The Agency proposes to revise rules related to fire control, construction plans submission and fee requirements and physical plant requirements for ambulatory surgical centers, to conform to current statutory requirements.

 

AGENCY FOR HEALTH CARE ADMINISTRATION

Health Facility and Agency Licensing

RULE NOS.:RULE TITLES:

59A-5.021Plans Submission and Fee Requirements

59A-5.022Physical Plant Requirements for Ambulatory Surgical Centers

PURPOSE AND EFFECT: The Agency proposes to revise rules related to fire control, construction plans submission and fee requirements and physical plant requirements for ambulatory surgical centers, to conform to current statutory requirements.

SUMMARY: This rule revision will revise or repeal existing rules to conform to the current Florida Building Code and Florida Fire Prevention Code.

SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COSTS AND LEGISLATIVE RATIFICATION: The Agency has determined that this will not have an adverse impact on small business or likely increase directly or indirectly regulatory costs in excess of $200,000 in the aggregate within one year after the implementation of the rule. A SERC has not been prepared by the Agency.

The Agency has determined that the proposed rule is not expected to require legislative ratification based on the statement of estimated regulatory costs or if no SERC is required, the information expressly relied upon and described herein: A SERC has not been prepared by the agency. For Rules 59A-5.021 and 59A-5.022, F.A.C., a checklist was prepared to determine the need for a SERC. Based on this information at the time of the analysis and pursuant to Section 120.541, F.S., the rule will not require legislative ratification.

Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.

RULEMAKING AUTHORITY: 395.1055 FS.

LAW IMPLEMENTED: 395.0163 FS.

IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW:

DATE AND TIME: March 5, 2015, 2:00p.m. – 3:00p.m.

PLACE: Agency for Health Care Administration, Ft. Knox Bldg. 3, Conference Room C, 2727 Mahan Drive, Tallahassee, FL 32308

Pursuant to the provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate in this workshop/meeting is asked to advise the agency at least 7 days before the workshop/meeting by contacting: Scott Waltz, Bureau of Plans and Construction, 2727 Mahan Drive, MS #24, Tallahassee, FL 32308 or [phone]. If you are hearing or speech impaired, please contact the agency using the Florida Relay Service, 1(800)955-8771 (TDD) or 1(800)955-8770 (Voice).

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Scott Waltz, Bureau of Plans and Construction, 2727 Mahan Drive, MS #24, Tallahassee, FL 32308 or [phone]

 

THE FULL TEXT OF THE PROPOSED RULE IS:

 

(Substantial rewording of Rule 59A-5.021 follows. See Florida Administrative Code for present text.)

59A-5.021 Plans Submission and Fee Requirements.

(1) No construction work, including demolition, shall be started until prior written approval has been given by the Office of Plans and Construction. This includes all construction of new facilities and any and all additions, modifications, renovations, or refurbishment of the site, building, equipment or systems of all existing facilities.

(2)Approval to start construction limited to demolition, site work, foundation, and building structural frame may be obtained prior to construction document approval when the following is submitted for review and approval:

(a) Preliminary Stage II approval letter from the Office of Plans and Construction.

(b) Construction documents, specifications and construction details for all work to be undertaken.

(c) A letter from the facility holding the agency harmless for any changes that may occur to the project as a result of the final construction document review.

(d) An infection control risk assessment (IRCA) and a life safety plan indicating temporary egress and detailed phasing plans indicating how the area(s) to be demolished or constructed is to be separated from all occupied areas shall be submitted for review and approval when demolition or construction in and around occupied buildings is to be undertaken, 

(3) Projects which have not received approval to begin construction will be considered abandoned following 12 months of inactivity and the project will be terminated. Construction must commence within 12 months of receiving approval from the Office of Plans and Construction to begin construction. Once construction begins construction activities should be continuous until the completion of the project. Failure to commence construction within 12 months of plan approval or periods of construction inactivity exceeding 12 months following commencement of construction will result in termination of the project. Restarting a terminated project will require resubmission of the construction documents accompanied by a new plan review application and will be subject to all fees prescribed by Section 395.0163, F.S

(4) When construction is planned, either for new buildings or additions, alterations or renovations to existing buildings, the plans and specifications shall be prepared and submitted to the Office of Plans and Construction for approval by the appropriate Florida-registered design professionals as required by the Florida Building Code, Chapter 471, Florida Statutes and Chapter 481, Florida Statutes. All architecture or engineering firms not practicing as a sole proprietor shall also be registered as an architecture or engineering firm with the Florida Department of Business and Professional Regulation.

