02C RLP 36C10F23R0095 Appendix A_2 Lease Design Narrative LDN Allentown PA CBOC.pdf

November 29, 2022

VA Leased CBOC Design Narrative

Allentown, PA September 14, 2023

ALLENTOWN, PA

LEASED CBOC DESIGN NARRATIVE

VA Leased CBOC Allentown PA Design Narrative

September 14, 2023 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

4. TECHNICAL NARRATIVE

4.1 General

4.1.1 Demarcation Room (DEMARC)

4.1.2 Special Systems Room

4.1.3 Security

4.1.4 Rubbish Handling and Recycling

4.1.5 POW/MIA Flag

4.1.6 Exterior Signage

4.2 Site/Civil/Landscape

4.2.1 Pedestrian and Vehicle Access & Circulation

4.2.2 Parking

4.2.3 Site Grading

4.3 Architecture

4.3.1 General Criteria

4.3.2 Accommodations for Care of Patients of Size

4.3.3 Acoustics

4.3.4 Equipment/Accessories/Furnishings

4.3.5 Signage and Wayfinding

4.3.6 Critical Dimensions

4.3.7 Entry Canopies

4.3.8 Elevators

4.3.9 Slab Depressions and Thickened Slabs

4.3.10 Millwork

4.3.11 Joint Sealant Systems

4.3.12 Doors and Frames

4.3.13 Roofs

4.3.14 Hardware

4.3.15 Radiation Shielding

4.4 Interior Design

4.4.1 General Criteria

4.4.2 Wayfinding

4.4.3 Acoustic Ceiling Tile

4.4.4 Concrete Floor Treatment

4.4.5 Fiberglass-Reinforced Panels

September 14, 2023 Table of Contents - Page 2

4.4.6 Painting

4.4.7 Wall Protection

4.4.8 Window Shades

4.4.9 Privacy Curtains / Screens

4.4.10 Flooring, Carpet

4.4.11 Systems Furniture

4.4.12 Modular Casework

4.4.13 Work Benches

4.4.14 Lab Work Benches

4.5 Mechanical

4.5.1 References

4.5.2 HVAC Design Basis

4.5.3 Air Handling Units (AHUs)

4.5.4 Exhaust Systems

4.5.5 Cooling System

4.5.6 Hot Water Heating System

4.5.7 Humidification System

4.5.8 HVAC Piping Systems

4.5.9 Air Distribution and Duct Systems

4.5.10 HVAC Insulation Systems

4.5.11 Testing, Adjusting and Balancing

4.5.12 Automatic Temperature Control Systems

4.5.13 Special Conditions

4.6 Plumbing

4.6.1 References

4.6.2 Plumbing Design Basis

4.6.3 Materials

4.6.4 Medical Gases

4.6.5 Special Conditions

4.7 Electrical

4.7.1 Standby Generator

4.8 Lighting

4.8.1 General

4.8.2 Indoor Lighting Specifics

4.8.3 Lighting Controls

4.8.4 LED Drivers

4.8.5 Special Conditions

4.9 Telecommunications

4.9.1 Scope of Work

4.9.2 Pathways

4.9.3 Spaces

4.9.4 Telecommunications Bonding and Grounding

4.9.5 Equipment Racks and Equipment Cabinets

4.9.6 Power Distribution Units and Uninterruptable Power Supplies

4.9.7 Telecommunications Infrastructure Plant

4.9.8 Special Systems

5. HARDWARE GROUPS AND MODIFIERS

September 14, 2023 Table of Contents - Page 3

6. NOT APPLICABLE

7. DESIGN PHASE REQUIREMENTS

7.1 Design Review Documentation

8. CONSTRUCTION PHASE REQUIREMENTS

8.1 Construction Observation

SECTION 1

INTRODUCTION

September 14, 2023 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

A team-based model of care that provides patient-centered service to Veterans 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

A VA-operated, VA-funded, or VA-reimbursed site of care which is located separately 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.

OPC Outpatient Clinic.

For the purpose of this LDN OPC and CBOC are used interchangeably.

RDM Room Data Matrix

RCM Room Contents Matrix

VA US Department of Veterans Affairs

VHA Veterans Health Administration

SECTION 2

GENERAL REQUIREMENTS

VA Leased Allentown PA CBOC Design Narrative

September 14, 2023 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 ongoing maintenance of the facility.

2.1.3 Design and construction of the CBOC shall be in compliance 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 of codes, standards, and references at the date and time of bid submission.

2.1.5 Use the most stringent requirement between codes, references, and standards.

2.2 Codes

2.2.1 All VA leased CBOC facilities are to conform to the most recent applicable codes, which include but are not limited to the 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 National Fire Protection Association (NFPA) 99

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

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

2.2.1.4.1 International Building Code

2.2.1.4.2 International Energy Code

2.2.1.4.3 International Mechanical Code

2.2.1.4.4 International Plumbing Code

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

(AHJ).

