mental health alert,

showed this population to be 250, or 25.2% of our average daily inmate population for 2015‐2019.  

Given there are 24 existing medical cells, the lowest risk inmates in this high risk population must

sometimes be housed in either general population or segregated housing, which can exacerbate their

mental health conditions.   Given the mental health impacts of COVID‐19 and its related isolation

mandates, these numbers are expected to have increased and will continue to increase along with Collin

County’s growing population.   

With an infirmary capacity of only 24 medical cells, it is clear there is a gap in the medical and mental

health capacity within the Adult Detention Center.  The planned added capacity of approximately 450

medical and mental health infirmary beds will enable Collin County to provide better care for more

inmates requiring these services, as well as comply with CDC COVID‐19 infectious disease prevention

and containment directives.

PROJECT 2: Health Care Services Building & Parking Garage   

This project can be classified into Expenditure Category 1 “Public Health” and primarily relates to

subcategory 1.1 “COVID‐19 Vaccination”.   

This project allocates ARPA funding for construction of a new Health Care Services building and parking

garage to establish capacity for a vaccination hub and provides sufficient operational, storage, meeting

and office space to meet the community’s incremental public health needs, which have occurred as a

result of the COVID‐19 pandemic.   While Collin County Health Care Services is dedicated to protecting

the health of all high‐risk and underserved people and communities within Collin County, the onset of

COVID‐19 has required more extensive involvement in a direct care role to support those with the

greatest needs and impact from this public health crisis.    

In order to respond to the COVID‐19 public health emergency, this infrastructure project will enable the

County to provide a low‐barrier health system to:  

 execute the CDC‐mandated strategies of physical distancing and segregation of staff, patients

and other clientele

 plan, prepare for, promote, distribute, administer and track COVID‐19 vaccines, and to carry out

all other vaccine‐related activities
Collin County 2021 Recovery Plan Performance Report 9

 detect, diagnose, trace and monitor COVID‐19 infections and related activities necessary to

mitigate the spread of COVID‐19  

 provide additional medical treatment areas and examination rooms, as well as laboratory test

analysis space and storage for additional equipment and supplies purchased to combat the

COVID‐19 pandemic now and in the future

 sustain the health care workforce to prevent, prepare for and respond to COVID‐19, and to carry

out other health workforce‐related activities

Currently, Collin County Health Care Services shares space with other departments in an existing 76 year

old building and has 87 employees, including those hired with COVID‐19 grant funds.  Health Care

Services utilizes 28,437 square feet of the building, including 21 medical rooms totaling 2,300 square

feet, 18 offices and 3 meeting rooms.  Expansion beyond this existing space is not possible and is further

restricted by the already limited parking in the shared‐use lot and on the adjacent street.   

In determining the required capacity and requirements of the new facility, Collin County reviewed its

current programs that support high‐risk and underserved populations impacted by COVID‐19.  Through

this review, gaps in current capacity were underscored.

Collin County Health Care Services works with vulnerable populations in all of its clinics and services.  

Each of these programs has either directly served clients needing COVID‐19 services and vaccinations or

instituted mitigation actions to reduce the spread of COVID‐19 within the clinic.  

 The Immunizations Clinic provides childhood and adult vaccines at no or reduced cost to

individuals who are uninsured and under‐insured.  This clinic also provides no‐cost COVID‐19

vaccinations to any individual, regardless of insurance status, at its physical clinic location and

via a mobile team.  The mobile team serves those who are unable to travel to a vaccination site,

such as individuals who are homebound

 The Employee Health Clinic provides COVID‐19 testing and vaccines for county employees who

are all essential workers, many of which are in high‐risk occupations

 The WIC Clinic provides supplemental food and nutrition assistance to children under the age of

five, as well as pregnant, breastfeeding and up‐to‐six month post‐partum mothers who are at or

below 185% of the federal poverty line (or are enrolled in Medicaid or SNAP).  This service is

utilized by families impacted by COVID‐19‐related work and financial disruptions

 The Epidemiology Department conducts case investigations into COVID‐19 cases and outbreaks

that are determined to be at elevated risk by DSHS.  This service is offered to all Collin County

residents.  The Epidemiology Department also works with many vulnerable populations by

conducting disease mitigation strategies and providing education to long‐term care facilities,

daycares, schools, private businesses, correctional facilities and group homes (such as homeless

