99 A2023 HEA HES FD Agenda 7 21 - nfpa.org

AGENDA

NFPA Health Care Facilities Technical Committee on Health Care Emergency Management and Security (HEA-HES) NFPA 99 First Draft Meeting (A2023)

July 14-15, 2021 11:00 a.m. – 5:00 p.m. (ET)

Microsoft Teams Web Conference To join the meeting, please contact [email protected]

1. Call to order – Chair Nicholas Gabriele

2. Introductions, pg. 2

3. Chair report - Nicholas Gabriele

4. Staff liaison report - Camille Levy

a. Presentation on first draft meeting process, pg. 5

b. Reference publication update process

5. Previous meeting minutes, pg. 23

6. Public Input (PI) review

a. NFPA 99 PIs, pg. 25

7. Other business

8. Future meetings

9. Adjournment

1

Address List No PhoneHealth Care Emergency Management and Security HEA-HES

Health Care Facilities

Camille Levy06/11/2021

HEA-HES

Nicholas E. Gabriele

ChairJENSEN HUGHES31 Cooke StreetPlainville, CT 06062Alternate: Andrew D. Mcguire

SE 10/20/2010HEA-HES

Robert M. Becker

PrincipalIncident Management Solutions, Inc.626 RXR PlazaUniondale, NY 11556Alternate: Zachary Goldfarb

SE 3/4/2008

HEA-HES

Pete Brewster

PrincipalUS Department of Veterans AffairsOffice of Emergency Management510 Butler Avenue, Bldg. 203-BMartinsburg, WV 25405

U 10/28/2008HEA-HES

David A. Dagenais

PrincipalPartners/Wentworth-Douglass Hospital789 Central AvenueDover, NH 03820

U 1/25/2007

HEA-HES

Sharon S. Gilyeat

PrincipalKoffel Associates, Inc.8815 Centre Park DriveSuite 200Columbia, MD 21045Alternate: Myron Lee Draper

SE 1/25/2007HEA-HES

Kenneth J. Hebert

PrincipalThe Joint CommissionOne Renaissance BoulevardOakbrook Terrace, IL 60181

E 04/03/2019

HEA-HES

Susan B. McLaughlin

PrincipalMSL Health Care Partners229 Whitney DriveBarrington, IL 60010-6001American Society for Healthcare EngineeringAlternate: Chad E. Beebe

U 1/15/1999HEA-HES

James L. Paturas

PrincipalYale New Haven Health SystemCenter for Emergency Preparedness & Disaster Response1 Church Street, 5th FloorNew Haven, CT 06510Alternate: John Pelazza

U 08/09/2012

HEA-HES

Jack Poole

PrincipalPoole Fire Protection, Inc.19910 West 161st StreetOlathe, KS 66062-2700Alternate: Eric Reed


Pamela Reno

PrincipalTelgianFire Protection Consultant1623 Mapleview CourtStreetsboro, OH 44241Alternate: Jennifer A. Wetzel

SE 11/30/2016

HEA-HES

Patrick C. Rhinehart

PrincipalNorthside Hospital975 Johnson Ferry RoadSuite 220Atlanta, GA 30342-1601

U 08/17/2017HEA-HES

Kevin A. Scarlett

PrincipalWashington State Department of Health5801 60th Street WestUniversity Place, WA 98467-2831

E 07/29/2013

12




HEA-HES

James P. Simpson

PrincipalElectrical Training Alliance49440 405th PlacePalisade, MN 56469International Brotherhood of Electrical Workers

L 1/10/2008HEA-HES

Jerry Spickler

PrincipalJohnson Controls17295 Foltz Industrial ParkwaySuite GStrongsville, OH 44149Alternate: Michael Jenkins

M 08/17/2017

HEA-HES

Michael D. Widdekind

PrincipalZurich Services CorporationRisk Engineering112 Andrew CourtCentreville, MD 21617Alternate: Valerie Miller

I 1/14/2005HEA-HES

Chad E. Beebe

AlternateASHE - AHAPO Box 5756Lacey, WA 98509-5756Principal: Susan B. McLaughlin

U 10/20/2010

HEA-HES

Myron Lee Draper

AlternateKoffel Associates, Inc.1349 Western Chapel RoadNew Windsor, MD 21776Principal: Sharon S. Gilyeat


Zachary Goldfarb

AlternateIncident Management Solutions, Inc.626 RXR PlazaUniondale, NY 11556Principal: Robert M. Becker

SE 3/4/2008

HEA-HES

Michael Jenkins

AlternateJohnson Controls13073 Rockbridge CircleColorado Springs, CO 80921Principal: Jerry Spickler

M 08/11/2020HEA-HES

Andrew D. Mcguire

AlternateJENSEN HUGHES31 Cooke StreetPlainville, CT 06062Principal: Nicholas E. Gabriele

SE 08/17/2017

HEA-HES

Valerie Miller

AlternateZurich North America259 Briarwood DriveElverson, PA 19520Principal: Michael D. Widdekind

I 10/29/2012HEA-HES

John Pelazza

AlternateYale New Haven Health SystemCenter For Emergency Preparedness1 Church Street 5th FloorNew Haven, CT 06510Principal: James L. Paturas

U 10/23/2013

HEA-HES

Eric Reed

AlternatePoole Fire Protection, Inc.19910 W 161st StreetOlathe, KS 66062Principal: Jack Poole


Jennifer A. Wetzel

AlternateTelgian Corporation4001 Kennett Pike, Suite 308Wilmington, DE 19807Principal: Pamela Reno

SE 12/07/2018

23




HEA-HES

Reginald D. Jackson

Nonvoting MemberUS Department of LaborOccupational Safety and Health Administration200 Constitution AvenueNW, Room 3107Washtington, DC 20210-0001

E 10/23/2013HEA-HES

Camille Levy

Staff LiaisonNational Fire Protection Association (NFPA)One Batterymarch ParkQuincy, MA 02169

3/31/2021

34

NFPA 99/99B First Draft MeetingsJuly & August 2021

1

NFPA.ORG | © National Fire Protection Association. All rights reserved.

IT’S A BIG WORLD. LET’S PROTECT IT TOGETHER.TM

NFPA 99 & NFPA 99BFirst Draft MeetingsMicrosoft Teams Remote Meeting/Teleconference


NFPA Virtual Meeting

2

• Please use the “hand raise” function to speak

1

2

5


2


NFPA First Draft Meeting

3

• Use “raise hand” function to be recognized

• State name before speaking

• Mute your microphone/phone when not speaking (*6 on phone) – staff can mute you but CAN’T unmute you

• Shut off video if you have a slow connection

Web Conference Tips



4

• Please verify your contact information on roster at www.nfpa.org/99tc or www.nfpa.org/99Btc and email any changes to [email protected]

• Use of audio recorders or other means capable of reproducing verbatim transcriptions of this or any NFPA meeting is not permitted

Members

3

4

6


3



• Sign in and identify affiliations

• Participation

• Requested 7 days prior to the meeting or;

• At the discretion of the Chair

• Equal opportunity granted to opposing views

5

Guests



Members categorized in ANY interest category who have been retained to represent the interests of ANOTHER interest category (with respect to a specific issue or issues that are to be addressed by a TC/CC) shall declare those interests to the committee and refrain from voting on any Public Input, Comment, or other matter relating to those issues throughout the process.