Additional Code information:

For Lessor to properly determine occupancy type, VA intends to simultaneously treat up to 3 (three) patients at any given time who are incapable of self-preservation.

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).

September 14, 2023 Section 2 – Page 2

2.3.1.3 The Joint Commission (TJC) accreditation standards apply to the facility under the affiliated VA medical center license. Building construction and ongoing maintenance procedures shall meet TJC standards. Lessor shall provide and submit all documentation that is required for TJC requirements. Location-specific VA TJC standards that must be included in the construction and operation of the lease. Lessor shall refer to all TJC standards to ensure they understand and apply all the requirements.

2.3.1.4 TJC requirements for Ambulatory Healthcare, Behavioral Health, and Laboratory categories. Submit all documentation that is required for TJC requirements within 30 days of inspection completion.

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

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

2.3.1.7 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)

2.3.1.8 ASHRAE Standard 12, Minimizing the Risk of Legionellosis Associated with

Building Water Systems, current edition

2.3.1.9 ASHRAE Standard 188, Legionellosis: Risk Management for Building Water

Systems, current edition

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

2.3.1.11 ANSI/ASHRAE/IES Standard 90.1-2019 – Energy Standard for Buildings Except

Low-Rise Residential Buildings

2.3.1.12 Sheet Metal and Air Conditioning Contractors National Association (SMACNA)

Standard, HVAC Duct Construction Standards – Metal and Flexible

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

2.3.1.14 Illuminating Engineering Society North America (IESNA) Handbook - latest edition

2.3.1.15 VA Signage Design Manual PG 18-12

2.3.1.16 H 18-8 Seismic Design Handbook is required when the clinic includes Ambulatory Surgery.

2.3.1.17 Architectural Barriers Act Accessibility Standards (ABAAS), current edition

2.3.1.18 State and local codes as required by the local Authority Having Jurisdiction (AHJ)

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 VA Infrastructure Standard for Telecommunications Spaces https://www.cfm.va.gov/til/dguide/OIT-InfrastrucStdTelecommSpaces.pdf

2.4.1.3 Prototype for Standardized Design and Construction of Community Based

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

2.4.1.4 PACT Space Module Design Guide

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

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

September 14, 2023 Section 2 – Page 3

2.4.1.6 VA Design Guides PG18-12

2.4.1.7 VA Directive and Handbook 7545 Cultural Resources Management and 36 CFR

Part 800 Protection of Historic Properties

2.4.1.8 VA Sustainable Design Manual, Current Edition

2.4.1.9 VA Barrier Free Design Standards, Current Edition

2.4.1.10 www.cfm.va.gov/til/dguide/OIT-InfrastrucStdTelecommSpaces.pdf

2.4.1.11 VA Program Guide PG 18-14 Room Finishes, Door, and Hardware Schedule.

2.4.1.12 VA Signage Design Manual PG 18-10, May 16, 2023, edition.

2.4.1.13 MILSTD 1691 Equipment Database (max.gov)

SECTION 3

PLANNING AND DESIGN CRITERIA

September 14, 2023 Section 3 - Page 1

SECTION 3 – PLANNING AND DESIGN CRITERIA

3.1 Background

3.1.1 VHA is committed to the development of a patient-centered medical home model for enhanced outpatient primary care services to veterans, resulting in the creation of 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 complemented 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 The Room Data Matrix is a collection of typical rooms within leased OPCs and 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 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 4

TECHNICAL NARRATIVE

VA Leased Allentown PA CBOC Design Narrative

Section 4 – Page 1

SECTION 4 – TECHNICAL NARRATIVE

4.1 General

4.1.1 Demarcation Room (DEMARC)

4.1.1.1 Demarcation Room by Lessor.

4.1.1.2 Interface between customer-premises equipment and network service provider equipment shall be provided by Lessor. Minimum room size is 80 sf.

4.1.2 Special Systems Room

4.1.2.1 This room shall be provided by Lessor. It houses fire alarm, nurse call, CCTV, and TV cable service. Include an UPS for any equipment that does not contain backup batteries.

4.1.3 Security

4.1.3.1 Security Room, security monitoring, cameras, and dedicated security server rack area (closet) shall be provided by Lessor. Include a UPS for any parts of the security or camera system that do not have battery backup, including for remote computers and monitors which are to be located in the police operations room.

4.1.3.2 Emergency Generator is by Lessor and shall be protected by masonry wall minimum 7 feet high or protective bollards and decorative security fencing minimum 7 feet high.