shelters) that are experiencing COVID‐19 cases or outbreaks

 The Public Health Emergency Preparedness team works with stakeholders that serve vulnerable

populations to ensure COVID‐19 vaccine plans are in place and being executed smoothly.  City

governments, social service organizations, volunteer organizations and healthcare coalitions are

among their partner organizations.  This program is additionally responsible for the logistical

planning and execution of non‐medical operations during large scale COVID‐19 vaccination

clinics hosted by Collin County

 The Tuberculosis Clinic serves Collin County residents who have active tuberculosis and

completes contact tracing for these individuals.  Patients utilize this clinic for regular medical
Collin County 2021 Recovery Plan Performance Report 10

visits and are screened for COVID‐19.  Additionally, COVID‐19 elevated infection control and

social distancing procedures must be used for these patients

 The Sexually Transmitted Disease (“STD”) Clinic provides low‐cost STD testing and treatment

referrals for Collin County residents.  Patients utilize the Health Care Services clinic for medical

visits and must be screened for COVID‐19 and socially distanced

 The Substance Abuse Clinic operates as an evaluation, referral and education program for both

adult and adolescent Collin County residents

 The Indigent Health Clinic provides health care benefits to Collin County residents who are

medically indigent.  In addition to other qualifying criteria, this clinic serves individuals who are

at or below 100% of the federal poverty line.  Clients utilize the Health Care Services clinic to

apply for this program and must be screened for COVID‐19 and socially distanced

Most recently, a COVID‐19 mobile vaccine team has been hired to vaccinate homebound individuals and

other vulnerable populations.  Additional staff have also been hired to assist with COVID‐19 case

investigations, coordinate with partners in planning for non‐traditional vaccine clinics and distribute

COVID‐19 vaccines to local healthcare providers that are too small to order their own vaccines.  All of

these services have been added so populations that would not otherwise have access to COVID‐19

services or vaccinations can be served.  There is no office workspace for these and other added staff.

   

With increased demand on existing services and more services added to address COVID‐19, the existing

Health Care Services building and parking space is beyond its capacity.  The planned new facility will

provide augmented capacity in operational and back‐office areas, but will also have infection control

mechanisms incorporated into its design to keep staff and patients safe.  The additional square footage

planned for the new building will allow for physical distancing, segregation and decontamination, as well

as space to add medical staff.  Infectious disease design concepts, including modern HVAC and filtration

systems, will be a part of this project as well.

As administrator of a local safety net system, Collin County Health Care Services takes on the care for

the underinsured and medically indigent.  Increased numbers of newly uninsured individuals seeking

these services can be directly attributed to the economic impact of the COVID‐19 pandemic.

In addition, the lack of space and parking at, and adjacent to, the Collin County Health Care Services

building prevents the county from operating a single vaccination hub.  Instead, a distributed model using

various local city and outsourced resources has been utilized.  Coordination of multiple wait lists,

weather exposure and limitations inherent at available hub sites created challenges impacting Collin

County’s ability to provide the number of vaccinations per day desired.

With less than 29,000 square feet of space, only 21 medical rooms and no capabilities for a centralized

vaccination hub, there is a clear gap between the existing public health capacity and the requirements of

Collin County’s under‐served population.  The additional capacity the new Health Care Services building

and parking garage will provide can fill these gaps to allow Collin County to better meet the demands of

our growing county as we continue to follow CDC protocols in order to fight the pandemic.

PROJECT 3: Medical Examiner Building

This project can be classified into Expenditure Category 1 “Public Health”, subcategory 1.7, which is

“Capital Investments or Physical Plant Changes to Public Facilities that Respond to the COVID‐19 Public

Health Emergency”.   
Collin County 2021 Recovery Plan Performance Report 11

This project uses ARPA funding for construction of a new Medical Examiner building.  The Medical

Examiner is directly engaged in matters related to public health and provides a public health support

service that is essential.  In order to respond to the COVID‐19 public health emergency, the strategies of

physical distancing, segregation, cleansing and de‐contamination have proven necessary to preventing

the spread of this virus and its existing and future variants.  In addition to the increased space needed to

provide for these public health strategies, the additional square feet will also address the incremental

needs of our community resulting from the COVID‐19 pandemic by growing the capacity of medical

examiner operational areas, such as autopsy rooms, meeting rooms, office space and body storage.  In

addition to surge management, these operational areas have been severely impacted by the COVID‐19

protocols for isolation and segregation.   