6

5

6

7


4


Annual 2023 Revision Cycle – Key Dates• Public Input Stage (First Draft):

First Draft Meeting: July 8 – August 6, 2021 Posting of First Draft for Balloting Date: November 2, 2021 Posting of First Draft for Public Comment: March 22, 2022

• Comment Stage (Second Draft): Public Comment Closing Date: May 31, 2022 Second Draft Meeting Period: NLT August 23, 2022 Posting of Second Draft for Balloting Date: October 4, 2022 Posting of Second Draft for NITMAM: February 28, 2023

• Tech Session Preparation: NITMAM Closing Date: March 28, 2023 NFPA Technical Meeting: June 2023

• Standards Council Issuance: Documents with CAMs: August 2023

7



• Either Principal or Alternate can vote, not both.

• All Principals are encouraged to have an Alternate.

• Voting (simple majority) during meeting is used to create proposed First Revisions.

• Voting (simple majority) during meeting is also used to establish Public Input resolution responses and to create Committee Inputs.

8

Voting During the First Draft Meeting:

7

8

8


5



• Follow Robert’s Rules of Order

• Discussion requires a motion

9

General Procedures:



• Member addresses the chair

• Receives recognition from the chair

• Member introduces the motion

• Another member seconds the motion

10

Committee Member Actions:

9

10

9


6



• Restates the motion

• Calls for discussion

• Ensures all issues have been heard

• Calls for a vote

• Announces the vote result

11

Committee Chair Actions:



• Not in order when another member has the floor

• Requires a second

• Not debatable and DOES NOT automatically stop debate

• 2/3 affirmative vote immediately closes debate, returns to the original motion

• Less than 2/3 allows debate to continue

12

Motion to End Debate, Previous Question, or to “Call the Question”

11

12

10


7

13nfpa.org



• Resolve Public Input (PI)

• Create a First Revision (FR)

• Create a Committee Input (CI) – a placeholder used to solicit Public Comments and permit further work at Second Draft stage

14

Committee Actions and Motions:

13

14

11


8



• Committee develops a committee statement to respond to (i.e., resolve) a Public Input.

• Committee indicates in statement its reasons for not accepting the recommendation and/or points to a relevant First Revision.

• PI response does not get balloted.

15

Resolve a Public Input (PI):



• FR is created to change current text or add new text.

• Committee statement is developed to substantiate the change.

• Associated PIs get a committee response, often simply referring to the relevant FR.

• Each FR gets balloted.

16

Create a First Revision (FR):

15

16

12


9



• Committee is not ready to incorporate a change into the First Draft but wants to receive Public Comment on a topic that can be revisited at Second Draft stage.

• Committee statement is developed to explain committee’s intent.

• CI is not balloted.

17

Create a Committee Input (CI):



• All Public Input must receive a Committee Statement.

• A valid technical reason must be provided.

• Vague references to “intent” should not be used.

• Reasons for why the submitter’s substantiation is inadequate should be provided.

• A First Revision should be referenced if it addresses the intent of the submitter’s Public Input.

18

Committee Statements:

17

18

13


10



• In-meeting votes establish a base committee position on the development of First Revisions (FRs).

• FRs are secured by electronic balloting (≥2/3 of completed ballots affirmative, and affirmative by ≥1/2 voting members).

• Only the results of the electronic ballot determine the official position of the committee on the First Draft.

19

Formal Voting on First Revisions



• Only First Revisions (FR) are balloted.

Public Inputs and Committee Statements are not balloted.

Reference materials are available.

• First Draft, PI, CI, and CS

• Voting options:

Affirmative on all FRs

Affirmative on all FRs with exceptions specifically noted

• Ballot provides option to vote affirmative with comment.

• Vote to reject or abstain requires a reason.

20

Ballots:

19

20

14


11



• Ballot system is web-based.

• Alternates are encouraged to complete ballots.

• Ballot session will time out after 90 minutes.

• Use “submit” to save your work – ballots can be revised until the balloting period is closed.

21

Electronic Balloting:



22

• Click link provided in ballot email.

• Sign in with NFPA.org username and password.

21

22

15


12



23

• Select either ‘Affirmative All’ or ‘Affirmative with Exception(s)’.



24

• Use “See FR- #” link to review all First Revisions.

• Use “edit election” to change individual votes or to modify vote after submitting ballot.

23

24

16


13



25

• Make selection: Affirmative with Comment, Negative, or Abstain

• No selection defaults to affirmative

• Must include comment (reason) on each vote other than Affirmative



26

• To complete ballot, click ‘Participant Consent and Submit’.

• Return to edit any votes by ballot due date.

25

26

17


14



• Initial ballot

• Circulation of negatives and comments – electronic balloting re-opened to permit members to change votes

• Any First Revision that fails ballot becomes a Committee Input (CI)

27

Balloting:


Legal

• Must comply with state and federal antitrust laws

• Participants are to conduct themselves in strict accordance with these laws

• Read and understand NFPA’s Antitrust Policy which can be accessed at nfpa.org/regs

28

Antitrust Matters:

27

28

18


15


Legal

• Participants must avoid any conduct, conversation or agreement that would constitute an unreasonable restraint of trade

• Conversation topics that are off limits include:

Profit, margin, or cost data

Prices, rates, or fees

Selection, division or allocation of sales territories, markets or customers

Refusal to deal with a specific business entity

29

Antitrust Matters (cont’d):


Legal

• NFPA’s standards development activities are based on openness, honesty, fairness and balance

• Participants must adhere to the Regulations Governing the Development of NFPA Standards and the Guide for the Conduct of Participants in the NFPA Standards Development Processwhich can accessed at nfpa.org/regs

• Follow guidance and direction from your employer or other organization you may represent

30


29

30

19


16


Legal

• Manner is which standards development activity is conducted can be important

• The Guide of Conduct requires standards development activity to be conducted with openness, honesty and in good faith

• Participants are not entitled to speak on behalf of NFPA

• Participants must take appropriate steps to ensure their statements whether written or oral and regardless of the setting, are portrayed as personal opinions, not the position of NFPA

• Be sure to ask questions if you have them

31



Legal

• Disclosures of essential patent claims should be made by the patent holder

• Patent disclosures should be made early in the process

• Others may also notify NFPA if they believe that a proposed or existing NFPA standard includes an essential patent claim

• NFPA has adopted and follows ANSI’s Patent Policy

• It is the obligation of each participant to read and understand NFPA’s Patent Policy which can be accessed at nfpa.org/regs

32

Patents:

31

32

20


17


NFPA 99 Reference Publication Updates

33

• FUN to create CIs to update all reference publication editions at SD

• Each TC to notify FUN if they have a technical reason for not updating reference publication within their scope.

