EXHIBIT K Space Plan.pdf

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Texas City New Replacing Lease
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36C256R0143
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This document is a Program for Design for a new VA Community Based Outpatient Clinic (CBOC) lease located in Texas City, Texas. The facility is part of VISN 16 and will be associated with the Michael E. Debakey VA Medical Center. The design accommodates a two-PACT (Patient Aligned Care Team) module layout with approximately 41,334 gross square feet, including multiple functional areas such as outpatient clinics, mental health services, audiology, eye clinic, radiology, laboratory medicine, pharmacy, and support spaces.

The detailed space program breaks down specific room requirements for each functional area, including exam rooms, consultation spaces, team work areas, staff support zones, and utility spaces. The linear prototype design emphasizes integrated care delivery, with strategically located reception, shared medical appointment rooms, and supportive infrastructure. The clinic is designed to support multiple clinical specialties, with flexible spaces that can adapt to changing healthcare delivery models, and includes provisions for team-based care, patient education, and comprehensive medical services across various departments.

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RLP_Texas City New Replacing_01132026.pdf PDF
EXHIBIT A Global Lease Template L100.pdf PDF
36C25625R0143 0001 Signed.pdf PDF
Combined Synopsis 36C25625R0143.pdf PDF
Combined Synopsis.pdf PDF
EXHIBIT C Security Requirements (FSL Level II) (Oct 2024).pdf PDF
EXHIBIT D 3516 Solicitation Provisions Dec. 2023.pdf PDF
Exhibit S Room_Data_Matrix_7_3_24.xlsx XLSX spreadsheet
S02 RLP_Texas City New Replacing_12112025.pdf PDF
EXHIBIT E 3517B General Clauses (Dec. 2023).pdf PDF
EXHIBIT F Form 1364 Proposal to Lease Space Jan. 2023.pdf PDF
EXHIBIT H Prelease FPLS Evaluation Form 12000 May 2015.pdf PDF
Exhibit M Past Performance Questionnaire.pdf PDF
EXHIBIT A Global Lease Template L100.pdf PDF
Exhibit B Agency Specific Requirements.pdf PDF
EXHIBIT J FAR 52.204-24 Representation Digital Nov. 2021.pdf PDF
Exhibit O Janitorial Services and Site Management.pdf PDF
Exhibit P Operations and Maintenance OM Plan.pdf PDF
Exhibit Q Safety Fire Protection EM Appendix.pdf PDF
Exhibit R OIT-InfrastrucStdTelecomSpaces-v4-0.pdf PDF
EXHIBIT G Form 1217 - Lessor_s Annual Cost Statement Nov. 2016.pdf PDF
EXHIBIT I WAGE DETERMINATION_GALVESTON COUNTY.pdf PDF
Exhibit L Tenant Improvements Cost Summary.pdf PDF
Exhibit N VA_Leased_CBOC_Design_Narrative_Appendix A.pdf PDF
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PROGRAM FOR DESIGN

TEXAS CITY NEW LEASE (COPIED 18 JAN 2022 10:58AM ET)

TX CITY CBOC NEW LEASE

TEXAS CITY, TX

Projected Year: 2022 Midpoint Year: 2023

VISN: 16 State: TX Station ID: 580 Station: Houston

Installation: Michael E. Debakey VA Medical Center

Project Created: 12 Sep 2016 02:22PM ET by Lara Horvith Space Plan Last Edited: 18 Jan 2022 05:27PM ET by Lara Horvith

Contents List Created: 28 Sep 2016 03:57PM ET by Lara Horvith Contents List Last Edited: 18 Jan 2022 03:13PM ET by Lara Horvith

Report Generated: 18 Jan 2022 05:29PM

EXHIBIT K

LESSOR__________GOVERNMENT__________

Department: 1 - OUTPATIENT / PACT CLINIC (265)

Functional Area: 1 - LOBBY / RECEPTION AREA

Qty Room Code Room Name Unit Area

Net Area

Const Phase

Const Type

2 CLSC2 Workstation, Patient Education 0 0 1 0

1 LOB02 Vestibule 200 200 1 0

10 RECP3 Reception 60 600 1 0

3 RECP5 Reception, Accessible 100 300 1 0

1 SRLW1 Alcove, Wheelchair 90 90 1 0

1 TLTF2 Toilet, Female 200 200 1 0

2 TLTF3 Toilet, Family 75 150 1 0

1 TLTM2 Toilet, Male 200 200 1 0

1 WRC05 Waiting, PACT 2 3,400 3,400 1 0

1 WRF01 Waiting, PACT Family 60 60 1 0

FA Totals: Room Qty: 23 Net Area: 5,200 Gross Area: 7,800

Department: 1 - OUTPATIENT / PACT CLINIC (265)

Functional Area: 3 - PATIENT ALIGNED CARE TEAM (PACT) CLINIC 2

Qty Room Code Room Name Unit Area

Net Area

Const Phase

Const Type

2 CLSC4 Shared Medical Appointment Room 0 0 1 0

2 CRA01 Conference Room 250 500 1 0

16 EXPA1 Exam Room, Patient Aligned Care Team (PACT) 125 2,000 1 0

4 EXW01 Exam Room, Women's Health 125 500 1 0

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Program For Design (18 Jan 2022 05:29PM)

TEXAS CITY NEW LEASE (COPIED 18 JAN 2022 10:58AM ET)

TX CITY CBOC NEW LEASE

TEXAS CITY, TX

Functional Area: 3 - PATIENT ALIGNED CARE TEAM (PACT) CLINIC 2

Qty Room Code Room Name Unit Area

Net Area

Const Phase

Const Type

2 LR001 Locker, Staff Personal Property 60 120 1 0

2 OFA07 Workstation, Administrative 0 0 1 0

8 OFA07 Workstation, Extended Team 0 0 1 0

8 OFDC2 Consult Room, Patient Aligned Care Team (PACT) 125 1,000 1 0

2 PEHW1 Alcove, Height / Weight Station 30 60 1 0

1 PEHW2 Alcove, Height / Weight Accessible Station 40 40 1 0

2 RCA01 Alcove, Resuscitation Cart 0 0 1 0

2 RCA06 Alcove, Medication 20 40 1 0

2 SL001 Lounge, Staff 220 440 1 0

2 SRE01 Storage, Medical Equipment 120 240 1 0

2 SRE01 Storage, Shared Medical Appointments 0 0 1 0

1 TLTB1 Toilet, General Procedure Room Patient 75 75 1 0

4 TLTF1 Toilet, Women's Health Exam Room Patient 60 240 1 0

4 TLTU1 TOILET, General 60 240 1 0

2 TLTU1 Toilet, Staff 60 120 1 0

1 TRPR1 Procedure Room, General 180 180 1 0

2 UCCL1 Utility Room, Clean 60 120 1 0

1 WKTM1 Classroom 0 0 1 0

2 WKTM3 Workroom, Patient Aligned Care Team (PACT) 100 200 1 0

8 WRTM1 Team Work Area 240 1,920 1 0

1 WRTM2 Tele-Health Room 0 0 1 0

1 WRTM3 Tele-Retinal Room 125 125 1 0

FA Totals: Room Qty: 84 Net Area: 8,160 Gross Area: 12,240

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Program For Design (18 Jan 2022 05:29PM)

TEXAS CITY NEW LEASE (COPIED 18 JAN 2022 10:58AM ET)