The current Collin County Medical Examiner building offices 13 employees and has 9,509 square feet of

space, including approximately 800 square feet of combined space for autopsy and transplant services.  

The existing freezer space is 300 square feet and can hold 15 bodies.   

The Collin County Medical Examiner’s office reported an overall increase of 1,172 deaths in 2020, with

702 (60%) designated as COVID‐19 deaths.  Although many of these deaths were not cases brought in

for examination, this increase is still significant in terms of the demand on capacity of this building.

In reviewing the areas where the existing facility has failed to meet the demand of COVID‐19, several

obvious areas for improvement and gaps in capacity have been identified:

 There are no segregated areas for intake, processing and storing infectious cases.  A portable

morgue trailer has been used during COVID‐19 to isolate these cases

 Transplant Services has no separate space for tissue harvesting.  They have been sharing space

in the same room where infectious disease autopsies take place

 The infectious disease autopsy room needs to be upgraded to provide for 12 air circulation/

filtration cycles per hour.  It currently provides 6 cycles per hour, which was the standard from

when the building was first built in 1988

 The only cart wash area is in the autopsy room where infectious disease autopsies take place.  A

separate area is needed for washing autopsy tables

 No barrier exists between the law enforcement viewing area and the autopsy space

 Existing lobby, office and meeting space do not allow for physical distancing required by COVID‐

19 health and safety protocols

 No separate male/female changing areas for the changing of personal protective equipment

exist

 Personal protective equipment storage space in operational areas is scarce

Overall, the existing 1988 building was not designed with infectious disease containment in mind.  

Biosafety guidance and needs have since changed.    

As a county of more than one million residents and one of the fastest growing counties in the nation,

the capacity constraints currently seen in response to the first year of COVID‐19 will continue to

increase.   This public health infrastructure project will allow Collin County to continue to treat the

deceased with dignity and respect while addressing the gaps in the current building’s capacity and

infectious disease containment functionality.  

 
Collin County 2021 Recovery Plan Performance Report 12

COMMUNITY ENGAGEMENT 

In determining Collin County’s use of ARPA funds for these projects, written and oral input from

constituents and community‐based organizations was incorporated through input at weekly public

Commissioners Court meetings.  These meetings provide an opportunity for the public to speak about

topics of interest.  Since the pandemic began, public health has been a topic of many speakers, both

from community organizations and individuals.

Among the public health topics repeatedly mentioned at Commissioners Court meetings beyond the

COVID‐19 contract tracing, testing and vaccination discussions, concerns were greatest for the mental

health of both the public and inmates at the Collin County Adult Detention Center.  The construction of

a new public health care building and parking garage (to serve as a vaccination hub) and the expansion

of an infirmary at the jail address these topics.   

While the impact of the pandemic on the Medical Examiner’s office is not often seen by the public, this

office functions as a public health support service and is directly engaged in matters related to public

health.  This county office was severely impacted as the pandemic fatalities grew.  As such, Collin County

believes it is necessary to ensure the needs of this less publicly involved public health department are

addressed with these funds as well.

LABOR PRACTICES 

While Collin County is not performing any water, sewer or broadband projects in the Expenditure

Category EC5 “Infrastructure”, the county does have infrastructure projects in its recovery plan.  As such

and with the best intentions in complying with ARPA, Collin County is using strong labor standards to

promote effective and efficient delivery of these projects while also supporting economic recovery

through strong employment opportunities for workers.

The County requires all contracts and subcontracts that result from a solicitation using Federal Funds to

incorporate by reference the provisions of 29 CFR part 201, the Federal Fair Labor Standards Act (FLSA)

with the same force and effect as if given in full text. The FLSA sets minimum wage, overtime pay,

recordkeeping, and child labor standards for full and part time workers. The County requires the Supplier

have full responsibility to monitor compliance to the referenced statute or regulation. The Supplier must

address any claims or disputesthat arise from thisrequirement directly with the U.S. Department of Labor

– Wage and Hour Division.

During the solicitation process, the County also takes the affirmative steps to assure minority

businesses, women’s business enterprises, and labor surplus area firms are utilized when possible, as

outlined in 2 C.F.R. §200.321. Further, the County contractually requires the awarded Contractor to

adhere to the same procurement requirements, when soliciting for subcontractors and suppliers.

