02C.Lewiston App A.2-LDN.pdf

November 29, 2022

VA Leased CBOC Design Narrative

LEASED CBOC DESIGN NARRATIVE

TABLE OF CONTENTS

VA Leased CBOC Design Narrative November 29th, 2022

Table of Contents - Page 1

1. INTRODUCTION

2. GENERAL REQUIREMENTS

2.1 General

2.2 Codes

2.3 Standards

2.4 References

3. PLANNING AND DESIGN CRITERIA

3.1 Background

3.2 PACT Guiding Principles

3.3 Community Based Outpatient Clinics (CBOC) Planning Approach

3.4 Room Data Matrix

3.5 Surgical Design Criteria

4. TECHNICAL NARRATIVE

4.1 Site/Civil

4.1.1 Pedestrian and Vehicle Access & Circulation

4.1.2 Parking

4.1.3 Site Grading

4.2 Architecture

4.2.1 General Criteria

4.2.2 Accommodations for Care of Patients of Size

4.2.3 Acoustics

4.2.4 Equipment/Accessories/Furnishings

4.2.5 Signage and Wayfinding

4.2.6 Critical Dimensions

4.2.7 Entry Canopies

4.2.8 Elevators

4.2.9 Slab Depressions and Thickened Slabs

4.2.10 Millwork

4.2.11 Joint Sealant Systems

4.2.12 Doors and Frames

4.2.13 Hardware

4.2.14 Pharmacy Dispensing Windows

4.2.15 Radiation Shielding

4.2.16 Radio Frequency Shielding and Magnetic Shielding

4.3 Interior Design

4.3.1 General Criteria

4.3.2 Acoustic Ceiling Tile

4.3.3 Concrete Floor Treatment

4.3.4 Fiberglass-Reinforced Panels

4.3.5 Painting

4.3.6 Wall Protection

4.3.7 Window Shades

LEASED CBOC DESIGN NARRATIVE

TABLE OF CONTENTS

VA Leased CBOC Design Narrative

Table of Contents - Page 2

4.3.8 Privacy Curtains / Screens

4.3.9 Flooring, Carpet

4.4 Mechanical

4.4.1 References

4.4.2 HVAC Design Basis

4.4.3 Air Handling Units (AHUs)

4.4.4 Exhaust Systems

4.4.5 Cooling System

4.4.6 Hot Water Heating System

4.4.7 Humidification System

4.4.8 HVAC Piping Systems

4.4.9 Air Distribution and Duct Systems

4.4.10 HVAC Insulation Systems

4.4.11 Testing, Adjusting and Balancing

4.4.12 Automatic Temperature Control Systems

4.4.13 Special Conditions

4.5 Plumbing

4.5.1 References

4.5.2 Plumbing Design Basis

4.5.3 Materials

4.5.4 Medical Gases

4.5.5 Special Conditions

4.6 Electrical

4.6.1 Standby Generator

4.7 Lighting

4.7.1 General

4.7.2 Indoor Lighting Specifics

4.7.3 Lighting Controls

4.7.4 LED Drivers

4.7.5 Special Conditions

4.8 Telecommunications

4.8.1 Scope of Work

4.8.2 Pathways

4.8.3 Spaces

4.8.4 Telecommunications Bonding and Grounding

4.8.5 Equipment Racks and Equipment Cabinets

4.8.6 Power Distribution Units and Uninterruptable Power Supplies

4.8.7 Telecommunications Infrastructure Plant

4.8.8 Special Systems

5. Hardware Groups and Modifiers

SECTION 1

INTRODUCTION

Section 1 - Page 1

SECTION 1 - INTRODUCTION

1.1 The purpose of this Leased CBOC Design Narrative is to consolidate the governing codes, standards, references, and guidelines in a document that provides performance-based standards for a VA leased CBOC.

1.2 The governing codes, standards, and references are based on a VA affiliated outpatient clinic.

1.3 The design of the VA leased CBOC is based on the Prototype for Standardized Design and

Construction of Community Based Outpatient Clinics which is described in Part 3 Planning and Design Criteria.

1.4 Commonly Used Acronyms and Definitions:

PCMH Patient Centered Medical Home

A team based, comprehensive, coordinated patient care model (refer to PACT) PACT Patient Aligned Care Team

Provides service to veterans that is patient-centered with the right care at the right time by the right person. A typical “teamlet” serving a veteran consists of four caregivers: A Primary Care Provider – physician (MD), physician assistant (PA) or nurse practitioner (NP); a Registered Nurse (RN); a clinical staff assistant (LPN or Medical Assistant) and an administrative staff member (Clerk).

CBOC Community Based Outpatient Clinic Is VA-operated, VA-funded, or VA-reimbursed site of care which is located separate from a VA Medical Facility. A CBOC can provide primary, specialty, subspeciality, mental health, or any combination of healthcare delivery services that can be appropriately provided in an outpatient setting.

PFD Program for Design Net square feet (NSF) listing of all spaces and rooms that are to be included in a construction project.

VA Veterans Affairs VHA Veterans Health Administration VISN Veterans Integrated Services Network

SECTION 2

GENERAL REQUIREMENTS

VA Leased CBOC Design Narrative

Section 2 - Page 1

SECTION 2 – GENERAL REQUIREMENTS

2.1 General

2.1.1 The codes, standards, and references listed below indicate minimum performance requirements. Based on input from Owner representatives and recommendations from the architectural/engineering firm, minimum requirements or standards may be exceeded by site specific project design.

2.1.2 Compliance is required with applicable codes and standards throughout the process of design, construction, acceptance, and on-going maintenance of the facility.

2.1.3 Design and construction of the CBOC shall comply with the requirements of the GSA Form L100 Global Lease and the codes, standards, and references listed below. This Leased CBOC Design Narrative covers construction materials and standards not fully addressed by the codes, standards, and references below.

2.1.4 Use the most current edition at the date and time of bid submission.

2.1.4.1 Within 10 days of contract award, submit one full electronic copy of all applicable standards and codes intended for use in the project. As the design develops, furnish the lease COR with all standards and codes incorporated in the project. Design reviews may be delayed if this requirement isn’t met prior to design submissions.

