tahfm seminar september 20, 2019tahfm seminar september 20, 2019 topics Ø updating the regulations...

Rebecca ReadChad Kursinsky

Health and Human Services Commission

TAHFM Seminar September 20, 2019

Topics

Ø Updating the Regulations

Ø Electronic Submission of Documents

Ø Useful Tips

Topics – Regulations

Topics – Regulations

Topic: Electronic Document

Topics: Fire Alarm

ARU Jurisdiction

Ø Hospitals

Ø 643 Hospitals in TexasØIn 2001, Texas licensed 519 HospitalsØIn 2010, Texas licensed 625 Hospitals

ARU Jurisdiction

Ø Psychiatric Hospitals

Ø 57 Psychiatric Hospitals in TexasØIn 2001, Texas licensed 28 Psychiatric Hospitals ØIn 2010, Texas licensed 35 Psychiatric Hospitals

ARU Jurisdiction

Ø Crisis Stabilization Units (CSU)

Ø 3 CSU in TexasØIn 2010, Texas licensed 3 CSU

ARU Jurisdiction

Ø Ambulatory Surgical Centers (ASC)

Ø 525 ASC in TexasØIn 2001, Texas licensed 217 ASCØIn 2010, Texas licensed 403 ASC

ARU Jurisdiction

Ø End Stage Renal Disease Facilities (ESRD)

Ø 755 ESRD in TexasØIn 2001, Texas licensed 283 ESRDØIn 2010, Texas licensed 504 ESRD

ARU Jurisdiction

Ø Freestanding Emergency Medical Care Facilities (FEMC)

Ø 209 FEMC in TexasØIn 2010, Texas licensed 19 FEMC

ARU Jurisdiction

Ø Special Care Facilities (SCF)

Ø 11 SCF in TexasØIn 2010, Texas had 13 SCFØIn 2002, Texas licensed 8 SCF

Updating the Regulations

Ø Adopting 2018 edition of FGI, with amendments and new sections

Ø Adopting 2018 edition of NFPA 101: Life Safety Code (LSC)

Ø Adopting 2018 edition of NFPA 99: Health Care Facilities Code (HCFC)

Ø Adopting 2017 ANSI/ASHRAE/ASHE 170: Ventilation of Health Care Facilities

Adopting 2018 edition of FGI

Ø Estimated adoption date summer 2020

Ø Open commentary period

Ø Submittal grace period

Ø Contract construction drawings period

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What AmendmentsØ Hot Topics or the Webpage

Ø A dedicated email and phone number for inquiries

Updating the Regulations

Reminder – Still under current rules until the adoption

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Risk AssessmentØ Risk Assessment. Replace Safety Risk

Assessment with Functional Program

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What AmendmentsØ Risk Assessment. Replace Safety Risk

Assessment with Functional Program

Ø Phasing of a project

Ø Site locations

Ø Accommodations for care of patients of size

Ø Types of invasive and non-invasive procedures

Ø Food services

Ø Air-borne isolation accommodations

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What AmendmentsØ Risk Assessment. Replace Safety Risk

Assessment with Functional Program

Ø Mental Health accommodations

Ø Mobile unit usage

Ø Smoke evacuation process for anesthesia locations

Ø Emergency power system in ESRD

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What AmendmentsØ Codes on opening a facility

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What AmendmentsØ Codes on re-opening a closed facility

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What AmendmentsØ Codes on construction in existing facility

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What AmendmentsØ Codes on construction in existing facility

Reminders

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Topics: Fire Alarm

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Fire Alarm Systems

Ø Conventional- Analog

Ø Digital- Addressable

Ø NFPA 72

Ø NAC- Notification Appliance Circuit

Ø Alarm System Monitoring

Ø Fire Alarm system requirements

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Site QuestionsØ Fire Alarm Panel Type

Ø Conventional- Analog outdated fire alarm system, notifications made difficult, accessibility virtually impossible

Ø Fire Department ease of use, effective ability to determine location of problem, or location of fire if smoke is limited from the exterior of building.

Ø Decades old technology, can not effectively handle and maintain large high rises, or structures of large square footage

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Fire Alarm Panel Example

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Site QuestionsØ To much ground area to cover Ø Inadequate responses to the wrong areas Ø Lack of InformationØ Virtually impossible to find a ground faultØ Typically it could be 110v or 220Ø Easily compromised Ø Testing made difficult Ø To easy to fix small problems that can create

larger problemsØ Obsolete for code requirementsØ Difficulty tying other fire alarm functions to the

panel

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Analog Fire Alarm System

Ø AlarmØ Trouble

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Site QuestionsØ How do we minimize confusion at a true fire

emergency?