 
Collin County 2021 Recovery Plan Performance Report 13

USE OF EVIDENCE 

 

Collin County’s ARPA public health projects were selected to comply with evidence‐based interventions

recommended by the CDC.  In order to comply with the CDC’s COVID‐19 infectious disease directives,

Collin County will increase public health capacity at its three core public health facilities.  The CDC’s

existing evidence‐based strategies for COVID‐19 prevention and containment were relied on in the

selection of these infrastructure projects which support public health and mitigate the spread of COVID‐

19.   The evidence base includes:

 According to “Public Health’s Infrastructure”, a status report prepared for The Appropriations

Committee of the United States Senate by the CDC, the CDC’s recommendations to improve

public health infrastructure include addressing crucial gaps in organizational capacities of local

and State health departments and laboratories. Within the “What is the Public Health

Infrastructure” section of this report, organizational capacity is described as a basic necessary

foundation of public health system preparedness.  This status report was published in 2001 and

can be found at https://stacks.cdc.gov/view/cdc/11337.  

 According to a U.S. Department of Health and Human Services (“HHS”) press release on April 27,

2021 [https://www.hhs.gov/about/news/2021/04/27/hhs‐announces‐1‐billion‐dollar‐from‐

american‐rescue‐plan‐for‐construction‐and‐renovation‐projects‐at‐health‐centers.html], HHS

Secretary Xavier Becerra is quoted as stating, “"As the pandemic has made clear, modernizing

the physical infrastructure of many of our country's health centers is long overdue."  In line with

the $1 billion that has been allocated from the American Rescue plan for construction and

renovation projects for Health Resources and Services Administration (“HRSA”) funded health

centers, Collin County’s has approved use of ARPA funds for these same purposes for a new

Health Care Services facility, which is not HRSA‐funded.  Within the April 27, 2021 press release,

HRSA Acting Administrator Diana Espinosa states "HRSA‐funded health centers have adapted to

the evolving needs in their communities throughout the pandemic.  This historic influx of

funding for infrastructure improvements will allow them to continue the critical work of

connecting underserved patients and communities with high‐quality health care."  Collin County

agrees and is allocating $54.8m of the ARPA funds to its Health Care Services project and

$134.1m for its Adult Detention Center infirmary project.

 Each of Collin County’s approved projects specifically incorporates the CDC recommended public

health strategies [Honein MA, Christie A, Rose DA, et al. Summary of Guidance for Public Health

Strategies to Address High Levels of Community Transmission of SARS‐CoV‐2 and Related

Deaths, December 2020. MMWR Morb Mortal Wkly Rep 2020; 69:1860‐1867. DOI:

http://dx.doi.org/10.15585/mmwr.mm6949e2].  The 10 strategies endorsed by the CDC in this

publication include:  1) universal face mask use, 2) maintaining physical distance from other

persons and limiting in‐person contacts, 3) avoiding nonessential indoor spaces and crowded

outdoor spaces, 4) increasing testing to rapidly identify and isolate infected persons, 5) promptly

identifying, quarantining, and testing close contacts of persons with known COVID‐19, 6)

safeguarding persons most at risk for severe illness or death from infection with SARS‐CoV‐2,

the virus that causes COVID‐19, 7) protecting essential workers with provision of adequate

personal protective equipment and safe work practices, 8) postponing travel, 9) increasing room

air ventilation and enhancing hand hygiene and environmental disinfection, and 10) achieving

widespread availability and high community coverage with effective COVID‐19 vaccines.  
Collin County 2021 Recovery Plan Performance Report 14

The impact of not following these recommended public strategies is clearly outlined by the CDC.  As

such, Collin County is investing these funds in public health capacity to support the community’s public

health and mitigate the spread of COVID‐19.

All $200,984,172 of Collin County’s ARPA funds are being allocated to support these CDC evidence‐based

strategies.

TABLE OF EXPENSES BY EXPENDITURE CATEGORY 

Category Cumulative 

expenditures to 

date ($) 

Amount spent 

since last 

Recovery Plan 

1 Expenditure Category: Public Health 

1.1 COVID-19 Vaccination $0 $0 

1.4 Prevention in Congregate Settings (Nursing 

Homes, Prisons/Jails, Dense Work Sites, 

Schools, etc.) 

