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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
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In Case You Haven’t Heard
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We’ve Moved!Approved as noted
Facilities Development DivisionCalifornia’s Building Department for Hospitals
Plan Review and Field Performance Update
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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
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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
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$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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