Ø How do we educate the general public?

Ø How do we teach facilities personal on the operation of their individual system?

Ø How do we educate first responders?

Ø What does NFPA 72 tell us?

Ø What is an effective way to protect our customers?

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Site QuestionsØ Digital/ Addressable/Intelligent Fire Alarm

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Site QuestionsUser Friendly

Ø Pin Point accuracy on a true fire emergencyØ Fire Department Response time cut in halfØ Educating customers and staff made easy

and user friendlyØ Low Voltage 24 voltsØ Building Personal response times also cut in

halfØ Service Technicians repairs made easierØ Isolation of a problem not affecting the fire

alarm system as a wholeØ Performance and ability literally x1000

greater

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Equipment ReplacementSystem component parts

Ø Easily program devices not designed from the fire alarm panel manufacturer

Ø Repairs take minutes, rather then hours

Ø Programming can be done at the panel at the customers location

Ø Some non proprietary systems will allow you to tie different fire alarm manufacturer panels to one dedicated location

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Fire Alarm Monitoring

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Monitoring OptionsNFPA 72 Options for types of monitoring Ø AuxiliaryNFPA 72

Ø RemoteNFPA 72 3.3.267.3

Ø ProprietaryNFPA 72 3.3.267.2

Ø Central Station NFPA 3.3.267.1

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Auxiliary Monitoring RequirementsØ Auxiliary station alarm systems are

connected from the protected premises through a fire alarm box that interfaces with municipal circuits or with the municipal city

Ø Only used on the East coast

Ø Dedicated Alarm box number for response

Ø Directly tied to Fire Department

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Remote Monitoring RequirementsØ The use of a system included the protected

premises fire alarm system in which the operation of circuits and devices are signaled to and recorded in and supervised from a supervising station that has competent and experienced operators who upon receipt of the signal take such action as required in code

Ø Location is exclusively off site of the property

Ø Not directly tied to the fire department, a phone call or dispatch system must take place for Fire Department response

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Proprietary Monitoring RequirementsØ The use of a system or group of systems in

which thee operations of circuits and devices are signaled too and recorded in and supervised under the same ownership as the protected line property

Ø All fire alarm monitoring is done on siteØ Verify specific rules and guidelines must be

followed to allow this type to exist Ø Usually decided and allowed by the AHJ Ø Mandatory requirement of competent personal

on site 24/7,365Ø Expand fire alarm system required with remote

annunciator's

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Central Station Monitoring RequirementsØ Protected premises fire alarm system ad

circuits are signaled, recorded and supervised at an off site central monitoring location, typically a company’s sole purpose is fire alarm and security monitoring

Ø Most common type of fire alarm monitoring

Ø Most AHJ requires this type of monitoring

Ø Signals are received then emergency services are contacted by on duty monitoring personal

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Monitoring Devices RequirementsØ Phone Line, and a back up secondary phone lineØ Physical phone is not needed, phone line is fed

from phone line connections are fed to an onsite built in dialer. Phone lines must be dedicated exclusively for fire alarm system.

Ø Cellular phone back up system Ø UL FM listed wireless communicator Ø Power supply panels on site, feed power to

necessary alarm devices and fire alarm equipment.

Ø Typically monitoring company will contact protected property when trouble signals are received.

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Architectural ReviewRequirementsØ ARU requires health care facilities to have

fire alarm system monitored by an off site, 3rd party central monitoring line station

Ø Life safety code survey’s signals are tested by State inspector and verified that the 3rd

party received the signals, and verification needed for exact signals received

Ø ARU Inspections of constructed or renovated health care facilities also test fire alarm signals received at the 3rd party central monitoring station

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Alternative Optional Devices

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Pros and Cons to Alternates

Ø The need for phone lines is eliminated, cost savings is in the thousands

Ø Only direct cost is a one time purchase of the communicator

Ø UL/FM listed device that is compatible with most addressable digital fire alarm systems

Ø Installation only takes minutes

Ø As it says in the name it a wireless device with only a single connection to fire alarm panel

Ø Can also be used as a back up device for monitoring in case phone line failures

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Pros and Cons to Alternate

Ø Must have it located in a good area that has plenty of signal

Ø Signal does go in and out

Ø Not widely accepted by all AHJ’S

Ø New to market in the last 5 years

Ø Does replace cellular connection

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NFPA 25 Fire Sprinkler SystemNFPA 25 13.3.1.3

Ø Each normally open control valve shall be secured by means of a seal or locked or shall be electronically monitored.