• Public comment• Note to CC via

meeting minutes

First Draft

• Staff to draft SRs with all reference publication updates (Ch. 2 & annexes)

• FUN to act on draft SRs

• TCs provided with draft SRs for information

• Title changes to be updated editorially in code body by staff

Second DraftNOTES:

• FUN will not update documents that are withdrawn, merged, or otherwise unclear. Responsible TC to provide new reference document via SR.

• Newly referenced documents in code body will be added editorially to Ch. 2.

• TC responsible for providing all information required by Chapter 2 for newly referenced publications.

• Correlating Committee to resolve any conflicts or correlation issues between committees.


TC Struggles with an Issue

•TC needs data on a new technology or emerging issue

•Two opposing views on an issue with no real data

•Data presented is not trusted by committee

Code Fund Lends a Hand

•TC rep and/or staff liaison submits a Code Fund Request

•Requests are reviewed by a Panel and chosen based on need / feasibility

Research Project Carried Out

•Funding for project is provided by the Code Fund and/or industry sponsors

•Project is completed and data is available to TC

www.nfpa.org/research

33

34

21


18


Document Information Pages

About

• Document scope• Table of contents• Articles• Research and statistical reports

• Latest codes and standards news on NFPA Today blog feed

• Free access

Current and Previous Editions

• Issued TIAs, FIs, Errata• Archived revision information such as meeting and ballot information, First Draft Reports (previously ROPs), Second Draft Reports (previously ROCs), and Standards Council and NITMAM information

Next Edition

• Revision cycle schedule• Posting & closing dates• Submit public input/comments via electronic submission system.

• Meeting and ballot information

• First Draft Report and Second Draft Report

• NITMAM information• Standard Council Decisions

• Private TC info (*red asterisk)• Ballot circulations, informational ballots and other committee info

Technical Committee

• Committee name and staff liaison

• Committee scope and responsibility

• Committee list with private information

• Committee documents (codes & standards) in PDF format

• Committees seeking members

• Online committee membership application


Questions?

• www.nfpa.org/99

• www.nfpa.org/99B

36

NFPA 99 & NFPA 99B Document Information Pages:

35

36

22

Technical Committee on Health Care Emergency

Management and Security

(HEA-HES) NFPA 99 Second Draft Meeting (Annual 2020)

Wednesday, June 26, 2019

Indianapolis Marriott Downtown 350 West Maryland Street Indianapolis, IN 46225

Minutes


1. Call to Order. The meeting was called to order at 8:10 am ET on Wednesday, June 26, 2019

by Chair, Susan McLaughlin.

2. Chairman Comments. Susan McLaughlin spoke to the agenda of the meeting and stated

that the purpose of the meeting is to address public comments and create a Second Draft of

the next edition.

3. Introductions and Attendance. Those members who were in attendance are listed below.

Name Organization

Susan McLaughlin, Chair American Society for Healthcare

Engineers

Pamela Reno, Principal Telgian Corporation

Michael Widdekind, Principal Zurich Services Corporation

Andrew Mcguire, Alternate JENSEN HUGHES

Richard Bielen (Staff Liaison) National Fire Protection Association

John Williams, Guest WA State Dept. of Health

4. Approval of Previous Meeting Minutes. The minutes of the committee’s August, 2018

First Draft committee meeting were approved as distributed in the agenda package.

5. Staff Liaison Presentation. Rich Bielen reviewed the meeting procedures and available

actions for the committee during the meeting.

6. Task Group Reports. There were no Task Group reports.

23

Technical Committee on Health Care Emergency

Management and Security

(HEA-HES) NFPA 99 Second Draft Meeting (Annual 2020)


Indianapolis Marriott Downtown 350 West Maryland Street Indianapolis, IN 46225

7. Preparation of the First Draft. The Committee reviewed all of the Public Comments that

were submitted and did not create any Second Revisions.

8. New Business. Several committee members provided an update on the CMS requirements

for emergency preparedness.

9. Next Meeting. The next meeting of the committee will be after the next Public Input period.

The meeting location will be determined at a later date.

10. Adjournment – The Meeting was adjourned on June 26 around 9:30 am ET.

24

Public Input No. 98-NFPA 99-2021 [ Section No. 12.2.2.4 ]

12.2.2.4

Senior management shall direct the prioritization of opportunities for improvement identifiedduring exercises and actual events or incidents .

Statement of Problem and Substantiation for Public Input

This clarification reflects NIMS/ICS definitions of events (planned) and incidents (unplanned).

Submitter Information Verification

Submitter Full Name: Grant Finch

Organization: PeaceHealth

Street Address:

City:

State:

Zip:

Submittal Date: Mon Mar 01 15:08:07 EST 2021

Committee: HEA-HES

National Fire Protection Association Report https://submittals.nfpa.org/TerraViewWeb/ContentFetcher?commentPar...

1 of 30 6/11/2021, 2:15 PM

25

Public Input No. 274-NFPA 99-2021 [ Section No. 12.3 ]

12.3 Emergency Management Categories.

The application of requirements in this chapter shall be based on the emergency managementcategory of the health care facility as defined in Table 12.3.

Table 12.3 Emergency Management Categories

Those inpatient or outpatient facilities that augment the critical mission. These facilities managethe existing inpatient or outpatient loads but

Emergency Management Category Definition

1

Those inpatient facilities that remain operable toprovide advanced life support services to injuredresponders and disaster victims, or thoseinpatient facilities that serve as a receiving facilityfor evacuating health care facilities. Thesefacilities manage the existing inpatient load aswell as plan for the influx of additional patients asa result of an emergency.

2

Facilities that are responsible for theprovision of medical and surgical care topatients arriving at the facility in need ofimmediate care, including injuredresponders and diaster victims. Thesefacilities remain operable during anemergency, and plan for the influx ofpatients needing emergency care; and, ifthey have inpatients, also plan to managethe existing inpatient load.

2

Inpatient facilities that are responsible to managethe existing inpatient load, and remain operableduring an emergency. These facilities, if apotential receiving site for otherevacuating healthcare facilities, also plans formedical surge capacity.

3

Outpatient facilities that are responsible tomanage the existing outpatient load, but do notplan to receive additional patients as a result ofan emergency or do not plan to remain operableshould essential utilities or services be lost.


Creating three categories better defines the planning requirements in subsequent sections. Hospitals with Emergency Departments and freestanding emergency department (FSED) provide emergency care routinely and are expected to provide that care during an disaster and therefore, have distinct planning requirements (Category 1), Inpatient facilities of all types (Hospitals, Nursing Homes, etc.) have to plan for their mission to be resilient and maintain continuity of care of patients in their facility during a disaster, also - if they are a potential receiving facility for other evacuating healthcare facilities, they also have to prepare for medical surge beyond their normal capacity. Outpatient Facilities; however, have a lower expectation for resiliency and can terminate operations if necessary due to a


2 of 30 6/11/2021, 2:15 PM

26

disaster's impact.


