Health Facilities Design An Overview of the Latest Changes to the Codes & Standards

1. Health Facilities DesignAn Overview of the Latest Changes to the Codes & Standards

2. David B. Uhaze, RA Chief, Bureau of Construction Project Review • Healthcare Architect • NJ Construction Official • DOH Inspector • Supervisor of Healthcare Plan Review • NJ Codes Advisory Board Member • AIA Guidelines Revision Committee Member • NCPCCI Committee Member

3. Introduction • Process Overview • Bureau of Construction Project Review – Health Care Unit • The NJ Department of Health and Senior Services • The NJ Uniform Construction Code • The NJ Uniform Fire Code • Center for Medicare/Medicaid Services • The AIA Guidelines for Design and Construction of Hospital and Health Care Facilities

4. Process Overview • The pieces of the puzzle • How all of the individual pieces fit together AIA DCA DHSS UCC

5. DCA – Bureau of Construction Project Review The Bureau • Functions as the construction office for all building types or projects reserved to the State at NJAC 5:23-3.11 • Includes such projects as: • Healthcare Facilities • Casinos • State Buildings (State colleges, NJTP, NJT, etc.) • Utility Plants ( Electrical Generating, Solid Waste Treatment, Incineration Plants) • Mausoleums ( with Crematories)

6. 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 • Can grant permission for a Local review • To contact call : Farivar Kiani, Supervisor at 609.633.8151

7. NJ Dept. of Health & Senior Services • No significant new proposals at this time. • Looking at adoptions and deletions in the AIA Guidelines for the first time. • Small Inpatient Primary Care Hospitals - OUT • Assisted Living facilities - OUT • Office Surgical Facilities - OUT • Hospice Facilities – IN ? • Medical Daycare Facilities – IN ?

8. NJ Uniform Construction Code Proposed Adoptions – Dec. 2006 • 2006 International Building Code • 2006 International Residential Code • 2006 International Mechanical Code • 2006 International Fuel Gas Code • 2006 National Standard Plumbing Code • 2006 International Energy Compliance Code

9. NJ Uniform Construction Code Overview of Amendments • International Building Code 2006 • Table 503 “Height & Area” would be amended to reflect 1996 BOCA values in certain use groups and for certain construction types similar to the 2001 NJ edition. • Table 302.2.2 “Separation of Occupancies” has been heavily revised and is now in Chapter 5 as Table 508.3.3. In many cases separation of certain uses is no longer required.

10. NJ Uniform Construction Code • International Building Code 2006(cont.) • Deletes the Section 707.14.2 option allowing elevator hoistway pressurization in lieu of enclosed lobbies. • Deletes the Section 903.4.1 option for an alarm to ring to a constantly attended location in lieu of going to a central station.

11. NJ Uniform Construction Code • New section 903.2.14 adds additional automatic suppression threshold as follows:

12. NJ Uniform Construction Code • International Building Code 2006(cont.) • Section 905.3.2 retains the current requirements for standpipes based on building floor area and distance. (>10,000sf & >200’ travel to fire dept. vehicle access) • Retains the current Fire Department Connections language from the 2000 NJIBC • Deletes Chapter 11 “Accessibility” – refers you to NJUCC Subchapter 7

13. NJ Uniform Construction Code • 2006 Plumbing & Mechanical Codes • Typical editorial changes (references to other adopted codes – IBC, NEC, etc.) • 2006 Fuel Gas Code • Will Amend Sec. 401.2 to prohibit LP gas containers on roofs of buildings • Typical editorial changes (references to other adopted codes – IBC, NEC, etc.)

14. NJ Uniform Construction Code • 2006 Energy Conservation Code • Amends Chap. 3 “Climate Zones” to insert new table specific to NJ with 4 climate zones based on true heating degree days data.

15. NJ Uniform Construction Code & Uniform Fire Code • Proposal 3377(a) • Will require the installation of an automatic fire suppression system throughout all existing Nursing Homes • NJ Uniform Fire Code • Currently being upgraded to match NJUCC • IFC 2006

16. CMS – Center for Medicare/Medicaid Services • Have recognized NFPA 101 TIA 00-1 as an amendment to NFPA 101 – 2000. This deals with alcohol based hand rubs (ABHR’s) This allows ABHR’s to be placed in egress corridors with certain limitations. [Federal Register 9/22/06] • Corridors must be min. 6’- 0” wide • Max. unit capacity is .3 gallons (1.2 liters) • Min. horizontal spacing of 4ft. • Max. 10 gallons ( 37.8 liters) per smoke compartment • Cannot be installed over or adjacent to an ignition source • Dispensers may be located over carpet only in sprinkered smoke compartments

17. The AIA Guidelines • Established as a Federal Standard in 1947 • Published by the American Institute of Architects since 1984 • The Facilities Guidelines Institute formed in 1998

18. The AIA Guidelines • The 2006 edition has been completely reorganized and renumbered to make it easier to find material in the document. A relocation matrix for users of earlier editions can be found in the back of the book. • The reorganization of the Guidelines is accompanied by a new numbering system, which places the chapter number at the top of the page and paragraph numbers in the text. Thus, each paragraph reference must include both the chapter number (followed by a hyphen) and the paragraph number. For instance, the reference to typical patient rooms in a hospital medical/surgical unit in Chapter 2.1, General Hospitals, is 2.1-3.1.1

19. The AIA Guidelines Old Format New Format

20. The AIA Guidelines New content and major revisions that appear in the 2006 edition are summarized below: • Part 1 - General(applicable to all health care facilities) • Expansion of the environment of care chapter, including detailed functional program requirements and an appendix on green design • New material on infection control risk assessments (ICRAs) and infection control risk mitigation recommendations • A chapter on common requirements for all health care facility types

21. The AIA Guidelines • Part 2 - Hospitals • Single-bed rooms as the minimum standard for medical/surgical and postpartum nursing units in general hospitals • Revised bed clearances and new bedside documentation areas in critical care units • New sections on intermediate care units in general hospitals, observation units in emergency departments, freestanding emergency facilities, and in-hospital skilled nursing units • Revised text for decontamination areas and appendix language on surge capacity in emergency departments • Revised section on in-hospital psychiatric nursing units • New chapter on small inpatient primary care hospitals

22. The AIA Guidelines • Part 3 - Ambulatory Care Facilities • A chapter of common elements for outpatient facilities • Revised chapters on freestanding surgical facilities, birthing centers, and primary care outpatient facilities • New chapters on urgent care facilities, office surgical facilities, gastrointestinal endoscopy facilities, renal dialysis centers, and psychiatric outpatient centers • Part 4 - Other Health Care Facilities • Revised chapter on nursing facilities • Completely new chapters on assisted living, hospice, and adult day health care facilities

23. The AIA Guidelines 2010 • The revision process involves two opportunities for public comment. • 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 changes. • From its review of these comments, the Facilities Guidelines Revision Committee develops the manuscript for the next edition of the Guidelines.

24. The AIA Guidelines 2010 • New revision cycle will begin in December of 2006 • First full Committee meeting will be held in April 2007 • This is a consensus process dependant on public input and public commentary

25. The AIA Guidelines 2010 • The form for Change Proposals can be found at the back of the 2006 edition • Change proposals can also be submitted on line

26. Where to Get More Information • AIA Guidelines • AIA Bookstore 1.800.242.3837, press 4 • NJ Uniform Construction Code • 609.984.0040 • www.nj.gov/dca/codes/forms/pubsandsubs.htm • International Codes • 1.800.214.4321, ext.371