Ø What the code is saying is lock and chain your control valves or install a UL/FM listed tamper switch on your control valves.

Ø Cost of lock and chain

Ø Who currently has access?

Ø Things to consider

In Conclusion

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Holiday Inn Fire – Farmington Hills, MI

Electronic Submission

Electronic Submissions

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General MailboxØ Inquiries: AskARU@hhsc.state.tx.us

Ø 512-834-6649

Ø Application: ApplicationARU@hhsc.state.tx.usØ Minor: 512-834-4579Ø Major: 512-834-4599

Ø Inspection: InspectionARU@hhsc.state.tx.usØ 512-834-4598

Ø POC: AskARU@hhsc.state.tx.usØ 512-834-6649

Ø Surveys: LifeSafetyARU@hhsc.state.tx.usØ 512-834-4577

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Email MailboxØ Inquiries: AskARU@hhsc.state.tx.usØ Subject line: Question regarding <enter question brief description>

Ø Application: ApplicationARU@hhsc.state.tx.usØ Subject line: Minor Application Package; <enter address of facility>

Major Application Package; <enter address of facility>

Ø Inspection: InspectionARU@hhsc.state.tx.usØ Subject line: Inspection: App # <enter application no.>

Ø POC: AskARU@hhsc.state.tx.usØ Subject line: POC: App # <enter app #> for <Inspector name >

Ø Only submit one POC per each inspection date, do not combine POC's into one email.

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Traditional Mailing

Ø Mailing Address: (USPS or overnight service or delivery)ØWhere a fee is required, the preferred method is email first, then mail check & Inspection Form

HHSCThe Exchange BuildingArchitectural Review UnitMail code 28358407 Wall StreetAustin TX 78754

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SubmittalsStakeholders must submit an application package to ARU for state approval to begin any of the following projects

Ø Remodeling

Ø Renovations

Ø Additions

Ø Alterations

Ø Change of Service

Ø Change of Function (including licensed bed /

ESRD Station Change)

Ø Reopening of a closed facility

Ø Any initial construction

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SubmittalsØ Visit the ARU Web Site and get the Application

Form, regulations, and hot topics, located at:

or search “TX HHSC Architectural Review

https://hhs.texas.gov/doing-business-hhs/provider-portals/health-care-facilities-regulation/architectural-review

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SubmittalsØ Pre-conference surveys will be removed.Ø Major was formerly known as “self-certification”Ø List of examples of submittal types on website

3 Types of Applications

Major Projects

Minor Projects

Fast Track Projects

Generator or HVAC replacement

Replacement of automatic transfer switches for essential electrical system

Any alarm systems, including nurse call systems

Pharmacy 800

Change of licensed bed (minimal wall movement)

Replacing kitchen equipment, including walk-in refrigerator/freezer

Minor Projects

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Submittals

Minor Projects

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Generator replacement

Infill of s shelled space

Relocated emergency room

HVAC unit replacement

Change of licensed bed (minimal wall movement)

Replacing kitchen equipment, including walk-in refrigerator/freezer

Major Projects

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Submittals

Major Projects

New Hospital (8 or more stories)

Hospital addition (8 or more stories)

Must have ARU approval for fast track application

Only applies to Hospitals

Include self-certification (part of the application)

Optional plan review

Fast Track

Projects

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Submittals

Fast Track Projects

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SubmittalsØ Application Form, FM ARU-01 (fillable pdf)

Ø Application Package Instructions, ARU-21

Ø Inspection Instructions, ARU-22

Ø Project Closeout Instructions, ARU-25

https://hhs.texas.gov/doing-business-hhs/provider-portals/health-care-facilities-regulation/architectural-review

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Fees

Major/Fast Track application for Hospital & Crisis Stabilization & Special Care Facility

Any Inspection at a Hospital(minor or major)

Application Fee

$100,000 or less $300.00$100,001 $600,000 $850.00$600,001 $2,000,000 $2,000.00$2,000,001 $5,000,000 $3,000.00$5,000,001 $10,000,000 $4,000.00$10,000,001 and over $5,000.00

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HHSC cares about Stakeholders

HHSC cares about Patients

Thank you

Health and Human Services CommissionArchitectural Review Unit

TAHFM Seminar September 20, 2019