1. NFPA 99 2012 EDITION OVERVIEW AND DISCUSSION Presented by Dave Dagenais, BS, SASHE, CHFM, CHSP Tuesday, October 5, 2010 Not Speaking on Behalf of NFPA

2. New England Healthcare Engineers Society NFPA Process Overview (Document Cycle) Proposal period NFPA generates a Report On Proposal Comment period NFPA generates a Report on Comments Notice of Intent to Make A Motion NFPA publishes the NITMAMs Annual meeting with Technical Session Membership Votes

3. New England Healthcare Engineers Society NFPA 99 (2 nd cycle) Specific Opportunities to Influence Code Anyone can submit proposals na Proposal Closing Date was – na Technical Committees met December, 2009 (previous proposals) (Report on Proposals posted – 6/25/2010) Anyone can submit comments Comment Closing Date – 9/3/2010 (over 330 comments) Technical Committees meet next week (Report on Comments posted – 2/25/2011 Notice of Intent to Make A Motion NITMAM closing date – 4/8/2011 NFPA Conference with Technical Session June 2011 BOSTON Opportunity

4. New England Healthcare Engineers Society New Items Overview Standard becomes a Code Fundamentals Chapter on Risk Information Technology and Communication Systems Plumbing Heating Emergency Management (new requirements) Security Fire Protection unique to Health Care Facilities

5. New England Healthcare Engineers Society Scope Establish criteria to minimize: The hazards of fire, Explosion, and Electricity Applies to facilities providing services to human beings only

6. New England Healthcare Engineers Society Purpose To provide minimum requirements for the: Performance Maintenance, Testing and Inspection Safe practices based on risk

7. New England Healthcare Engineers Society Application Applies to all health care facilities Applies to new Construction and equipment only altered or renovated or modernized Some testing and maintenance requirements apply to existing Emergency Management and Security apply to existing

8. New England Healthcare Engineers Society How the Code Works Determine the worst case procedure. Select the Risk Category. Select the systems or procedures in the Code that are prescribed by that level of risk Category

9. New England Healthcare Engineers Society Categories Category 1 - System Failure that would probably cause patients or caregivers major injury or death. Category 2 - System Failure that would most likely cause minor injury to patients or caregivers.

10. New England Healthcare Engineers Society Categories Category 3 - System Failure that would most likely cause discomfort to patients or caregivers. Category 4 - System failure has no impact on patients or caregivers.

11. New England Healthcare Engineers Society Definition of Healthcare Facility 3.3.68 Buildings or portions of building in which medical, dental psychiatric, nursing, obstetrical, or surgical care is provided. (ADM) (Non-residential) Buildings or portions of building in which medical, dental psychiatric, nursing, obstetrical, or surgical care is provided. (ADM)

12. New England Healthcare Engineers Society Gas and Vacuum Systems (Chapter 5) New Section on Cryogenic Systems Working with NFPA 55 on bulk oxygen requirements Tested for proper function For purity, alarm sensors Operation of the control sensors Installers need 6015 qualification

13. New England Healthcare Engineers Society Gas and Vacuum Systems (Chapter 5) Technical Committee rejected annual outlet/inlet testing requirement

14. New England Healthcare Engineers Society Gas and Vacuum Systems (Chapter 5) Rejected requiring ASSE 6040 (certification of maintenance workers) but recommended it in the annex

15. New England Healthcare Engineers Society Gas and Vacuum Systems (Chapter 5) Continue to prohibit the use of medical air for any other purpose Scope cleaning Decontamination Laser plume, etc. Med gasses may only be used for human consumption and calibration

16. New England Healthcare Engineers Society Gas and Vacuum Systems (Chapter 5) Adding testing and inspection requirements on existing non-stationary medical booms (annually)

17. New England Healthcare Engineers Society Electrical Systems (Chapter 6) Definition of Wet Location changes to Wet Procedure Located throughout the entire document

18. New England Healthcare Engineers Society Electrical Systems (Chapter 6) Requires all operating rooms to be wet procedure locations (unless risk assessment is done)

19. New England Healthcare Engineers Society Electrical Receptacle Testing Revise 4.3.4.1.2 to read: Additional testing of receptacles in patient care areas shall be performed at intervals defined by documented performance data, but not exceeding 5 years.