Submitter Full Name: Nicholas Gabriele

Organization: JENSEN HUGHES

Street Address:

City:

State:

Zip:

Submittal Date: Sat May 29 11:41:30 EDT 2021

Committee: HEA-HES


3 of 30 6/11/2021, 2:15 PM

27

Public Input No. 275-NFPA 99-2021 [ Section No. 12.4.3 ]

12.4.3

The medical health care facility, in combination with the local or federal authorities, or both,shall establish the required emergency management category as defined in Table 12.3.


To maintain consistent verbiage for the scope of this document.




Street Address:

City:

State:

Zip:


Committee: HEA-HES


4 of 30 6/11/2021, 2:15 PM

28

Public Input No. 276-NFPA 99-2021 [ Section No. 12.5 ]

12.5 Emergency Management Category 1 and Emergency Management Category 2Requirements. Program Elements

12.5.1

All emergency management Category 1 and emergency management Category 2 healthAll health care facilities shall be required to develop and maintain an emergency managementprogram that addresses all program elements as prescribed in 12.5.2 and 12.5.3.

12.5.2

The elements and complexity of the subsequent code sections in this chapter shall apply, asappropriate to the hazard vulnerability analysis (HVA), the community’s expectations, and theleadership’s defined mission of the health care facility.

12.5.3 Program Elements.

12.5.3.1 Hazard Vulnerability Analysis (HVA).

12.5.3.1.1

A hazard vulnerability analysis (HVA) shall be conducted to during the design phase for newconstruction, every two (2) years, or anytime there is a change in operations or knownhazards, to identify and prioritize hazards that pose a threat to the facility and can affect thedemand for its services.

12.5.3.1.2*

The hazards to be considered shall include, but not be limited to, the following:

(1) Natural hazards (geological, meteorological, and biological)

(2) Human-caused events (accidental or intentional)

(3) Technological events

12.5.3.1.3

The analysis shall include the potential impact of the hazards on conditions including, but notlimited to, the following:

(1)

(2) Care for new and existing patients/residents/clients

(3) Health, safety, and security of persons in the affected area

(4) Support of staff

(5) Property, facilities, and infrastructure

(6) Environmental impact

(7) Economic and financial conditions

(8) Regulatory and contractual obligations

(9) Reputation of, or confidence in, the facility

12.5.3.1.4

The facility shall prioritize the hazards and threats identified in the HVA with input from thecommunity.

12.5.3.2 Mitigation.

* Continuity of operations


5 of 30 6/11/2021, 2:15 PM

29

12.5.3.2.1

The facility shall develop and implement a strategy to eliminate hazards or mitigate the effectsof hazards that cannot be eliminated.

12.5.3.2.2

A mitigation strategy shall be developed for priority hazards defined by the HVA.

12.5.3.2.3

The mitigation strategy shall consider, but not be limited to, the following:

(1) Use of applicable building construction standards

(2) Hazard avoidance through appropriate land-use practices

(3) Relocation, retrofitting, or removal of structures at risk

(4) Removal or elimination of the hazard

(5) Reduction or limitation of the amount or size of the hazard

(6) Segregation of the hazard from that which is to be protected

(7)

(8) Control of the rate of release of the hazard

(9) Provision of protective systems or equipment for both cyber or physical risks

(10) Establishment of hazard warning and communications procedures

(11) Redundancy or duplication of essential personnel, critical systems, equipment, information,operations, or materials

12.5.3.3 Preparedness.

12.5.3.3.1

The facility shall prepare for any emergency as determined by the HVA by organizing andmobilizing essential resources.

12.5.3.3.2

The facility shall maintain a current, documented inventory of the assets and resources it hason-site that would be needed during an emergency, such as medical, surgical, andpharmaceutical resources; water; fuel; staffing; food; and linen.

12.5.3.3.3

The facility shall identify the resource capability shortfalls from 96 hours of sustainability anddetermine if mitigation activities are necessary and feasible.

12.5.3.3.4

The facility shall establish a protocol for monitoring the quantity of assets and resources as theyare utilized.

* Modification of the basic characteristics of the hazard


6 of 30 6/11/2021, 2:15 PM

30

12.5.3.3.5

The facility shall write an emergency operations plan (EOP) that describes a commandstructure and the following critical functions within the facility during an emergency:

(1) Communications

(2) Resources and assets

(3) Safety and security

(4) Clinical support activities

(5) Essential utilities

(6) Exterior connections

(7) Staff roles

12.5.3.3.6 Critical Function Strategies.

During the development of the EOP, the facility shall consider the strategies required in12.5.3.3.6.1 through 12.5.3.3.6.8 in order to manage critical functions during an emergencywithin the facility.

12.5.3.3.6.1 Communications.

The facility shall plan for the following during an emergency:

(1) Initial notification and ongoing communication of information and instructions to staff

(2) Initial notification and ongoing communication with the external authorities

(3) Communication with the following:

(4) Patients and their families (responsible parties)

(5) Responsible parties when patients are relocated to alternative care sites

(6) Community and the media

(7) Suppliers of essential materials, services, and equipment

(8) Alternative care sites

(9) Definition of when and how to communicate patient information to third parties

(10)

(11) Cooperative planning with other local or regional health care facilities, including thefollowing:

(12) Exchange of information relating to command operations, including contactinformation

(13) Staffing and supplies that could be shared

(14) System to locate the victims of the event

* Establishment of backup communications systems


7 of 30 6/11/2021, 2:15 PM

31

12.5.3.3.6.2 Resources and Assets.


(1) Acquiring medical, pharmaceutical, and nonmedical supplies

(2) Replacing medical supplies and equipment that will be used throughout response andrecovery

(3) Replacing pharmaceutical supplies that will be consumed throughout response andrecovery

(4) Replacing nonmedical supplies that will be depleted throughout response and recovery

(5) Managing staff support activities, such as housing, transportation, incident stressdebriefing, sanitation, hydration, nutrition, comfort, morale, and mental health

(6) Managing staff family support needs, such as child care, elder care, pet care, andcommunication to home

(7) Providing staff, equipment, and transportation vehicles needed for evacuation

12.5.3.3.6.3* Safety and Security.