TX CITY CBOC NEW LEASE

TEXAS CITY, TX

Functional Area: 5 - AUDIOLOGY AND SPEECH PATHOLOGY CLINIC

Qty Room Code Room Name Unit Area

Net Area

Const Phase

Const Type

2 EXAU1 Exam / Consult, Audiology 125 250 1 0

1 HAFR1 Hearing Aid Fitting Room 125 125 1 0

1 OPMH1 Group Therapy Room, Audiology 0 0 1 0

2 PEHS4 Exam, Audiometric Booth 260 520 1 0

1 SRSE1 Storage, Equipment 100 100 1 0

1 TLTU1 Toilet, Audiology Patient 0 0 1 0

FA Totals: Room Qty: 8 Net Area: 995 Gross Area: 1,493

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Program For Design (18 Jan 2022 05:29PM)

TEXAS CITY NEW LEASE (COPIED 18 JAN 2022 10:58AM ET)

TX CITY CBOC NEW LEASE

TEXAS CITY, TX

Functional Area: 7 - EYE CLINIC

Qty Room Code Room Name Unit Area

Net Area

Const Phase

Const Type

2 EYFD1 Fitting and Dispensing Room 125 250 1 0

3 EYOT2 Exam / Eye Lane 125 375 1 0

2 EYOT2 Exam / Treatment Room 0 0 1 0

1 EYOT4 Exam / Training Room, Low Vision 0 0 1 0

1 EYVF1 Visual Fields Room 125 125 1 0

1 EYVS1 OCT Room 120 120 1 0

1 EYVS1 Pre-Testing Room 0 0 1 0

1 WRC03 Sub-Waiting, Dilation Patient 60 60 1 0

1 WRTM1 Team Work Area, Eye Clinic 180 180 1 0

FA Totals: Room Qty: 13 Net Area: 1,110 Gross Area: 1,665

Department: 1 - OUTPATIENT / PACT CLINIC (265)

Functional Area: 8 - MENTAL HEALTH CLINIC

Qty Room Code Room Name Unit Area

Net Area

Const Phase

Const Type

12 OFDC1 Consult Room, Mental Health 125 1,500 1 0

1 OPMH1 Group Therapy Room, Mental Health 250 250 1 0

1 WRTM1 Team Work Area, Mental Health 0 0 1 0

FA Totals: Room Qty: 14 Net Area: 1,750 Gross Area: 2,625

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Program For Design (18 Jan 2022 05:29PM)

TEXAS CITY NEW LEASE (COPIED 18 JAN 2022 10:58AM ET)

TX CITY CBOC NEW LEASE

TEXAS CITY, TX

Functional Area: 10 - PHYSICAL MEDICINE AND REHABILITATION (PM&R) CLINIC

Qty Room Code Room Name Unit Area

Net Area

Const Phase

Const Type

1 DR001 Dressing Room 50 50 1 0

3 OFA09 Office, Therapist 100 300 1 0

1 PTEA1 Treatment Exercise Area 1,200 1,200 1 0

1 PTTC1 Treatment Room 0 0 1 0

1 SRE01 Storage, Equipment 200 200 1 0

1 TLTU1 Toilet, PM&R Patient 0 0 1 0

1 TLTU1 Toilet, PM&R Patient 60 60 1 0

FA Totals: Room Qty: 9 Net Area: 1,810 Gross Area: 2,715

Department: 1 - OUTPATIENT / PACT CLINIC (265)

Functional Area: 11 - PROSTHETICS AND SENSORY AIDS CLINIC

Qty Room Code Room Name Unit Area

Net Area

Const Phase

Const Type

2 EXR10 EXAM, Prosthetics 120 240 1 0

1 MRPA1 Mailing Room, Prosthetic Appliances 80 80 1 0

1 OFA03 Workstation, Dispensing Prosthetic Clerk 0 0 1 0

1 SRCS1 Storage, Prosthetic Appliances 225 225 1 0

1 WRC03 Sub-Waiting, Prosthetics Patient 0 0 1 0

FA Totals: Room Qty: 6 Net Area: 545 Gross Area: 818

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Program For Design (18 Jan 2022 05:29PM)

TEXAS CITY NEW LEASE (COPIED 18 JAN 2022 10:58AM ET)

TX CITY CBOC NEW LEASE

TEXAS CITY, TX

Functional Area: 12 - HOME BASED PRIMARY CARE

Qty Room Code Room Name Unit Area

Net Area

Const Phase

Const Type

1 SRE01 Storage Room 0 0 1 0

1 WRTM1 Team Work Area, Home-Based Primary Care 200 200 1 0

FA Totals: Room Qty: 2 Net Area: 200 Gross Area: 300

Department: 1 - OUTPATIENT / PACT CLINIC (265)

Functional Area: 13 - RADIOLOGY SERVICE

Qty Room Code Room Name Unit Area

Net Area

Const Phase

Const Type

1 DR001 Dressing Room 0 0 1 0

1 DR001 Dressing Room 50 50 1 0

1 OFDR1 Office, Radiology 100 100 1 0

1 WRC01 Sub-Waiting, Diagnostic Patient 0 0 1 0

1 XDR01 Radiology Room, General Purpose 400 400 1 0

1 XVC01 Viewing Room, Picture Archiving and Communication System (PACS) 0 0 1 0

FA Totals: Room Qty: 6 Net Area: 550 Gross Area: 825

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Program For Design (18 Jan 2022 05:29PM)

TEXAS CITY NEW LEASE (COPIED 18 JAN 2022 10:58AM ET)

TX CITY CBOC NEW LEASE

TEXAS CITY, TX

Functional Area: 14 - PATHOLOGY AND LABORATORY MEDICINE (PLM) SERVICE

Qty Room Code Room Name Unit Area

Net Area

Const Phase

Const Type

1 JANC1 Housekeeping Aides Closet (HAC) 60 60 1 0

1 LBBD2 Specimen Accessioning, Processing and Distribution Room 120 120 1 0

1 LBSS1 Shipping / Receiving 100 100 1 0

4 LBVP1 Blood Specimen Collection Room 80 320 1 0

1 LMCH3 Clinical Chemistry 630 630 1 0

1 LMHI3 Hematology, Routine Laboratory 420 420 1 0

1 LMU03 Urine (Urinalysis) and Feces 270 270 1 0

1 OFA09 Office, Chief Medical Technologist 100 100 1 0

1 SRR01 STORAGE, REFRIGERATOR, WALK-IN 120 120 1 0

1 SRS01 Storage, Bulk 100 100 1 0

1 TLTU1 Toilet, Specimen Collection 60 60 1 0

1 TLTU1 Toilet, Staff 60 60 1 0

FA Totals: Room Qty: 15 Net Area: 2,360 Gross Area: 3,540

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Program For Design (18 Jan 2022 05:29PM)

TEXAS CITY NEW LEASE (COPIED 18 JAN 2022 10:58AM ET)

TX CITY CBOC NEW LEASE

TEXAS CITY, TX

Functional Area: 16 - CLINIC MANAGEMENT

Qty Room Code Room Name Unit Area

Net Area

Const Phase

Const Type

1 OFA09 Office, AO 100 100 1 0

1 OFA09 Office, CMO 100 100 1 0

1 OFA09 Office, Nurse Manager 100 100 1 0

1 OFA09 Office, Pt. Advocate 100 100 1 0

1 OFA09 Office, VSO 100 100 1 0

1 WKTM1 Secretary/Workroom 175 175 1 0

FA Totals: Room Qty: 6 Net Area: 675 Gross Area: 1,013

Department: 1 - OUTPATIENT / PACT CLINIC (265)

Functional Area: 17 - BUSINESS SERVICES

Qty Room Code Room Name Unit Area

Net Area

Const Phase

Const Type

1 WKTM1 Workroom, Business Services 240 240 1 0

FA Totals: Room Qty: 1 Net Area: 240 Gross Area: 360

Department: 1 - OUTPATIENT / PACT CLINIC (265)

