05.A.2 RLP 36C10F26R0024 Lease Design Narrative LDN SPB County FL OPC 7_17_2026.pdf

April 15, 2026

VA Leased CBOC Design Narrative

SECTION 1

INTRODUCTION

April 15, 2026 Section 1 - Page 1

1. INTRODUCTION

2. GENERAL REQUIREMENTS

2.1 General

2.2 Codes

2.3 Standards

2.4 References

2.5 Pricing Standards

2.6 CPM Schedule Requirements

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, Vehicle Access & Circulation

4.1.2 Physical Security

4.1.3 Parking

4.1.4 Roadway & Walkway Cross Slopes

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(Not Used)

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 & Handrails

4.3.7 Window Shades

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4.3.8 Privacy Curtains / Screens

4.3.9 Flooring, Carpet

4.3.10 Special Architectural Conditions for Surgical and Endovascular Services

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 Humidification System

4.4.7 HVAC Piping Systems

4.4.8 Air Distribution and Duct Systems

4.4.9 HVAC Insulation Systems

4.4.10 Testing, Adjusting and Balancing

4.4.11 Automatic Temperature Control Systems

4.4.12 Temperature, Humidity and Pressure Monitoring

4.4.13 Special Conditions

4.5 Plumbing

4.5.1 References

4.5.2 Plumbing Design Basis

4.5.3 Medical Gases

4.5.4 Special Conditions

4.6 Electrical

4.6.1 Standby Generator

4.6.2 Special Conditions

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

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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 shall be 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 This document, and the associated Room Data Matrix (RDM), provides performance-based standards for rooms/functions that are a part of the project’s Program for Design. If there are standards covered by this document, or room types in the RDM, that are not a part of a specific project’s Program for Design, those standards are considered not applicable to that specific project. However, standards added to the grey “additional requirements” boxes in this document are project specific and are applicable.

1.5 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 RDM Room Data Matrix

SECTION 2

GENERAL REQUIREMENTS

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SECTION 2 – GENERAL REQUIREMENTS

2.1 General

2.1.1 The codes and standards listed below indicate minimum performance requirements.

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 be in compliance with the requirements of the GSA Form L100 Global Lease as well as the codes and standards 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.

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

(AHJ).

2.2.1.2 National Fire Protection Association (NFPA), NFPA 101 Life Safety Code and those codes and standards referenced by NFPA 101. (NFPA 99 Health Care Facilities Code, etc.)

2.2.1.3 NFPA 70B Standard for Electrical Equipment Maintenance, NFPA 70E Workplace Electrical Safety, NFPA 75 Standard for the Fire Protection of Information Technology.

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

2.2.1.5 International Building Code (IBC): The latest edition shall be used for structural, wind load and seismic design.

Additional Code information:

• Lessor shall work with AHJ to properly determine occupancy type, with the following considerations:

o List rooms or procedures that are planned that may render a patient incapable of self-preservation.

o Applicable to NFPA 99, the facil ity is considered Category (Insert determined category from risk assessment or insert table that shows different categories for different departments.)

Applicable to NFPA 99, the facil ity is considered Category 2.

o Primary Care/PACT 1 – 3 discomfort o Mult ispecialty outpatient medicine and surgery – 2 minor injury o Mental Health – 3 discomfort o Audiology – 3 discomfort

April 15, 2026 Section 2 - Page 2 o Eye – 2 minor injury o Prosthetics – 3 discomfort o Lab – 3 discomfort o Imaging – 3 discomfort o Logistics – 2 minor injury o Police – 2 minor injury o OIT – 3 discomfort o Building Support – 3 discomfort o Whole Health – 3 discomfort o HAS/check-in Reception – 3 discomfort

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.

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

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

2.3.1.16 VA Signage Design Manual PG 18-10

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

Ambulatory Surgery

2.3.1.18 VA HVAC Design Manual (Specifically regarding the AHU design requirements for Pharmacy Compounding Suite, Sterile Processing Service (SPS), and Surgical Suite)

2.4 References

2.4.1 The following guides, manuals, and other references developed by VA are for reference only:

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)

2.5 Pricing Standards

2.5.1 Building Shell Definition

2.5.1.1 Building shell is the complete enveloping structure, the base building systems, and the finished common areas (building common and floor common) of a building that adjoin the occupant areas.

