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Health Facilities Design: An Overview of Upcoming Code Changes

Health Facilities Design: An Overview of Upcoming Code Changes. David B.Uhaze , RA Chief - Bureau of Construction Project Review NJ Dept. Of Community Affairs. Health Facilities Management Society of New Jersey. November 2011 Meeting. Introduction.

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Health Facilities Design: An Overview of Upcoming Code Changes

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  1. Health Facilities Design:AnOverview of Upcoming Code Changes David B.Uhaze, RA Chief - Bureau of Construction Project Review NJ Dept. Of Community Affairs Health Facilities Management Society of New Jersey November 2011 Meeting

  2. Introduction • Bureau of Construction Project Review • Department of Health & Senior Services • Guidelines for Design & Construction of Health Care Facilities 2014 • NFPA 101-2012 • NFPA 99-2012 • International Codes

  3. DCA – Bureau of Construction Project Review The Bureau • Functions as the construction office for all building types or projects reserved to the State atNJAC 5:23-3.11 • This includes such projects as: Healthcare Facilities Casinos State Buildings (State colleges, NJTPA, NJT, NJSEA, etc.) Special Projects (Electrical Generating, Solid Waste Treatment, Incineration Plants) Prototypes (Big box stores, banks, etc.)

  4. DCA – Bureau of Construction Project Review Health Care Plan Review Unit • Performs both a UCC and Licensing review on all projects submitted • Will comment on Licensing requirements, but cannot grant waivers to those requirements • 20 day review cycle for new projects with complete applications • 7 day review cycle for re-submitted projects • Permitting and inspections are done at the local level • May grant permission for a Local review of certain projects • To contact call: Frank Kiani, Supervisor at609.633.8151

  5. DCA – Bureau of Construction Project Review You can find additional information about the Bureau including Bureau mailing addresses and phone numbers, a listing of when a Bureau review and release is required, answers to frequently asked questions about the plan review and release process, and you can access all of the necessary forms for submission at the Bureau’s website: http://www.nj.gov/dca/divisions/codes/offices/bcpr.html

  6. NJ Uniform Construction Code • Established January 1, 1977 to eliminate inconsistency and standardize codes throughout NJ • Establishes uniform administrative procedures for • enforcing construction standards throughout NJ • Establishes licensing standards and organizational standards for all NJ Construction Code Officials and construction departments • Incorporates adopted national standards as well as NJ specific standards such as the Rehabilitation Subcode, the Barrier Free Subcode, the Asbestos Subcode, etc.

  7. NJ Uniform Construction Code • The following codes are currently in effect : • 2009 International Building Code – NJ Edition • 2009 International Mechanical Code • 2009 International Fuel Gas Code • 2009 National Standard Plumbing Code • 2009 International Energy Code • 2007 ASHRAE 90.1 • 2003 ANSI A117.1 (Barrier Free) • NJ Rehabilitation Subcode

  8. NJ Uniform Construction Code • Rehab Code Revision – November 7, 2011 • At N.J.A.C. 5:23-6.4(c)2, the prohibition against the removal of • existing fire protection systems is deleted from this section for • consistency with the Uniform Fire Code. • This change allows the removal of an existing fire protection system: • because the system is so antiquated that it can no longer be repaired • because the existing system is in a building that has undergone a change of use and the installation of a fire protection system would not be required in new construction for the same use. • The removal of existing fire protection would require the approval of both the fire protection subcode official and the fire official; the applicant would have the right of appeal should the application for removal be denied.

  9. NJ Dept. of Health & Senior Services • Hospital Licensing Standards • Standards for Licensure of Ambulatory Care Facilities You can view these standards and any code change proposals on the DHSS website at : http://www.state.nj.us/health/healthfacilities/rules.shtml

  10. NJ Dept. of Health & Senior Services Newly Adopted Standards: The new rules for Safe Patient Handling apply to hospitals and nursing homes, and require : • Minimizing unassisted patient handling through the use of assistive devices • Establishing a safe patient handling program, committee and plan • Preparation of a Needs Assessment for each patient and each unit within the facility to determine the need for assistive patient handling. • Training of healthcare workers in the safe use of patient handling equipment • Establishing procedures for injury reporting, investigation, analysis and recordkeeping

  11. NJ Dept. of Health & Senior Services Newly Adopted Standards: • The new rules for Violence Prevention apply to hospitals and nursing homes, and require: • Establishing a violence prevention program, committee and plan • Completion of an annual violence risk assessment • Provision of violence prevention training for all employees • Establishing procedures for incident handling, investigation and reporting • Maintaining records of violent acts