Functional Area: 18 - ENGINEERING SERVICE

Qty Room Code Room Name Unit Area

Net Area

Const Phase

Const Type

1 BMER1 Repair Shop, Biomedical Engineering 200 200 1 0

FA Totals: Room Qty: 1 Net Area: 200 Gross Area: 300

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Program For Design (18 Jan 2022 05:29PM)

TEXAS CITY NEW LEASE (COPIED 18 JAN 2022 10:58AM ET)

TX CITY CBOC NEW LEASE

TEXAS CITY, TX

Functional Area: 19 - LOGISTICS SERVICE

Qty Room Code Room Name Unit Area

Net Area

Const Phase

Const Type

1 DOCK1 Receiving / Shipping Dock 130 130 1 0

1 OFA07 Workstation, Logistics 56 56 1 0

1 SRLG2 Storage Area, Logistics PACT 2 600 600 1 0

FA Totals: Room Qty: 3 Net Area: 786 Gross Area: 1,179

Department: 1 - OUTPATIENT / PACT CLINIC (265)

Functional Area: 20 - POLICE SERVICE

Qty Room Code Room Name Unit Area

Net Area

Const Phase

Const Type

1 CROP1 Operations Room 140 140 1 0

1 SSS01 Storage, Secure 40 40 1 0

FA Totals: Room Qty: 2 Net Area: 180 Gross Area: 270

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Program For Design (18 Jan 2022 05:29PM)

TEXAS CITY NEW LEASE (COPIED 18 JAN 2022 10:58AM ET)

TX CITY CBOC NEW LEASE

TEXAS CITY, TX

Functional Area: 22 - STAFF SUPPORT AREA

Qty Room Code Room Name Unit Area

Net Area

Const Phase

Const Type

1 CRA01 Conference Room 250 250 1 0

1 CRA03 CONF RM LG, TELEHEALTH ROOM 400 400 1 0

1 LAC01 Lactation Room 100 100 1 0

1 OFDC2 Consult Room, Clinical Support 0 0 1 0

1 SRE01 Storage, Equipment 100 100 1 0

4 TLTU1 Toilet, Staff 60 240 1 0

1 WKTM1 Classroom 0 0 1 0

1 WRTM1 Team Work Area, Clinical Support 240 240 1 0

1 WRTM2 Tele-Health Room 0 0 1 0

FA Totals: Room Qty: 12 Net Area: 1,330 Gross Area: 1,995

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Program For Design (18 Jan 2022 05:29PM)

TEXAS CITY NEW LEASE (COPIED 18 JAN 2022 10:58AM ET)

TX CITY CBOC NEW LEASE

TEXAS CITY, TX

Functional Area: 23 - SUPPORT AREA

Qty Room Code Room Name Unit Area

Net Area

Const Phase

Const Type

2 COMC1 Communications Room 110 220 1 0

4 JANC1 Housekeeping Aides Closet (HAC) 60 240 1 0

4 NT001 Pneumatic Tube Station 0 0 1 0

1 UCCL1 Utility Room, Clean 125 125 1 0

1 USCL1 Utility Room, Soiled 80 80 1 0

1 UTC01 Utility Room, Recycled Material 80 80 1 0

FA Totals: Room Qty: 13 Net Area: 745 Gross Area: 1,118

Department: 1 - OUTPATIENT / PACT CLINIC (265)

Functional Area: 24 - SPECIALTY CARE

Qty Room Code Room Name Unit Area

Net Area

Const Phase

Const Type

4 EXR10 EXAM, CONSULT 120 480 1 0

1 WRTM1 Team Workroom 240 240 1 0

FA Totals: Room Qty: 5 Net Area: 720 Gross Area: 1,080

Dept Totals: Room Qty: 223 Net Area: 27,556 Gross Area: 41,334

Bldg Totals: Room Qty: 223 Net Area: 27,556 Sum of Dept Gross Area: Gross Area: 41,33441,334

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Program For Design (18 Jan 2022 05:29PM)

TEXAS CITY NEW LEASE (COPIED 18 JAN 2022 10:58AM ET)

TX CITY CBOC NEW LEASE

TEXAS CITY, TX

Department Area Summary (NSF/GSF)

Department Total NSF Total GSF

1 - OUTPATIENT / PACT CLINIC (265) (NTG Factor: 1.50) 27,556 41,334

Totals: 27,556 41,334

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Program For Design (18 Jan 2022 05:29PM)

TEXAS CITY NEW LEASE (COPIED 18 JAN 2022 10:58AM ET)

TX CITY CBOC NEW LEASE

TEXAS CITY, TX

Building Area Summary And Net to Gross Factor Breakdown

Current Building Factor applied to this Project: 1.00

Building GSF

Current 41,334

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Program For Design (18 Jan 2022 05:29PM)

TEXAS CITY NEW LEASE (COPIED 18 JAN 2022 10:58AM ET)

TX CITY CBOC NEW LEASE

TEXAS CITY, TX

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(NUSF = 27,500) (ABOB = 37,200) RSF NTE = 41,300

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EXHIBIT K

LESSOR__________GOVERNMENT__________

VHAHOUArdT Stamp

VHAHOUArdT Stamp

VHAHOUArdT Rectangle

VHAHOUArdT Rectangle

VHAHOUArdT Rectangle

VHAHOUArdT Rectangle

VHAHOUArdT Stamp

CHAPTER 263: COMMUNITY BASED OUTPATIENT CLINIC (PACT) INTERIM

1. PURPOSE AND SCOPE ........................................................................................................ 263-2

2. DEFINITIONS ....................................................................................................................... 263-2

3. OPERATING RATIONALE AND BASIS OF CRITERIA ............................................................. 263-2

4. INPUT DATA STATEMENTS (IDS) ........................................................................................ 263-2

5. SPACE PLANNING CRITERIA ............................................................................................... 263-2

6. PLANNING AND DESIGN CONSIDERATIONS ................................................................... 263-212

7. FUNCTIONAL RELATIONSHIPS .......................................................................................... 263-22

8. FUNCTIONAL DIAGRAM ................................................................................................... 263-22

1. PURPOSE AND SCOPE

This PG-18-9 Space Planning Criteria Program Guide containing the December 2014 version of CBOC (PACT) as is being published as Chapter 263 for interim use on current CBOC Projects while the final Chapter 265 CBOC is being developed. This version contains revisions requested by CFM Planners and is available in SEPS.

2. DEFINITIONS

3. OPERATING RATIONALE AND BASIS OF CRITERIA

4. INPUT DATA STATEMENTS (IDS)

A. How many PACT Modules are authorized? (Misc) (Values: 1 to 3) (Default: 1)

5. SPACE PLANNING CRITERIA

A. FA 1: LOBBY / RECEPTION AREA

1. Vestibule (LOB02) ..................................................................... 200 NSF (18.6 NSM)

a. Provide one if [PACT Modules authorized] is between 1 and 3

2. Alcove, Wheelchair (SRLW1) ......................................................... 90 NSF (8.4 NSM)

a. Provide one if [PACT Modules authorized] is between 1 and 2

b. Provide one at 120 NSF if [PACT Modules authorized] is three

3. Waiting, PACT 1 (WTPC1) ..................................................... 1,260 NSF (117.1 NSM)

a. Provide one if [PACT Modules authorized] is 1

Allocated space accommodates forty-five standard chairs @ 9 NSF each, six bariatric chairs @ 14 NSF each, six accessible spaces @ 10 NSF each, and circulation; total fifty seven people. Allocated NSF provides waiting for the following clinics: General (Lobby / Common Areas), Mental Health Clinic, Patient Aligned Care Team (PACT) Clinic 1, and Pathology and Laboratory Medicine (PLM) Service.