2.5.1.2 Any demolition cost necessary shall be included in the building shell rental rate.

2.5.1.3 Third-party green building certification do not change what elements are considered part of building shell or tenant improvements. Instead, building elements may be required to have certain attributes, such as low volatile organic compound emissions.

2.5.1.4 Section 3 of the L-100 provides minimum requirements of the shell. Any further requirements identified in this LDN to items in Section 3 shall remain shell unless specifically designated as TI.

2.5.1.5 The following table shows the Shell requirements of the Base Building and the Occupant Areas.

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

April 15, 2026 Section 2 - Page 4

Base Building Occupant Areas

Base structure and building enclosure components (windows with exterior finishes) and any required enhancements not designated as TI are complete.

Broom-clean concrete floor slab, with a flat and level floor.

Base building electrical, HVAC and plumbing systems (e.g., central fire alarm, chiller plant, cooling tower) are complete and functional.

Gypsum wallboard, spackled and prime painted, on exterior perimeter walls and tenant demising walls, without suite entry door.

All common areas, such as lobbies, elevators, fire egress corridors and stairwells, garages, and service areas are complete.

Suspended acoustical ceiling system including grid and lay-in tiles (or other building standard). Lighting luminaires should be installed in the ceiling grid for an open office plan at the rate of fixtures per 80 USF. Lighting controls with ambient lighting adjusted per daylight availability, occupancy, vacancy, or other building automation system signals.

Building common restrooms are complete and operational.

Tappable domestic water riser, service sanitary drain, sanitary vent, ready for extension to tenant demised areas.

All electrical power distribution panels and circuit breakers available in electrical closets, with capacities at 120/208 volt, 3- phase, 4-wire and 277/480 volt, 3-phase, 4-wire.

Designated connection point to the central fire alarm system for extension to tenant demised areas.

Devices and distribution in an open plan.

Fire suppression system ready for extension to tenant demised areas.

Sprinkler mains and distribution piping in a protection layout (open plan) with heads turned down, concealed with an escutcheon or trim plate, are installed.

Conduit pathways to distribution backboard within a demarcation room for connection to tenant telecommunications MCR or TR.

All security requirements designated as “Shell” in the Facility Security Level (FSL) Appendix are complete.

Proposed and required exterior site (property) improvements required for VA’s use of the premises and local municipality required off-site improvements are complete.

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2.5.2 Tenant Improvement Definitions

2.5.2.1 TIs are the finishes and fixtures that typically take space from the shell condition to a finished, usable condition. The resulting space is complete and meets applicable building codes.

2.5.2.2 TIs are typically items in addition to the items listed in the table above.

2.5.2.3 Section 5 of the L-100 provides minimum requirements of the TI. Any further requirements identified in this LDN to items in Section 5 shall remain TI unless specifically designated as Shell.

2.5.2.4 Typical Tenant Improvements include:

2.5.2.4.1 Electrical wiring, outlets, and horizontal conduit, including cable trays and hooks, within the demised premises. Telephone jacks, data, jacks, and horizontal conduit, including cable trays and hooks, within the demised premises.

2.5.2.4.2 Carpeting or other floor covering; raised access flooring.

2.5.2.4.3 Plumbing fixtures withing the demised premises and all distribution, drainage and vent piping connecting to the building core – except for common bathrooms.

2.5.2.4.4 Partitioning and wall finishes

2.5.2.4.5 Doors, sidelights, frames, and hardware.

2.5.2.4.6 Millwork

2.5.2.4.7 Window treatments

2.5.2.4.8 Adjustments or repositioning of fire sprinklers to avoid conflict with partitioning; additional sprinklers required by code to meet layout.

2.5.2.4.9 VA required signage on site, in the common areas and within the demised premises.

2.5.2.4.10 Additional lighting over the open office layout at a rate of fixtures per 80

USF.

2.5.2.4.11 Exterior site amenities required such as therapy gardens, gait training therapy areas and dining areas (site amenities proposed as building improvements by the lessor shall be shell).

