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On-Site vs. Off-Site
THE ARCHITECT'S ANGLE
September 2016
Greetings!  

In this issue we discuss how construction and programmatic standards differ between Medicaid Reimbursed Clinics and Private Medical Practices.  This is the second in our three-part series.  Our companion article centers on Life Safety Codes which govern fire protection and exits in Medicaid reimbursed clinics.
Medicaid Reimbursed Clinics vs.
Private Practices
Programmatic Differences
(Second in a Three-Part Series)

In our last issue, we focused on how the Americans with Disabilities Act (ADA) impacts physical plant configurations in Medicaid funded Diagnostic and Treatment Centers (D&TCs). In this issue, we will discuss a D&TCs functional program which is considerably more extensive than that of a private medical practice.
 
The primary code governing the Programmatic requirements for D&TCs is the Facility Guidelines Institute's "Guidelines for the Design of Health Care Facilities" (FGI). Most jurisdictions are using FGI 2010 or FGI 2015. FGI has chapters relating to "Small Neighborhood Health Centers" (3 or fewer exam rooms per provider) and "Outpatient Facilities" (more than 3 exam rooms). For the purposes of this article, we will be focusing on larger primary care D&TCs, which are covered by other FGI chapters and are also subject to the requirement of FGI 3.1.
 
Like ADA Compliance, FGI Compliance starts outside the building with stated requirements for proximate and accessible parking and a grade level sheltered entry.
  
De-Mystifying Building Life Safety Codes 

The National Fire Protection Association's "Life Safety Code" (known as NFPA 101) has been around in some form for over 50 years. For most of that time, NFPA 101 was a code standard applied by State Health Departments to regulate the construction and alteration of health care and health related facilities.
 
Over the past decade, building codes across the country have moved towards standardization through local adoption of the International Building Code or IBC. Although many jurisdictions create local code supplements, the core of the IBC is now, for the most part, a national code.
 
The IBC in turn, adopts the NFPA "Family of Codes" as reference standards. Foremost of these is NFPA 101. So now, whether you own or operate a hotel, a school, nursing home, a community health center or any number of other occupancies, your building is being regulated in some part by NFPA 101.
   
We hope you enjoy this month's issue. Do you have questions or feedback about the information provided or regarding your facility that we can answer?  Contact us at info@jwbarch.com and we will be happy to provide you with any additional information you may need.  We want to continue to offer content that interests you, our readers. Please drop us a line and let us know what topics you might want to learn more about. As always, we love hearing from you.

Sincerely,

John W. Baumgarten, RA, AIA, NCARB, LEED AP
Principal & President

Michael A. Sciara, RA, AIA, NCARB, LEED AP
Principal & Vice President