4.1.3.3 Police

4.1.3.3.1 Reference and follow VA Handbook 0730 appendix B for wall construction and building compliance where applicable.

4.1.3.3.2 Confirm Armory location and need during design.

4.1.3.3.3 Provide proper exhaust in armory for mitigating fumes generated by weapon cleaning products.

4.1.3.3.4 Provide direct access to the exterior from the Police Suite.

4.1.3.3.5 Provide one-way glass between operations room and vestibule and lobby with micro shade.

4.1.3.3.6 Overhead speaker system to function in the operations room.

4.1.3.3.7 Provide a camera in Armory. Armory room security system must be separate from the rest of the facility.

4.1.3.3.8 Provide pathway for antennae to roof for police systems.

4.1.3.3.9 Camera head end shall be located in a Systems Room in Police Area.

4.1.3.3.10 Card reader system computer, camera system, computer with wall displays, IDS system, nurse call system, and panic alarms shall all annunciate and be monitored/controlled in the police command center/control room.

4.1.3.3.11 Secure Storage shall be located between the two Locker Rooms with a pass-through window. Lockers and Secure Storage have the same security level.

4.1.4 Rubbish Handling and Recycling

4.1.4.1 Lessor shall establish a recycling program as required by local law, code, or ordinances for materials where local markets for recovered materials exist.

4.1.4.2 Lessor shall provide an easily accessible and appropriately sized area for collecting and storing materials for recycling.

4.1.4.3 Lessor shall provide recycling services and exterior recycling containers.

VA Leased Allentown PA CBOC Design Narrative

Section 4 – Page 2

4.1.5 POW/MIA Flag

4.1.5.1 Provide one POW/MIA flag for display on the flagpole required by the Lease. The size of the flag should be the same size as the flag of the United States of America and shall be always replaced during the Lease term when showing signs of wear. Appropriate illumination of the flags shall be provided. US Flag and pole requirements are listed in the L100 document. (Total of minimum of three flags, US Flag, VA agency flag and POW/MIA flag, appropriately sized for the pole.) Flag poles to including lockable covers to prevent tampering with the rope or cable.

4.1.6 Exterior Signage

4.1.6.1 Refer to VA Signage Design Guide PG 18-10 latest edition for signage standards and requirements, including dedication plaque and main entrance monuments.

4.2 Site/Civil/Landscape

4.2.1 Pedestrian and Vehicle Access & Circulation

4.2.1.1 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.

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

4.2.1.3 Provide a service area with a loading dock designed to accommodate truck (WB-

62) maneuverability. The loading dock shall be 4 feet above the driveway.

Platforms shall have a minimum depth of 8 feet front to back or between dock lift/leveler and back wall. Provide canopy over the platform with minimum 14 feet of clearance from grade to the underside of the canopy. The canopy shall extend a minimum of 4 feet beyond the edge of the dock for weather protection. Provide stairs or ramp to the platform. Provide hydraulic dock levelers with 25,000 pounds capacity for recessed installation at loading dock. Dock leveler to include toe guard sensor and safety skirting.

4.2.1.4 Service area shall accommodate vehicles that pick up trash and recycled materials. Locate service area away from public and patient areas. Provide reflective traffic control signs as required for intersections, no parking lanes, and guidance of site traffic.

4.2.1.5 Traffic flow must differentiate between patient/visitors, ambulettes/ambulance, staff, and loading dock traffic.

4.2.1.6 Site parking lot/pathway/driveway lighting shall be maintained at minimum levels throughout the night. Provide a minimum of 3 footcandles of light (average) in all areas of the site parking lot/pathway/driveway from one hour prior to building opening to one hour after last person leaves in the evenings.

Addit ional Site/Civil Requirements:

Fire Truck Access: Fire Department access, access roads, and water supplies shall comply with NFPA.

Fire apparatus access roads, fire hydrant systems, and access boxes shall be submitted to the authority having jurisdiction (AHJ) for review and approval prior to construction.

Traffic calming devices are by Lessor and must be approved by the AHJ.

Gates and Fencing: Gates and fencing around the property are to be provided by Lessor and must be confirmed with the VA.

VA Leased Allentown PA CBOC Design Narrative

Section 4 – Page 3

Landscaping: Where conditions permit, the site shall be landscaped for low maintenance and water conservation with plants that are either native or well adapted to local growing conditions.

Provide a walking path around perimeter of property.

Allow for generous green space within the property including generous green space adjacent to one side of the building, including a walking path.

4.2.2 Parking

4.2.2.1 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. Parking lot shall be minimum two-layer asphalt with access drive to front entrance heavy duty asphalt for fire truck / city bus.

Heavy duty asphalt must be used on ALL travel ways. Motorcycle parking pads shall be concrete.