2.5.2.4.12 Interior and exterior components of special systems required such as nurse call and duress systems.

2.5.2.4.13 Drop-off canopies

2.5.2.4.14 NFPA 99 required Essential Electrical Systems or standby power alternately specified.

2.5.2.4.15 HVAC system, components and electrical necessary to meet the requirements greater than the shell requirement in the L100 (.75 CFM per

SF).

2.6 CPM Schedule Requirements

CPM Schedules must include the following milestones.

2.6.1 All L100 section 4.01 Activities

2.6.2 Submission of Permits

2.6.3 Permits Received

2.6.4 Foundations Complete

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2.6.5 Structure Complete (steel erection)

2.6.6 Dry-in (skin and windows)

2.6.7 Conditioned Space (HVAC equipment startup)

2.6.8 Begin Final Inspections

2.6.9 Certificate of Occupancy Received

2.6.10 Space Acceptance

SECTION 3

PLANNING AND DESIGN CRITERIA

Section 3 - Page 1

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. The Lessor must use these concepts to deliver facilities for the VA that have consistent concepts.

3.3.2. The Department of Veterans Affairs (VA) seeks to create outpatient clinics that are familiar, functional, and efficient for Veterans and staff nationwide. This is achieved through these concepts which allow for uniformity in clinic appearance and operations. However, recognizing the diverse realities of leased buildings and regional needs, the VA supports flexible implementation of these standards to best adapt to local constraints and opportunities. Leased CBOCs are encouraged to maintain core spatial relationships and flow patterns, while adjusting layouts as necessary to fit within existing buildings.

3.3.3. Improvements to any and all included conceptual or block diagrams for the purpose of cost efficiency are highly encouraged.

3.4. Health Care Centers (HCC) Planning Approach

3.4.1. HCCs include outpatient Ambulatory Surgical and Endovascular services and/or

Digestive Diseases – Endoscopy services within the program for design in addition to other typical CBOC services.

3.4.2. The Surgical and Endovascular Service Design Guide must be referenced and used to incorporate the VA typical departmental layout and workflow when the PFD includes these services.

3.4.3. The Digestive Diseases – Endoscopy Services Design Guide must be referenced and used to incorporate the VA typical departmental layout and workflow when the PFD includes these services.

3.5. Room Data Matrix

3.5.1. A collection of typical rooms within leased CBOCs.

• It lists the required finishes, STC ratings, ceiling heights, door size and type, hardware sets, and HVAC space ventilation minimum requirements.

• as well as the estimated number of electrical receptacles, lighting controls and fixture types, and the number of standard density work area outlets for each room type,

• actual quantities shall be determined as necessary based on minimum required quantities for furniture, fixture and equipment planned.

3.5.2. 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.

3.5.3. 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 https://www.cfm.va.gov/til/dGuide/dgSurg.pdf https://www.cfm.va.gov/til/dGuide/dgDigestiveEndoscopy.pdf

SECTION 3

PLANNING AND DESIGN CRITERIA

Section 3 - Page 2

ASHRAE 170” lists the equivalent room name for use in the tables.

3.5.4. 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.

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

SECTION 4

TECHNICAL NARRATIVE

Section 4 - Page 1

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 Primary pedestrian access and circulation paths shall comfortably accommodate two-way wheelchair traffic.

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

4.1.1.4 For one way traffic lanes that are used as fire and emergency equipment access the minimum width shall be 20 feet.

4.1.1.5 Provide a service/loading area designed to accommodate truck (WB-62) maneuverability. Provide canopy for unloading in adverse weather conditions with 14 feet of clearance from grade to the underside of the canopy.

4.1.1.6 Service area shall accommodate vehicles that pick-up trash and recycled materials.

Locate service area away from public and patient areas.

4.1.2 Physical Security

4.1.2.1 The physical security requirements are listed in the FSL Appendix as developed by the ISC process.

4.1.3 Parking

4.1.3.1 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.

4.1.3.2 The total amount of accessible parking spaces provided shall be 6% of the total required spaces unless more is required by local code.

Additional Parking Requirements:

Design shall include separate staff and patient parking and service entry.

• Provide a minimum of 350 (55% patient, 45% staff) parking spaces. Provide ten (10) percent of patient and six (6) percent of staff parking as accessible parking. Provide ten (10) percent of the accessible parking as van accessible parking. Offeror shall follow ABAAS requirements for accessible patient/staff parking.