(5) The initial submission of plans to the Office of Plans and Construction for any new project shall include a completed Application for Plan Review, AHCA Form 3500-0011, June 2014, incorporated by reference and available at http://www.flrules.org/Gateway/reference.asp?No=Ref-XXXXX , and a valid Certificate of Need if required by the agency. This information shall accompany the initial submission, and approval will not be granted for any project without a certificate of need if required by the agency. Applications for Plan Review are available from the Agency for Health Care Administration, Office of Plans and Construction, 2727 Mahan Drive, Mail Stop 24, Tallahassee, Florida 32308, or at the web address at: http://ahca.myflorida.com/MCHQ/PlansandConstruction.shtml.

(6) Plans and specifications submitted for review shall be subject to plan review fees prescribed by Section 395.0163, F.S. All fees shall be payable to the Agency for Health Care Administration and shall annotate the Office of Plans and Construction and the facility log number. Fees are not refundable.

(7) Plans and specifications may be submitted for review at any of the three stages of development described in this rule. Approval of a Stage III submission is required to begin construction.  Limited early construction may be permitted for projects with an approved Stage II submission, submission of construction documents limited to the scope of work for early construction, and a letter from the facility holding the Agency for Health Care Administration harmless for any changes required as a result of the final construction document review.

(8) For each stage of submission, a program or scope of work shall be submitted. It shall consist of a detailed written description of all contemplated work and any required phasing and shall identify the types of medical services to be provided.

(9) For projects involving only equipment changes or system renovations, only Stage III, construction documents may be submitted. These documents shall include the following:

(a) Life safety plans showing the fire/smoke compartments in the area of renovation.

(b) Detailed phasing plans indicating how the new work will be separated from all occupied areas.

(c) Engineering plans and specifications for all of the required work.

(10) Stage I, Schematic Plans. 

(a) At a minimum, the following shall be incorporated into the schematic plans:

1. Single-line drawings of each floor that indicates the relationship of the various activities or services to each other and the room arrangement in each.

2. The function of each room or space shall be noted in or near the room or space.

3. The proposed roads and walkways, service and entrance courts, parking, and orientation shown on either a small plot plan or on the first floor plan.

4. A simple cross-section diagram showing the anticipated construction.

5. A schematic life safety plan showing smoke and fire compartments, exits, exit passageways and gross areas of required smoke and fire compartments.

6. Indicate which areas are sprinklered, both new and existing.

(b) If the proposed construction is an addition or is otherwise related to existing buildings on the site, the schematic plans shall show the facilities and general arrangement of those buildings.

(c)  If the project involves increasing, decreasing, relocating or transferring licensed beds, a schedule showing the total number of beds, types of bedrooms and types of ancillary spaces must be provided.

(11) Stage II, Preliminary Plans.

At a minimum, the following shall be incorporated into the preliminary plans.

(a) A Vicinity Map. For new ambulatory surgery center construction, provide a vicinity map showing the major local highway intersections.

(b) Site Development Plans.

(c) Plans depicting existing grades and proposed improvements.

(d Building locating dimensions.

(e) Location of the fire protection services water source to the building.

(f) Architectural Plans.

1. Floor plans, 1/8-inch scale minimum, showing door swings, windows, case work and mill work, fixed equipment and plumbing fixtures. Indicate the function of each space.

2. Typical large-scale interior and exterior wall sections to include typical rated fire and fire/smoke partitions and a typical corridor partition.

3. All exterior building elevations.

(g) Equipment which is not included in the construction contract that requires mechanical or electrical service connections or construction modifications shall be identified to assure coordination with the architectural, mechanical and electrical phases of construction.

(h) If the project is located in an occupied facility, preliminary phasing plans indicating how the project is to be separated from all occupied areas.

(i) Life Safety Plans.

1. Life safety plans must include the following:

a. Single-sheet floor plans depicting required fire and smoke compartmentation, all means of egress and all exit signs. If smoke compartmentation is required, depict and provide the dimension for the longest path of travel in each smoke compartment to the door(s) accessing the nearest adjoining smoke compartment, calculate the total area of the smoke compartment in square feet, and tabulate exit inches.

b. All sprinklered areas.

c. All fire extinguishers.

d. All fire alarm devices and pull station locations.

2. If the project is an addition, or conversion of an existing building, fully developed life safety plans must be submitted.

3. If the project is a renovation in an existing building, life safety plans of the floor being renovated and the required exit egress floor(s) must be submitted.

4. When demolition or construction in and around occupied buildings will be undertaken, a life safety plan indicating temporary egress, and detailed phasing plans indicating how the area(s) to be demolished or constructed will be separated from all occupied areas must be submitted.

(j) Mechanical Engineering Plans.