Additional Parking Requirements:

Parking requirements shall meet local AHJ.

Lessor shall provide, at a minimum, a total of 600 parking spaces with 540 standard, 50 accessible, 10 van and three motorcycle parking stalls. Parking for one government vehicle shall be provided.

Lessor shall provide six Level 2 Electric Vehicle Charging Stations for GSA fleet vehicles of which one shall be an accessible parking stall. Electrical infrastructure shall be sized to accommodate a total of 10 Electric Vehicle Charging Stations in the future.

Provide signage for dedicated parking spaces (VA Police / Volunteers / GSA Vehicles).

4.2.3 Site Grading

4.2.3.1 Roads and walks shall have a typical cross slope of 2 percent unless adequate surface drainage is provided by other slope conditions, except as required for compliant slope at handicap parking spaces.

4.3 Architecture

4.3.1 General Criteria

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

4.3.1.2 Women’s Clinic optimal location within the clinic to be further studied by

Developer A/E.

4.3.1.3 Identify a minimum of two Exam Rooms during design to be negative pressure within PACT with HEPA filtered exhaust, and room air pressure monitor.

4.3.1.4 Police Department Secure Storage is to be secured and alarmed separately from

Police Locker Rooms.

4.3.1.5 For Police Department, include a wall mounted personal weapon carry locker box within the Locker Rooms.

4.3.1.6 Avoid placing exterior windows in Police Department Secure Storage area.

4.3.1.7 Any perforations in Police Department Secure Storage and Locker Rooms are to be less than 96 square inches, including HVAC supply and return registers.

VA Leased Allentown PA CBOC Design Narrative

Section 4 – Page 4

4.3.1.8 Provide PIV readers with pin pad at all Police Department areas. All other doors requiring PIV within the facility must be coordinated with VA.

4.3.1.9 Dental Clinic Operatories shall be designed as enclosed rooms with doors containing glazing for visibility/direct view into the Operatories. Confirm use of barn doors in Operatories during design.

4.3.1.10 Provide Dental Treatment Rooms with negative pressure.

4.3.1.11 If building is proposed to be two story, services to be prioritized to locate

Diagnostic Testing and PACT on First Floor and other Multi-Specialty Clinics on the Second Floor.

4.3.1.12 Consult Rooms should be able to be easily converted to Exam Rooms. Provide rough-ins for water/piping for a sink and blocking for wall and base cabinets.

4.3.1.13 Curtain track length as shown on room contents will vary depending on Exam

Room layout during design. Confirm length during design.

4.3.1.14 All Procedure Rooms must have a bariatric patient lift (1,000 lb.) with trajectory into the bathroom, where applicable.

4.3.1.15 At least two Exam Rooms must have patient lifts, non-bariatric (650 lb.).

4.3.1.16 Provide blocking for all wall mounted equipment and cabinets.

4.3.1.17 Provide a moveable partition between two Shared Medical Equipment rooms.

4.3.1.18 Add flag poles in the main entry/waiting area.

4.3.1.19 Provide slab recess for a wheelchair accessible scale in PACT area.

4.3.1.20 Lessor shall provide and install recessed Automated External Defibrillators (AED) in easily accessible and visible locations throughout the facility. AED locations shall include reception desks, waiting rooms, near elevators (as applicable), and in hallways/corridors. Additionally, they should be placed near areas where there is a higher risk of cardiac emergencies. AED quantity and precise location to be confirmed during design.

4.3.1.21 Provide blocking for ceiling mounted safety mirrors on hallways. Location is to be defined during design.

4.3.1.22 Provide a sink outside the Staff Collection Toilet within the Lab Pathology functional area.

4.3.1.23 Sterile Consumables Storage room to be temperature and humidity controlled.

Refer to VA Design Guides for requirements.

4.3.1.24 Provide wall bumper wall protection in all Storage Rooms.

4.3.1.25 Logistics Bulk Storage shall have a vault bolted to floor.

4.3.1.26 General Radiology control room siting coordination and corresponding components are to be completed during design phase.

4.3.1.27 Fluoroscopy Room control room siting coordination and corresponding components are to be completed during design phase.

4.3.1.28 Audio booths are to be recessed in slab.

4.3.1.29 Operating Endodontic Microscope is to be ceiling mounted. Provide structural support and blocking as required for installation.

VA Leased Allentown PA CBOC Design Narrative

Section 4 – Page 5

4.3.1.30 Provide an eye wash to the sink in one of the Dental Treatment Rooms (DTR) to use “Formalin.” Provide this eye station in the DTR farthest from the Laboratory.

Coordinate during design.

4.3.1.31 Three Exam Rooms in PACT are to be negatively pressurized. One Exam Room in each PACT. Provide pressurization status controller outside the Exam Room.