(1) Internal security and safety operations

(2) Roles of agencies such as police, sheriff, and national guard

(3) Managing hazardous materials and waste

(4) Radioactive, biological, and chemical isolation and decontamination

(5) Patients susceptible to wandering

(6) Controlling entrance into the health care facility during emergencies

(7) Conducting a risk assessment with applicable authorities if it becomes necessary to controlegress from the health care facility

(8) Controlling people movement within the health care facility

(9) Controlling traffic access to the facility


8 of 30 6/11/2021, 2:15 PM

32

12.5.3.3.6.4 Clinical Support Activities.


(1) Clinical activities that could need modification or discontinuation during an emergency,such as patient scheduling, triage, assessment, treatment, admission, transfer, discharge,and evacuation

(2) Clinical services for special needs populations in the community, such as pediatric,geriatric, disabled, and chronically ill patients, and those with addictions (EmergencyManagement Category 1 only)

(3) Process to shelter patients in place

(4) Patient cleanliness and sanitation

(5) Behavioral needs of patients

(6) Mortuary services

(7) Evacuation both horizontally and, when required by circumstances, vertically, when theenvironment cannot support care, treatment, and services

(8) Transportation of patients, and their medications and equipment, and staff to an alternativecare site(s) when the environment cannot support care, treatment, and services

(9) Transportation of pertinent patient information, including essential clinical and medication-related information, to an alternative care site(s) when the environment cannot supportcare, treatment, and services

(10) Documentation and tracking of patient location and patient clinical information

12.5.3.3.6.5* Essential Utilities and Systems.

The facility shall plan for continuity of operations during the loss or interruption of the followingutilities and systems during an emergency, as applicable:

(1) Electricity

(2) Potable water

(3) Nonpotable water

(4) Wastewater

(5) HVAC

(6) Fire protection

(7) Fuel for building operations

(8) Fuel for essential transportation

(9) Medical gas and vacuum

(10) Information technology

12.5.3.3.6.6 Exterior Connections.

For essential utility systems in Emergency Management Category 1 facilities only, and based onthe facility’s HVA, consideration shall be given to the installation of exterior building connectorsto allow for the attachment of portable emergency utility modules.

12.5.3.3.6.7 Staff Roles.

(A)

Staff roles shall be defined for the areas of communications, resources and assets, safety andsecurity, essential utilities, and clinical activities.

(B)

Staff shall receive training for their assigned roles in the EOP.


9 of 30 6/11/2021, 2:15 PM

33

(C)

The facility shall communicate to licensed independent health care providers their roles in theEOP.

(D)

The facility shall ensure that staff, volunteers, and other personnel are credentialed by thefacility for their assignment and wear visible identification demonstrating such credentialingwhile on-site at the facility.

(E)

The facility shall include in its plan the alerting, managing, and tracking of all staff in anemergency.

(F)

The facility shall include in its plan a process for integrating the use of volunteers, includingthose of the federal government, in their emergency response.

12.5.3.3.6.8

The facility shall include the following in its EOP:

(1)

(2) Reporting structure consistent with the command structure

(3) Activation and deactivation of the response and recovery phases, including the authorityand process

(4) Facility capabilities and appropriate response efforts when the facility cannot be supportedfrom the outside for extended periods in the six critical areas with an acceptable response,including examples such as the following:

(5) Resource conservation

(6) Service curtailment

(7) Partial or total evacuation consistent with the staff’s designated role in communityresponse plan

(8) Alternative treatment sites to meet the needs of the patients

12.5.3.3.7 Staff Education.

12.5.3.3.7.1

Each facility shall implement an educational program in emergency management that includestraining, drills, and exercises.

12.5.3.3.7.2

The educational program shall include an overview of the components of the emergencymanagement program and concepts of the incident command system (ICS).

12.5.3.3.7.3

Individuals who are expected to perform as incident commanders or to be assigned to specificpositions within the command structure shall be trained in and familiar with the ICS and theparticular levels at which they are expected to perform.

12.5.3.3.7.4

Education concerning the staff’s specific duties and responsibilities shall be conducted.

12.5.3.3.7.5

General overview education of the emergency management program and the ICS shall beconducted at the time of hire.

* Standard command structure that is consistent with its community


10 of 30 6/11/2021, 2:15 PM

34

12.5.3.3.7.6

Department- and staff-specific education shall be conducted upon appointment todepartment/staff assignments or positions and annually thereafter.

12.5.3.3.8* Testing Emergency Plans and Operations.

12.5.3.3.8.1

The facility shall test its EOP at least twice annually, either through functional or full-scaleexercises or actual events.

12.5.3.3.8.2

Exercises shall be based on the HVA priorities and be as realistic as feasible.

12.5.3.3.8.3 Exercise Requirements

12.5.3.3.8.3.1 For Emergency Management Category 1 only, an influx of volunteer orsimulated patients shall needing emergency care of such number (volume) or type (e.g.,infectious diseases, contaminated patients, etc.) that test the facility's normal operational andmedical surge capabilities shall be tested annually, either through a functional or full-scaleexercise or an actual event. The number or type of (See Table 12.3.)

12.5.3.3.8. 3.2 For Emergency Management Category 1 that has inpatients, and EmergencyManagement Category 2, the facility shall conduct at least one exercise every two (2) yearsthat tests the facility's normal operational and medical surge capacities.

12.5.3.3.8.3.3 For Emergency Management Category 1 that has inpatients, and EmergencyManagement Category 2, the facility shall conduct at least one exercise every two (2) yearsthat tests the facility's full building evacuation plan.

12.5.3.3.8. 4

Annual table top, required functional, or full-scale exercises shall include the following:

(1) Community integration

(2) Assessment of sustainability


11 of 30 6/11/2021, 2:15 PM

35

12.5.3.3.8.5


12 of 30 6/11/2021, 2:15 PM

36

For Emergency Management Category 1 only, if so required by the community designation toreceive infectious patients, the facility shall conduct at least one exercise a year that includes asurge of infectious patients. (See Table

12.

3.)

12.

5.3.3.8.6

The identified exercises shall be conducted independently or in combination.

12.5.3.3.9 Scope of Exercises.

12.5.3.3.9.1

Exercises shall be monitored by at least one designated evaluator who has knowledge of thefacility’s plan and who is not involved in the exercise.

12.5.3.3.9.2

Exercises shall monitor the critical functions.

12.5.3.3.9.3

The facility shall conduct a debriefing session not more than 72 hours after the conclusion ofthe exercise or the event.

12.5.3.3.9.4

The debriefing shall include all key individuals, including observers; administration; clinicalstaff, including a physician(s); and appropriate support staff.

12.5.3.3.9.5

Exercises and actual events shall be critiqued to identify areas for improvement.

12.5.3.3.9.6

The critiques required by 12.5.3.3.9.5 shall identify deficiencies and opportunities forimprovement based upon monitoring activities and observations during the exercise.

12.5.3.3.9.7

Opportunities for improvement identified in critiques shall be incorporated in the facility’simprovement plan.

12.5.3.3.9.8 *

Improvements made to the emergency management program shall be evaluated insubsequent exercises.

12.5.3.4 Response.

12.5.3.4.1 *

The facility shall declare itself in an emergency mode based on current conditions thatleadership considers extraordinary.

12.5.3.4.2

Once an emergency mode has been declared, the facility shall activate its EOP.

12.5.3.4.3

The decision to activate the EOP shall be made by the incident commander designated withinthe plan, in accordance with the facility’s activation criteria.

12.5.3.4.4

The decision to deactivate the EOP shall be made by the incident commander in the healthcare organization in coordination with the applicable external command authority.

12.5.3.4.5 *


13 of 30 6/11/2021, 2:15 PM

37

The organization shall make provisions for emergency credentialing of volunteer clinical staff.