2.2 Codes

2.2.1 All VA leased CBOC facilities are to conform to the most recent applicable codes, which include but is not limited to following:

2.2.1.1 National Fire Protection Association (NFPA) 70 National Electric Code, NFPA 75 Standard for the Fire Protection of Information Technology (applicable when CBOC contains a Data Center), NFPA 99 Health Care Facilities Code and all standards referenced therein, NFPA 101 Life Safety Code, NFPA 110 Standard for Emergency and Standby Power Systems, current editions.

2.2.1.2 Architectural Barriers Act Accessibility Standards (ABAAS), current edition.

2.2.1.3 International Building Codes (IBC): 2018 or latest edition (within 2 years of release). The latest edition shall be used for structural and seismic design.

2.2.1.3.1 International Building Code

2.2.1.3.2 International Energy Code

2.2.1.3.3 International Mechanical Code

2.2.1.3.4 International Plumbing Code

2.2.1.4 State and local codes as required by the local Authority Having Jurisdiction

(AHJ).

Additional Code information:

• For the Lessor to properly determine occupancy type, VA intends to simultaneously treat zero (0) patients at any given time who are incapable of self-preservation.

• Lessor will maintain utilities and equipment as prescribed by local codes and references listed. Lessor will provide a standard of maintenance and records of such maintenance in the format and frequency required by the VAMC to ensure site compliance with TJC (The Joint Commission). This shall include not only maintenance, but system testing in accordance with TJC and VA requirements such as: medical gas semiannual testing, annual and triennial load bank testing, quarterly fire sprinkler testing, monthly fire pump testing (if pump required), semiannual fire alarm testing, monthly and annual emergency lighting testing, MRI quench duct testing, etc. Lessor shall provide inspection reports within 15

VA Leased CBOC Design Narrative

Section 2 - Page 1 days of inspection. Inspection report shall be delivered electronically to the COR and CO.

2.3 Standards

2.3.1 All leased CBOC facilities are to conform to the following standards:

2.3.1.1 FGI Guidelines for the Design and Construction of Outpatient Facilities, current edition (referred to as FGI Guidelines herein).

2.3.1.2 The Joint Commission (TJC) accreditation standards apply to the facility under the affiliated VA medical center license. Building construction and on-going maintenance procedures shall meet TJC standards. Lessor shall provide and submit all documentation that is required for TJC requirements.

VA Leased CBOC Design Narrative

Section 2 - Page 2

2.3.1.3 Facility Security Level (FSL) shall be as outlined in GSA Form L100 Global Lease.

2.3.1.4 Sustainability standards shall be as outlined in GSA Form L100 Global Lease.

2.3.1.5 American Society of Heating, Refrigerating and Air-Conditioning Engineers

(ASHRAE) Standard 170, Ventilation of Health Care Facilities, current edition (referred to as ASHRAE 170 herein)

2.3.1.6 ASHRAE Standard 12, Minimizing the Risk of Legionellosis Associated with Building Water Systems, current edition.

2.3.1.7 ASHRAE Standard 188, Legionellosis: Risk Management for Building Water Systems, current edition.

2.3.1.8 ASHRAE Standard 62.1, Ventilation for Acceptable Indoor Air Quality, current edition (referred to as ASHRAE 62.1 herein)

2.3.1.9 ANSI/ASHRAE/IES Standard 90.1-2019 – Energy Standard for Buildings Except Low-Rise Residential Buildings

2.3.1.10 Sheet Metal and Air Conditioning Contractors National Association (SMACNA) Standard, HVAC Duct Construction Standards – Metal and Flexible.

2.3.1.11 USP General Chapter 795 Pharmaceutical Compounding – Nonsterile Preparations

2.3.1.12 USP General Chapter 797 Pharmaceutical Compounding – Sterile Preparations

2.3.1.13 USP General Chapter 800 Hazardous Drugs – Handling in Healthcare Settings

2.3.1.14 Association for the Advancement of Medical Instruments (AAMI) standards as applicable to SPS and RME storage

2.3.1.15 Illuminating Engineering Society North America (IESNA) Handbook – latest edition

2.3.1.16 VA Signage Design Manual PG 18-12

2.3.1.17 H 18-8 Seismic Design Handbook is required when the clinic includes

Ambulatory Surgery

2.4 References

2.4.1 The following guides, manuals, and other references developed by VA are for reference only, however, they are applicable to VA leased CBOCs:

2.4.1.1 VA Enterprise Facility IT Support Infrastructure Standard, most current.

2.4.1.2 Prototype for Standardized Design and Construction of Community Based

Outpatient Clinicshttps://www.cfm.va.gov/til/prototypes.asp#CBOC

2.4.1.3 PACT Space Module Design Guide

https://www.cfm.va.gov/til/dGuide/dgPACT.pdf

2.4.1.4 Room Templates, Leased Community Based Outpatient Clinics https://www.cfm.va.gov/til/rTemplate/LeasingCBOCw.asp

2.4.1.5 VA Design Guides (PG18-12)

https://www.cfm.va.gov/til/prototypes.asp#CBOC https://www.cfm.va.gov/til/dGuide/dgPACT.pdf https://www.cfm.va.gov/til/rTemplate/LeasingCBOCw.asp

SECTION 3

PLANNING AND DESIGN CRITERIA

SECTION 3 – PLANNING AND DESIGN CRITERIA

3.1. Background

3.1.1. VHA has committed to the development of a patient-centered medical home model for enhanced outpatient primary care services to veterans. The result was a patient care delivery model and a set of planning and design standards.

3.2. PACT Guiding Principles

3.2.1. An operational and planning design guide was developed which identified key principles and objectives. Refer to PACT Space Module Design Guide under References Section 2.4.

3.3. Community Based Outpatient Clinics (CBOC) Planning Approach

3.3.1. The development of the PACT Planning Module was complimented by the development of a Prototype for Standardized Design and Construction of Community Based Outpatient Clinics. Using the PACT Module as the building block, prototypes were developed for three types and sizes of outpatient facilities.

3.4. Room Data Matrix

3.4.1. A collection of typical rooms within leased CBOCs. It lists the required finishes, STC ratings, ceiling heights, door size and type, hardware sets, HVAC space ventilation, number of electrical receptacles, lighting controls and fixture types, and number of standard density work area outlets for each room type.

