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s u s ta i n a b i l i t y / / f r e d e . c a s e

C an (and should) major California

healthcare projects be green? Yes, of
course. The road may be steeper
and curvier than for non-healthcare
projects, however. Let's review the
main characteristics that differen-
tiate the design and construction of
major healthcare projects in the
state, and then see where and why
sustainable practices can be either
easy or difficult.

The two main differences between hos-

pitals and non-healthcare projects are
the Office of Statewide Healthcare
Planning and Development (OSHPD)
and the nature of hospitals themselves.
The construction and occupancy of all
(non-federal) acute care projects in the
state of California, such as hospitals,
fall under the oversight of OSHPD. It
acts as the building official, instead of
the municipality where the project is
located. OSHPD provides plan check
and permitting services, and has a com-
plement of field inspectors to perform
periodic reviews.
The agency checks designs against a
building code; it is currently moving to
the International Building Code (IBC)
newly adopted by the state of
California. There, however, the similar-
ity to most other project types ends;
OSHPD marches to its own beat.
OSHPD’s leadership believes the
hospitals in California should be the
last buildings to remain substantially
undamaged and functioning following
any disaster.
Hospitals are the lifeboats of any
community, where we will all ultimate-
ly turn for help. This philosophy
informs the approach OSHPD takes to
the codes – to plan check, permitting,
field inspections, changes to projects
and occupancy. The codes are stricter,
justified not only by the above philoso-
phy but by the need to “defend-in-
Despite the challenges of con-
structing sustainable healtchare
facilities in California, they are
worthwhile endeavors that are
becoming easier to manage.
A Healthy Challenge
> Constructing sustainable healthcare facilities is more
challenging than other sectors, but there are several helpful
resources to make the process easier.
place” its immobile patients against fire
and smoke.
Tight Restrictions
Hospitals have more complex systems
than many other buildings, such as fire
and smoke compartmentalization,
highly regulated medical gas systems
and carefully scripted positive and neg-
ative air systems in the various patient
care areas. The plan check is exhausting
and long, running 12 to 36 months for
most major projects, and evaluating
even the flame-spread rating of all fin-
ish materials.
The permitting is rigidly controlled
and accompanied by the designation of
a licensed inspector of record (IOR),
contractor of record (COR) and design
professional of record (DPOR). The
IOR will enforce standards of work-
manship that are simply not economi-
cally viable on non-OSHPD projects.
The work cannot begin without a
highly detailed test, inspection and
observation (TIO) program, tediously
developed for each specific project. The
TIO goes so far as to identify individual
plumbers, electricians, ironworkers
and others who will be allowed to per-
form specific tasks in construction.
The important medical equipment
and building systems such as electrical
gear are not only engineered in their

10 b&c southwest fall 2008