12.5.3.4.5.1

At a minimum, a peer evaluation of skill shall be conducted to validate proficiency for volunteerclinical staff.

12.5.3.4.5.2

Prior to beginning work, the identity of other volunteers offering to assist during responseactivities shall be verified.

12.5.3.4.5.3

Personnel designated or involved in the EOP of the health care facility shall be supplied with ameans of identification, which shall be worn at all times in a visible location.

12.5.3.4.5.4

Identification issued to volunteers shall distinguish volunteers from staff members.

12.5.3.4.6

The command staff shall actively monitor conditions present in the environment and remain incommunication with community emergency response agencies during an emergencyresponse.

12.5.3.4.7

When conditions approach untenable, the command staff, in combination with communityemergency response agencies, shall determine when to activate the facility evacuation plan.

12.5.3.4.8

Evacuation to the alternative care site shall follow the planning conducted during thepreparedness phase.

12.5.3.4.9 * Crisis Standards of Care.

Crisis standards of care shall be developed through a communitywide approach, as approvedby the authority having jurisdiction.

12.5.3.4.9.1

The decision to implement crisis standards of care shall be coordinated with the communityleadership.

12.5.3.4.9.2

Upon implementation of crisis standards of care in a community, the following shall beconsidered:

(1) The triage process

(2) The allocation of medical services across the population

12.5.3.4.9.3

Standards of care shall be returned to normal at the earliest feasible time.

12.5.3.4.10 Medical Surge Capacity and Capability.

The requirements of 12.5.3.4.10.1 and 12.5.3.4.10.2 shall apply only to those facilitiesdesignated as Emergency Management Category 1 as defined by the HVA.

12.5.3.4.10.1 *

The facility shall plan for medical surge capacity and capability.


14 of 30 6/11/2021, 2:15 PM

38

12.5.3.4.10.2

The triage process shall be implemented as follows:

(1) The arriving victim shall be assessed into the following cohorts:

(2) Risk to others, as follows:

(3) Mentally unstable

(4) Contaminated

(5) Infectious

(6) Risk to self, as follows:

(7) Emotionally impaired

(8) Suicidal

(9) Risk of death or permanent injury, as follows:

(10) Walking wounded

(11) Severely injured but stable

(12) Suffering from life-threatening injury

(13) Beyond care

(14) Patients shall be admitted for treatment depending on facility capacity, the facility’sspecialty, and clinical need.

(15) Creation of ancillary clinical space shall have adequate utility support for the following:

(16) HVAC

(17) Sanitation

(18) Lighting

(19) Proximity to operating room (OR)

12.5.3.4.11

Health care facilities shall have a designated media spokesperson to facilitate news releasesduring the response process.

12.5.3.4.12

An area shall be designated for media representatives to assemble where they will notinterfere with the operations of the health care facility.

12.5.3.5 * Recovery.

12.5.3.5.1

Plans shall reflect measures needed to restore operational capability to pre-disaster levels.

12.5.3.5.2

Fiscal aspects shall be considered with respect to restoration costs and possible cash flowlosses associated with the disruption.


15 of 30 6/11/2021, 2:15 PM

39

12.5.3.5.3

Facility leadership shall accept and accommodate federal, state, and local assistance that willbe beneficial for recovery of operations.

12.5.3.5.4

No party to recovery shall take action to unfairly limit lawful competition once recoveryoperations are completed.

12.5.3.5.5

Recovery shall not be deemed complete until infection control decontamination efforts arevalidated.

12.5.3.6 Administration.

12.5.3.6.1

The facility shall modify, as necessary, its HVA, EOP, supply chain (including the currentemergency supplies inventory), and other components of the emergency managementprogram, as a result of exercises, actual events, and annual review.

12.5.3.6.2

The facility shall maintain written records of drills, exercises, and training as required by thischapter for a period of 3 years.


12.5 – These Emergency Management Program Elements apply to all health care facilities – and as noted in 12.5.2 they are applied based on the HVA, community expectations and the health care facility’s mission (they are not all automatically applicable) .

12.5.3.1.1 – The HVA should be done at least every two years, or as situations warrant. Also, an HVA should also be accomplished for new construction or additions, renovations to inform the design. This concept is carried into the proposed 2022 FGI Guidelines and should be included here to reinforce the need for thoughtful design. Lessons learned during the COVID-19 pandemic reinforced the need for flexible patient units (e.g., converting L&D to ICU), Surge spaces (non-traditional patient care converted to medical units, doubling up rooms if big enough, etc.).

12.5.3.3.8.3.1 This combines the requirement to test annually test an influx of patients and infectious disease patients. This only applies to Hospitals with Emergency Departments and free standing Emergency Care Centers.

12.5.3.3.8.3.2 This creates a new requirement to test every two years, for an inpatient medical surge. Lessons learned from the COVID-19 pandemic is that inpatient healthcare facilities have not tested, or planned for the catastrophic surge that was experienced. This also prepares facilities for surge from other evacuating facilities.

12.5.3.3.8.3.3 A full evacuation is a catastrophic event all inpatient facilities must be prepared for. Although statistically rare, more facilities are evacuating each year either proactively prior to events (hurricanes) or reactively (due to natural disasters or utility loss). This requirement will reinforce planning – for facilities who’s HVA drives this (e.g., known hurricane or tornado hazard) but will also reinforce planning for facilities that may not rank catastrophic failure on their HVA, but it could still happen.

12.5.3.3.8.4 Tabletop exercises do not meet the current requirements in this Chapter. Unless considering to now allow Tabletop exercise as meeting the required exercises (like other AHJs have) this should not be included here.




16 of 30 6/11/2021, 2:15 PM

40


Street Address:

City:

State:

Zip:


Committee: HEA-HES


17 of 30 6/11/2021, 2:15 PM

41

Public Input No. 99-NFPA 99-2021 [ Section No. 12.5.3.1.2 ]

12.5.3.1.2*

The hazards to be considered shall include, but not be limited to, the following:

(1) Natural hazards (geological, meteorological, and biological)

(2) Human-caused events hazards (accidental or intentional)

(3) Technological events hazards


This standardizes the language used across the three hazard types.




Street Address:

City:

State:

Zip:


Committee: HEA-HES


18 of 30 6/11/2021, 2:15 PM

42

Public Input No. 100-NFPA 99-2021 [ Section No. 12.5.3.3.6.1 ]

12.5.3.3.6.1 Communications.


(1) Initial notification and ongoing communication of information and instructions to staff

(2) Initial notification and ongoing communication with the external authorities

(3) Communication with the following:

(4) Patients and their families (responsible parties)

(5) Responsible parties when patients are relocated to alternative care sites

(6) Community and the media

(7) Suppliers of essential materials, services, and equipment

(8) Alternative care sites

(9) Definition of when and how to communicate patient information to third parties

(10)

(11) Cooperative planning with other local or regional health care facilities, including thefollowing:

(12) Exchange of information relating to command operations, including contactinformation

(13) Staffing and supplies that could be shared

(14) System to locate the victims of the event or incident


See input to 12.2.2.4

Related Public Inputs for This Document

Related Input Relationship

Public Input No. 98-NFPA 99-2021 [Section No. 12.2.2.4]




Street Address:

City:

State:

Zip:


* Establishment of backup communications systems


19 of 30 6/11/2021, 2:15 PM

43

Committee: HEA-HES


20 of 30 6/11/2021, 2:15 PM

44


12.5.3.3.8.1

The facility shall test its EOP at least twice annually, either through functional or full-scaleexercises or actual events or incidents .