Coordinate during design.

4.3.1.32 Card reader system to be integrated with the Medical Center System.

4.3.1.33 Space distribution shall have the Secure Storage Room for Police Services located between the two Locker Rooms. Provide a pass-through between Locker

Rooms and Secure Storage. Secure Storage Room must have access from corridor.

4.3.1.34 Avoid placing Police Secure Storage Room by an exterior window. Coordinate location of this room during design.

4.3.1.35 Size of penetrations into Police Secure Storage areas must follow VA Design

Guides. Coordinate during design.

4.3.1.36 Police Locker Rooms must have a countertop and compressed air for gun cleaning.

4.3.1.37 Guest Wi-Fi is to be provided by Lessor.

4.3.1.38 Confirm Clinical Staff Workroom/Nurse Alcove optimal location during design.

4.3.1.39 Locate Optometry Reusable Medical Equipment (RME) Room in close proximity to Dental Clinic and Eye Clinic during design.

4.3.1.40 Additional Lessor Spaces/Items

4.3.1.40.1 Maintenance Staff Office

4.3.1.40.2 Cleaning Supplies/Equipment Storage

4.3.1.40.3 Housekeeping Rooms

4.3.1.40.4 Special Systems Room to include but not limited to:

4.3.1.40.4.1 CCTV

4.3.1.40.4.2 Duress

4.3.1.40.4.3 Fire Alarm

4.3.1.40.5 All vestibules in the facility are Lessor spaces. Lessor is to provide vestibules at all entry points as required by the building code.

4.3.1.40.6 Concrete pad with partial covered outdoor area for staff respite/seating areas with outdoor furniture and privacy area designed with landscaping.

4.3.1.41 Radiology Mobile Unit requirements:

4.3.1.41.1 Lessor shall provide medical diagnostics trailer concrete pad on grade with an awning. There shall be no contiguous physical connection to building.

4.3.1.41.2 Provide adequate turning radius and access for radiology mobile unit sized vehicles.

4.3.1.41.3 There shall be a utility pedestal rough-in to provide future infrastructure services required to the Radiology Mobile Medical Unit.

4.3.1.41.4 Concrete pad to be provided with drainage/sanitary.

4.3.1.42 Reception areas:

4.3.1.42.1 Provide dividers between reception staff work areas.

VA Leased Allentown PA CBOC Design Narrative

Section 4 – Page 6

4.3.1.42.2 Reception areas are to be designed contiguous as much as possible.

4.3.1.42.3 Provide laptop bar seating at individual waiting seating areas.

4.3.1.43 Police area adjacent to main building vestibule shall contain a ballistic glass wall min 2/3 the width of the wall and shall contain a pass-through tray and a voice port.

4.3.1.44 Police Operations Room is to include minimum of one large screen TV/monitor to view security cameras. A security computer is to be located in this room to control/monitor/program the CCTV, card reader system, duress/panic alarms, and intrusion detection system.

4.3.1.45 PIV card reader system shall be connected by VA VLAN back to the Wilkes

Barre VAMC. The CCTV camera system shall be able to be remotely viewed via

VA VLAN from the Wilkes-Barre VAMC. The intrusion detection system (IDS) shall by monitored by a 3rd party alarm monitoring company (paid for by the lessor) and shall also send alarms back to the Wilkes-Barre VAMC by VLAN or telephone line (or both).

4.3.1.46 Power failure alarms are to be provided and shall be active 24 hours a day. Upon instantaneous utility power failure, a power failure alarm shall send an automated text message and or email and or other notification to at least all of the following:

Lessor’s building manager, VA police dispatch Wilkes Barre VAMC, designated

VA facilities manager, VA Allentown police supervisor, and others as directed.

4.3.1.47 Police suite perimeter walls and doors and windows shall be ballistic rated, meeting ULS 752 Level 3.

4.3.1.48 Lessor is to ensure building cellular phone coverage from all major cell phone vendors and add repeaters and amplifiers as needed.

4.3.2 Accommodations for Care of Patients of Size

4.3.2.1 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 650-pound capacity design requirement. Additional capacity may be required and listed in the project specific requirements.

4.3.3 Acoustics

4.3.3.1 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. In addition to room requirements, provide an electronic sound masking system for all team/workstation areas.

4.3.4 Equipment/Accessories/Furnishings

4.3.4.1 Refer to CBOC Project Contents List and Room Template sheets provided with the RLP for equipment, accessories, and furnishing 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.

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4.3.5 Signage and Wayfinding

4.3.5.1 Refer to VA Signage Design Guide PG 18-10 for signage standards and requirements including dedication plaque in Facility Dedication Plaques and

Seals.