• Provide eighteen (18) concrete spaces for motorcycles.

• Staff and patients shall have separate entrances.

• If there is shared parking with other facil it ies, the VA shall retain the use of 350 spaces for VA only.

• The Lessor shall furnish and install a minimum of one rack each at patient and staff entrance for a minimum of 20 bicycles.

• Furnish & install a secure/fenced covered golf cart parking station large enough for

Section 4 - Page 2 two eight passenger golf carts.

• Golf cart parking station will include charging stations for each of the two golf carts.

• Lessor shall provide electrical infrastructure for 6 future Government electric vehicles.

• GOV shall be metered separately and paid as part of the facil ity util i t ies. Lessor can

Charging stations shall be Level 3 capable; 240 V power.

• Charging Stations shall have appropriate protection and space from vehicles (i.e.

parking bollards).

• Electr ic vehicle (EV) parking must be located at least 25 feet from any occupied structure unless the Office of Healthcare Engineering (OHE) has approved a deviation.

• EV parking must be located in an open surface area of the facil ity.

• EV parking cannot be located in any parking garage structure due to l imited access of mobile f ire suppression units within the garage, as well as limitations of current fire suppressions systems related to electric vehicle f ires.

• Provide (1) one covered PM&R staff GOV parking space for patient transport.

4.1.4 Roadway & Walkway Cross Slopes

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

Additional Site and Civil Requirements:

• The driveway shall be off a two directional entry ( i.e. Do not locate on a one-way street or boulevard).

• Provide a separate service/ambulance drive-thru pick up entrance.

• Provide direct access from Physical Medicine & Rehabil itation (PM&R) to an outside secure covered courtyard for gait training with fans.

• Provide ADA accessible, 6’ wide walking path around property perimeter.

• ADA accessible paths must be embedded in surface. No rubberized or similar material can be used.

• Provide a pet relief area.

• In addit ion to a f lagpole and flag representing the United States of America, the Lessor shall furnish and install flagpoles and flags representing the Department of Veterans Affairs and the state of Florida either near the entry to the building or along the entry drive in a landscaped setting. Confirm with the VA in f inal site selection and landscape/parking layout.

• Dumpsters are to be placed on a concrete pad and shall not be visible to patients.

Enclosure materials shall meet AHJ standards and complement the building architecture.

• Green spaces visible from within the building; waiting areas and exam rooms are high priority.

• Benches:

o Provide concrete pads for benches in green spaces. Pad shall be equipped

Section 4 - Page 3 with means to anchor benches.

o Six (6) benches are required within the parking areas and around the building; should play an integral part of this design. Provide exterior paved dining area large enough to accommodate twenty (20) staff.

• Provide covered space for outdoor green plaza space, approximately 750 SF. Area to be used for training, obstacle course for wheelchair and gait training.

• Main entrance canopy shall cover entire three decorative concrete traff ic lanes.

• Parking lot shall be minimum two-layer asphalt with access drive to front entrance heavy duty asphalt for f ire truck / city bus. Heavy duty asphalt must be used on ALL travel ways.

• Motorcycle parking pads shall be concrete.

• Exterior Signage - Lessor to provided exterior monument and building signs, both i lluminated internally.

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. A 750lb capacity must be used for the design of the space and its contents to include but not be limited to the lavatory, toilet, patient lifts, and necessary infrastructure to support. Additional capacity may be required and listed in the project specific requirements.

4.2.2.2 Rooms that are designed for access by individuals of size as noted on the PFD as Bariatric must have space for bariatric wheelchairs along the whole accessible route from the front doors to the bariatric spaces, to include elevators and lobby doors.

4.2.2.3 Turning Radius, Bariatric must be 1830 mm (6’0”)

4.2.2.4 T-Shaped Turning Space, Bariatric must be 1830 mm (6’0”) x (6’0”)

4.2.2.5 Distance from edge of toilet to side wall, Bariatric must be 915 mm (3’0”)

4.2.2.6 Grab bar configuration must have double swing-up bars with integral toilet paper dispenser.

4.2.2.7 Minimum width of doors in route to bariatric space must be 1220 mm (4’0”)

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

Section 4 - Page 4 requirements.

