1. Facilities Development Division California’s Building Department for Hospitals
Paul A. Coleman, Architect, Deputy Director
Chris Tokas, S.E., Deputy Division Chief
Gordon Oakley, Fire Marshal, Deputy Division Chief
Roy Lobo, Ph.D., S.E., Principal Structural Engineer
Glenn Gall, Supervisor, Building Standards Unit
Nanci Timmins, Fire Marshal, Chief Fire Life Safety Officer
California Healthcare Association
August 8, 2017

2. In Case You Haven’t Heard
We’ve Moved!
Approved as noted

3. Plan Review and Field Performance Update
Facilities Development Division California’s Building Department for Hospitals
Plan Review and Field Performance Update

4. Workload Summary/Performance

5. No. of Reviews Year 2016
65%
35%
≈ 59 reviews/day

6. Project Plan Review Data Analysis 2st Qtr. 2017
68% of the Plan Reviews are completed w/in 21 days or less
92% of the PAD Reviews are completed w/in 21 days or less
Or 40% of Office Plan Approval
Reviews
62%
35%
S=552 or 14% of All Projects
≈ 62 reviews/day

7. Number of Permits – 4th Qtr. 2010 thru 2nd Qtr. 2017
Statewide combined Office and Field Number of Permits Issued by Quarter
724
582
With SB 1838 Permits
Without SB 1838 Permits

8. Workload in Construction Values for projects in Construction - % Completion
65%
26% 8%
66%
28% 9%
(1st Qtr Numbers)

9. Number of SB 1838 Projects – 2nd Qtr. 2017
Statewide Number of SB 1838 EXEMPT Projects Approved by Quarter
113 40

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

11. Seismic Compliance Update
Facilities Development Division California’s Building Department for Hospitals
Seismic Compliance Update

12. 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 construction
For SPC - "Not Assigned" is for non-building structures such as equipment yards, cooling towers etc that are still under construction

13. Hospital Seismic Compliance to Date
217
7/28/17
1096 Buildings 83.5%
< 2½ years left

14. Nonstructural Performance Categories
***Includes buildings under construction, tunnels and equipment yards
For NPC - "Not Assigned" are for buildings and nonbuilding structures either under construction or where the nonstructural performance category has not been verified

15. 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

16. Project Closure and Invoicing
Facilities Development Division California’s Building Department for Hospitals
Project Closure and Invoicing

17. Projects Awaiting Final Client Cost
Projects Awaiting Final Costs from Clients; Number of Projects by OSHPD Region
No. of Projects
5 Month Trend
Projects waiting for final client costs
The distribution of projects in the time waiting stays relatively consistent.

18. Projects Awaiting Final Client Cost
$ Value
5 Month Trend
As higher value projects move into the closure process, the time segments expand and contract as well as the duration of time spent in each time period.

19. Status of Accounts Receivable
No. of Open Invoices
The total number of outstanding invoices starting 7/1 and ending in 8/1 jumped 16%.

20. Status of Accounts Receivable
$ Value 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

21. FDD Income and Expenses

22. FDD Income and Expenses

23. FDD Expenditures FY 2016/17

24. Facilities Development Division California’s Building Department for Hospitals
eServices

25. eServices Update
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:

26. eServices Update 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

27. eServices Update Automated Letters
For projects approved in the field, plan approval letters recognize whether the plan was electronic or paper and populates correct processing instructions.

28. eServices Update 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 ed to clients.

29. Project & Child Documents Report
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.

30. Project & Child Documents Report
The report identifies the records where documents have been uploaded to avoid looking on records where no documents exist.

31. Project & Child Documents Report
Expanding the Record ID lists all documents that have been uploaded to the Attachments section of the record.

32. Project & Child Documents Report
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.

33. Project & Child Documents Report
This report is currently available in the OSHPD Report Center.

34. Project List by Region, County, Facility Report
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.

35. Project List by Region, County, Facility Report
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.

36. eCPR
Auto Codes e

37. eCPR 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

38. eCPR
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 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.

39. eCPR
Acceptance or denial of the appeal is documented with an 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.

