RATCLIFF provided strategic facilities planning and full architectural services for the expansion and consolidation of the San Mateo County Health Center, formerly the San Mateo County General Hospital. With consolidated outpatient and inpatient services, the expanded and renovated facility serves as a model County Health Center within the era of managed-care economic constraints. RATCLIFF revised an original plan which had sited new development as two â€œbookendsâ€ surrounding the existing hospital, confining potential growth. The new plan placed the new construction to one side, allowing for eventual demolition of the existing 1954 hospital without compromising the integrity of the addition. The new construction provides an array of outpatient clinics (primary care, general and specialty, public health, and a new aids clinic), a nursing wing addition, and a new central plant. Complex phasing issues were resolved to allow the existing hospital to remain fully functional as new buildings were added to the site.