4. Waiting, PACT 2 (WTPC2) ..................................................... 4,000 NSF (371.6 NSM)

a. Provide one if [PACT Modules authorized] is 2

Allocated space accommodates one hundred forty-six standard chairs @ 9 NSF each, eighteen bariatric chairs @ 14 NSF each, eighteen accessible spaces @ 10 NSF each, and circulation; total one hundred and eighty two people. Allocated NSF provides waiting for the following clinics: General (Lobby / Common Areas), Audiology and Speech Pathology Clinic, Business Services, Eye Clinic, Mental Health Clinic, Pathology and Laboratory Medicine (PLM) Service, Patient Aligned Care Team (PACT) Clinic 1 and 2, Pharmacy Service, Prosthetics and Sensory Aids Clinic, Physical Medicine and Rehabilitation (PM&R) Clinic, and Radiology Service.

5. Waiting, PACT 3 (WTPC3) ..................................................... 7,200 NSF (668.9 NSM)

a. Provide one if [PACT Modules authorized] is 3

Allocated space accommodates two hundred sixty-two standard chairs @ 9 NSF each, thirty-three bariatric chairs @ 14 NSF each, thirty-three accessible spaces @ 10 NSF each, and circulation; total three hundred and twenty eight people.

Allocated NSF provides waiting for the following clinics: General (Lobby / Common Areas), Audiology and Speech Pathology Clinic, Business Services, Eye Clinic, Mental Health Clinic, Pathology and Laboratory Medicine (PLM) Service, Patient Aligned Care Team (PACT) Clinic 1, 2 and 3, Multi-Specialty Clinic, Pharmacy Service, Prosthetics and Sensory Aids Clinic, Physical Medicine and Rehabilitation (PM&R) Clinic, Radiology Service, and Dental Clinic.

6. Waiting, PACT Family (WTF03) .................................................. 225 NSF (21.0 NSM)

a. Provide one if [PACT Modules authorized] is between 1 and 3

Allocated NSF accommodates two standard chairs @ 9 NSF each, one bariatric chair at 14 NSF, one accessible space @ 10 NSF, one child table and chairs @ 50 NSF, and circulation; total seven people.

7. Lactation Room (LAC01) .............................................................. 100 NSF (9.3 NSM)

a. Provide one if [PACT Modules authorized] is between 1 and 3

Allocated NSF accommodates three Receptionist FTEs, patient privacy area, and circulation.

8. Reception (RCP03) .................................................................... 385 NSF (35.8 NSM)

a. Provide one if [PACT Modules authorized] is 1

b. Provide two if [PACT Modules authorized] is 2

c. Provide three if [PACT Modules authorized] is 3

Allocated NSF accommodates three Receptionist FTEs, patient privacy area, and circulation.

9. Alcove, Volunteer (NCWD4) ...................................................... 120 NSF (11.2 NSM)

a. Provide one if [PACT Modules authorized] is between 1 and 3

Allocated NSF accommodates refreshment center, information board, etc.

10. Workstation, Patient Education (CLSC2) ........................................ 30 NSF (2.8 NSM)

a. Provide two if [PACT Modules authorized] is 1

b. Provide four if [PACT Modules authorized] is 2

c. Provide six if [PACT Modules authorized] is 3

11. Toilet, Family (TNPFM) .................................................................. 80 NSF (7.5 NSM)

a. Provide one if [PACT Modules authorized] is 1

b. Provide two if [PACT Modules authorized] is between 2 and 3

Allocated NSF accommodates one accessible toilet @ 25 NSF, one wall-hung lavatory @ 12 NSF, ABA clearances, and circulation.

12. Toilet, Male (TNPM1) ................................................................ 205 NSF (19.1 NSM)

a. Provide one if [PACT Modules authorized] is one

Allocated NSF accommodates one accessible toilet stall @ 33 NSF, one accessible urinal @ 10 NSF, two accessible counter lavatories @ 16 NSF each, ABA clearances, and circulation.

13. Toilet, Male (TNPM2) ................................................................ 235 NSF (21.9 NSM)

a. Provide one if [PACT Modules authorized] is two

Allocated NSF accommodates one accessible toilet stall @ 33 NSF, one standard toilet stall @ 15 NSF, one accessible urinal @ 10 NSF, two accessible counter lavatories @ 16 NSF each, ABA clearances, and circulation.

14. Toilet, Male (TNPM3) ................................................................ 295 NSF (27.5 NSM)

a. Provide one if [PACT Modules authorized] is three

Allocated NSF accommodates one accessible toilet stall @ 33 NSF, three standard toilet stalls @ 15 NSF each, one accessible urinal @ 10 NSF, two accessible counter lavatories @ 16 NSF each, ABA clearances, and circulation.

15. Toilet, Female (TNPF1) .............................................................. 205 NSF (19.1 NSM)

a. Provide one if [PACT Modules authorized] is 1

Allocated NSF accommodates one accessible toilet stall @ 33 NSF, one standard toilet stall @ 15 NSF, two accessible counter lavatories @ 16 NSF each, one chair @ 9 NSF, ABA clearances, and circulation.

16. Toilet, Female (TNPF2) .............................................................. 235 NSF (21.9 NSM)

a. Provide one if [PACT Modules authorized] is 2

Allocated NSF accommodates one accessible toilet stall @ 33 NSF, two standard toilet stalls @ 15 NSF each, two accessible counter lavatories @ 16 NSF each, one chair @ 9 NSF, ABA clearances, and circulation.

17. Toilet, Female (TNPF3) .............................................................. 295 NSF (27.5 NSM)

a. Provide one if [PACT Modules authorized] is 3

Allocated NSF accommodates one accessible toilet stall @ 33 NSF, four standard toilet stalls @ 15 NSF each, two accessible counter lavatories @ 16 NSF each, one chair @ 9 NSF, ABA clearances, and circulation.

B. FA 2: PATIENT ALIGNED CARE TEAM (PACT) CLINIC 1

1. Alcove, Height / Weight Accessible Station (PEHW2) ..................... 40 NSF (3.8 NSM)

a. Provide one if [PACT Modules authorized] is 1

2. Consult Room, Patient Aligned Care Team (PACT) (OFDC2) ........ 125 NSF (11.7 NSM)

a. Provide four if [PACT Modules authorized] is 1

3. Exam Room, Patient Aligned Care Team (PACT) (EXPA1) ........... 125 NSF (11.7 NSM)

a. Provide eight if [PACT Modules authorized] is 1

4. Toilet, PACT Patient (TPG01) ......................................................... 60 NSF (5.6 NSM)

a. Provide one if [PACT Modules authorized] is 1

Allocated NSF accommodates one accessible toilet @ 25 NSF, one accessible wall-hung lavatory @ 13 NSF, ABA clearances, and circulation.

5. Exam Room, Women’s Health (EXW01) ..................................... 125 NSF (11.7 NSM)

a. Provide two if [PACT Modules authorized] is 1

6. Toilet, Women’s Health Exam Room Patient (TPG01) .................... 60 NSF (5.6 NSM)

a. Provide one if [PACT Modules authorized] is 1

Allocated NSF accommodates one accessible toilet @ 25 NSF, one accessible wall-hung lavatory @ 13 NSF, ABA clearances, and circulation.

7. Procedure Room, General (TRPR1) ............................................ 180 NSF (16.8 NSM)

a. Provide one if [PACT Modules authorized] is 1

8. Toilet, General Procedure Room Patient (TPB01) ........................... 75 NSF (7.0 NSM)

a. Provide one if [PACT Modules authorized] is 1

Allocated NSF accommodates one bariatric toilet @ 25 NSF, one bariatric lavatory @ 21 NSF, ABA clearances, and circulation. Allocated NSF accommodates bariatric patients.