3.4.2. The Lessor shall associate rooms listed on the program for design with the room data matrix by room name. Use department level room names and types when available, otherwise use general room/space for like room function.

3.4.3. FGI Equivalent for ASHRAE 170 – Where HVAC space ventilation requirements are omitted, ASHRAE 170 Tables 8-1 and 8-2 shall be followed. Column “FGI Equivalent for ASHRAE 170” lists the equivalent room name for use in the tables.

3.4.4. FGI Equivalent for Table 1.2-5 “Minimum Sound Isolation” – Where Column “STC” in the Room Data Matrix states “See FGI”, Column “FGI Equivalent for Table 1.2-5 Minimum Sound Isolation” lists the equivalent room name for use in FGI Table 1.2-5.

3.4.5. Additional Requirements in this LDN take precedence over the standard in the RDM.

Section 3 – Page 1

SECTION 4

TECHNICAL NARRATIVE

SECTION 4 – TECHNICAL NARRATIVE

4.1 Site/Civil

4.1.1 Pedestrian and Vehicle Access & Circulation

4.1.1.1 Minimum traffic lane width is 12 feet, and minimum sidewalk width is 4 feet.

Curves for traffic lanes and radii at intersections must be adequately sized to prevent vehicles from encroaching on an opposing lane of traffic.

4.1.1.2 An accessible route must be provided from the public right-of-way abutting the site to the accessible building entrance.

4.1.1.3 Provide a service area designed to accommodate single unit truck (SU) maneuverability. Provide canopy over the service area with 14 feet of clearance from grade to the underside of the canopy.

4.1.1.4 Service area shall accommodate vehicles that pick-up trash and recycled materials. Locate service area away from public and patient areas.

4.1.1.5 Provide reflective traffic control signs as required for intersections, no parking lanes, and guidance of site traffic.

Additional Site/Civil Requirements:

4.1.2 Parking

4.1.2.1 Parking lots with 90-degree stalls must have minimum parking stall dimensions of 9 feet by 18 feet, and a minimum drive aisle width of 24 feet. Angled parking must have one-way drive aisles with the same stall sizes as 90-degree parking.

Angled parking drive aisle width must comply with a published design standard for a designated parking angle.

Additional Parking Requirements:

4.1.2.2 Provide two dual-head, commercially billed electric vehicle charging stations, similar to ChargePoint CP6000 12kW, for Government use only, service as approved by the Government, with parking signage restricting public use.

4.1.2.3 Provide one Level 3, commercially billed electric vehicle charging station, minimum 250kW output, for Government use only, with parking signage restricting public use.

The Government will provide final specifications during design.

4.1.2.4 The charging stations will be owned and maintained by the Lessor. The Government will operate the commercial charging account, setting rates, and receiving proceeds.

4.1.2.5 The lessor shall repair any vehicle charger defects, failures, damage, malfunctions, or similar, within 72 hours.

4.1.2.6 The Lessor shall furnish and install a minimum of one bicycle rack accommodating a minimum of 5 bicycles.

4.1.2.7 The electricity used for Government EV Charging shall be included as part of the operating expenses and not billed separately.

4.1.2.8 Charging stations installed by the lessor for public use shall be metered separately and all electricity used for that purpose shall be paid for by the Lessor, whether through direct billing to the utility or with a negotiated per unit fee to the Government. The US Government is expressly forbidden from providing electricity to the general public free of charge.

4.1.2.9 EV Charging station shall have full CCTV/VSS coverage.

4.1.2.10 Parking for EV charging must be a minimum of 25 feet from building.

4.1.3 Site Grading

4.1.3.1 Roads and walks should have a typical cross slope of 2% unless adequate surface drainage is provided by other slope conditions.

4.2 Architecture

4.2.1 General Criteria

4.2.1.1 Refer to Appendix: Room Data Matrix for Door, Hardware and Acoustic requirements listed by Room Type.

4.2.2 Accommodations for Care of Patients of Size

4.2.2.1 Refer to FGI Guidelines for Outpatient Facilities for accommodations for care of patients of size. Minimum requirements are to provide access to a Procedure Room and Procedure Room Toilet in one PACT Module using a 650lb capacity design requirement. Additional capacity may be required and listed in the project specific requirements.

4.2.3 Acoustics

4.2.3.1 Refer to FGI Guidelines for Outpatient Facilities for acoustics requirements for enclosed rooms. Refer to the Room Data Matrix-Interior Construction for information on rooms not covered under FGI or rooms with special acoustics requirements.

4.2.4 Equipment/Accessories/Furnishings

4.2.4.1 Refer to the provided CBOC Project Contents List and Room Template sheets

(available on the website noted) for preliminary equipment, accessories, and furnishings descriptions and locations. Items to be provided and/or installed by Lessor are noted on the list. Provide partitions, partition backing, and above ceiling structural support as required for wall and/or ceiling mounted equipment, accessories, and furnishings. Provide required utility connections for scheduled equipment.

Additional Equipment Requirements:

Lessor is responsible for providing and connecting utility connections for all VA equipment which requires mechanical, plumbing, electrical, gas, water, air, data, steam, or any other utility.

4.2.5 Signage and Wayfinding

4.2.5.1 Refer to VA Signage Design Guide in Section 2.4 for signage standards and requirements.

Additional Signage Requirements:

Lessor shall develop and provide a complete exterior signage program to include identif ication, directional, informational, and regulatory signage in accordance with VA’s Exterior Signage standards. Signage must comply with local municipality’s codes and specif ications. Careful consideration of the location of monument signs shall be taken to avoid sight tr iangle encroachment at vehicular entrances. Lessor shall provide exterior, i l luminated monument signs as permitted and required by local zoning requirements.

4.2.6 Critical Dimensions

4.2.6.1 Patient-use corridors are to be 6 feet minimum width. Staff corridors for transport of supplies from service area to services shall be 8 feet minimum width.

4.2.6.2 Refer to Room Data Matrix – Interior Construction for required ceiling heights by room type.

4.2.7 Entry Canopies

4.2.7.1 Provide non-combustible canopies over the following locations: patient entry to clinic, ambulance building access point and receiving area/loading dock.

4.2.7.2 At patient entry, provide a covered patient drop-off zone with space for at least one full size passenger vehicle (19 feet long) and an accessible access aisle.

