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Facilities Development DivisionCalifornia’s Building Department for Hospitals

Paul A. Coleman, Architect, Deputy DirectorChris Tokas, S.E., Deputy Division Chief

Gordon Oakley, Fire Marshal, Deputy Division ChiefRoy Lobo, Ph.D., S.E., Principal Structural Engineer

Glenn Gall, Supervisor, Building Standards UnitNanci Timmins, Fire Marshal, Chief Fire Life Safety Officer

California Healthcare AssociationAugust 8, 2017

1

In Case You Haven’t Heard

2

We’ve Moved!Approved as noted

Facilities Development DivisionCalifornia’s Building Department for Hospitals

Plan Review and Field Performance Update

3

Workload Summary/Performance

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No. of Reviews Year 2016

65%

35%

≈ 59 reviews/day

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Project Plan Review Data Analysis 2st Qtr. 2017

68% of the Plan Reviews are completed w/in 21 days or less

Σ=552 or 14% of All Projects

92% of the PAD Reviews are completed w/in 21 days or lessOr 40% of Office Plan ApprovalReviews

6

62%

35%

≈ 62 reviews/day

Number of Permits – 4th Qtr. 2010 thru 2nd Qtr. 2017

7

758

669

745

471504 494 510

557

470

549586 595

512 500

601640

589630

694664

614 630

730

639603 594

644

285

0

100

200

300

400

500

600

700

800

Num

ber o

f Per

mits

Quarter-Year

Statewide combined Office and Field Number of Permits Issued by Quarter

724

582

With SB 1838 Permits

Without SB 1838 Permits

Workload in Construction Values for projects in Construction - % Completion

8%26%65%

(1st Qtr. 2017 Numbers)

8

66% 28% 9%

117107

115

58

91

7668

74 7570

38

5345

30

43

3018

3022 22 19

1318

2516 14

6 7

0

20

40

60

80

100

120

140

Num

ber o

f Per

mits

Quarter-Year

Number of SB 1838 Projects – 2nd Qtr. 2017

Statewide Number of SB 1838 EXEMPT Projects Approved by Quarter

113

40

9

Workload in Construction Values for projects in Pending Construction State By Region

10

$0.0B$0.1B$0.2B$0.3B$0.4B$0.5B$0.6B$0.7B$0.8B$0.9B$1.0B

CentralRegion

CoastalRegion

NorthRegion Rapid

ReviewUnit

North LosAngelesRegion

South LosAngelesRegion

SouthRegion Sum

$0.1B$0.2B

$0.1B$0.0B

$0.2B

$0.1B$0.2B

$0.9B

Total = $12,608,359,949

Facilities Development DivisionCalifornia’s Building Department for Hospitals

Seismic Compliance Update

Structure Performance Categories

* Based on 2001 Hospital Survey Results based on hospital “self-report” and then “state-of-the-art” FEMA 178 standards from 1996** SPC-5 includes buildings currently under constructionFor SPC - "Not Assigned" is for non-building structures such as equipment yards, cooling towers etc that are still under construction

Hospital Seismic Compliance to Date

217 7/28/17

1096

Bui

ldin

gs 8

3.5%

< 2½ years left

Nonstructural Performance Categories

***Includes buildings under construction, tunnels and equipment yardsFor NPC - "Not Assigned" are for buildings and nonbuilding structures either under construction or where the nonstructural performance category has not been verified

2017 SB499 Report Timeline• Building Inventory/SB499 Preparation Letter – 6/27/17• Building Inventory/SB499 Preparation Reminder Letter –

7/25/17• Building Inventory Revisions cutoff deadline – 7/28/17• Release of Online Report with passwords – 8/21/17• Online Report Reminder Letter – 9/25/17• Online Report Warning Letter – 10/16/17• Online Report submittal deadline – Wednesday, 11/1/17• OSHPD Website Final Report posting deadline 2/1/18

Facilities Development DivisionCalifornia’s Building Department for Hospitals

Project Closure and Invoicing

Projects Awaiting Final Costs from Clients; Number of Projects by OSHPD Region

• Projects waiting for final client costs

• The distribution of projects in the time waiting stays relatively consistent.