Street Address:

City:

State:

Zip:


Committee: HEA-HES


21 of 30 6/11/2021, 2:15 PM

45


12.5.3.3.8.3

For Emergency Management Category 1 only, an influx of volunteer or simulated patients shallbe tested annually, either through a functional or full-scale exercise or an actual event orincident . (See Table 12.3.)









Street Address:

City:

State:

Zip:


Committee: HEA-HES


22 of 30 6/11/2021, 2:15 PM

46


12.5.3.3.9.3

The facility shall conduct a debriefing session not more than 72 hours after the conclusion of theexercise, event, or the event incident .









Street Address:

City:

State:

Zip:


Committee: HEA-HES


23 of 30 6/11/2021, 2:15 PM

47


12.5.3.3.9.4

The debriefing shall include all key individuals, including which may include the IncidentManagement Team; observers; administration; clinical staff, including a physician(s); andappropriate support staff.


This clarification reflects that debriefings occurring after real incidents or events (as opposed to exercises) may not have observers. Additionally, this clarifies that the makeup of the debriefing team is flexible based on the type of event.




Street Address:

City:

State:

Zip:

Submittal Date: Fri Feb 26 21:04:56 EST 2021

Committee: HEA-HES


24 of 30 6/11/2021, 2:15 PM

48


12.5.3.3.9.5

Exercises and actual events or incidents shall be critiqued to identify areas for improvement.









Street Address:

City:

State:

Zip:


Committee: HEA-HES


25 of 30 6/11/2021, 2:15 PM

49


12.5.3.3.9.6

The critiques required by 12.5.3.3.9.5 shall identify deficiencies and opportunities forimprovement based upon monitoring activities and observations during the exercise or actualevent or incident .


See input to 12.2.2.4. Additionally, this changes inserts "event" to bring the language into alignment with the rest of the chapter.







Street Address:

City:

State:

Zip:

Submittal Date: Fri Feb 26 21:13:01 EST 2021

Committee: HEA-HES


26 of 30 6/11/2021, 2:15 PM

50


12.5.3.4.10 Medical Surge Capacity and Capability.

The requirements of 12.5.3.4.10.1 and 12.5.3.4.10.2 shall apply only to those facilitiesdesignated as Emergency Management Category 1 as that have inpatients, and EmergencyManagement Category 2, and as defined by the HVA.

12.5.3.4.10.1*

The facility shall plan for medical surge capacity and capability.

12.5.3.4.10.2

The triage process shall be implemented as follows:

(1) The arriving victim shall be assessed into the following cohorts:

(2) Risk to others, as follows:

(3) Mentally unstable

(4) Contaminated

(5) Infectious

(6) Risk to self, as follows:

(7) Emotionally impaired

(8) Suicidal

(9) Risk of death or permanent injury, as follows:

(10) Walking wounded

(11) Severely injured but stable

(12) Suffering from life-threatening injury

(13) Beyond care

(14) Patients shall be admitted for treatment depending on facility capacity, the facility’sspecialty, and clinical need.

(15) Creation of ancillary clinical space shall have adequate utility support for the following:

(16) HVAC

(17) Sanitation

(18) Lighting

(19) Proximity to operating room (OR)


Aspects of Medical Surge Capacity and Capability apply to all inpatient facilities.


27 of 30 6/11/2021, 2:15 PM

51




Street Address:

City:

State:

Zip:


Committee: HEA-HES


28 of 30 6/11/2021, 2:15 PM

52


12.5.3.6.1

The facility shall modify, as necessary, its HVA, EOP, supply chain (including the currentemergency supplies inventory), and other components of the emergency managementprogram, as a result of exercises, actual events or incidents , and annual review.









Street Address:

City:

State:

Zip:


Committee: HEA-HES


29 of 30 6/11/2021, 2:15 PM

53

Public Input No. 378-NFPA 99-2021 [ Section No. 13.3.1 ]

13.3.1*

At least annually, the The health care facility shall conduct a security vulnerability assessment(SVA) during the design phase for new construction, every two (2) years, or anytime there is achange in operations or known security risks .


This would align with proposed HVA cadence.




Street Address:

City:

State:

Zip:

Submittal Date: Tue Jun 01 13:26:02 EDT 2021

Committee: HEA-HES


30 of 30 6/11/2021, 2:15 PM

54

Public Input No. 85-NFPA 99-2021 [ Global Input ]

Coordinate terminology with the NEC. Replace terms such as emergency power andauxiliary power with "alternate power source" where appropriate.

Additional Proposed Changes

File Name Description Approved

NEC_Terminology.xlsxThis document identifies the similar terms that are used throughout NFPA 99, 70 and 101. Where possible these terms should be consistent between documents.


There are a lot of inconsistencies of terminology used between NFPA 70, 99, 101, 110 and 111. Many terms are very similar, but not the same. This creates confusion for the users - who don't know if there is an intended difference between the terms. for example: alternate power source(s), alternate source(s),auxiliary power supply and emergency power systememergency source of poweremergency source(s)emergency supply emergency supply sourceemergency system

If there is an intent or need to have these terms be different, then they should be defined so the difference can be understood. other terms to look at:normal electrical servicenormal power normal power distribution systemnormal power sourcenormal power supplynormal power systemnormal sourcenormal source(s) of powernormal supplyoptional loadsoptional standby power sourceoptional standby sourceprimary power sourceprimary sourceprimary source of powerstandby generatorstandby power standby power sourcestandby power systemstandby source


1 of 2 6/10/2021, 10:24 AM

Informational Only - Designated to HEA-ELS

55


Submitter Full Name: Chad Beebe

Organization: ASHE - AHA

Street Address:

City:

State:

Zip:

Submittal Date: Thu Feb 04 22:00:57 EST 2021

Committee:


2 of 2 6/10/2021, 10:24 AM

56

Code Section Existing Definition NEC 424.101(B) alternate energy

source NEC 250.30 Info Note

517.2 (Alt Pwr Source) 517.2 (Critical Branch) 517.2 (Equip Branch) 517.2 (Life Safety) 517.30(B)(1) 517.30(B)(2) 517.30(B)(3) 517.30(C)(2) 517.31(D) 517.31(F) 517.32(B) 517.35 517.35(A) 517.35(B) 517.41(B) 517.41(C) 517.43 517.43(G) 517.44 517.44(A) 517.44(B) 517.45(E) 551.31(A) 551.31(C) 695.4(B)(3) 700.3(F) 700.4(C) 700.7(B) 701.4(C) 701.7(B)

alternate power source(s)