9. Tele-Health Room (WRTM2) ..................................................... 125 NSF (11.7 NSM)

a. Provide one if [PACT Modules authorized] is 1

10. Tele-Retinal Room (WRTM3) ..................................................... 125 NSF (11.7 NSM)

a. Provide one if [PACT Modules authorized] is 1

11. Shared Medical Appointment Room (CLSC4) ............................. 400 NSF (37.2 NSM)

a. Provide one if [PACT Modules authorized] is 1

12. Storage, Shared Medical Appointments (SRE01) .......................... 100 NSF (9.3 NSM)

a. Provide one if [PACT Modules authorized] is 1

13. Alcove, Medication (RCA06) .......................................................... 20 NSF (1.9 NSM)

a. Provide one if [PACT Modules authorized] is 1

14. Alcove, AED (RCA01) ..................................................................... 20 NSF (1.9 NSM)

a. Provide one if [PACT Modules authorized] is 1

15. Teamwork Area (WRTM1) ......................................................... 240 NSF (22.3 NSM)

a. Provide four if [PACT Modules authorized] is 1

One Teamwork Area per Teamlet.

16. Workstation, Extended Team (OFA07) .......................................... 56 NSF (5.3 NSM)

a. Provide four if [PACT Modules authorized] is 1

Allocated workstation is for Mental Health providers, Dieticians, Clinical Pharmacists, Social Workers, and Whole Health Coach FTEs.

17. Workroom, Patient Aligned Care Team (PACT) (WKTM3) ............. 100 NSF (9.3 NSM)

a. Provide one if [PACT Modules authorized] is 1

18. Training Room, Staff (CFR01)..................................................... 240 NSF (22.3 NSM)

a. Provide one if [PACT Modules authorized] is 1

Allocated NSF accommodates six conference chairs @ 7.5 NSF each, two 5’-0” x 2’- 0” tables at 10 NSF each, one credenza @ 8 NSF, and circulation; total six people.

19. Workstation, Administrative (OFA07)............................................ 56 NSF (5.3 NSM)

a. Provide one if [PACT Modules authorized] is 1

20. Conference Room (CFR01)......................................................... 240 NSF (22.3 NSM)

a. Provide one if [PACT Modules authorized] is 1

Allocated NSF accommodates six conference chairs @ 7.5 NSF each, two 5’-0” x 2’- 0” tables at 10 NSF each, one credenza @ 8 NSF, and circulation; total six people.

21. Utility Room, Clean (UCCL1) .......................................................... 60 NSF (5.6 NSM)

a. Provide one if [PACT Modules authorized] is 1

22. Storage, Medical Equipment (SRE01) ......................................... 120 NSF (11.2 NSM)

a. Provide one if [PACT Modules authorized] is 1

23. Lounge, Staff (SL001) ................................................................ 220 NSF (20.5 NSM)

a. Provide one if [PACT Modules authorized] is 1

24. Locker, Staff Personal Property (LR001) ......................................... 60 NSF (5.6 NSM)

a. Provide one if [PACT Modules authorized] is 1

25. Toilet, Staff (TNPG1) ..................................................................... 60 NSF (5.6 NSM)

a. Provide two if [PACT Modules authorized] is 1

Allocated NSF accommodates one accessible toilet @ 25 NSF, one wall-hung lavatory @ 12 NSF, ABA clearances, and circulation.

C. FA 3: PATIENT ALIGNED CARE TEAM (PACT) CLINIC 2

1. Alcove, Height / Weight Accessible Station (PEHW2) ..................... 40 NSF (3.8 NSM)

a. Provide two if [PACT Modules authorized] is 2

2. Consult Room, Patient Aligned Care Team (PACT) (OFDC2) ........ 125 NSF (11.7 NSM)

a. Provide eight if [PACT Modules authorized] is 2

3. Exam Room, Patient Aligned Care Team (PACT) (EXPA1) ........... 125 NSF (11.7 NSM)

a. Provide sixteen if [PACT Modules authorized] is 2

4. Toilet, PACT Patient (TPG01) ......................................................... 60 NSF (5.6 NSM)

a. Provide two if [PACT Modules authorized] is 2

Allocated NSF accommodates one accessible toilet @ 25 NSF, one accessible wall-hung lavatory @ 13 NSF, ABA clearances, and circulation.

5. Exam Room, Women’s Health (EXW01) ..................................... 125 NSF (11.7 NSM)

a. Provide four if [PACT Modules authorized] is 2

6. Toilet, Women’s Health Exam Room Patient (TPG01) .................... 60 NSF (5.6 NSM)

a. Provide four if [PACT Modules authorized] is 2

Allocated NSF accommodates one accessible toilet @ 25 NSF, one accessible wall-hung lavatory @ 13 NSF, ABA clearances, and circulation.

7. Procedure Room, General (TRPR1) ............................................ 180 NSF (16.8 NSM)

a. Provide one if [PACT Modules authorized] is 2

8. Toilet, General Procedure Room Patient (TPB01) ........................... 75 NSF (7.0 NSM)

a. Provide one if [PACT Modules authorized] is 2

Allocated NSF accommodates one bariatric toilet @ 25 NSF, one bariatric lavatory @ 21 NSF, ABA clearances, and circulation Allocated NSF accommodates bariatric patients.

9. Tele-Health Room (WRTM2) ..................................................... 125 NSF (11.7 NSM)

a. Provide one if [PACT Modules authorized] is 2

10. Tele-Retinal Room (WRTM3) ..................................................... 125 NSF (11.7 NSM)

a. Provide one if [PACT Modules authorized] is 2

11. Shared Medical Appointment Room (CLSC4) ............................. 400 NSF (37.2 NSM)

a. Provide two if [PACT Modules authorized] is 2

12. Storage, Shared Medical Appointments (SRE01) .......................... 100 NSF (9.3 NSM)

a. Provide two if [PACT Modules authorized] is 2

13. Alcove, Medication (RCA06) .......................................................... 20 NSF (1.9 NSM)

a. Provide two if [PACT Modules authorized] is 2

14. Alcove, AED (RCA01) ..................................................................... 20 NSF (1.9 NSM)

a. Provide two if [PACT Modules authorized] is 2

15. Teamwork Area (WRTM1) ......................................................... 240 NSF (22.3 NSM)

a. Provide eight if [PACT Modules authorized] is 2

One Teamwork Area per Teamlet.

16. Workstation, Extended Team (OFA07) .......................................... 56 NSF (5.3 NSM)

a. Provide eight if [PACT Modules authorized] is 2

Allocated workstation is for Mental Health providers, Dieticians, Clinical Pharmacists, Social Workers, and Whole Health Coach FTEs.

17. Workroom, Patient Aligned Care Team (PACT) (WKTM3) ............. 100 NSF (9.3 NSM)

a. Provide two if [PACT Modules authorized] is 2

18. Training Room, Staff (CFR01)..................................................... 240 NSF (22.3 NSM)

a. Provide two if [PACT Modules authorized] is 2

Allocated NSF accommodates six conference chairs @ 7.5 NSF each, two 5’-0” x 2’- 0” tables at 10 NSF each, one credenza @ 8 NSF, and circulation; total six people.

19. Workstation, Administrative (OFA07)............................................ 56 NSF (5.3 NSM)

a. Provide two if [PACT Modules authorized] is 2

20. Conference Room (CFR01)......................................................... 240 NSF (22.3 NSM)

a. Provide two if [PACT Modules authorized] is 2

Allocated NSF accommodates six conference chairs @ 7.5 NSF each, two 5’-0” x 2’- 0” tables at 10 NSF each, one credenza @ 8 NSF, and circulation; total six people.