4.2.7.3 At ambulance building access point, provide a covered patient drop-off zone with space for at least one ambulance (typical size used in area) and an accessible access aisle.

4.2.7.4 Provide clearance from grade to underside of canopy with for typical emergency and transport vehicles used in the area.

4.2.8 Elevators

4.2.8.1 Where elevators are provided in a leased facility, not less than one elevator car shall accommodate an ambulance stretcher of 24 inches by 84 inches in the horizontal open position and shall be identified by the international symbol for emergency medical services (star of life). The symbol shall be not less than 3 inches high placed inside on both sides of the hoist way door frame.

4.2.9 Slab Depressions and Thickened Slabs

4.2.9.1 At new construction, provide slab depression and thickened slabs as required to provide flush threshold installation at audiology booths, MRIs, and other equipment requiring recessed installation or additional structure as recommended by equipment manufacturer. At these equipment locations, concrete slab levelness shall be level and true to meet vendor requirements and shall have a minimum flatness and levelness of FF=45 and FL=35. At existing construction, provide ramp to meet ABAAS.

4.2.10 Millwork

4.2.10.1 Quality compliance to conform to Architectural Woodwork Institute (AWI) and

Woodwork Institute (WI) quality standards.

4.2.10.2 Wood Veneer Casework Construction: Combination of custom wood casework and countertops to conform to program and functional requirements. (Location:

Lobby, Reception)

4.2.10.2.1 Construction: Flush overlay construction with concealed hinges. AWI custom grade.

4.2.10.3 Plastic Laminate Casework Construction: Custom plastic laminate casework to conform to program and functional requirements. (Location: Typical).

4.2.10.3.1 Construction: Flush overlay construction with concealed hinges, AWI

Custom Grade.

4.2.10.3.2 Cabinet Hardware:

4.2.10.3.2.1 Concealed hinges, all metal, 110 degree opening, self-closing.

4.2.10.3.2.2 Full extension drawer guides, 100 lbs. capacity.

4.2.10.3.2.3 Door and drawer pulls: 4” center to center wire pull, 5/16” diameter round, 1 ¼” projection, satin chrome.

4.2.10.4 Solid Surface Fabrications: Hard, solid, non-porous mineral-filled acrylic resin

(methyl methacrylate) material in color to be selected by designer. Thickness:

1/2” minimum.

4.2.10.4.1 Locations:

4.2.10.4.1.1 Transaction tops at nurse stations and reception desks.

4.2.10.4.1.2 All counters in patient treatment areas to have solid surface countertop with 4” high minimum integral coved side and backsplash.

4.2.10.4.1.3 Where scheduled as wall protection, provide ¼” thick material with welded seams.

4.2.10.5 Heavy gauge stainless steel (SS): fully welded with a work surface load capacity of at least 300 lbs. per linear foot and antimicrobial

4.2.10.5.1 Locations:

4.2.10.5.1.1 SPS Decontamination, Scope Processing, Preparations and

Assembly, and Sterilization Areas.

4.2.11 Joint Sealant Systems

4.2.11.1 Joints at plumbing fixtures, ceramic tile to be mildew resistant silicone.

4.2.12 Doors and Frames

4.2.12.1 Refer to Room Data Matrix for door and hardware requirements by room type.

4.2.12.2 Finish: Prefinished in compliance with AWI Section 1500.

4.2.12.3 Automatic Sliding Doors: Single Slide Automatic Sliding Door, Class 1 Clean

Room Certified, narrow stile, 84” wide w/ 35.3” nominal clear door opening, trackless, clear anodized finish, and touchless actuators.

4.2.12.3.1 Comply with BHMA Standard ANSI A156.10 (BHMA 1601), Power Operated Pedestrian Door Standard and UL Standard UL 325, Electric Door, Drapery, Gate, Louver and Window Operators and Systems.

4.2.12.3.2 Service Life: Provide automatic sliding doors capable of operating without failure of any component, for not less than 300,000 open and close cycles, with normal maintenance as defined in manufacturer's standard operating manual.

4.2.12.4 Access Panels:

4.2.12.4.1 Flush stainless steel at toilet areas.

4.2.12.4.2 Flush gypsum board surface with concealed hinges at public and office areas.

4.2.12.4.3 Fire rated steel at rated construction.

Additional Door Requirements:

Entrance doors at Main Entry shall be automatic sliding anodized aluminum construction with safety glazing and shall comply with energy and sustainability requirements.

4.2.13 Hardware

4.2.13.1 General Note

4.2.13.1.1 Hardware sets shall be provided as per Section 5 Hardware Groups and

Modifiers. Provide extra heavy duty, Grade 1 hardware for all components.

4.2.13.2 Major components and finishes are as follows:

4.2.13.2.1 Cylinders and Keying: Key locks/cylinders in groups with new master key or grandmaster key system as directed by Owner. Provide three (3) keys per lock. Provide construction keying for all doors throughout the duration of construction. Cylinders shall meet the requirements of ANSI/BHMA A156.5-14.

4.2.13.2.2 Low Energy Automatic operators, ANSI A156.19-07. Heavy duty commercial grade. Provide complete with drop plates, bracket, or adapters for arms as required to suit details. Provide a terminal strip in an enclosed box near or above door that indicates connections for Security and Fire Alarm equipment and for electrified hardware items associated with proper door operation, as indicated by hardware group operational description.

Coordinate with Security Contractor for doors actuated by electronic access control system.

4.2.13.2.3 Electronic access control: Electronic access control system/device(s), power supplies (unless otherwise noted in hardware group) and monitoring/alarm(s) are provided with Security System. General Contractor to coordinate the provision and installation of the products. Refer to documents with Security Information for location(s) and type(s) of control(s). Connection by Electrical.

Additional Hardware Requirements:

• All toilet rooms, dressing rooms, and lactation rooms shall have occupancy indicator on hardware.

4.3 Interior Design

4.3.1 General Criteria

4.3.1.1 Refer to Appendix: Room Data Matrix – Interior Construction for finish requirements listed by room type.

4.3.2 Acoustic Ceiling Tile

4.3.2.1 AT: Acoustical ceiling tile, standard size to be 24”x24”x 1”.

4.3.2.2 AT-SP: Acoustical, scrubbable ceiling tile, standard size to be 24”x24”x 1”, with vinyl- laminated or sealed face and sealed edges.