$0 $0 

1.7 Capital Investments or Physical Plant Changes 

to Public Facilities that respond to the COVID19 public health emergency $0 $0 
Collin County 2021 Recovery Plan Performance Report 15

Project Inventory 

Below is an inventory of the projects discussed in more detail above:

PROJECT 1: Adult Detention Center Medical/Mental Health Infirmary

Funding Amount: $134,108,429

Project Expenditure Category: 1.4, “Public Health ‐ Prevention in Congregate Settings”

Project Overview

This project encompasses the construction of a specialized medical and mental health infirmary of

approximately 450 beds at the Collin County Adult Detention Center, as well as capital investments in

directly related ancillary infrastructure needed to support the infirmary.   

The main activities of this project in the coming months start with selection of an architect and a

construction manager‐at‐risk, if deemed appropriate.  Major construction areas required for the

objectives of this project to be accomplished include central plant renovations and construction; design

and construction of the new infirmary building; expansion and move of detention kitchen; expansion of

detention laundry and remodel of the existing 24 medical infirmary cells.

In the coming months, a Request for Qualifications will be published to ensure competitive solicitation.  

This process will be followed by selection of appropriate vendors.  The design phase will begin in late

2021, followed by permitting and construction.  The facility is planned to be open in 2026.

The planned additional capacity of approximately 450 medical and mental health infirmary beds will

enable Collin County to meet its intended outcome of providing better care for more inmates requiring

these services, as well as comply with CDC COVID‐19 infectious disease prevention and containment

directives.

Use of Evidence

In order to comply with CDC COVID‐19 infectious disease prevention and containment directives that

support public health and mitigate the spread of COVID‐19, the goal of this project is to increase the

community public health capacity at the Adult Detention Center.  Those incarcerated, even for a short

time, in a detention setting are typically among the highest risk and most under‐served.   

This Collin County public health project was selected to comply with evidence‐based interventions

recommended by the CDC.  In order to comply with the CDC’s COVID‐19 infectious disease directives,

Collin County will increase public health capacity by building an infirmary at the Adult Detention Center.  

The CDC’s existing evidence‐based strategies for COVID‐19 prevention and containment were relied on

in the selection of this infrastructure project which supports public health and mitigates the spread of

COVID‐19.   The evidence base includes:

 According to “Public Health’s Infrastructure”, a status report prepared for The Appropriations

Committee of the United States Senate by the CDC, the CDC’s recommendations to improve

public health infrastructure include addressing crucial gaps in organizational capacities of local

and State health departments and laboratories.  Within the “What is the Public Health

Infrastructure” section of this report, organizational capacity is described as a basic necessary
Collin County 2021 Recovery Plan Performance Report 16

foundation of public health system preparedness.  This status report was published in 2001 and

can be found at https://stacks.cdc.gov/view/cdc/11337.  

 According to a U.S. Department of Health and Human Services (“HHS”) press release on April 27,

2021 [https://www.hhs.gov/about/news/2021/04/27/hhs‐announces‐1‐billion‐dollar‐from‐

american‐rescue‐plan‐for‐construction‐and‐renovation‐projects‐at‐health‐centers.html], HHS

Secretary Xavier Becerra is quoted as stating, “"As the pandemic has made clear, modernizing

the physical infrastructure of many of our country's health centers is long overdue."  In line with

the $1 billion that has been allocated from the American Rescue plan for construction and

renovation projects for Health Resources and Services Administration (“HRSA”) funded health

centers, Collin County’s has approved use of ARPA funds for these same purposes for a new

Health Care Services facility, which is not HRSA‐funded.  Within the April 27, 2021 press release,

HRSA Acting Administrator Diana Espinosa states "HRSA‐funded health centers have adapted to

the evolving needs in their communities throughout the pandemic.  This historic influx of

funding for infrastructure improvements will allow them to continue the critical work of

connecting underserved patients and communities with high‐quality health care."  Collin County

agrees and is allocating $54.8m of the ARPA funds to its Health Care Services project and

$134.1m for its Adult Detention Center infirmary project.