21. Utility Room, Clean (UCCL1) .......................................................... 60 NSF (5.6 NSM)

a. Provide two if [PACT Modules authorized] is 2

22. Storage, Medical Equipment (SRE01) ......................................... 120 NSF (11.2 NSM)

a. Provide two if [PACT Modules authorized] is 2

23. Lounge, Staff (SL001) ................................................................ 220 NSF (20.5 NSM)

a. Provide two if [PACT Modules authorized] is 2

24. Locker, Staff Personal Property (LR001) ......................................... 60 NSF (5.6 NSM)

a. Provide two if [PACT Modules authorized] is 2

25. Toilet, Staff (TNPG1) ..................................................................... 60 NSF (5.6 NSM)

a. Provide four if [PACT Modules authorized] is 2

Allocated NSF accommodates one accessible toilet @ 25 NSF, one wall-hung lavatory @ 12 NSF, ABA clearances, and circulation.

D. FA 4: PATIENT ALIGNED CARE TEAM (PACT) CLINIC 3

1. Alcove, Height / Weight Accessible Station (PEHW2) ..................... 40 NSF (3.8 NSM)

a. Provide three if [PACT Modules authorized] is 3

2. Consult Room, Patient Aligned Care Team (PACT) (OFDC2) ........ 125 NSF (11.7 NSM)

a. Provide twelve if [PACT Modules authorized] is 3

3. Exam Room, Patient Aligned Care Team (PACT) (EXPA1) ........... 125 NSF (11.7 NSM)

a. Provide 24 if [PACT Modules authorized] is 3

4. Toilet, PACT Patient (TPG01) ......................................................... 60 NSF (5.6 NSM)

a. Provide three if [PACT Modules authorized] is 3

Allocated NSF accommodates one accessible toilet @ 25 NSF, one accessible wall-hung lavatory @ 13 NSF, ABA clearances, and circulation.

5. Exam Room, Women’s Health (EXW01) ..................................... 125 NSF (11.7 NSM)

a. Provide six if [PACT Modules authorized] is 3

6. Toilet, Women’s Health Exam Room Patient (TPG01) .................... 60 NSF (5.6 NSM)

a. Provide six if [PACT Modules authorized] is 3

Allocated NSF accommodates one accessible toilet @ 25 NSF, one accessible wall-hung lavatory @ 13 NSF, ABA clearances, and circulation.

7. Procedure Room, General (TRPR1) ............................................ 180 NSF (16.8 NSM)

a. Provide three if [PACT Modules authorized] is 3

8. Toilet, General Procedure Room Patient (TPB01) ........................... 75 NSF (7.0 NSM)

a. Provide three if [PACT Modules authorized] is 3

Allocated NSF accommodates one bariatric toilet @ 25 NSF, one bariatric lavatory @ 21 NSF, ABA clearances, and circulation. Allocated NSF accommodates bariatric patients.

9. Tele-Health Room (WRTM2) ..................................................... 125 NSF (11.7 NSM)

a. Provide one if [PACT Modules authorized] is 3

10. Tele-Retinal Room (WRTM3) ..................................................... 125 NSF (11.7 NSM)

a. Provide one if [PACT Modules authorized] is 3

11. Shared Medical Appointment Room (CLSC4) ............................. 400 NSF (37.2 NSM)

a. Provide three if [PACT Modules authorized] is 3

12. Storage, Shared Medical Appointments (SRE01) .......................... 100 NSF (9.3 NSM)

a. Provide three if [PACT Modules authorized] is 3

13. Alcove, Medication (RCA06) .......................................................... 20 NSF (1.9 NSM)

a. Provide three if [PACT Modules authorized] is 3

14. Alcove, AED (RCA01) ..................................................................... 20 NSF (1.9 NSM)

a. Provide three if [PACT Modules authorized] is 3

15. Teamwork Area (WRTM1) ......................................................... 240 NSF (22.3 NSM)

a. Provide twelve if [PACT Modules authorized] is 3

One Teamwork Area per Teamlet.

16. Workstation, Extended Team (OFA07) .......................................... 56 NSF (5.3 NSM)

a. Provide twelve if [PACT Modules authorized] is 3

Allocated workstation is for Mental Health providers, Dieticians, Clinical Pharmacists, Social Workers, and Whole Health Coach FTEs.

17. Workroom, Patient Aligned Care Team (PACT) (WKTM3) ............. 100 NSF (9.3 NSM)

a. Provide three if [PACT Modules authorized] is 3

18. Training Room, Staff (CFR01)..................................................... 240 NSF (22.3 NSM)

a. Provide three if [PACT Modules authorized] is 3

Allocated NSF accommodates six conference chairs @ 7.5 NSF each, two 5’-0” x 2’- 0” tables at 10 NSF each, one credenza @ 8 NSF, and circulation; total six people.

19. Workstation, Administrative (OFA07)............................................ 56 NSF (5.3 NSM)

a. Provide three if [PACT Modules authorized] is 3

20. Conference Room (CFR01)......................................................... 240 NSF (22.3 NSM)

a. Provide three if [PACT Modules authorized] is 3

Allocated NSF accommodates six conference chairs @ 7.5 NSF each, two 5’-0” x 2’- 0” tables at 10 NSF each, one credenza @ 8 NSF, and circulation; total six people.

21. Utility Room, Clean (UCCL1) .......................................................... 60 NSF (5.6 NSM)

a. Provide three if [PACT Modules authorized] is 3

22. Storage, Medical Equipment (SRE01) ......................................... 120 NSF (11.2 NSM)

a. Provide three if [PACT Modules authorized] is 3

23. Lounge, Staff (SL001) ................................................................ 220 NSF (20.5 NSM)

a. Provide three if [PACT Modules authorized] is 3

24. Locker, Staff Personal Property (LR001) ......................................... 60 NSF (5.6 NSM)

a. Provide three if [PACT Modules authorized] is 3

25. Toilet, Staff (TNPG1) ..................................................................... 60 NSF (5.6 NSM)

a. Provide six if [PACT Modules authorized] is 3

Allocated NSF accommodates one accessible toilet @ 25 NSF, one wall-hung lavatory @ 12 NSF, ABA clearances, and circulation.

E. FA 5: AUDIOLOGY AND SPEECH-LANGUAGE PATHOLOGY CLINIC

1. Hearing Aid Fitting Room (HAFR1) ............................................. 125 NSF (11.7 NSM)

a. Provide one if [PACT Modules authorized] is between 1 and 3

2. Exam / Consult, Audiology (EXAU1) ........................................... 125 NSF (11.7 NSM)

a. Provide one if [PACT Modules authorized] is between 2 and 3

3. Exam / Consult, Speech-Language Pathology (EXOS1) ............... 125 NSF (11.7 NSM)

a. Provide one if [PACT Modules authorized] is 3

This space works as a Therapy Room.

4. Exam, Audiometric Booth (PEHS4) ............................................ 300 NSF (27.9 NSM)

a. Provide two if [PACT Modules authorized] is 2

b. Provide three if [PACT Modules authorized] is 3

5. Electrophysiology Room (OPAE2) .............................................. 125 NSF (11.7 NSM)

a. Provide one if [PACT Modules authorized] is 3

6. Vestibulography Room (EXVE1) ................................................. 180 NSF (16.8 NSM)

7. Group Therapy Room (OPMH1) ................................................. 240 NSF (22.3 NSM)

a. Provide one if [PACT Modules authorized] is 2

b. Provide two if [PACT Modules authorized] is 3

8. Toilet, Audiology Patient (TPG01) ................................................. 60 NSF (5.6 NSM)

a. Provide one if [PACT Modules authorized] is between 2 and 3

Allocated NSF accommodates one accessible toilet @ 25 NSF, one accessible wall-hung lavatory @ 13 NSF, ABA clearances, and circulation.