Additional Acoustics Requirements:

• Refer to RDM for specif ic acoustic requirements beyond FGI guidelines.

4.2.4 Equipment/Accessories/Furnishings

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

RLP for 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 uti l ity connections for all VA equipment which requires mechanical, plumbing, electrical, gas, water, air, data, steam, or any other uti li ty.

• Refer to Room Content List (RCL) for addit ional room furniture and accessories required for this project.

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:

Site Monument Sign shall be type El-01.01. Monument sign shall display “South Palm Beach County, FL Outpatient Clinic” with “West Palm Beach VA Healthcare System” and the facil ity address. It shall be backlit.

• Building signage, in addit ion to VA logo, read EI-09.9 TBD.

• Provide a facil ity dedication plaque per VA SD101400-04.

4.2.6 Critical Dimensions

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

4.2.6.2 Patient-use corridor doors must be a minimum of 42 inches wide.

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

Additional Critical Dimensions Requirements:

• Hallway access to Audio Booths shall be 8 feet minimum to allow for open booth doors.

4.2.7 Entry Canopies (TI)

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

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). The drop-off zone must have minimal change in level from drive isle to walkway for a minimum length of 20 feet.

Section 4 - Page 5

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.

Additional Canopy Requirements:

• Canopies complying with requirements of the Lease Design Narrative shall be provided at all Staff entrances.

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.

4.2.8.2 Where bariatric spaces are above ground level, elevator doors must open minimum 48 inches.

4.2.9 Slab Depressions and Thickened Slabs (TI)

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.

Additional Plastic Laminate Casework Constructions Requirements:

• All corners shall be rounded.

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.

Door and drawer pulls: 4” center to center wire pull, 5/16” diameter round, 1 ¼” projection, satin chrome. Addit ional Plastic Cabinet Hardware Requirements:

Section 4 - Page 6

• Doors opening to walls shall have hinge restr ictors to avoid pull handle damage.

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 Minimum width of any door for patient use not specified in the RDM must be 42”.

4.2.12.3 Finish: Prefinished in compliance with AWI Section 1500.

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 Doors and Frames Requirements:

• Provide corridor doors to separate patient and staff areas; minimum 42 inches in width. All corr idor doors must have 14” x 25” door l ites.

Provide 10 ft x 10 ft high clear opening roll up or overhead door and a 6 ft x 8 ft high double door in Receiving for deliveries.

• Provide steel doors with hollow metal frames and heavy-duty hinges in Logistics Biomedical Repair, and Medical Equipment Storage; wooden doors are not allowed in working areas.

• All rooms where a wall mounted folding chair is specif ied to be installed behind the door, the door frame must be a minimum 6” from the wall and include an overhead door stop to keep door from hitt ing chair.

• The following doors shall be full glass.

• Conference Rooms

• Staff Lounges

• Staff Entrances and Exits

• Doors from patient to staff areas and Police Screening shall be solid.

Section 4 - Page 7

• Doors from the PACT patient corridor to the PACT work area shall have lights.

• Provide visual and audio intercom system at Police, Logistics, Ambulance access and Management suite areas.

• Main and Ambulance entrances must have automatic sliding doors.

• Changing room doors must be capable of opening both inward and outward.

4.2.13 Hardware

4.2.13.1 General Note

4.2.13.1.1 Hardware sets shall be provided as per RDM and 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 master keying. Cylinders shall meet the requirements of ANSI/BHMA A156.5-14.

4.2.13.2.2 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 toilets, specimen toilets, dressing rooms, and lactation rooms shall have occupancy indicator on hardware.

• All Primary Care exam rooms shall have two locking mechanisms on staff side door:

one will be a one-sided deadbolt, lockable from patient side, with occupancy indicator and coin turn on opposite side, the other will be an off ice lock, lockable from staff side.

• Soiled and biohazard/hazard rooms shall have door closers.

• Automatic Door Openers shall be required in the following locations:

• Vestibule entrances (main lobby, ambulance/staff, etc.)

• Doors from back-of-house to lobby

• Main lobby toilets

• Doors leading from clinical areas to lobby.

• All patient restrooms.

Doors to clinic Management suite shall have door closers.

• Include 10” tall stainless steel kick plates on the egress side of all doors

• Include 34” tall stainless steel kick plates on all warehouse and delivery corridor doors.