4.3.3 Concrete Floor Treatment

4.3.3.1 Concrete Sealer (CS): 30 percent clear, non-yellowing, waterborne, membrane-forming curing and sealing compound: ASTM C1315, Type 1, Class A, minimum 30 percent total solids. Comply with ACI 301.

4.3.4 Fiberglass-Reinforced Panels

4.3.4.1 Fiberglass-reinforced panels (FRP): Gelcoat-finished, glass-fiber reinforced plastic panels complying with ASTM D 5319. Fire-Rating per ASTM E 84: Class A. Nominal thickness: 0.09 inch.

4.3.5 Painting

4.3.5.1 Interior painting: Paint (P) and Epoxy Paint (EP): Paint surfaces with primer and two finish coats that are compatible with one another as demonstrated by manufacturer or field experience, unless otherwise indicated.

4.3.5.2 Materials: Use low VOC, low odor latex topcoats. Paint the following items and surfaces:

4.3.5.2.1 Ceilings: Flat latex.

4.3.5.2.2 Walls - gypsum wallboard: Satin latex.

4.3.5.2.3 Walls - concrete block: Semi-gloss latex with block filler.

4.3.5.2.4 Hollow metal doors and frames: Semi-gloss latex over alkyd primer.

4.3.6 Wall Protection

4.3.6.1 Rigid Wall Covering (RWC): Nominal thickness .060 inch, high-impact, PVC-free, standard texture, chemical and stain resistant, with vertical, inside and outside trims. To comply with ASTM E84, ASTM F476 and ASTM D543.

4.3.6.2 Corner Guard (CG): Surface mounted assembly for angled corner consisting of a continuous aluminum retainer and vinyl/alloy extrusion in standard texture with ¼ inch corner radius. Size to be 2” width each way from corner. Height to be 7’ from top of base.

4.3.6.2.1 Location: Provide at all outside exposed corners in all clinic corridors outside of public areas as defined by FGI.

4.3.6.3 Corner Guard – Stainless Steel (CG-SS): Surface mounted stainless steel, 3- 1/2” wing size, 7’ height, 16 gauge in Kitchen and/or Standard Grade, #4 satin finish.

4.3.6.3.1 Location: Provide at all outside exposed corners in food service areas, loading dock area and heavy use equipment storage areas.

4.3.7 Window Shades

4.3.7.1 Manually operated window shade, chain driven, vertical roll-up, stainless steel bead chain with hold down clips, extruded aluminum rollers, and bottom slats.

Aluminum headbox with endcaps and fascia with powder coat finish. Light gap reduction channels available for black out shades. PVC-free shades, Flame- Resistance Ratings: NFPA 701. Comply with WCMA A100.1. Window treatments should not compromise patient safety.

4.3.7.1.1 Locations:

4.3.7.1.1.1 Semi-Transparent to be typical, unless otherwise noted.

4.3.7.1.1.2 Black-out at conference rooms, tele-medicine rooms, optometry exam rooms.

4.3.8 Privacy Curtains / Screens

4.3.8.1 Provide curtain tracks with carriers and hooks (curtains shall be provided by the

VA). Tracks shall be of extruded aluminum, ASTM B221, alloy 6063, temper T5 or T6, channel shaped, with smooth inside raceway for curtain carriers. End stop connectors, ceiling flanges and other accessories shall be fabricated from the same material with the same finish as the tracks or from nylon.

4.3.8.2 Provide privacy curtains/screens to encompass adequate space for the healthcare provider to perform examination unencumbered by the curtain and provide a visually private patient changing area that allows the provider to remain in the room.

4.3.8.2.1 Locations shall be per the room contents list.

4.3.9 Flooring, Carpet

4.3.9.1 Rooms specified to receive carpet and also contain a sink shall a minimum 4’ x

4’ area of LVT installed at the sink location.

Additional Architectural Requirements:

Except in administrative areas, provide handrails and wall guards on both sides of all patient corridors.

4.4 Mechanical

4.4.1 References

4.4.1.1 The following publications shall be referenced for applicable systems calculations and design information.

4.4.1.1.1 ASHRAE Handbooks.

4.4.2 HVAC Design Basis

4.4.2.1 Indoor design conditions:

4.4.2.1.1 Health care function design conditions shall be in compliance with the requirements of the FGI Guidelines and ASHRAE Standard 170, with the Room Data Matrix taking precedence and/or indicating required space design conditions when the FGI Guidelines do not fully address a space or room type.

4.4.2.1.2 Basic MEP Equipment Room Design Conditions:

4.7.2.1.5.1 Design conditions shall be as required to ensure tenant space design conditions are maintained.

4.4.2.1.3 Loading Docks:

4.4.2.1.3.1 Space shall have provisions to limit the intrusion of airborne particulate and insects through dock door openings.

4.4.2.2 Outdoor design conditions:

4.4.2.2.1 ASHRAE 99.6% (winter) and 0.4% (summer) conditions associated with the site-specific location and adopting best practices from ASHRAE regarding climate change projections.

4.4.3 Air Handling Units (AHUs)

4.4.3.1 Air handling units shall consist of, but not be limited to, the following:

4.7.3.1.1 The units shall be constructed of double wall, insulated metal panels with an overall U-value and necessary features to meet/exceed energy code (and prevent condensation based on the site-specific outdoor design conditions).

4.7.3.1.2 Incorporate supply, return and outdoor air flow measuring stations for proper control feedback and ensure minimum ventilation needs.

4.7.3.1.3 For AHU’s that are in excess of 15,000 cfm, SA/RA Array fans (minimum 2 fans per system) with backdraft isolation dampers shall be employed.

4.7.3.1.4 VSD controllers for fan array systems shall be provided in quantities that will provide no less than a 50% loss of nominal fan capacity if a single VSD were to fail.

4.4.3.2 For overall building capacity needs greater than 50,000 cfm, multiple AHUs shall be provided.

4.4.4 Exhaust Systems

4.4.4.1 Provide exhaust fans to provide general exhaust for toilet rooms, janitor’s closets, soiled utility rooms and similar spaces.