9. Storage, Equipment (SRSE1) ........................................................ 100 NSF (9.3 NSM)

a. Provide one if [PACT Modules authorized] is 2

b. Provide one at 150 NSF if [PACT Modules authorized] is 3

F. FA 6: DENTAL CLINIC

1. Consult Room, Dental (OFDC2) .................................................. 125 NSF (11.7 NSM)

a. Provide one if [PACT Modules authorized] is 3

2. X-Ray Room, Panoramic / Cephalometric (DNXS1) .................... 150 NSF (14.0 NSM)

a. Provide one if [PACT Modules authorized] is 3

3. Dental Treatment Room (DTR), Multi-Functional (DNTG1) ......... 130 NSF (12.1 NSM)

a. Provide six if [PACT Modules authorized] is 3

4. Toilet, Dental Patient (TPG01) ....................................................... 60 NSF (5.6 NSM)

a. Provide one if [PACT Modules authorized] is 3

Allocated NSF accommodates one accessible toilet @ 25 NSF, one accessible wall-hung lavatory @ 13 NSF, ABA clearances, and circulation.

5. Teamwork Area, Dental Clinic (WRTM1).................................... 240 NSF (22.3 NSM)

a. Provide one if [PACT Modules authorized] is 3

6. Laboratory, Dental Prosthetics (DNPL1) .................................... 240 NSF (22.3 NSM)

a. Provide one if [PACT Modules authorized] is 3

7. Utility Room, Clean (LCCL1) ......................................................... 100 NSF (9.3 NSM)

a. Provide one if [PACT Modules authorized] is 3

Space provided for the Sterile Processing Service (SPS) Cart holding.

8. Utility Room, Soiled (LCSL2) .......................................................... 60 NSF (5.6 NSM)

a. Provide one if [PACT Modules authorized] is 3

Space provided for the Sterile Processing Service (SPS) Cart holding.

9. Storage, Sterile Equipment (SRE01) ............................................. 100 NSF (9.3 NSM)

a. Provide one if [PACT Modules authorized] is 3

10. Dental Equipment Mechanical Room (MECH1) .......................... 120 NSF (11.2 NSM)

a. Provide one if [PACT Modules authorized] is 3

G. FA 7: EYE CLINIC

1. Sub-Waiting, Dilation Patient (WTG03) ......................................... 80 NSF (7.5 NSM)

a. Provide one if [PACT Modules authorized] is 2

b. Provide one at 120 NSF if [PACT Modules authorized] is 3

Allocated space accommodates one standard chair @ 9 NSF, one bariatric chair @ 14 NSF, one accessible space @ 10 NSF, and circulation; total three people.

2. Fitting and Dispensing Room (EYFD1) ........................................ 130 NSF (12.1 NSM)

a. Provide one if [PACT Modules authorized] is between 2 and 3

This space can also be used as a spectacle shop.

3. Exam / Treatment Room (EYOT2) .............................................. 130 NSF (12.1 NSM)

a. Provide five if [PACT Modules authorized] is 2

b. provide ten if [PACT Modules authorized] is 3

4. Exam / Training Room, Low Vision (EYOT4) ............................... 180 NSF (16.8 NSM)

a. Provide one if [PACT Modules authorized] is between 2 and 3

5. Pre-Testing Room (EYVS1) ......................................................... 130 NSF (12.1 NSM)

a. Provide one if [PACT Modules authorized] is 2

b. Provide two if [PACT Modules authorized] is 3

6. Visual Fields Room (EYVF1) ....................................................... 130 NSF (12.1 NSM)

a. Provide one if [PACT Modules authorized] is 2

b. Provide two if [PACT Modules authorized] is 3

7. Photography Room (EYVS1) ...................................................... 180 NSF (16.8 NSM)

a. Provide one if [PACT Modules authorized] is between 2 and 3

8. Teamwork Area, Eye Clinic (WRTM1) ........................................ 180 NSF (16.8 NSM)

a. Provide one if [PACT Modules authorized] is 2

b. Provide one at 360 NSF if [PACT Modules authorized] is 3

Allocated NSF accommodates two providers in two PACT Modules, and four providers and two trainees in three PACT Modules.

9. Office, Blind Rehabilitation (VIST) Counselor (OFA09) .................. 100 NSF (9.3 NSM)

a. Provide one if [PACT Modules authorized] is 3

10. Office, Supervisor (OFA09) .......................................................... 100 NSF (9.3 NSM)

a. Provide one if [PACT Modules authorized] is between 2 and 3

H. FA 8: MENTAL HEALTH CLINIC

1. Exam Room, Mental Health (EXPA1) ......................................... 125 NSF (11.7 NSM)

a. Provide one if [PACT Modules authorized] is between 2 and 3

2. Group Therapy Room, Mental Health (OPMH1) ......................... 300 NSF (27.9 NSM)

a. Provide one if [PACT Modules authorized] is 1

b. Provide two if [PACT Modules authorized] is 2

c. Provide three if [PACT Modules authorized] is 3

Locate next to the PACT Shared Medical Appointments Room in one PACT Module projects.

3. Consult Room, Mental Health (OFDC1) ...................................... 125 NSF (11.7 NSM)

a. Provide one if [PACT Modules authorized] is 1

b. Provide eight if [PACT Modules authorized] is 2

c. Provide eleven if [PACT Modules authorized] is 3

4. Office, Supervisor (OFDC1) ........................................................ 125 NSF (11.7 NSM)

a. Provide one if [PACT Modules authorized] is between 2 and 3

5. Storage, General (SRS01) ............................................................ 100 NSF (9.3 NSM)

a. Provide one if [PACT Modules authorized] is 1

b. Provide one at 130 NSF if [PACT Modules authorized] is 2

c. Provide one at 160 NSF if [PACT Modules authorized] is 3

6. Teamwork Area, Mental Health (WRTM1) ................................. 480 NSF (44.6 NSM)

a. Provide one if [PACT Modules authorized] is 2

b. Provide one at 660 NSF if [PACT Modules authorized] is 3

I. FA 9: MULTI-SPECIALTY CLINIC

1. Alcove, Height / Weight Accessible Station (PEHW2) ..................... 40 NSF (3.8 NSM)

a. Provide one if [PACT Modules authorized] is 3

2. Consult Room, Multi-Specialty (OFDC2) .................................... 125 NSF (11.7 NSM)

a. Provide one if [PACT Modules authorized] is 3

3. Exam Room, Multi-Specialty (EXPA1) ........................................ 125 NSF (11.7 NSM)

a. Provide five if [PACT Modules authorized] is 3

This space to be shared among permanent and visiting staff.

4. Exam Room, Podiatry (EXP01) ................................................... 130 NSF (12.1 NSM)

a. Provide one if [PACT Modules authorized] is 3

5. Procedure Room, Multi-Specialty (TRPR1) ................................. 180 NSF (16.8 NSM)

a. Provide one if [PACT Modules authorized] is 3

6. Toilet, Multi-Specialty Procedure Room Patient (TPB01) ............... 75 NSF (7.0 NSM)

a. Provide one if [PACT Modules authorized] is 3

Allocated NSF accommodates one bariatric toilet @ 25 NSF, one bariatric lavatory @ 21 NSF, ABA clearances, and circulation. Allocated NSF accommodates bariatric patients.

7. Treadmill Room (OPTM1) .......................................................... 240 NSF (22.3 NSM)

a. Provide one if [PACT Modules authorized] is 3

Allocated NSF accommodates stress test treadmill for Cardiology and Pulmonary Medicine.