 Each of Collin County’s approved projects specifically incorporates the CDC recommended public

health strategies [Honein MA, Christie A, Rose DA, et al. Summary of Guidance for Public Health

Strategies to Address High Levels of Community Transmission of SARS‐CoV‐2 and Related

Deaths, December 2020. MMWR Morb Mortal Wkly Rep 2020; 69:1860‐1867. DOI:

http://dx.doi.org/10.15585/mmwr.mm6949e2].  The 10 strategies endorsed by the CDC in this

publication include:  1) universal face mask use, 2) maintaining physical distance from other

persons and limiting in‐person contacts, 3) avoiding nonessential indoor spaces and crowded

outdoor spaces, 4) increasing testing to rapidly identify and isolate infected persons, 5) promptly

identifying, quarantining, and testing close contacts of persons with known COVID‐19, 6)

safeguarding persons most at risk for severe illness or death from infection with SARS‐CoV‐2,

the virus that causes COVID‐19, 7) protecting essential workers with provision of adequate

personal protective equipment and safe work practices, 8) postponing travel, 9) increasing room

air ventilation and enhancing hand hygiene and environmental disinfection, and 10) achieving

widespread availability and high community coverage with effective COVID‐19 vaccines.  

The impact of not following these recommended public strategies is clearly outlined by the CDC.  As

such, Collin County is investing these funds in public health capacity to support the community’s public

health and mitigate the spread of COVID‐19.

All ARPA funds are being allocated to support these CDC evidence‐based strategies.

   
Collin County 2021 Recovery Plan Performance Report 17

PROJECT 2: Health Care Services Building & Parking Garage  

Funding Amount: $54,841,679

Project Expenditure Category: 1.1, “Public Health ‐ COVID‐19 Vaccination”

Project Overview

This project allocates ARPA funding for construction of a new Health Care Services building and parking

garage to establish the capacity for a vaccination hub and provides sufficient operational, storage,

meeting and office space to meet the community’s incremental public health needs, which have

occurred as a result of the COVID‐19 pandemic.   

The main activities of this project in the coming months start with selection of an architect and a

construction manager‐at‐risk, if deemed appropriate.  Major construction areas required for the

objectives of this project to be accomplished include the design, permitting and construction of both the

parking garage and the Health Care Services building.

  

In the coming months, a Request for Qualifications will be published to ensure competitive solicitation.  

This process will be followed by selection of appropriate vendors.  The design phase is planned to start

in summer 2022 for the parking garage and early 2023 for the Health Care Service building, followed by

permitting and construction.  The parking garage is expected to be finished during spring 2024, and the

facility is planned to be open in late 2025.

The intended outcome of this project is to increase the capacity of Collin County Health Care Services,

including establishing space suitable for a vaccination hub.  This outcome will enable Collin County to

provide better care of at‐risk and other marginalized residents.

No activities have been performed on this project beyond approval of the funds use for this purpose.

Use of Evidence

In order to comply with CDC COVID‐19 infectious disease prevention and containment directives that

support public health and mitigate the spread of COVID‐19, the goal of this project is to increase the

community public health capacity at Health Care Services.  As administrator of a local safety net system,

Collin County Health Care Services takes on the care for the county’s uninsured, underinsured and

medically indigent.  

This Collin County public health project was selected to comply with evidence‐based interventions

recommended by the CDC.  In order to comply with the CDC’s COVID‐19 infectious disease directives,

Collin County will increase public health capacity by building a new, larger Health Care Services building

and parking garage suitable as a vaccination hub.  The CDC’s existing evidence‐based strategies for

COVID‐19 prevention and containment were relied on in the selection of this infrastructure project

which supports public health and mitigates the spread of COVID‐19.   The evidence base includes:

 According to “Public Health’s Infrastructure”, a status report prepared for The Appropriations

Committee of the United States Senate by the CDC, the CDC’s recommendations to improve

public health infrastructure include addressing crucial gaps in organizational capacities of local

and State health departments and laboratories.  Within the “What is the Public Health

Infrastructure” section of this report, organizational capacity is described as a basic necessary

foundation of public health system preparedness.  This status report was published in 2001 and

can be found at https://stacks.cdc.gov/view/cdc/11337.  
Collin County 2021 Recovery Plan Performance Report 18

 According to a U.S. Department of Health and Human Services (“HHS”) press release on April 27,

2021 [https://www.hhs.gov/about/news/2021/04/27/hhs‐announces‐1‐billion‐dollar‐from‐

american‐rescue‐plan‐for‐construction‐and‐renovation‐projects‐at‐health‐centers.html], HHS

Secretary Xavier Becerra is quoted as stating, “"As the pandemic has made clear, modernizing

the physical infrastructure of many of our country's health centers is long overdue."  In line with

the $1 billion that has been allocated from the American Rescue plan for construction and

renovation projects for Health Resources and Services Administration (“HRSA”) funded health

centers, Collin County’s has approved use of ARPA funds for these same purposes for a new

Health Care Services facility, which is not HRSA‐funded.  Within the April 27, 2021 press release,

HRSA Acting Administrator Diana Espinosa states "HRSA‐funded health centers have adapted to

the evolving needs in their communities throughout the pandemic.  This historic influx of

funding for infrastructure improvements will allow them to continue the critical work of

connecting underserved patients and communities with high‐quality health care."  Collin County

agrees and is allocating $54.8m of the ARPA funds to its Health Care Services project and

$134.1m for its Adult Detention Center infirmary project.