1. Single-sheet floor plans with a one-line diagram of the ventilating system with relative pressures of each space. Provide a written description and drawings of the anticipated smoke control system, passive or active, and a sequence of operation correlated with the life safety plans.

2. The general location of all fire and smoke dampers, all duct smoke detectors and fire stats.

3. If the building is equipped with fire sprinklers, indicate the location of the sprinkler system risers and the point of connection for the fire sprinkler system. State the method of design for the existing and new fire sprinkler systems.

4. The locations of all plumbing fixtures and other items of equipment requiring plumbing services and/or gas services.

5. The locations of any fume, radiological or chemical hoods.

6. The locations of all medical gas outlets, piping distribution risers, terminals, alarm panel(s), low pressure emergency oxygen connection, isolation/zone valve(s), and gas source location(s).

7. The locations and relative size of major items of mechanical equipment such as chillers, air handling units, fire pumps, medical gas storage, boilers, vacuum pumps, air compressors and fuel storage vessels.

8. The locations of hazardous areas and the volume of products to be contained therein.

9. The location of fire pump, stand pipes, and sprinkler riser(s).

(k) Electrical Engineering Drawings. 

1. A one-line diagram of normal and essential electrical power systems showing service transformers and entrances, switchboards, transfer switches, distribution feeders and over-current devices, panel boards and step-down transformers. The diagram shall include a preliminary listing and description of new and existing, normal and emergency loads, preliminary estimates of available short-circuit current at all new equipment and existing equipment serving any new equipment, short-circuit and withstand ratings of existing equipment serving new loads and any new or revised grounding requirements.

2. Show fire alarm zones and correlate with the life safety plan.

(l) Outline Specifications. Outline specifications must include a general description of the construction, including construction classification and ratings of components, interior finishes, general types and locations of acoustical material, floor coverings, ventilating equipment, plumbing fixtures, fire protection equipment, medical gas equipment and electrical equipment.

(m) Whenever an existing building is to be converted to a health care facility, the general layout of spaces of the existing structure shall be submitted with the preliminary plans for the proposed facility.

(n) Whenever an addition, alteration, renovation or remodeling to an existing facility is proposed, the general layout of spaces of the existing facility shall be submitted with the preliminary plans.

(12) Stage III, Construction Documents.

The Stage III, construction documents shall be an extension of the Stage II, preliminary plan submission and shall provide a complete description of the contemplated construction. Construction documents shall be signed, sealed and dated and submitted for written approval to the Office of Plans and Construction by a Florida-registered architect and Florida-registered professional engineer. These documents shall consist of work related to civil, structural, mechanical, and electrical engineering, fire protection, lightning protection, landscape architecture and all architectural work. At a minimum, and in addition to the requirements for Stage II submission, the following shall be incorporated into the construction documents:

(a) Site and civil engineering plans indicating building and site elevations, site utilities, paving plans, grading and drainage plans and details, locations of the two fire hydrants utilized to perform the water supply flow test, and landscaping plans.

(b) Life safety plans for the entire project.  Projects located on floors above or below the exit discharge level must also include life safety plans for the exit discharge serving the project area.

(c) Architectural Plans. 

1. Typical large-scale details of all typical interior and exterior walls and smoke walls, horizontal exits and exit passageways.

2. Comprehensive ceiling plans that show all utilities, lighting fixtures, smoke detectors, ventilation devices, sprinkler head locations and fire-rated ceiling suspension member locations where applicable.

3. Floor/ceiling and roof/ceiling assembly descriptions for all conditions.

4. Details and other instructions to the contractor on the construction documents describing the techniques to be used to seal floor construction penetrations necessary to prevent smoke migration from floor to floor during a fire.

(d) Structural engineering plans, schedules and details.

(e) Mechanical engineering plans including fire and smoke control plans. Show all items of owner furnished equipment requiring mechanical services. Provide a clear and concise narrative control sequence of operations for each item of mechanical equipment including but not limited to air conditioning, heating, ventilation, medical gas, plumbing, and fire protection and any interconnection of the equipment of the systems. Mechanical engineering drawings shall depict completely the systems to be utilized, whether new or existing, from the point of system origination to termination. Provide a tabular schedule giving the required air flow (as computed from the information contained on the ventilation rate table) in cubic feet per minute (cfm) for supply, return, exhaust, outdoor, and ventilation air for each space, as applicable, shown on the architectural documents. The schedule shall also contain the HVAC system design air flow rates and the resulting space relative pressures.  The schedule or portion of the schedule as applicable shall be placed on each floor plan drawing sheet containing the spaces depicted on the drawing.

(f) Fire protection system layout documents as defined in 61G15-32.002, F.A.C., where applicable, that shall include the existing system as necessary to define the new work. These documents shall be signed and sealed by a Florida-registered professional engineer.