8. Toilet, Multi-Specialty Patient (TPB01) .......................................... 60 NSF (5.6 NSM)

Allocated NSF accommodates one accessible toilet @ 25 NSF, one accessible wall-hung lavatory @ 13 NSF, ABA clearances, and circulation.

J. FA 10: PHYSICAL MEDICINE AND REHABILITATION (PM&R) CLINIC

1. Treatment Exercise Area (PTEA1) .............................................. 690 NSF (64.2 NSM)

a. Provide one if [PACT Modules authorized] is 2

b. Provide one at 1,000 NSF if [PACT Modules authorized] is 3

Allocated NSF includes a private treatment space.

2. Treatment Room (PTTC1) .......................................................... 140 NSF (13.1 NSM)

a. Provide one if [PACT Modules authorized] is between 2 and 3

3. Therapy Team Room (WRTM1) ................................................. 180 NSF (16.8 NSM)

a. Provide one if [PACT Modules authorized] is between 2 and 3

4. Storage, Equipment (SRE01) ...................................................... 200 NSF (18.6 NSM)

a. Provide one if [PACT Modules authorized] is 2

b. Provide one at 400 NSF if [PACT Modules authorized] is 3

This space can be combined with Prosthetic Appliances Storage.

5. Toilet, PM&R Patient (TPG01) ....................................................... 60 NSF (5.6 NSM)

a. Provide two if [PACT Modules authorized] is between 2 and 3

Allocated NSF accommodates one accessible toilet @ 25 NSF, one accessible wall-hung lavatory @ 13 NSF, ABA clearances, and circulation.

K. FA 11: PROSTHETICS AND SENSORY AIDS CLINIC

1. Sub-Waiting, Prosthetics Patient (WTG03) .................................... 80 NSF (7.5 NSM)

a. Provide one if [PACT Modules authorized] is between 2 and 3

Allocated space accommodates one standard chair @ 9 NSF, one bariatric chair @ 14 NSF, one accessible space @ 10 NSF, and circulation; total three people.

2. Workstation, Dispensing Prosthetic Clerk (OFA03) ........................ 56 NSF (5.3 NSM)

a. Provide one if [PACT Modules authorized] is between 2 and 3

3. Mailing Room, Prosthetic Appliances (MRPA1) .............................. 80 NSF (7.5 NSM)

a. Provide one if [PACT Modules authorized] is between 2 and 3

This space can be combined with Prosthetic Appliances Storage.

4. Storage, Prosthetic Appliances (SRCS1) ..................................... 150 NSF (14.0 NSM)

a. Provide one if [PACT Modules authorized] is 2

b. Provide one at 200 NSF if [PACT Modules authorized] is 3

This space can be combined with Prosthetic Appliances Mailing Room.

L. FA 12: HOME BASED PRIMARY CARE

1. Teamwork Area, Home-Based Primary Care (WRTM1)............... 360 NSF (33.5 NSM)

a. Provide one if [PACT Modules authorized] is 2

b. Provide one at 480 NSF if [PACT Modules authorized] is 3

2. Storage Room (SRE01) .............................................................. 120 NSF (11.2 NSM)

a. Provide one if [PACT Modules authorized] is between 2 and 3

M. FA 13: IMAGING SERVICE

1. Sub-Waiting, Diagnostic Patient (WTG02) ..................................... 45 NSF (4.2 NSM)

a. Provide one if [PACT Modules authorized] is 2

b. Provide two if [PACT Modules authorized] is 3

Allocated NSF accommodates one bariatric chair @ 14 NSF, one accessible space @ 10 NSF, and circulation; total two people.

2. Dressing Room (DR001) ................................................................ 60 NSF (5.6 NSM)

a. Provide two if [PACT Modules authorized] is 2

b. Provide four if [PACT Modules authorized] is 3

3. Bone Densitometer (XDBD1) ..................................................... 125 NSF (11.7 NSM)

a. Provide one if [PACT Modules authorized] is 3

4. Radiology Room, General Purpose (XDR01) ............................... 300 NSF (27.9 NSM)

a. Provide one if [PACT Modules authorized] is between 2 and 3

5. Radiographic / Fluoroscopic (R/F) Room (XDRF1) ...................... 320 NSF (29.8 NSM)

a. Provide one if [PACT Modules authorized] is 3

6. Toilet, R/F Patient (TPG01) ............................................................ 60 NSF (5.6 NSM)

a. Provide one if [PACT Modules authorized] is 3

Allocated NSF accommodates one accessible toilet @ 25 NSF, one accessible wall-hung lavatory @ 13 NSF, ABA clearances, and circulation.

7. Ultrasound Room (XDUS1) ........................................................ 180 NSF (16.8 NSM)

a. Provide one if [PACT Modules authorized] is between 2 and 3

8. Toilet, Ultrasound Patient (TPG01) ................................................ 60 NSF (5.6 NSM)

a. Provide one if [PACT Modules authorized] is between 2 and 3

Allocated NSF accommodates one accessible toilet @ 25 NSF, one accessible wall-hung lavatory @ 13 NSF, ABA clearances, and circulation.

9. Sub-Waiting, Mammography Patient (WTG02) .............................. 45 NSF (4.2 NSM)

a. Provide one if [PACT Modules authorized] is 3

Allocated NSF accommodates one bariatric chair @ 14 NSF, one accessible space @ 10 NSF, and circulation; total two people.

10. Mammography Room (XDM01) ................................................ 180 NSF (16.8 NSM)

11. Toilet, Mammography Patient (TPG01) ......................................... 60 NSF (5.6 NSM)

a. Provide one if [PACT Modules authorized] is 3

Allocated NSF accommodates one accessible toilet @ 25 NSF, one accessible wall-hung lavatory @ 13 NSF, ABA clearances, and circulation.

12. Viewing Room, Picture Archiving and Communication System (PACS) (XVC01) ...125

NSF (11.7 NSM)

a. Provide one if [PACT Modules authorized] is between 2 and 3

Accommodates tele-radiology.

13. Office, Radiology (OFDR1) ........................................................... 100 NSF (9.3 NSM)

a. Provide one if [PACT Modules authorized] is 3

14. Workstation, Radiology Tech (OFA07) ........................................... 56 NSF (5.3 NSM)

a. Provide one if [PACT Modules authorized] is between 2 and 3

N. FA 14: PATHOLOGY AND LABORATORY MEDICINE (PLM) SERVICE

1. Blood Specimen Collection Room (LBVP1) ..................................... 80 NSF (7.5 NSM)

a. Provide two if [PACT Modules authorized] is 1

b. Provide four if [PACT Modules authorized] is 2

c. Provide five if [PACT Modules authorized] is 3

2. Toilet, Specimen Collection (TPSP1) .............................................. 60 NSF (5.6 NSM)

a. Provide one if [PACT Modules authorized] is between 1 and 2

b. Provide two if [PACT Modules authorized] is 3

Allocated NSF accommodates one accessible toilet @ 25 NSF, one accessible wall-hung lavatory @ 13 NSF, ABA clearances, and circulation.

3. Laboratory, General (LBGM1) .................................................... 150 NSF (14.0 NSM)

a. Provide one if [PACT Modules authorized] is between 1 and 2

4. Laboratory, Clinical Chemistry (LMCH1) .................................... 400 NSF (37.2 NSM)

a. Provide one if [PACT Modules authorized] is 3

5. Shipping / Receiving (LBSS1) ....................................................... 100 NSF (9.3 NSM)

a. Provide one if [PACT Modules authorized] is between 2 and 3

6. Storage, Bulk (SRS01) ............................................

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