• Install wall mounted door stops.

Section 4 - Page 8

4.2.14 Pharmacy Dispensing Windows(Not Used)

4.2.15 Radiation Shielding

4.2.15.1 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, test and certifies the installations.

4.2.15.2 Comply with requirements of the National Council on Radiation Protection and Measurement (NCRP) Report #49.

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

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

4.2.16 Radio Frequency Shielding and Magnetic Shielding

4.2.16.1 Magnetic Resonance Imaging (MRI) Radio Frequency Interference Shielding: It is required that the RF shielded room and all penetrations through the RF Shielding, i.e., electrical plumbing, and venting be electrically isolated by 1000 ohms or greater and RFI filtered to meet the minimum attenuation level of 100dB (10 MHz- 100 MHz) for plane wave and 90 dB (10 MHz-30 MHz) for magnetic wave.

4.2.16.1.1 Material should be brass-copper or aluminum which has been treated to prevent oxidation and all joints should be either welded or lapped and bolted.

4.2.16.1.2 Shielding to include wall, floor, door, and windows.

4.2.16.2 Magnetic Shielding System: Annealed steel plate, accessories, and coordination of shielding work.

4.2.16.3 Applicable Standards: Comply with requirements of State and Local regulating agencies where standards and criteria apply. Comply with MIL-STDS-220A and 285.

4.2.16.4 Employ Independent Testing Laboratory (ITL), experienced in testing and design of RF and magnetic shielded rooms, to review fabrication, design, and installation, and perform tests of radio frequency shielding as required to ascertain correct functioning of shielding.

4.3.20.4.1 Correct part of work which is found to be deficient in electromagnetic shielding.

4.3.20.4.2 Provide second test of RF enclosure after construction is complete.

4.3.20.4.3 Submit certified test results.

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.

Additional Ceiling Requirements:

Section 4 - Page 9

• Ceil ing height in PM&R exercise area shall be 12’-0” minimum unobstructed.

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 where indicated. 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.

Additional Materials Requirements:

• All toilets shall have minimum 52” high t i le wainscot with plumbing walls to be full-height wall t i le.

• Water closet partit ions shall be of phenolic material.

4.3.6 Wall Protection & Handrails

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.

4.3.6.4 Handrails:

4.3.6.4.1 Location: Provide on both walls in all patient corridors.

Additional Wall Protection Requirements:

• Handrails shall be provided in patient corridors on both sides.

Section 4 - Page 10

• Bumper guards shall be provided in delivery corridors.

• Handrails shall have rounded corners.

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.

Additional Window Shades Requirements:

• For any window above eight (8) feet provide automatic window shades.

• Window shades on exterior walls in the Mental Health Service Consult Rooms shall be spring loaded; no pull chords shall be used.

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.

Additional Privacy Curtains/Screens Requirements:

• Provide double blind setup to all perimeter windows.

4.3.9 Flooring, Carpet

4.3.9.1 Rooms specified to receive carpet and contain a sink shall have a minimum 4’ x 4’ area of RFT installed at the sink location.

4.3.10 Special Architectural Conditions for Surgical and Endovascular Services

4.3.10.1 Minimum corridor width shall be 8 feet in patient areas to accommodate passage of equipment or beds, non-patient areas where gurneys are not utilized can be a minimum of 5 feet.

4.3.10.2 The Clean Core shall have a ceiling height minimum of 9 feet above finished floor and shall be monolithic and scrubbable.

Additional Architectural Requirements:

Flooring transit ions shall be no more than ¼” max. where dissimilar materials are used.

• Transit ions are required where dissimilar f looring materials cause a change in elevation.

Section 4 - Page 11

• •Specialty flooring for specif ic equipment to be coordinated with manufacturer standards, i.e. Dissipative Flooring for Spec CT equipment.

• Building managers off icial shall be located in the back of the house area near logistics not near clinical areas.

• When determining location of various departments within the clinic there were numerous considerations made by the VA and design team. Such considerations include but are not limited to accessibility and visual wayfinding to the public, operational hours of the department and patient through-put time, access to the exterior, daylighting, and movement of staff, supplies, and equipment. As well, walking distances for the Veterans, visitors and staff were considered which led to a maximum overall floor footprint and corridor lengths.