20. New England Healthcare Engineers Society Electrical Systems (Chapter 6) Permits isolated power or ground fault protection within operating rooms

21. New England Healthcare Engineers Society Electrical Systems (Chapter 6) Requires that overcurrent protection devices only be accessible to authorized personnel and not permitted in public access spaces

22. New England Healthcare Engineers Society Electrical Systems (Chapter 6) Increases number of receptacles General Care – From 4 to 8 Critical Care – From 6 to 14 Operating Rooms – New requirement of 36

23. New England Healthcare Engineers Society Electrical Systems (Chapter 6) Eliminates emergency system heading and equipment system heading and utilizes branches Life Safety Critical Equipment This should exempt us from the 700 chapter in the NEC

24. New England Healthcare Engineers Society Electrical Systems (Chapter 6) Permits fuel transfer pumps, receptacles, ventilation fans, louvers and cooling systems related to generators to be added to the life safety or critical branch (deleted from equipment branch)

25. New England Healthcare Engineers Society Electrical Systems (Chapter 6) Added text to permit a 0.1 second delay for selective coordination

26. New England Healthcare Engineers Society Electrical Systems (Chapter 6) Monthly Generator Testing - 10 second transfer not required (Annual Confirmation)

27. New England Healthcare Engineers Society Electrical Systems (Chapter 6) In existing facilities with no separate grounding conductor – annual test requirement Voltage readings Impedance measurements with conductive surfaces in the areas

28. New England Healthcare Engineers Society Electrical Systems (Chapter 6) New section which permits switches in lighting circuits connected to Life Safety and critical branch as long as they dont serve as illumination of egress as required by NFPA 101

29. New England Healthcare Engineers Society Electrical Systems (Chapter 6) New section on campus electrical systems being added Clears up conflicts with NEC

30. New England Healthcare Engineers Society IT and Communication (Chapter 7) New chapter covers IT rooms Fire protection Nurse call Emergency call Staff emergency assistance

31. New England Healthcare Engineers Society Plumbing (Chapter 8) New chapter based on categories Potable water Non-potable water Heating water Water conditioning Black waste water Grey waste water Clear waste water

32. New England Healthcare Engineers Society Heating (Chapter 9) New chapter addresses Heating, cooling and ventilation Humidity control Ventilation system requirements Airborne contaminant controls Ventilation for waste anesthetic gases disposal system

33. New England Healthcare Engineers Society Medical Equipment (Chapter 10) Patient Care Vicinity The Technical Committee rejected expanded definition of the patient vicinity Proposal stated: an electrical appliance that is intended to be used for diagnostic, therapeutic or monitoring purposes

34. New England Healthcare Engineers Society Gas Equipment (Chapter 11) New standard allows use of piped 0 2 for ozone sterilizers Equipment using medical grade oxygen from the piped distribution system shall meet the following requirements Not permanently attached Connected using wall outlet or flexible hose Medical device listed by FDA The TCC will have to address the conflict with Med Gas

35. New England Healthcare Engineers Society Emergency Management (Chapter 12) Completely rewritten and expanded for 2012 Two categories of risk In-patient facility is expected to be operable In-patient and out-patient areas that augment the critical mission but not receive in-patients Requires a Hazard Vulnerability Analysis (HVA) Natural Hazards Human-caused Events Technological Events

36. New England Healthcare Engineers Society Emergency Management (Chapter 12) Requires plans to manage resources and assets Requires Exercises Requires Evaluation of Exercises Special Care was taken to avoid conflicts with the Joint Commission and CMS

37. New England Healthcare Engineers Society Security Management (Chapter 13) Planning for protection of the Staff and Facility beyond disasters Requires a Security Vulnerability Assessment (SVA) Requires a responsible person Education requirements of security staff Customer Service Emergency Procedures Use of Force De-escalation Use of Restraints

38. New England Healthcare Engineers Society Security Management (Chapter 13) Requires procedures for Hostage Bomb Threat Workplace Violence Disorderly Conduct Restraining Orders

39. New England Healthcare Engineers Society Security Management (Chapter 13) Identifies known security sensitive areas Emergency Departments Pediatric and Infant Care units Medication Storage Clinical Labs Forensic Patient Treatment Areas Dementia or Behavior Health Units Communications, data infrastructure and medical records

40. New England Healthcare Engineers Society Security Management (Chapter 13) Other subjects covered Media control Crowd control Security equipment – follow NFPA 731 Employee practices Security operations

41. New England Healthcare Engineers Society Features of Fire Protection (Chapter 15) Fire alarm and detection Protection of gas cylinder storage HVAC detection requirements Comments on sprinklers in closets Comments on defend in place concepts Comments on mobile storage units

42. New England Healthcare Engineers Society Next Steps Technical committees meet next week NFPA 99 Goes to annual NFPA meeting in 2011 for adoption in BOSTON I predict that 30 items or more will go to a floor vote.

43. New England Healthcare Engineers Society Its Time for All of Us to Get Involved 1.Become an NFPA member by December 14, 2010 2.Go to Boston for the vote on June 14 and 15, 2011 3.Support Healthcare on the floor

44. New England Healthcare Engineers Society Your Vote Can Make a Difference Last year we removed the 5-year requirement for an obstruction inspection from NFPA 25; the vote was 43 to 35 Weekly fire pump test was eliminated with a vote of 40 to 40 Last year NFPA 99 got set back to committee with a vote of 73 to 50 This Membership alone could blow those votes out of the water

45. THANK YOU FOR YOUR TIME. QUESTIONS? Dave Dagenais, BS, SASHE, CHFM, CHSP Dave.Dagenais@wdhospital.com