40. eCPR
Example of CPR Results Letter

41. eServices Update Next steps:
Field Operations improvements & enhancements
ePC improvements
Updated rendering engine
Ability to render-on-demand to create overlay pages for backcheck reviews

42. Tableau Reports – Report Card

43. Tableau Reports – Timely Review

44. Tableau – Timely Traige

45. Tableau – Workload Analysis by Regions

46. Tableau – Workload Analysis by Counties

47. Educational Opportunities
Facilities Development Division California’s Building Department for Hospitals
Educational Opportunities

48. Webinars 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

49. Webinar on Sterile Compounding Pharmacies
# of connections = 231
# of participants =

50. Webinar on 2016 CBSC Fire and Life Safety Provisions
# of connections = 80
# of participants =

51. Webinar on 2016 CBSC Administrative, Architectural, MEP Systems and Pharmacy Provisions
# of connections = 78
# of participants =

52. Webinar on 2016 CBSC Structural Provisions
# of connections = 76
# of participants =

53. 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

54. Upcoming Webinars/Seminars

55. Facilities Development Division California’s Building Department for Hospitals
Other Stuff

56. FDD’s Top 3 Objectives for 2017
Expand Electronic Plan Review
Reevaluate FDD’s Plan Review Performance Goals
Develop an IOR Trainee/Apprentice Program

57. HBSB Stuff
DATE
MEETING
August 9, 2017
Technology Committee
August 23, 2017
Energy Conservation and Management Committee
September 14, 2017
Administrative Processes, Code Changes and Standard Details Committee
October 12, 2017

58. California Building Standards Code Changes

59. 2019 CBC Structural Regulations
Started preparing for the 2019 Code Adoption process
ASCE 7-16, TMS-402/602-16, AISC-360/ are all published
IBC 2018 slated for publication September, 2017
ASCE 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

60. 2016 Intervening Code Adoption Cycle
Facilities Development Division California’s Building Department for Hospitals
2016 Intervening Code Adoption Cycle

61. California Building Code Changes× ×
6/20/17
8/14/17

62. California Building Code Changes

63. 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

64. Subsequent Actions/Comments Received
CBC provisions
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. 
Of note on this item, the proposals for change to ASHRAE 170 for reduced ventilation rates for 100% outside air systems (CMC allowance) was rejected by the 170 committee. CMS directly references compliance with 170. This will likely be subject to future rule making. 

65. 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

66. Outpatient Observation Unit
(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.

67. Outpatient Observation Unit
Original Proposed Language - Withdrawn ✔ ✔
These requirements fall under the 2016 CBC section:
EMERGENCY SERVICES
Other Space Considerations
Observation Units

68. Outpatient Observation Unit
Original Proposed Language – Referenced Requirements
Other space considerations.
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:
Handwashing stations shall be provided in each patient room or for each four treatment stations or major fraction thereof
Each patient station shall have a minimum of 120 square feet (11.15 m2) of clear floor area
One toilet room shall be provided for each six treatment stations or major fraction thereof
An administrative center/nurse station
A nourishment area ✔ ✔ ✔ ✔

69. Outpatient Observation Unit
SB 1076 Intent
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:
Outpatient Observation only (with no admission)
Outpatient Pre-Admission
Patient Type 2 - Existing patient:
Outpatient Post-Discharge

70. Outpatient Observation Unit
SB 1076 Intent
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? 

71. Outpatient Observation Unit
SB 1076 Intent
Analysis - Patient Station:
CBC
2016 CBC
(effective thru 12/31/2006)
Nursing Unit
Single Patient Room
110 sf
120 sf
(3 feet sides and foot of bed)
Mullti-Patient Room
80 sf / bed
100 sf / bed
(3 feet clear between beds & 4 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 sides and foot of bed/gurney)
Observation Room
No Stated Size

72. Outpatient Observation Unit
Proposed Language Revisions
Patient Care Space:
120 sf per patient 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

73. Outpatient Observation Unit
Proposed Language Revisions
Defined Service Areas to Support a Stand-Alone Unit:
Supervisor Office
Staff Toilet(s)
Multipurpose Room(s)
Conferences
Reports
Training
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

74. Next Steps Next Steps Client Review Comment Period PIN Development
HBSB Committee
CBSC Adoption