  12. NJ Dept. of Health & Senior Services • Issues during Inspections There are times when, NJDHSS inspectors will cite deficiencies based on a facility’s compliance with the Uniform Construction Code and its adopted standards. The NJDHSS does not have the authority to make “building code” citations. In addition, because of the complexity of these codes, they are sometimes incorrectly cited. If you have a question regarding a NJDHSS citation which relates to a “building code” issue, please call the DCA-HCPR office for clarification before making any corrections

  13. Facility Guidelines Institute Guidelines for Design and Construction of Health Care Facilities • Established as a Federal Standard in 1947 • Published through the American Institute of Architects from 1984 to 2008 • No longer affiliated with the “AIA” • Now partnered with ASHE • Currently working on the 2014 Edition

  14. Facility Guidelines Institute The Facility Guidelines Institute (FGI) was formed in 1998 in an effort to create a more formal procedure and process of review and revision, and to ensure the document is kept current. The FGI Guidelines Revision Committee welcomes comments and language revision proposals from all interested parties. www.fgiguidelines.org

  15. The FGI Guidelines 2014 • New revision cycle began in January of 2011 • First full Committee meeting was held in April 2011 • The Public Proposal period ended October 31, 2011 • The next full Committee meeting will be in January 2012 • The last full Committee meeting will be held in April 2013 • This is a consensus process dependent on public input and public commentary

  16. The FGI Guidelines 2014 • The revision process involves two opportunities for public participation. • During a proposal period, anyone can submit a proposal to change language in the Guidelines. • The Facilities Guidelines Revision Committee considers these proposals and develops a draft manuscript.  • This draft is then posted for public comment, and anyone can comment on the proposed draft. • From its review of these comments, the Facilities Guidelines Revision Committee develops the final manuscript for the next edition of the Guidelines.

  17. The FGI Guidelines 2014 • Major topics of Discussion this cycle: • New book just for Residential Health Care facilities • Patient & Staff Safety Risk Assessment • Critical Access Hospitals • Coordination of Room Sizes & Clearances • Coordination between inpatient and outpatient requirements • Medical Imaging • Obstetric & Pediatric Facilities

  18. National Fire Protection Assoc.2012 Editions • Life Safety Code 101 • Health Care Facilities Code 99 These new NFPA editions must be adopted by the Center for Medicare & Medicaid Services (CMS) before they can be used in health care facility design. CMS has stated that they will be reviewing these standards for adoption but that it could take up to 20 months.

  19. NFPA 101- Life Safety Code2012Edition The following changes have been approved: • In areas with nine or fewer individuals, sliding doors no longer need a break-away feature, but corridor doors still need latching and smoke resistance. • One container of alcohol-based hand gel in each room may be exempted from the total quantity in a smoke compartment. • Above handrail height, 6-inch corridor projections of any type are acceptable.

  20. NFPA 101- Life Safety Code2012Edition • The section on suites has been reorganized, with the size of new sleeping suites at 7,500 square feet, or 10,000 square feet if there is direct visual supervision and the space is fully and automatically smoke detected. • Patient room closets of less than 6 square feet do not need to be sprinklered. • Larger recycling and linen containers will be permitted, up to 96 gallons in capacity, without being placed in an area protected as hazardous.

  21. NFPA 101- Life Safety Code2012Edition • Certain additional items will be permitted to be stored in corridors, as long as 5 feet of clear width remains and there is a fire plan to remove the equipment. • Seating will be allowed in an 8-foot corridor with some restrictions. (50sf per area, 10ft separation of areas, 6ft clear width maintained) • Home setting cooking facilities will be permitted to be open to the corridor. (500cfm exhaust, suppression, grease collection) • Gas fireplaces will be permitted in fully sprinklered sleeping compartments with some restrictions. (direct venting, not in sleeping rooms, controls locked)

  22. NFPA 99 – Health Care Facilities Code 2012Edition 2012 edition of NFPA 99 was rewritten and reorganized completely. Now includes a "Fundamentals" chapter that addresses risk based on the type of care provided in the health care organization as follows: Category 1 - Facility systems failure that is likely to cause major injury or death of patients or caregivers . Category 2 -Facility systems failure that is likely to cause minor injury to patients or caregivers . Category 3 -Facility systems failure that is not likely to cause injury to the patients or caregivers, but can cause patient discomfort . Category 4 – Facility systems failure that has no impact on patients or caregivers.