 Each of Collin County’s approved projects specifically incorporates the CDC recommended public

health strategies [Honein MA, Christie A, Rose DA, et al. Summary of Guidance for Public Health

Strategies to Address High Levels of Community Transmission of SARS‐CoV‐2 and Related

Deaths, December 2020. MMWR Morb Mortal Wkly Rep 2020; 69:1860‐1867. DOI:

http://dx.doi.org/10.15585/mmwr.mm6949e2].  The 10 strategies endorsed by the CDC in this

publication include:  1) universal face mask use, 2) maintaining physical distance from other

persons and limiting in‐person contacts, 3) avoiding nonessential indoor spaces and crowded

outdoor spaces, 4) increasing testing to rapidly identify and isolate infected persons, 5) promptly

identifying, quarantining, and testing close contacts of persons with known COVID‐19, 6)

safeguarding persons most at risk for severe illness or death from infection with SARS‐CoV‐2,

the virus that causes COVID‐19, 7) protecting essential workers with provision of adequate

personal protective equipment and safe work practices, 8) postponing travel, 9) increasing room

air ventilation and enhancing hand hygiene and environmental disinfection, and 10) achieving

widespread availability and high community coverage with effective COVID‐19 vaccines.  

The impact of not following these recommended public strategies is clearly outlined by the CDC.  As

such, Collin County is investing these funds in public health capacity to support the community’s public

health and mitigate the spread of COVID‐19.

All ARPA funds are being allocated to support these CDC evidence‐based strategies.

   
Collin County 2021 Recovery Plan Performance Report 19

PROJECT 3: Medical Examiner Building  

Funding Amount: $12,034,064.34

Project Expenditure Category: 1.7, “Public Health – Capital Investments or Physical Plant

Changes to Public Facilities that Respond to the COVID‐19 Public Health Emergency”   

Project Overview

This project uses ARPA funding for construction of a new Medical Examiner building.  The Medical

Examiner is directly engaged in matters related to public health and provides a public health support

service that is essential for care of the deceased.   

The main activities of this project in the coming months start with selection of an architect and a

construction manager‐at‐risk, if deemed appropriate.  Major construction activities required for the

objectives of this project to be accomplished include the design, permitting and construction of the

Medical Examiner building.

  

In the coming months, a Request for Qualifications will be published to ensure competitive solicitation.  

This process will be followed by selection of appropriate vendors.  The design phase is planned to start

in late 2023, and the facility is planned to be open in spring 2026.   

The intended outcome of this project is to increase the capacity of the Medical Examiner’s office.  This

outcome will enable Collin County to continue to treat the deceased with dignity and respect, as well as

comply with CDC COVID‐19 infectious disease prevention and containment directives.

No activities have been performed on this project beyond approval of the funds use for this purpose.

Use of Evidence

In order to comply with CDC COVID‐19 infectious disease prevention and containment directives that

support public health and mitigate the spread of COVID‐19, the goal of this project is to increase the

community public health capacity of the Medical Examiner’s office.   

This Collin County public health project was selected to comply with evidence‐based interventions

recommended by the CDC.  In order to comply with the CDC’s COVID‐19 infectious disease directives,

Collin County will increase public health capacity by building a Medical Examiner office.  The CDC’s

existing evidence‐based strategies for COVID‐19 prevention and containment were relied on in the

selection of this infrastructure project which supports public health and mitigates the spread of COVID‐

19.   The evidence base includes:

 According to “Public Health’s Infrastructure”, a status report prepared for The Appropriations

Committee of the United States Senate by the CDC, the CDC’s recommendations to improve

public health infrastructure include addressing crucial gaps in organizational capacities of local

and State health departments and laboratories.  Within the “What is the Public Health

Infrastructure” section of this report, organizational capacity is described as a basic necessary

foundation of public health system preparedness.  This status report was published in 2001 and

can be found at https://stacks.cdc.gov/view/cdc/11337.  