(g) Electrical engineering plans describing complete power, lighting, alarm, communications and lightning protection systems and power system study.

(h) A power study that shall include a fault study complete with calculations to demonstrate that over-current devices, transfer switches, switchboards, panel boards, motor controls, transformers and feeders are adequately sized to safely withstand available phase-to-phase and phase-to-ground faults. The study shall also include an analysis of generator performance under fault conditions and a coordination study resulting in the tabulation of settings for all over-current device adjustable trips, time delays, relays and ground fault coordination. This must be provided for all new equipment and existing equipment serving any new equipment. Power studies for renovations of existing distribution systems shall include only new equipment and existing equipment upstream to the normal and emergency sources of the new equipment. Renovations involving only branch circuit panel boards without modifications to the feeder do not require a full power study; instead, the power study shall be limited to the calculation of new and existing loads of the branch circuit panel.

(13) A complete set of specifications for all work to be undertaken.

(a) All project required contractor supplied testing and/or certification reports shall be submitted in writing, on standard forms, reviewed and accepted by the Engineer of Record prior to presenting to the agency for review.

(b) The specifications shall require a performance verification test and balance air quantity values report for a minimum of two operating conditions for each air handling unit system. One operating condition shall be with the specified air filters installed in the minimum pressure drop or clean state. The second operating condition is to be at the maximum pressure drop and/or dirty state. 

(14) All construction documents shall be well coordinated and phasing plans shall be clear and provide continuity of required services. In the case of additions to existing institutions, the mechanical and electrical, especially existing essential electrical systems and all other pertinent conditions shall be a part of this submission.

(a) All work described in subsequent addenda, change orders, field orders and other documents altering the above must be approved in writing by the Office of Plans and Construction prior to initiation.  Documents submitted for approval shall also be signed, sealed and dated.

(b) All submissions will be acted upon by the agency within 60 days of the receipt of properly executed construction documents and the initial payment of the plan review fee. The agency will either approve or disapprove the submission and shall provide a listing of deficiencies in writing. Each subsequent resubmission of documents for review on the project will initiate another 60-day response period.  All deficiencies noted by the agency must be satisfactorily corrected before final approval.

(15) Additions or revisions that substantially change the original scope of the project will be required to be submitted as a new project.

(16) Record Drawings. Within 60 days after final approval of the project has been obtained from the agency, the Office of Plans and Construction shall be provided with a complete set of legible record drawings showing all of the construction, fixed equipment and the mechanical and electrical systems as installed. These drawings shall include the life safety plans. Record drawings may be submitted electronically in Portable Document Format (PDF).  If record drawings are not received within this time frame specified in this section, only the construction document and project file will be retained.

Rulemaking Specific Authority 395.1055 FS. Law Implemented 395.001, 395.0163, 471.025, 481.221, 553.73, 633.033 FS. History–New 6-14-78, Formerly 10D-30.21, Amended 2-3-88, 5-6-92, Formerly 10D-30.021, Amended 11-12-96,                  .

 

(Substantial rewording of Rule 59A-5.022 follows. See Florida Administrative Code for present text.)

59A-5.022 Physical Plant Requirements for Ambulatory Surgical Centers.

(1) All construction of new ambulatory surgery centers and all construction of additions, alterations, refurbishing, renovations to and reconstruction of existing ambulatory surgery centers shall be in compliance with the following codes and standards:

(a) The building codes described in 61G20-1.001, F.A.C.;

(b) The fire codes described in Chapter 69A-60, F.A.C.;

(c) The handicap accessibility standards in Chapter 553, Part V, F.S., and 61G20-4.002, F.A.C;

(2) No building shall be converted to a licensed ambulatory surgery center unless it complies with the standards and codes set forth herein and with the physical plant standards set forth in the Florida Building Code, adopted pursuant to 61G20-4.002, F.A.C.

(3) Local codes which set more stringent standards or add additional requirements shall take precedence over these standards and requirements as set forth in this section. Contact the Office of Plans and Construction when conflicts occur.

(4) The fire safety evaluation system NFPA 101A Alternate Aproaches to Life Safety shall not be used as design criteria for new construction. The requirements of this rule are the minimum requirements.

Rulemaking Specific Authority 395.1055 FS. Law Implemented 395.1055 FS. History–New 6-14-78, Formerly 10D-30.22, Amended 2-3-88, Formerly 10D-30.022, Amended 6-11-97.

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Scott Waltz

NAME OF AGENCY HEAD WHO APPROVED THE PROPOSED RULE: Elizabeth Dudek, Secretary

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: December 10, 2014

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAR: September 18, 2014