4.4.4.2 Dedicated exhaust fans shall be provided for Laboratory space.

4.4.5 Cooling System

4.4.5.1 Chillers shall employ multiple, independent refrigerant circuits, and shall have capacity control provisions to achieve at least 4 to 1 turndown.

4.4.5.2 The pumping system for the chilled water supply shall consist of variable speed pumps providing variable primary flow, arranged in a headered approach.

Variable speed pumps shall each have a variable speed drive controller.

4.4.5.3 DX systems:

4.4.5.3.1 AHUs packaged with DX cooling sections shall have

compressors/condensing units with direct drive scroll or screw compressors, all-aluminum microchannel condenser coils, and direct drive TEFC condenser fans. Units shall employ multiple, independent refrigerant circuits, and shall have capacity control provisions to achieve at least 4 to 1 turndown.

4.4.5.3.2 Provide spring isolated mounting curbs for vibration attenuation, if applicable.

4.4.5.4 Provide unit supported screen wall panels, if roof supported structural screen wall elements are not incorporated.

4.4.5.5 Variable Refrigerant Flow (VRF) systems shall not be considered for VA CBOC projects due to various concerns such as inappropriate system type for healthcare facility applications due to higher amounts of fresh air requirement as well as safety risk to building occupants due to use of high refrigerant volumes and associated potential leaks.

4.4.6 Water Heating System

4.4.6.1 Water heating shall be generated by direct vent, sealed combustion, condensing type boilers.

4.4.6.2 The heating water system distribution shall be a variable/primary pumping system. The pumping system will consist of variable speed pumps providing variable primary flow. Variable speed pumps shall each have a variable speed drive controller.

4.4.7 Humidification System

4.4.7.1 Centralized humidification shall be provided to maintain 20%-60% relative humidity in all seasons. Each air handling unit shall have a dedicated humidifier.

4.4.7.2 Water treatment shall be provided for humidifier feedwater as required by the humidifier equipment manufacturer.

4.4.8 HVAC Piping Systems

4.4.8.1 Provide isolation valves on branch and lateral lines to reduce the amount of space that can be disrupted for maintenance and repair efforts. Provide isolation valves at each equipment connection.

4.4.8.2 For hydronic systems utilized in specific sites with freezing climate considerations, use of propylene glycol and/or proven freeze protection methodologies must be incorporated.

4.4.8.3 When propylene glycol is used, the freezing point of the glycol solution shall be at least 5°F lower than the minimum annual extreme daily temperature, to prevent the formation of crystals.

4.4.9 Air Distribution and Duct Systems

4.4.9.1 Duct construction shall be as follows:

4.4.9.1.1 All supply return and exhaust air ductwork shall be constructed of G90 galvanized steel. Non-ducted Return Air Plenum is not allowed. Flexible duct is prohibited except for the last three feet to connect diffusers.

4.4.9.1.2 Ductwork shall be rectangular, round or flat oval constructed to SMACNA standards.

4.4.9.1.3 Ductwork shall be constructed and tested with leakage classifications and pressure ratings and based on at least 125% of the actual operating pressure of the duct system.

4.4.9.2 Grilles, registers and diffusers shall be steel, aluminum or extruded aluminum with appropriate finish.

4.4.10 HVAC Insulation Systems

4.4.10.1 All exposed (visible in space) supply and return ductwork in the occupied conditioned spaces shall be provided with rigid insulation with proper seals.

Painting and finish requirements shall be coordinated with the finish schedule.

4.4.11 Testing, Adjusting and Balancing

4.4.11.1 An independent third-party NEBB, ABBC or TABB certified test and balance contractor shall be hired by the general contractor to balance and document all air and hydronic systems within project scope. All ductwork shall be constructed and properly sealed in accordance with applicable energy code requirements.

All ducts operating at 2 inches water gauge (wg) or greater shall be pressure tested based on code requirements for 3 in wg or greater pressure classification.

4.4.11.2 The balance contractor shall review all plans, components, access, etc. to ensure balancing activities may be successfully performed.

4.4.12 Automatic Temperature Control Systems

4.4.12.1 The temperature controls shall be direct digital control (DDC) system with industry open protocol compatibility. The system shall provide control of the environment and other parameters and collect data on the performance and deviations (alarms).

4.4.12.2 Dedicated thermal control zoning (thermostats) shall be provided for the following:

• each corner space,

• each conference room (or similar),

• each Procedure room (or similar dedicated spaces),

• each Pharmacy space,

• For typical blocks of rooms arranged together, 3 adjoining exterior offices or exam rooms with similar exposure to sunlight and other weather conditions, or 4 interior offices or exam rooms shall be permitted on a single zone.

4.4.13 Special Conditions

4.4.13.1 Room Pressurization: Health care function design conditions shall be in compliance with the requirements of ASHRAE 170, with the Room Data Matrix taking precedence and/or indicating required space design conditions when ASHRAE 170 does not fully address a space or room type.

4.4.13.1.1 Positive air balance is designated as (+)

4.4.13.1.2 More positive air balance is designated as (++)

4.4.13.1.3 Negative air balance is designated as (-)

4.4.13.1.4 More negative air balance is designated as (--)

4.4.13.1.5 If the room is not indicated with a specific pressure relationship (blank) or is indicated with NR then there is no requirement.

Additional Special Mechanical Conditions:

Additional Mechanical Requirements:

1. Provide the VA view-only remote access to the building controls system, for verification and monitoring purposes. Remote location is as accessed via the internet from offsite.

2. Provide one Procedure room which also functions as an Airborne Infection Isolation Room (A.I.I.). This room is noted on the Program for Design and conceptual block diagram. The Airborne Infection Isolation Room shall meet all requirements of FGI and ASHRAE 170.

3. Negative pressure rooms shall be monitored by the building controls system and a local visual alarm shall be triggered in the event negative pressure is lost.

4.5 Plumbing

4.5.1 References

4.5.1.1 The following publications shall be referenced for applicable systems calculations and design information:

4.5.1.1.1 ASPE Handbooks

4.5.2 Plumbing Design Basis

4.5.2.1 Domestic Water Service

4.5.2.1.1 Incoming service water pressure shall be ascertained to determine if adequate pressure is available on site to serve the facility without the use of booster pumps. Coordinate with the water supplier to provide and evaluate historical water data during all seasons.