4.3.5.1.1 Lessor is to coordinate with Authority Having Jurisdiction to provide or relocate off site signage to new facility location.

4.3.5.1.2 Additional signage by Lessor is to include military medallions and will be incorporated into the design in coordination with the Medical Center

Interior Designer.

Addit ional Signage Requirements:

Approved exterior signage and roadway surface markings shall be provided and maintained by Lessor and designed to identify fire apparatus access roads and to prohibit obstruction.

4.3.6 Critical Dimensions

4.3.6.1 Patient-use corridors shall be 6 feet minimum. Staff corridors for transport of supplies from loading dock area to services shall be 8 feet minimum. Corridors within the Radiology Department and dedicated path from ambulance entry shall be 8 feet minimum throughout to accommodate stretchers.

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

4.3.7 Entry Canopies

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

4.3.7.2 Lessor shall provide a main building entry canopy with traffic flow for drop-off, pick-up, and Uber/Lyft traffic with space for at least one full-size passenger vehicle (19 feet long) and an accessible access aisle. Canopy to cover minimum of two traffic lanes at drop-off. The main entrance sidewalk is to be at the same elevation as the drop off lane. This area of sidewalk, plus at least 20 feet on either side, shall be protected by security bollards to keep vehicles off the sidewalk but allow free pedestrian and wheelchair access.

4.3.7.3 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. Provide large, lettered signage on the building or on the canopy indicating Ambulance Entrance.

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

4.3.7.5 Audiology Booth

4.3.7.5.1 Booth are to be fitted with fully recessed fire sprinklers on interior.

4.3.7.5.2 Provide out single swinging doors in booths.

4.3.7.5.3 Provide minimum 7-feet 0-inch clear ceiling height interior.

4.3.7.5.4 Provide additional power/data VA to provide details and location with final booth layout.

4.3.7.5.5 Audiometric booth flooring shall be resilient tile.

4.3.7.5.6 Walls shall be metal sound absorbent panel walls (no fabric).

4.3.7.5.7 Provide phones on both sides.

4.3.7.5.8 Provide power and data for Biomet NOAH workstation.

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4.3.7.5.9 Provide audio/visual fire alarm in each booth section.

4.3.7.5.10 Provide recessed floor slab at the location of audio booths.

4.3.8 Elevators

4.3.8.1 Where elevators are provided in a leased facility, not less than at least 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.

4.3.9 Slab Depressions and Thickened Slabs

4.3.9.1 At new construction, provide slab depression and thickened slabs as required to provide flush threshold installation at audiology booths and other equipment requiring recessed installation or additional structure as recommended by equipment manufacturer. At these equipment locations, concrete slab 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.

4.3.10 Millwork

4.3.10.1 Quality compliance shall conform to Architectural Woodwork Institute (AWI) and

Woodwork Institute (WI) quality standards.

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

Lobby, Reception)

4.3.10.2.1 Construction: Flush overlay construction with concealed hinges. AWI custom grade. Provide HPL Thermoformed casework in patient care areas where applicable.

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

4.3.10.3.1 Construction: Flush overlay construction with concealed hinges, AWI

Custom Grade

4.3.10.3.2 Cabinet Hardware:

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

4.3.10.3.2.2 Full extension drawer guides, 100-pound capacity.

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

4.3.10.3.2.4 Provide hinge restrictors where millwork doors hit adjacent walls.

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

(methyl methacrylate) material in color to be selected by designer. Thickness: ½-inch minimum.

4.3.10.4.1 Locations:

4.3.10.4.1.1 Transaction tops at nurse stations and reception desks.

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

4.3.10.4.1.3 Where scheduled as wall protection, provide ¼-inch thick material with welded seams.

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

4.3.10.5.1 Locations:

4.3.10.5.1.1 SPS Decontamination, Scope Processing, Preparations and

Assembly, and Sterilization Areas

4.3.11 Joint Sealant Systems

4.3.11.1 Joints at plumbing fixtures, ceramic tile are to be mildew-resistant silicone.

4.3.12 Doors and Frames

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

4.3.12.2 Doors to General Rad/Fluoroscopy Rooms to be equipped with a pair of doors that provide a minimum 50-inch clear opening. Door opening sizes for these rooms shall comply with site-specific requirements with VAMC Imaging

Contractor's requirements. These site-specific requirements will not be fully known until after Award of VAMC Imaging Vendor contract.

4.3.12.3 Finish: Prefinished in compliance with AWI Section 1500.

4.3.12.3.1 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.

4.3.12.3.2 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.