Projects Awaiting Final Client Cost

No. of Projects5 Month Trend

As higher valueprojects move into the closure process, the time segments expand and contract as well as the duration of time spent in each time period.

Projects Awaiting Final Client Cost

$ Value5 Month Trend

The total number of outstanding invoices starting 7/1 and ending in 8/1 jumped 16%.

Status of Accounts Receivable

No. of Open Invoices

• Total value of unpaid invoices ending in July is $13.5M.

• increase of 17% from June, but down 37% from one year ago at $21M and down 53% from a 2017 high in February of $29M

Status of Accounts Receivable

$ Value Open Invoices

FDD Income and Expenses

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$-

$10,000

$20,000

$30,000

$40,000

$50,000

$60,000

$70,000

$69,678

$47,619

Thou

sand

s

FDD Year-to-Date Income & Expenses

Income

Expenses

FDD Income and Expenses

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$60.61M

$47.62M

$39.41M

$34.07M

$21.21M

$11.89M

$69.34M

0

$10M

$20M

$30M

$40M

$50M

$60M

$70M

$80M

Jul 01 Jul 31 Aug 31 Sep 30 Oct 31 Nov 30 Dec 31 Jan 31 Feb 28 Mar 31 Apr 30 May 31 Jun 30

FDD

Budg

et in

Mill

ions

Budgeted Dollars & Expenditure/Encumbrances

Target Budgeted $

Y-T-D Expenditures

Target BudgetedSalaries and Benefits $

Y-T-D Salaries &Benefits Expenditures

Target OE/E Budgeted $

Y-T-D Expenditures &Encumbrances*

Y-T-D Cash Income

FDD Expenditures FY 2016/17

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71.50%

11.82%

16.68%

FDD 2016/17 Expenditures thru 6/30/17

Personal Services

General Expenses, I.T., EOC/Equipment & Purchases in Process

OSHPD Overhead - Admin. & I.T.

Facilities Development DivisionCalifornia’s Building Department for Hospitals

eServices

eServices Update

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This quarter the eSP Team has focused on improving the quality of data being entered into the eServices Portal.

Many of the enhancements occur ‘behind the scenes’ or notify users when certain actions occur:

eServices Update

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Automated Email Notifications• GeoTech report uploaded to eSP• Plan approval notification to RCO for issuance of BP• Final payment received notification to PT• eRAD notification to RCO• Functional Program notification to CDPH for pharmacy

projects involving sterile or hazardous compounding

eServices Update

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Automated Letters• For projects approved in the field, plan approval letters

recognize whether the plan was electronic or paper and populates correct processing instructions.

eServices Update

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Data Improvements and Fixes• BPs are automatically assigned to the RCO, not the

Manager• Projects under an Annual Building Permit are

automatically connected to the ABP Record.• Project Closure Summary report displayed incorrect

status when emailed to clients.

Project & Child Documents Report

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A new report has been created that lists all documents associated with a project or any of its ‘child’ projects (BPs, ACDs, AMCs etc.). This can be very useful for completion of construction and project close-out.

Project & Child Documents Report

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The report identifies the records where documents have been uploaded to avoid looking on records where no documents exist.

Project & Child Documents Report

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Expanding the Record ID lists all documents that have been uploaded to the Attachments section of the record.

Project & Child Documents Report

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Using this report you can quickly confirm if the required closure documents have been uploaded as well as who uploaded them, when they where uploaded and where they were uploaded.

This report will eventually have hyperlinks to open the document by clicking on the document name. For security purposes, this feature will not be available to non-OSHPD staff.

Project & Child Documents Report

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This report is currently available in the OSHPD Report Center.

Project List by Region, County, Facility Report

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Clients have also requested access to the OSHPD Field Staff “Quarterly Report”. This report is very useful and lists all projects at a facility based on the search criteria entered. The report is currently available in the OSHPD Report Center.

Project List by Region, County, Facility Report

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The report can be all inclusive or customized to a single facility based on the values selected.

Once generated, the report gives an excellent snapshot of the status of all projects in the search criteria.

eCPR

Auto Codes

e

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eCPR

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eCPR was deployed on August 1, 2017.