4.5.2.1.2 If booster pumps are required, they shall utilize variable speed drives for pressure control.

4.5.2.2 Domestic Water Heating

4.5.2.2.1 If storage type heaters are utilized, they shall be set to 140 degrees F. Hot water in the distribution system piping must be maintained at the lowest temperature that will ensure the minimum of 124 degrees F (51.1 degrees C) throughout.

4.5.2.2.2 Provide point of use mixing valves to ensure water temperature is no greater than 110F.

4.5.2.2.3 A looped hot water recirculation system with a bronze in-line recirculation pump shall be provided.

4.5.2.3 Domestic Water Treatment

4.5.2.3.1 The facility water system shall have a building program for risk assessment and Legionella mitigation provisions as needed to comply with ASHRAE Standard 188.

4.5.2.4 Sump Pumps and Sewage Ejectors

4.5.2.4.1 If required, 50/50 duplex submersible sump pump and/or sewage ejector systems shall be utilized.

4.5.3 Materials

4.5.3.1 Domestic Water Piping:

4.5.3.1.1 Provide isolation valves on branch and lateral lines to reduce the amount of space that can get disrupted for maintenance and repair efforts. Also provide isolation valves at each equipment connection.

4.5.3.2 Sanitary, Storm, Vent, and Clear Water Waste Systems

4.5.3.2.1 Aboveground:

4.5.3.2.1.1 Cast-Iron pipe, with compatible joints and fittings.

4.5.3.2.1.2 Type DWV Copper Tube, with compatible joints and fittings.

4.5.3.2.1.3 Type 304 or 316 stainless steel pipe, with compatible joints and fittings.

4.5.3.2.1.4 Schedule 40 PVC pipe, solid wall, with compatible joints and fittings.

4.5.3.2.2 Underground:

4.5.3.2.2.1 Cast-Iron pipe, with compatible joints and fittings.

4.5.3.2.2.2 Type DWV Copper Tube, with compatible joints and fittings.

4.5.3.2.2.3 Type 304 or 316 stainless steel pipe, with compatible joints and fittings.

4.5.3.2.2.4 Schedule 40 PVC pipe, solid wall, with compatible joints and fittings.

4.5.3.3 Provide overflow roof drain inlets and piping system independent to storm water piping serving roof drains.

4.5.3.4 Floor drains shall not be provided in single user toilet rooms unless required by local or state code provisions.

4.5.3.5 Plumbing Fixtures

4.5.3.5.1 Fixtures shall be commercial or institutional grade.

4.5.3.6 Hot Water Supply and Recirculation Piping:

4.5.3.6.1 Insulation systems shall conform to applicable Energy Code requirements and current NAIMI standards.

4.5.3.6.2 Insulation on hot piping shall have thickness sufficient to prevent skin injury due to excessive temperature.

4.5.3.7 Cold Water Supply Piping: Insulation shall include vapor retarders and shall have thickness sufficient to prevent condensation.

4.5.3.8 Rainwater Piping: Insulation shall include vapor retarders and shall have thickness sufficient to prevent condensation.

4.5.3.9 Outdoor exposed insulation shall be protected from the elements with a fully sealed outer covering that is UV protected and has a minimum puncture resistance rating of 55 lbs.

Additional Special Plumbing Condit ions:

Additional Plumbing Requirements:

• Faucets and showerheads shall be of chromed brass, monel, or stainless steel;

plastic trim Is not permitted.

• Faucets shall be laminar flow; aerators are not permitted. Electronic hands-free controls shall be provided at all hand washing sinks and lavatories.

• Cold water temperature throughout the system must be maintained at or below 67 degrees F (19.4 degrees C) to the greatest extent practicable to inhibit Legionella growth.

• Electronic controls for plumbing fixtures shall be hardwired.

4.6 Electrical

4.6.1 Standby Generator requirements in the absence of a code required Essential Electrical System

4.6.1.1 Packaged Engine Generator

4.6.1.1.1 An exterior diesel fuel generator, in weatherproof sound attenuated enclosure, kW/kVA size as determined for loads noted below, will be provided supplying emergency power for the facility.

4.6.1.1.2 Engine: NFPA 37 compliant.

4.6.1.1.3 Cooling System: Closed-loop, liquid-cooled, radiator mounted on generator set base.

4.6.1.1.4 Fuel Tanks: 24 hour run time at full load sub-base tank

4.6.1.1.5 Engine Exhaust System: Critical silencing muffler.

4.6.1.1.6 Combustion Air-Intake System: Filter type air intake silencer, intake duct and connections.

4.6.1.1.7 Starting System: Electric with negative ground.

4.6.1.2 Automatic Transfer Switches: 4-pole switches are required.

4.6.1.3 Loads shall be determined as per the requirements of the room data matrix. In addition to these, all medical refrigerators/freezers and safes used to store medication, laboratory refrigerators/freezers, HVAC for clean rooms (RME storage), the requirements specified in the OI&T appendix and any additional requirements listed in the project specific requirements.

Additional Electr ical Requirements:

1. The lessor shall provide all testing and maintenance as required by NFPA, with test reports submitted to the lease COR.

4.7 Lighting

4.7.1 General: At a minimum, lighting systems design and installation shall be designed based on latest edition of the IESNA Handbook, as well as applicable IESNA standards.

4.7.2 Indoor Lighting Specifics

4.7.2.1 For specific room lighting requirements above and beyond IESNA's guidance, refer to Room Data Matrix.

4.7.3 Lighting Controls:

4.7.3.1 Local dual level switching or dimming will be provided in work and office areas to allow occupant selection of lighting level. Refer to room matrix for lighting control requirements.

4.7.3.2 Exterior lighting will be controlled by exterior photocell and astronomic timeclock input through the lighting control relay panel system.

4.7.4 LED Drivers

4.7.4.1 Minimum efficiency of 85%

4.7.4.2 20% THD or less

4.7.4.3 Dimmable in spaces where dimming controls are indicated in RDM.

Additional Special Lighting Condit ions:

Additional Lighting Requirements:

4.1.1 LED fixtures shall be100% recyclable with component parts that can easily be dismantled and separated. They shall be designed with serviceability in mind so have commonly used fixings or sizes for easy replacement long into the future. LED light sources shall be capable of be serviced and upgraded to the latest LED technology, minimizing the environmental impact of progress.