4.3.12.4 Access Panels:

4.3.12.4.1 Flush stainless steel at toilet areas

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

4.3.12.4.3 Fire rated steel at rated construction

4.3.12.5 All Communications Rooms doors are to swing out.

4.3.12.6 Entrance doors at Main Entry, Ambulance Pickup, and Staff Entry shall be automatic, sliding anodized aluminum construction with safety glazing and shall comply with energy and sustainability requirements. Where vestibules are provided, exterior and interior door assemblies shall match. Ambulance Pickup shall have 4 feet 0 inch minimum clear opening.

4.3.12.7 Swinging exterior doors and frames, except entrance doors, shall be heavy duty, insulated, continuously welded, flush, hollow steel construction. Exterior doors shall be weather-stripped, self-closing, and open outward. Door hardware shall be selected from pertinent chapters of VA Document PG 18-14 Room Finishes, Doors & Hardware Schedule including Chapter 265. Provide latch guards and hinges with non-removable pins to deter tampering or unauthorized entry.

4.3.12.8 Automatic Doors

4.3.12.8.1 Design automatic doors to operate manually in the event of power failure. Equip controls with safety devices for pedestrian protection.

Provide door operator controls and equipment that are easily accessible for maintenance. Design automatic doors to open from both sides.

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4.3.13 Roofs

4.3.13.1 Contractor shall provide a weathertight roofing system utilizing a low-slope, steep-slope, or combination of low and steep-slope systems that comply with all applicable Federal, State, and Local Codes & Ordinances and are installed in accordance with roof system manufacturer’s approved instructions.

4.3.13.2 Roof system shall utilize roof drains, overflow drains, scuppers, or gutters & downspouts as appropriate to roof design and drain into an underground stormwater drainage system. All roofs shall slope to roof drains or gutters.

4.3.13.3 Coordinate roof drainage with site (storm) drainage. Where roof drain leaders do not connect directly to storm drains, provide scuppers under all sidewalks and flatwork to convey storm flow to site drainage system.

4.3.13.4 Use a minimum 8-inch-high base flashing at walls and penetrations. Do not use pitch pockets or similar penetration seals.

4.3.13.5 VA will require a rooftop mounted satellite system or other roof top antennas for the building. The roof shall be maintained in a watertight condition at all such mounting locations. Provide appropriately sized conduit sleeving and weatherproof box at roof end of conduit sleeve.

4.3.14 Hardware

4.3.14.1 General Note

4.3.14.1.1 Hardware sets shall be provided as per Section 5 Hardware Groups and Modifiers. Provide extra heavy duty, Grade 1 hardware for all components.

4.3.14.2 Major components and finishes are as follows:

4.3.14.2.1 Cylinders and Keying: Key locks/cylinders in groups with new master key or grandmaster key system as directed by Owner. Provide three keys per lock. (Exact quantity of keys for each keyway to be determined later, based on the total quantity of locks times three keys). Provide construction master keying. Cylinders shall meet the requirements of

ANSI/BHMA A156.5-14.

4.3.14.2.2 Low Energy Automatic operators, ANSI A156.19-07. Heavy duty commercial grade. Provide complete with drop plates, brackets, 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. Refer to floor plans for type of actuation devices and bollards if required. Coordinate with Security Contractor for doors actuated by electronic access control system.

4.3.14.2.3 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 shall coordinate the provision and installation of the products to match the current system utilized at the main VA Medical Center.

Refer to documents with Security Information for location(s) and type(s) of control(s). Connection by Electrical Contractor. In addition to doors listed in the room data matrix, include budget for thirty-five (35) additional electronic access control doors, with card reader and all associated components and hardware.

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4.3.14.2.4 Stops

4.3.14.2.4.1 Provide stops as appropriate for opening/stop conditions, utilizing wall stops/bumpers, overhead stops or stop arms on closers.

4.3.14.2.4.2 Do not use floor stops unless specifically noted. Doorstops shall meet the requirements of wall stops ANSI/BHMA A156.16.08 and overhead stops ANSI/BHMA156.08-05.

4.3.14.2.5 Kick Plates/Armor Plates/Push Plates/Pull Plates

4.3.14.2.5.1 Provide kick plates, armor plates, and push/pull plates where specified in assigned hardware group. At pairs of doors provide plates for both doors.

4.3.15 Radiation Shielding

4.3.15.1 For Radiology, Fluoroscopy, Mammography, CT scan, and Dental X-Ray

Rooms, obtain the services of a physicist to design, specify the level of radiation protection required, and test and certify the installations.

4.3.15.2 Comply with requirements of the National Council on Radiation Protection and

Measurement (NCRP) Report #49.

4.3.15.3 Provide lead lining of gypsum wall board, wood doors and hardware, hollow metal frames, and lead glass view window.