  23. NFPA 99 – Health Care Facilities Code 2012Edition • Operating rooms will now be considered to be “wet procedure locations” by default. The health care facility will have the ability to do a risk assessment (which will be explained in the annex material of NFPA 99) to declare one or more of the ORs to be dry locations. • Added testing and inspection requirements for all new and existing non-stationary medical booms (annually) • Added text to permit a 0.1 second delay for selective coordination of the electrical systems in health care occupancies.

  24. NFPA 99 – Health Care Facilities Code 2012Edition • Permits fuel transfer pumps, receptacles, ventilation fans, louvers and cooling systems related to generators to be added to the life safety or critical branch (deleted from equipment branch) • New section which permits switches in lighting circuits connected to Life Safety and critical branch as long as they don’t serve as illumination of egress as required by NFPA 101 • Increases number of required receptacles • General Care – From 4 to 8 • Critical Care – From 6 to 14 • Operating Rooms – New requirement of 36

  25. International Building Code 2012Edition The following changes have been approved: • Classifications for health-care related facilities have been clarified. • Provisions for incidental-use rooms and spaces have been clarified. • Reformatted requirements for protection of vertical openings through floors. • Increased capacity for egress components in buildings with sprinklers & an emergency communication system.

  26. International Building Code 2012Edition • Clarification of when unenclosed stairways can be used as a part of the means of egress system • Means of egress provisions unique to special occupancies now in Chapter 4. • Wind design requirements extensively revised. • Wind load maps are now based on ultimate design wind speeds. • Updated seismic ground motion maps.

  27. International Mechanical Code 2012Edition The following changes have been approved: • New and existing mechanical systems must be maintained in accordance with ASHRAE/ACCA/ANSI Standard 180. • Parking garage exhaust now defined as environmental air. • Includes specifications for grease reservoirs in commercial cooking exhaust duct systems. • Requires any combustible material in a return air plenum to be listed and labeled to verify compliance with ASTM E-84 or UL 723. • New requirements for evaporative coolers.

  28. International Code Council • Ad Hoc Committee on Healthcare • At Section 806.1of the IBC, In Groups I-1 and I-2, an exception is being proposed to the requirement that combustible decorative materials meet the criteria of NFPA 701 The exception would exempt decorative materials, including, but not limited to, bulletin boards, artwork, posters, photographs and paintings in Groups I-1 and I-2 as long as they are less than 20 percent of the wall area. • At Section 407of the IBC, Corridors in I-2 occupancies would be allowed to have open spaces such as but not limited to waiting, nurse stations, chart areas, patient gathering spaces, or operational areas of unlimited size provided the contents are low hazard.

  29. International Code Council • Ad Hoc Committee on Healthcare • At 907.5.2.1Audible alarms, it is proposed to allow visible alarm notification appliances in lieu of audible alarm notification appliances in critical care areas of Group I-2 occupancies that are in compliance with Section 907.2.6, Exception 2. • Table 508.2.5, Incidental Accessory Occupancies, is being reworked to add spaces being currently maintained in healthcare and ambulatory care occupancies. This should make the table more relevant and consistent with current operational and programmatic standards in I-2 occupancies. • At 1008 ,They are reworking the sections on door locking arrangementsto address security/abduction issues. The changes will reduce confusion between delayed egress locks and other types of locks.

  30. International Code Council • Ad Hoc Committee on Healthcare • At 1018.2 Corridor Width, it is proposed to allow low hazard equipment, carts, and devices that are mobile (attended/in-use equipment, patient transport and handling devices, emergency equipment ) that do not encroach upon an effective 5' clear path provided the organization has a defend in place management plan to address egress and clearing of corridors in emergency situations. • In the IMC at Table 403.3 , they are proposing to delete the 6 spaces identified under “Hospitals, nursing and convalescent homes” and insert footnote “J” which states the following: “For hospital ventilation rates refer to ASHRAE Standard 170, Table 7-1 and addenda 1-5.

  31. Where to Get More Information • FGI Guidelines • AIA Bookstore 1.800.242.3837, press 4 • NJ Uniform Construction Code & Uniform Fire Code • 609.984.0040 • www.nj.gov/dca/codes/forms/pubsandsubs.htm • International Codes • 1.800.214.4321, ext.371 • National Fire Protection Association • 1.800.344.3555 • http://catalog.nfpa.org

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