Local advocacy proves crucial to preventing undue burdens

While the American Society for Health Care Engineering’s (ASHE’s) Regulatory Affairs Team’s focus is mainly national advocacy, it relies on state and regional ASHE Chapters and individual members to monitor and address regulatory issues at the local level.

“ASHE is monitoring at the national level, but we need people to do it locally as well to prevent undue burdens on health care facilities,” says Chad Beebe, AIA, CHFM, CFPS, CBO, FASHE, ASHE’s deputy executive director of regulatory affairs.

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One recent local advocacy issue threatening facilities managers’ ability to effectively run their health care buildings is special interest groups pushing for local/state lawmakers to create unnecessary and overburdensome requirements — like the recent move by labor unions to require that only union professionals conduct damper inspections in some states, Beebe says.

“Our facilities managers need to be fighting for their right to inspect, maintain and test all of their own equipment,” Beebe says. “Whether they want to do this or hire a consultant, it should be their decision on how that gets handled.”

There also is a growing trend of cities and states creating building performance and energy reduction standards that include hospitals, says Austin Wallace, MA, SFP, sustainability senior specialist at ASHE.

For example, the city of Seattle has adopted American National Standards Institute/ASHRAE/Illuminating Engineering Society Standard 100, Energy and Emissions Building Performance Standard for Existing Buildings, a building performance standard reducing energy consumption and carbon emissions, while the state of Maryland has passed both energy and emissions benchmarks for all commercial buildings over a certain square footage, which typically includes hospitals. And in Denver, legislators established a requirement for all buildings 25,000 square feet or larger to reduce their energy use index (EUI) by 30% by 2030.

The latter regulation’s EUI reduction rate was initially much higher but was lowered after local hospital facilities professionals cited ASHE’s Energy to Care^® Dashboard data and showed regulators the rate that is achievable for hospitals, Wallace says.

“It is important for ASHE members to recognize whether or not their jurisdictions are looking at similar regulations because some of them are tied to pretty costly fines if you don’t comply,” Wallace says. “In Seattle, with their emissions benchmarks, they’ve structured meeting the requirements in five-year increments, and if you are not in compliance every five years, you get hit with a fine of $10 per square foot. That can add up for large health care facilities in a way that just bites into your bottom line.”

As health care organizations continue to face a decrease in reimbursement alongside public and government calls not to raise prices, every department needs to look for places to cut costs, including facilities management, says Leah Hummel, AIA, CHFM, CHC, CHOP-B, SASHE, senior associate director of regulatory affairs at ASHE. Since work related to ensuring compliance with regulations eats up a considerable amount of a facilities management department’s funding, facilities managers should be identifying compliance areas that present an undue burden and then working to advocate for a change in those regulations, according to Hummel. From their seats on many code and regulation committees, ASHE representatives at all levels routinely monitor developing regulations for burdens that do not improve patient care.

Keeping an eye out for unnecessary regulations needs to occur with current rules as well as new regulations being created, especially at the state and local level. “We have to be very careful not to introduce new regulations that are going to put an increased burden on an already strained health care system without improving health care delivery,” Hummel says.

Wallace agrees, saying, “It is really the individual voices, those grounded in operational experience, that carry a significant amount of weight when it comes to advocating with regulatory bodies and code committees.” 

Chris Dimick is content development and communications manager at the American Society for Health Care Engineering and production editor at Health Facilities Management magazine.