This new process and record type is used for formal appeals to OSHPD using the Comment and Process Review currently codified in CAC Section 7-161.

eCPR

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Any person associated with the project may request an appeal using the eCPR. Upon successful completion of the application, the eCPR is automatically routed to the correct reviewer or field staff.The time limitations specified in CAC 7-161 are tracked by eSP; if the first level reviewer does not reply within 10 calendar days, the CPR is automatically escalated to the Supervisor or RCO.

eCPR

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Acceptance or denial of the appeal is documented with an email and a formal letter which will include the reason for any denial.

If the appellant wishes to escalate to the next level, a hyperlink is provided in the letter which will be automatically addressed to the appropriate next-level individual.

eCPR

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Example of CPR Results Letter

eServices Update

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Next steps:• Field Operations improvements & enhancements• ePC improvements

o Updated rendering engine

o Ability to render-on-demand to create overlay pages for backcheck reviews

Tableau Reports – Report Card

Tableau Reports – Timely Review

Tableau – Timely Traige

Tableau – Workload Analysis by Regions

Tableau – Workload Analysis by Counties

Facilities Development DivisionCalifornia’s Building Department for Hospitals

Educational Opportunities

Webinars

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New Pharmacy Standards/Regulations• CHA Sponsored, including Board of Pharmacy,

CDPH, and FDD

2016 California Building Standards Code• In conjunction with the HBSB

• Fire/life Safety• Administrative Regulations and Architectural, Mechanical

and Electrical• Structural

Webinar on Sterile Compounding Pharmacies

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# of connections = 231# of participants = 693-924

Webinar on 2016 CBSC Fire and Life Safety Provisions

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# of connections = 80# of participants = 240-320

Webinar on 2016 CBSC Administrative, Architectural, MEP Systems and Pharmacy Provisions

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# of connections = 78# of participants = 234-312

Webinar on 2016 CBSC Structural Provisions

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# of connections = 76# of participants = 228-304

Upcoming Webinars/Seminars

• Proposed Energy Standards (webinar): late August/early September 2017

• PINs and CANs (webinar): November 2017 ?• Mid-Term Code Changes (webinar): February

2018• Repurposing Hospital Buildings (seminar): April

2018• Final Energy Standards (webinar): February 2019

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Upcoming Webinars/Seminars

Facilities Development DivisionCalifornia’s Building Department for Hospitals

Other Stuff

FDD’s Top 3 Objectives for 2017

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1. Expand Electronic Plan Review

2. Reevaluate FDD’s Plan Review Performance Goals

3. Develop an IOR Trainee/Apprentice Program

HBSB Stuff

DATE MEETINGAugust 9, 2017 Technology CommitteeAugust 23, 2017 Energy Conservation and

Management CommitteeSeptember 14, 2017 Administrative Processes, Code

Changes and Standard Details Committee

October 12, 2017 Energy Conservation and Management Committee

California Building Standards Code Changes

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2019 CBC Structural Regulations

• Started preparing for the 2019 Code Adoption process– ASCE 7-16, TMS-402/602-16, AISC-360/341-16 are

all published– IBC 2018 slated for publication September, 2017– ASCE 41-17 not included in the IBC/IEBC 2018

• OSHPD plans to incorporate it in 2019 CBC, provided it’s published and available to meet 2019 CBSC adoption Schedule

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Facilities Development DivisionCalifornia’s Building Department for Hospitals

2016 Intervening Code Adoption Cycle

California Building Code Changes

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× ×

California Building Code Changes

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California Building Code Changes

• CAC, CBC, CEC, CMC and CPC proposed code changes submitted and processed through the code advisory committees and subsequent public comment periods

• Proposals – Psychiatric Functional Program Element– Alignment of Fees with Statute– Technology and Medical Communications– Acute Psychiatric Hospitals– Adoption of ASHRAE 170

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Subsequent Actions/Comments Received

• CBC provisions – 1224.39 Outpatient Observation Units

• OSHPD withdrawal of the originally proposed provisions regarding outpatient observation units for further study

– 1228 Acute Psychiatric Hospital provisions • Positive comments received• Resulted in an additional 15 day change for two

clarifications to the original proposal.