4.1.2 All lighting shall be LED.

4.1 Telecommunications

4.1.1 Scope of Work

4.7.4.4 The Lessor shall provide the following:

4.7.4.4.1 Telephone cabling, pathways (conduit and cable tray), outlets, faceplates, terminal blocks, backboards, cable terminations and cable testing.

4.7.4.4.2 Data cabling (fiber optic and copper), pathways (conduit and cable tray), outlets, faceplates, patch panels, network equipment racks, network equipment cabinets, cable terminations, UPSs, PDUs, and cable testing.

4.7.4.5 The VA IT department will provide the following:

4.7.4.5.1 Telephone System hardware and electronics such as voice mail servers and telephone handsets.

4.7.4.5.2 Data network electronics such as concentrators, Ethernet switches, servers, PCs, Wireless Access Points and other electronic equipment.

4.7.5 Pathways

4.7.5.1 Boxes and Conduits

4.7.5.1.1 Voice and data outlets shall be provided with a 4” square by 2-1/8” deep box with a single gang, telecommunication rated work box with a minimum of a ¾” conduit routed up to an accessible ceiling space.

4.7.5.2 Sleeves

4.7.5.2.1 Where cables penetrate through walls, conduit sleeves with bushings on both ends, shall be provided. All penetrations through fire rated walls shall be fire stopped.

4.7.5.2.2 Where cables penetrate through floors of telecommunications rooms, a minimum of four (4) 4-inch conduit sleeves with bushings on both ends, shall be provided. All penetrations through floors shall be fire stopped.

4.7.5.2.3 Conduit sleeves shall be sized to be filled with cables to no more than 40 percent of the cross-sectional area of the conduit.

4.7.5.3 Cable Support

4.7.5.3.1 Wire mesh cable tray a minimum of 4” deep x 12” wide shall be provided and supported from the structural steel or concrete structure with a minimum of 3/8” diameter threaded rods to support the horizontal and backbone communications cables along the main pathways above the suspended ceiling space. In finished spaces without a suspended ceiling, provide a minimum of 4” deep x 12” wide Solid Bottom cable tray instead of Wire Mesh cable tray along the main pathways. Cable trays shall be sized to be filled with cables to no more than 50% of the cross-sectional area of the cable tray. Where the cable tray fill ratio exceeds 50% of the cable tray cross-sectional area, provide a larger cable tray or two cable trays.

4.7.5.3.2 A minimum of 12 inches of free access shall be provided and maintained above the cable trays and along one side of the cable trays.

4.7.5.3.3 Where cables are routed in the open outside of the cable tray above the suspended ceiling space, adequate cable support via J-hooks shall be located at a maximum of 48" intervals.

4.7.5.3.4 As per National Electrical Code and TIA-569 standard, the suspended ceiling support wires or support rods shall not be used as a means of cable support. Cables shall not be laid directly on the ceiling tile, ceiling grid rails, or on the structural steel (bar joists). An independent hanger system shall be used.

4.7.6 Spaces

4.7.6.1 Entrance Facility Room (AKA Demarcation Point- Demarc)

4.7.6.1.1 The Entrance Facility Room is the location where the Local Exchange Carriers and other communications Service Providers such as telephone, data, and MATV/CATV install their cabling and equipment to bring services into the building. It also establishes the physical point where the service provider’s responsibilities for service and maintenance end.

4.7.6.1.2 The minimum size of the Entrance Facility Room shall be 80 sq. ft. with an additional 20 sq. ft. for every additional rack required.

4.7.6.1.3 The room shall not be located directly below or adjacent to laboratories, kitchens, laundries, rest rooms, showers, or other facilities where water service is provided.

4.7.6.1.4 Any pipe or duct system foreign to the room installation shall not enter or pass through the room. The design professional shall ensure that foreign piping such as water pipes, steam pipes, medical gas pipes, sanitary waste pipes, roof drains, AC ducts, and other unrelated piping containing liquids or gases are not installed or pass through the room. Sprinkler piping shall not be routed through the room, unless it serves to protect the installation.

4.7.6.1.5 A minimum of (2) 4” conduits shall be installed out to the property line to provide pathways for the services providers to install their cabling.

4.7.6.1.6 Install and activate cabling from services providers from the property line.

4.7.6.1.7 All the walls of the room shall be constructed from drywall deck to deck, not just from floor to suspended ceiling height. All the walls of the room shall be covered from the floor to a minimum height of 8’-0” above the floor with 3/4-inch exterior AC grade flame retardant plywood and painted a light color to reflect the room light and reduce dust.

4.7.6.1.8 The lighting shall be a minimum of 500 lux in the horizontal plane and 200 lux in the vertical plane when measured at 3 feet above the finished floor.

4.7.6.1.9 The door shall be a minimum of 36 inches wide and 96 inches high, hinged to open outward and fitted with a card reader security lock.

4.7.6.1.10 Protective cages shall be installed on all water-based fire protection sprinkler heads located within the room.

4.7.6.1.11 The Service Provider IT equipment installed in the Entrance Facility Room will be required to operate 24 hours a day and 365 days a year. The HVAC system shall be designed and installed to maintain a room temperature of 64-75 degrees Fahrenheit and relative humidity of 30-55 percent noncondensing on a 24-hour basis.

4.7.6.2 Main Computer Room (MCR)

4.7.6.2.1 The Main Computer Room is a centralized space for telecommunications and computer equipment that serves an entire building. Typical equipment includes phone switches, voice mail servers, file/application servers, video surveillance storage and Core Ethernet switches. The requirement for an MCR will be dependent upon the size and function of the CBOC.

4.7.6.2.2 The location of the Main Computer Room should be determined after careful consideration. Locations should be avoided that restrict expansion of the room due to building construction such as elevators, mechanical rooms, core hallways, outside walls, or other fixed building walls. The location should consider accessibility requirements for the delivery of large equipment to the room and be located away from EMI sources that limit EMI field strength to no more than 3.0 V/m throughout the frequency spectrum.

4.7.6.2.3 The room shall not be located directly below or adjacent to laboratories, kitchens, laundries, rest rooms, showers, or other facilities where water service is provided.

4.7…