1. NFPA 99 2012 EDITION OVERVIEW AND DISCUSSION Presented by Dave Dagenais, BS, SASHE, CHFM, CHSP Thursday, February 17, 2011 Not Speaking on Behalf of NFPA

2. Healthcare Facilities Management Society of New Jersey 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. Healthcare Facilities Management Society of New Jersey NFPA 99 History  NFPA Standards Council allowed a complete rewrite of NFPA 99 following the 2005 edition  ASHE set up task forces to submit proposals  Committees met on proposals  Comments were submitted by public  Committees met on comments  Sent back to Committee at NFPA 2009 annual meeting

4. Healthcare Facilities Management Society of New Jersey 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 met Fall 2010 (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

5. Healthcare Facilities Management Society of New Jersey 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

6. Healthcare Facilities Management Society of New Jersey Scope  Establish criteria to minimize:  The hazards of fire,  Explosion, and  Electricity  Applies to facilities providing services to human beings only

7. Healthcare Facilities Management Society of New Jersey Purpose  To provide minimum requirements for the:  Performance  Maintenance, Testing and Inspection  Safe practices based on risk

8. Healthcare Facilities Management Society of New Jersey 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

9. Healthcare Facilities Management Society of New Jersey 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

10. Healthcare Facilities Management Society of New Jersey 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.

11. Healthcare Facilities Management Society of New Jersey 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.

12. Healthcare Facilities Management Society of New Jersey 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)

13. Healthcare Facilities Management Society of New Jersey 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

14. Healthcare Facilities Management Society of New Jersey Gas and Vacuum Systems (Chapter 5)  Technical Committee rejected annual outlet/inlet testing requirement

15. Healthcare Facilities Management Society of New Jersey Gas and Vacuum Systems (Chapter 5)  Rejected requiring ASSE 6040 (certification of maintenance workers) but recommended it in the annex

16. Healthcare Facilities Management Society of New Jersey 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

17. Healthcare Facilities Management Society of New Jersey Gas and Vacuum Systems (Chapter 5)  Adding testing and inspection requirements on existing non-stationary medical booms (annually)

18. Healthcare Facilities Management Society of New Jersey Electrical Systems (Chapter 6)  Definition of “Wet Location” changes to “Wet Procedure Located” throughout the entire document

19. Healthcare Facilities Management Society of New Jersey Electrical Systems (Chapter 6)  Requires all operating rooms to be wet procedure locations (unless risk assessment is done)

20. Healthcare Facilities Management Society of New Jersey 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.”

21. Healthcare Facilities Management Society of New Jersey Electrical Systems (Chapter 6)  Permits isolated power or ground fault protection within operating rooms

22. Healthcare Facilities Management Society of New Jersey Electrical Systems (Chapter 6)  Requires that overcurrent protection devices only be accessible to authorized personnel and not permitted in public access spaces

23. Healthcare Facilities Management Society of New Jersey 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

24. Healthcare Facilities Management Society of New Jersey 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

25. Healthcare Facilities Management Society of New Jersey 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)

26. Healthcare Facilities Management Society of New Jersey Electrical Systems (Chapter 6)  Added text to permit a 0.1 second delay for selective coordination

27. Healthcare Facilities Management Society of New Jersey Electrical Systems (Chapter 6)  Monthly Generator Testing - 10 second transfer not required (Annual Confirmation)

28. Healthcare Facilities Management Society of New Jersey 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

29. Healthcare Facilities Management Society of New Jersey Electrical Systems (Chapter 6)  New section which permits switches in lighting circuits connected to Life Safety and critical branch as long as they don’t serve as illumination of egress as required by NFPA 101

30. Healthcare Facilities Management Society of New Jersey Electrical Systems (Chapter 6)  New section on campus electrical systems being added  Clears up conflicts with NEC

31. Healthcare Facilities Management Society of New Jersey IT and Communication (Chapter 7)  New chapter covers  IT rooms  Fire protection  Nurse call  Emergency call  Staff emergency assistance

32. Healthcare Facilities Management Society of New Jersey 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

33. Healthcare Facilities Management Society of New Jersey 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

34. Healthcare Facilities Management Society of New Jersey 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

35. Healthcare Facilities Management Society of New Jersey 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

36. Healthcare Facilities Management Society of New Jersey 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

37. Healthcare Facilities Management Society of New Jersey 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

38. Healthcare Facilities Management Society of New Jersey 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

39. Healthcare Facilities Management Society of New Jersey Security Management (Chapter 13)  Requires procedures for  Hostage  Bomb Threat  Workplace Violence  Disorderly Conduct  Restraining Orders

40. Healthcare Facilities Management Society of New Jersey 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

41. Healthcare Facilities Management Society of New Jersey Security Management (Chapter 13)  Other subjects covered  Media control  Crowd control  Security equipment – follow NFPA 731  Employee practices  Security operations

42. Healthcare Facilities Management Society of New Jersey Features of Fire Protection (Chapter 15)  Fire alarm and detection  Protection of gas cylinder storage  HVAC detection requirements  Comments on sprinklers in closets (6 sq. ft.)  Comments on defend in place concepts  Comments on mobile storage units (50 sq. ft.)

43. Healthcare Facilities Management Society of New Jersey Next Steps  Report on Comment 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.

44. Healthcare Facilities Management Society of New Jersey It’s Time for All of Us to Get Involved 1.Identify NFPA members 2.Go to Boston for the vote on June 14 and 15, 2011 3.Support Healthcare on the floor

45. Healthcare Facilities Management Society of New Jersey Your Vote Can Make a Difference  In 2009, 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  2009 NFPA 99 was sent back to committee with a vote of 73 to 50 This Membership alone could blow those votes out of the water

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