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Subsequent Actions/Comments Received

• CMC provisions– Integrated previously adopted California provisions

into the newly adopted model code - ASHRAE 170. – Majority of comments, while numerous, were on

previously adopted and substantiated language solely brought forward and reformatted into ASHRAE 170 including the ventilation table.

• These comments are considered "outside of the rule making” and resulted in no change to the original proposal

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Outpatient Observation Unit

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1253.7. (a) For purposes of this chapter, “observation services” means outpatient services provided by a general acute care hospital and that have been ordered by a provider, to those patients who have unstable or uncertain conditions potentially serious enough to warrant close observation, but not so serious as to warrant inpatient admission to the hospital.

Outpatient Observation Unit• Original Proposed Language - Withdrawn

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✔✔

These requirements fall under the 2016 CBC section:

1224.33 EMERGENCY SERVICES

- 1224.33.5 Other Space Considerations

- 1224.3.5.1 Observation Units

Outpatient Observation Unit• Original Proposed Language – Referenced Requirements

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1224.33.5 Other space considerations.1224.33.5.1 Observation units. Observation rooms for the monitoring of patients up to 24 hours may be provided as a distinct unit within the emergency department. If provided the unit shall have the following:

1. Handwashing stations shall be provided in each patient room or for each four treatment stations or major fraction thereof

2. Each patient station shall have a minimum of 120 square feet (11.15 m2) of clear floor area

3. One toilet room shall be provided for each six treatment stations or major fraction thereof

4. An administrative center/nurse station

5. A nourishment area

Outpatient Observation Unit• SB 1076 Intent

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Definition and Purpose:• SB 1076 defines “observation services” as “outpatient services… to those

patient who have unstable or uncertain conditions potentially serious enough to warrant close observation, but not so serious as to warrant inpatient admission to the hospital.”

• Observed acuity should be less than what would be readily apparent for immediate inpatient admission.

Potential Use: Patient Type 1 - New patient:

o Outpatient Observation only (with no admission)o Outpatient Pre-Admission

Patient Type 2 - Existing patient:o Outpatient Post-Discharge

Outpatient Observation Unit• SB 1076 Intent

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Required Services – may include the use of:• A bed

• Monitoring by nursing and other staff

• Any other services that are reasonable and necessary to safely evaluate a patient’s condition or determine the need for a possible inpatient admission to the hospital

Question:

What is implied by “reasonable and necessary” for patients currently at an outpatient status with the potential for inpatient admission?

Outpatient Observation Unit• SB 1076 Intent

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Analysis - Patient Station: 1988 - 2001 CBC 2016 CBC(effective thru 12/31/2006)

Nursing Unit

Single Patient Room 110 sf 120 sf(3 feet clear @ sides

and foot of bed)(3 feet clear @ sides and

foot of bed)

Mullti-Patient Room 80 sf / bed 100 sf / bed(3 feet clear between

beds & 4 feet @ foot of bed)

(3 feet clear between beds & 4 feet @ foot of

bed)

Emergency Services

Treatment Room 80 sf 120 sf single or 80 sf/multi-gurney

(the least dimension shall be 8')

(3 feet clear @ sides and foot of bed/gurney)

Observation Room No Stated Size 120 sf

Outpatient Observation Unit• Proposed Language Revisions

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Patient Care Space:120 sf per patient 110 sf single or 80 sf multiple patients

Negative Pressure Isolation:Optional patient isolation provisions defined

Time Limitation:Reference to 24 hour maximum not included

Location:Corridor systems shall connect unit to all Basic and Supplemental Services

Utility Services Infrastructure:Nurse call, emergency power, and portable oxygen

Outpatient Observation Unit• Proposed Language Revisions

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Defined Service Areas to Support a Stand-Alone Unit:• Supervisor Office

• Staff Toilet(s)

• Multipurpose Room(s)o Conferenceso Reportso Trainingo Consultation

• Examination or Treatment Rooms

• Medication Stations

• Nourishment Areas and Ice Machine(s)

• Clean and Soiled Utility Support Spaces

• General and Emergency Equipment Storage / Gurney & Wheelchair Storage

Next Steps

• Next Steps

Client Review

Comment Period

PIN Development

HBSB Committee

CBSC Adoption

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