 According to a U.S. Department of Health and Human Services (“HHS”) press release on April 27,

2021 [https://www.hhs.gov/about/news/2021/04/27/hhs‐announces‐1‐billion‐dollar‐from‐

american‐rescue‐plan‐for‐construction‐and‐renovation‐projects‐at‐health‐centers.html], HHS
Collin County 2021 Recovery Plan Performance Report 20

Secretary Xavier Becerra is quoted as stating, “"As the pandemic has made clear, modernizing

the physical infrastructure of many of our country's health centers is long overdue."  In line with

the $1 billion that has been allocated from the American Rescue plan for construction and

renovation projects for Health Resources and Services Administration (“HRSA”) funded health

centers, Collin County’s has approved use of ARPA funds for these same purposes for a new

Health Care Services facility, which is not HRSA‐funded.  Within the April 27, 2021 press release,

HRSA Acting Administrator Diana Espinosa states "HRSA‐funded health centers have adapted to

the evolving needs in their communities throughout the pandemic.  This historic influx of

funding for infrastructure improvements will allow them to continue the critical work of

connecting underserved patients and communities with high‐quality health care."  Collin County

agrees and is allocating $54.8m of the ARPA funds to its Health Care Services project and

$134.1m for its Adult Detention Center infirmary project.

 Each of Collin County’s approved projects specifically incorporates the CDC recommended public

health strategies [Honein MA, Christie A, Rose DA, et al. Summary of Guidance for Public Health

Strategies to Address High Levels of Community Transmission of SARS‐CoV‐2 and Related

Deaths, December 2020. MMWR Morb Mortal Wkly Rep 2020; 69:1860‐1867. DOI:

http://dx.doi.org/10.15585/mmwr.mm6949e2].  The 10 strategies endorsed by the CDC in this

publication include:  1) universal face mask use, 2) maintaining physical distance from other

persons and limiting in‐person contacts, 3) avoiding nonessential indoor spaces and crowded

outdoor spaces, 4) increasing testing to rapidly identify and isolate infected persons, 5) promptly

identifying, quarantining, and testing close contacts of persons with known COVID‐19, 6)

safeguarding persons most at risk for severe illness or death from infection with SARS‐CoV‐2,

the virus that causes COVID‐19, 7) protecting essential workers with provision of adequate

personal protective equipment and safe work practices, 8) postponing travel, 9) increasing room

air ventilation and enhancing hand hygiene and environmental disinfection, and 10) achieving

widespread availability and high community coverage with effective COVID‐19 vaccines.  

The impact of not following these recommended public strategies is clearly outlined by the CDC.  As

such, Collin County is investing these funds in public health capacity to support the community’s public

health and mitigate the spread of COVID‐19.

All ARPA funds are being allocated to support these CDC evidence‐based strategies.

 
Collin County 2021 Recovery Plan Performance Report 21

Performance Report 

PROJECT 1: Adult Detention Center Medical/Mental Health Infirmary

Goal:  Increase the community public health capacity of the Collin County Adult Detention Center

infirmary  

 Output Key Performance Indicator: Greater number of infirmary beds

 Output Key Performance Indicator: Additional infirmary square feet  

 Outcome Key Performance Indicator: Better serve residents requiring medical and mental

health services within the Adult Detention Center

 Outcome Key Performance Indicator: Increased compliance with CDC COVID‐19 infectious

disease prevention and containment directives

PROJECT 2: Health Care Services Building & Parking Garage

Goal:  Increase the community public health capacity of the Collin County Health Care Services building

 Output Key Performance Indicator: Greater number of examination rooms

 Output Key Performance Indicator: Additional Health Care Services square feet  

 Output Key Performance Indicator: Health Care Services parking garage (vaccination hub) is

complete

 Outcome Key Performance Indicator: Better serve residents requiring medical and mental

health services at Health Care  

 Outcome Key Performance Indicator: Increased compliance with CDC COVID‐19 infectious

disease prevention and containment directives

PROJECT 3: Medical Examiner Building

Goal:  Increase the community public health capacity of the Collin County Medical Examiner building

 Output Key Performance Indicator: Additional Medical Examiner building square feet  

 Outcome Key Performance Indicator: Better serve residents requiring services at the Medical

Examiner building  

 Outcome Key Performance Indicator: Increased compliance with CDC COVID‐19 infectious

disease prevention and containment directives