• Information/Volunteer Desk and Lobby: This area shall include the Welcome Desk, Coffee Café, Enrollment, VSO Offices, Patient Advocate, and Visitor Toilets. The Welcome Desk shall be located as a prominent feature at the main lobby doors.

• Primary Care: Team work areas should be open areas with daylighting and include skylights. Utilize light from outside walls into open work spaces. Provide full height interior and exterior store front glazing in conference rooms and break rooms to provide daylighting to team work spaces. Include a minimum of two checkout windows per PACT.

• Mental Health: Shall be located adjacent to Primary Care.

• Police: Police shall be located to allow quick response to any department via the corridors. They shall have access to the staff corridor as well as to the main lobby.

Screening Room shall be located by the Main Entrance. Glazing is prohibited in the Police Screening area.

• Blood Draw and Waiting: This department shall be located near the main entry.

• Radiology: There are large/heavy pieces of equipment associated within this department. For ease of moving this equipment in place and repair as needed, it is optimum to keep this department on the first floor. As well, it is pertinent to “path” the necessary equipment to its permanent location. Corridor ceiling heights and door clearances shall be sized accordingly from entering the building all the way to the room it will be located. Dimmable lighting system shall be provided in the ultrasound rooms.

• PMRS and Prosthetics: PMRS and Prosthetics shall be located adjacent to one another.

• Logistics, BioMed, ITOPS, and Environmental Services (EMS): Logistics must be located as to allow for access of deliveries and shipments to and from all departments and must be located on a staff corridor to allow for movement of these items without being seen by the general public. They work closely with BioMed and EMS. ITOPS main server room and department shall also be located in this staff corridor and area.

• Audiology & Eye Clinic: Audiology is sensitive for sound and is preferred to be as far away as possible from those spaces that create a lot of noise (main lobby, toilets, etc.). The Eye Clinic prefers space without natural daylight. Eye Exam Rooms on exterior walls shall have no windows.

• Clinic Administration: Shall be located so that it is accessible to the floor lobby and to staff areas.

• Staff Conferences, Lounges, Staff Toilets and Support Spaces shall be located throughout the building and be convenient to all departments.

Section 4 - Page 12

• Canopy shall be extended four (4’) feet beyond edge of dock.

• There shall be no L-shaped or off-set doors in front vestibule entry.

• Separate employee entrance shall be located convenient to staff parking.

• Maximize daylight where possible. Use clerestory windows and skylights as necessary. Maximize glass and exterior views in waiting areas/lobby. Utilize light from outside walls into open workspaces. Provide interior store front glazing in conference spaces to provide daylighting to teamwork spaces.

• Provide bulkheads above all wall mounted cabinets and lockers.

• All interior partition walls shall extend to the deck above.

• Specimen toilets to have stainless steel shelf.

• Provide direct access to outside or have exterior access nearby to PMRS.

• Provide recessed scissor lift at loading dock; 25,000 lbs. capacity with integrated scale.

• Provide a total of 3 bay doors aligned to recessed dock levelers.

• Provide heavy-duty PVC translucent strips at loading dock overhead bay door openings.

• Lobby shall have partial height partitions with necessary connectivity for mounted televisions.

• Flooring with uniform value (light/dark), avoid abutting light and dark materials that give impression of level change. Provide contrast colors between horizonal and vertical surfaces for low vision patients.

• Movable partitions for group rooms shall be STC 55 minimum.

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

Additional Mechanical References:

• ASHRAE CLIMATIC DESIGN CONDITIONS 2021 ASHRAE climatic design condit ions 2009/2013/2017/2021 (ashrae-meteo.info) https://ashrae-meteo.info/v2.0/index.php?lat=27.498&lng=- 80.377&place=%27%27&wmo=722103

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 ASHRAE 170 do not fully address a space or room type.

4.4.2.1.2 Imaging Equipment Space Design Conditions

4.4.2.1.2.1 Equipment manufacturer requirements shall be followed.

4.4.2.1.2.2 Provide a dedicated computer room type AC unit to cool and control humidity for separate equipment rooms for radiology equipment.

4.4.2.1.2.3 Provide a computer room type AC unit to cool UPS…