4.3.15.4 Lead sheet to be FS QQ-L-201, Grade C, thickness as required by physicist report but not less than 1/16 inch.

4.4 Interior Design

4.4.1 General Criteria

4.4.1.1 Refer to Appendix: Room Data Matrix – Interior Construction for finish requirements listed by room type. Interior finishes shall be provided as indicated in VA Program Guide 18-14 Room Finishes, Doors & Hardware Schedule including Chapter 265. VA must review and approve any deviation from this document prior to the start of final construction documents.

4.4.1.2 The Interior Design concept and materials, finishes, colors, patterns, and textures must be approved by the Senior Resident Engineer in coordination with the

Interior Designer of the main VA Medical Center.

4.4.1.3 The primary objective of the interior design is to provide a residential, therapeutic environment. Finishes, fixtures, and furnishings that maintain the safety and security of the facility need to be integrated into the design without detracting from this primary objective. A warm, welcoming, and familiar environment can help calm patients and promote their participation in treatment and their rehabilitation and recovery. The facility is to provide a supportive interior environment that is conducive to healing both the patient’s mind and body, is respectful of the public monies, promotes staff performance, and expresses high quality design.

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4.4.1.4 The design is to pivot from the facility’s mission and its patient profile. This includes a working knowledge of the profile and characteristics of the veteran as a patient population and the distinct profile of the users of said facility and said project. VA patients are often long-term, high repeaters with multi-medical problems. Each user group will reveal the degree of need for the design to address aging, physical and mental disabilities, abusiveness, loss of function and perceptual ability.

4.4.1.5 Functional requirements dictate maintainable colors, textures, patterns, material selections, combination of materials, and installation techniques. Materials must be chosen for longevity and good appearance retention.

4.4.1.6 Design attention shall be given to all spaces. Areas which could initiate the design may be the lobby or administrative suite, but extensions of the same quality and variety are required for the corridors, staff areas, and patient areas.

The design must offer a distinctive and clear lead for the planning and selecting of interior furnishings. Designs that narrow choices of procurement furnishings are inappropriate. A working understanding of the limits of government sources is to be considered. This consideration will produce a good environment for the furnishings.

4.4.1.7 Designs that use "lifetime of the building" materials in colors, patterns, and designs that transcend time are endorsed. Trendy colors and patterns are to be restricted to cycle replacement materials, such as paint and wall coverings.

4.4.2 Wayfinding

4.4.2.1 A "wayfinding" process shall be designed for the project. Patients, visitors, and staff need to know where they are, what their destination is, how to get there, and how to return to their origination point. Identification, personalization of occupied spaces, and orientation are all to be addressed in the design. Wayfinding is to be thought of broadly as building elements, color, texture, and pattern cues, as well as a coordinated set-up for separate contracted signage, artwork, with Directory.

4.4.2.2 Refer to VA Signage Design Manual PG 18-10 latest edition (May 16, 2023).

4.4.3 Acoustic Ceiling Tile

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

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

4.4.4 Concrete Floor Treatment

4.4.4.1 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.

4.4.5 Fiberglass-Reinforced Panels

4.4.5.1 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.

4.4.6 Painting

4.4.6.1 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.

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

4.4.6.2.1 Ceilings: Flat latex.

4.4.6.2.2 Walls - gypsum wallboard: Satin latex.

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

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

4.4.7 Wall Protection

4.4.7.1 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.

4.4.7.2 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-inch width each way from corner. Height to be 7 feet from top of base, including top and bottom matching trim.

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

4.4.7.3 Handrails: Provide snap-on covers of resilient material consisting of high impact resistant extruded acrylic vinyl, polyvinyl chloride, or injection molded thermal plastic. Class 1 fire rating when tested in accordance with ASTM E84.

Handrail/Wall Guard Combination shall consist of snap-on covers of resilient material, minimum 0.078-inch thick, free-floated on a continuous, extruded aluminum retainer, minimum 0.072-inch thick, anchored to wall at maximum 32 inches on center.

4.4.7.3.1 Location: Provide at all clinic corridors and public areas as defined by

FGI.

4.4.7.4 Wall Guards (Crash Rails) shall consist of snap-on covers of resilient material, minimum 0.110-inch thick, free-floated over a continuous extruded aluminum retainer, minimum 0.090-inch thick anchored to wall at maximum 24 inches on center.

4.4.7.4.1 Location: Provide at all clinic corridors and public areas as defined by

FGI.

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

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

4.4.8 Window Shades

4.4.8.1 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 are 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.

4.4.8.1.1 Locations:

4.4.8.1.1.1 Semi-Transparent to be typical, unless otherwise noted. Provide 1 percent, 3 percent, or 5 percent opacity depending on location.

Confirm opacity during design.

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

4.4.9 Privacy Curtains / Screens

4.4.9.1 Provide curtain tracks with carriers and hooks (antimicrobial curtains shall be provided by the VA).