57

702.7(B) 708.21 708.22(A) 708.22(B) 708.22(C) 750.20

NEC 702.1 alternate power supply

NEC 517.45(A) alternate power system

58

NEC 517.43695.3(C)(2)695.3(D)700.3(F) alternate source(s) of power

NEC 250.30 517.2 (Alternate Power) 517.2 (Equip Branch) 517.30(A) 517.30(B)(2) 517.30(B)(3) 517.30(C)(2) 517.31(D) 517.31(F) 517.35(B) 517.41(A) 517.41(B) 517.43 551.33 695.3(C)(2) 695.3(D) 695.3(F) 700.3(F) 700.31 701.4(C) 701.5(A) 701.7(B) 701.31 702.2 (Opt Std Info Note) 702.7(B) 708.52(D) Info Note

alternate source(s): One or more generator sets, or battery systems where permitted, intended to provide power during the interruption of the normal electrical service; or the public utility electrical service intended to provide power during interruption of service normally provided by the generating facilities on the premises. [99:3.3.4]

NEC 640.9(B) 700.12(D)(4)

auxiliary power supply

59

NEC 210.8(B) 517.2 Def (Patient Bed Loc) 517.2 Def (Cat 1) 517.17(A) 517.19 Title 517.19(A) 517.19(F) 517.21 Title & Text 517.29(A) 517.29(B) 517.31(C)(1) 517.34(A) 517.40 517.40(B) Title 517.45(C) Title & Text

Category 1 (critical care): Space in which failure of equipment or a system is likely to cause major injury or death of patients, staff, or visitors. [99:3.3.136.1]

NEC 210.8(B)517.2 Def (Cat 2)517.18 Title517.18(A)517.18(C) Title517.21 Title & Text517.29(A)517.31(C)(1)517.40517.40(A)517.45(D) Title & Text

Category 2 (general care):Space in which failure of equipment or a system is likely to cause minor injury to patients, staff, or visitors. [99:3.3.136.2]

NEC 517.2 Def (Cat 3) 517.29(A) 517.45(A)

Category 3 (basic care): Space in which failure of equipment or a system is not likely to cause injury to the patients, staff, or visitors but can cause

60

patient discomfort. [99:3.3.136.3]

NEC 517.2 Def (Cat 4) 517.29(A)

Category 4 (support): Space in which failure of equipment or a system is not likely to have a physical impact on patient care. [99:3.3.136.4]

NEC 517.2 Def 517.18(A) 517.19(A) 517.19(B)(1) 517.19(C)(1) 517.31(C)(1) 517.32(A) Title 517.32(B) Title 517.33(C) 517.34 Title 517.34(A) 517.34(B) 517.34(C) 517.35(A) 517.44(B)

Critical Branch: A system of feeders and branch circuits supplying power for task illumination, fixed equipment, select receptacles, and select power circuits serving areas and functions related to patient care that are automatically connected to alternate power sources by one or more transfer switches during interruption of the normal power source. [99:3.3.30]

61

NEC 230.82 625.48 626.27 705.1 705.6 705.11 705.40 Info Note 705.50 706.1 706.16(D) 712.3

electric power production source(s)

NEC 100 Def (Interactive Sys)700.5(A) 701.5(A) 702.5(E)708.24(A) electric power production system

NEC 100 100 (Hybrid Sys) 100 (Island Mode) 100 (Stand‐Alone Sys) 690.1 692.1 705.20 705.40 705.50 706.2 (ESS) 706.33(B)(3) 710.1

Electric Power Production: Electric Power Production and Distribution Network. Power production, distribution, and utilization equipment and facilities, such as electric utility systems that are connected to premises wiring and are external to and not controlled by an interactive system. (CMP‐13)

62

NEC 700.12 700.12(A) Title 700.18

emergency power

NEC 700.3(F) 700.7(A)

emergency power source

NEC 700.3(F) 700.3(F) Info Note Fg 700.7(A)

emergency power source

NEC 700.3(E) Info Note 701.3(E) Info Note 708.6(E) Info Note

emergency power supply

NEC 701.3(E) Info Note 708.6(E)

emergency power supply system

NEC 700.12(D)(2) emergency power system

NEC 700.3(F) 700.12(A) 700.12(F)

emergency source of power

63

NEC 701.6(D)700.3(F)700.5(A)700.6(A)700.6(B)700.6(D)700.7(A) 700.10(B)700.12(A)700.12(F) 700.23700.31701.6(D)

emergency source(s)

NEC 700.2 (Branch‐Cir) 700.18

emergency supply

NEC 700.18 emergency supply source

64

NEC 517.31(C)(3) 620.51(E) 700.3(C) 700.3(F) Info Note 700.3(F) Fig 700.4(A) 700.4(B) 700.5(A) 700.10 Title 700.10(A) 700.10(B) Info Note 700.10(B)(a) Fig 700.12(D)(3) 700.12(D)(4) Art 700 Part IV. Title 700.16(B) 700.16(D) 700.17 700.32 Info Note 700.32 Fig 701.5(A)

emergency system

NEC 700.3(F) emergency system source

65

NEC 225.30(A)230.2(A)230.72(B)517.31(C)(3)518.3(C)520.8540.11(C)551.30(B)551.33620.51(E)700.1700.2700.3(C)700.3(F)700.4(A)700.4(B)700.5(A)700.6(D)700.8700.10(B)700.10(D)(1)700.12(D)(3)700.12(D)(4)700.12(E)700.12(G)700.12(H)700.16(B)700.16(D)700.17 700.23700.24700.31700.32701.2 (Legally)701.5(A)750.20750.30(A)

Emergency System(s):Those systems legally required and classed as emergency by municipal, state, federal, or other codes, or by any governmental agency having jurisdiction. These systems are intended to automatically supply illumination, power, or both, to designated areas and equipment in the event of failure of the normal supply or in the event of accident to elements of a system intended to supply, distribute, and control power and illumination essential for safety to human life.

66

NEC 517.2 Def (Equip Branch) 517.18(A) 517.31(C)(1) 517.35 517.42(A) 517.42(D) 517.43 Title 517.44 517.44(A) 517.44(B)

equipment branch

67

NEC 517.14517.17(B)517.18(A)517.25 Title & Info Note517.26517.29(B)517.30(B)(2) 517.30(B)(3)517.30(C) Title & Text517.31517.31(B) Info Note 517.31(a) FigInfo Note 517.31(b) Fig517.31(C)(1)517.31(C)(3) Title517.31(D)517.31(F)517.31(G)517.32(A) 517.33(E) 517.40517.40(B) 517.41(C)517.42(A) 517.42(B) Info Note 517.42(a) FigInfo Note 517.42(b) Fig517.42(C)517.43(E)

Essential Electrical System:A system comprised of alternate sources of power and all connected distribution systems and ancillary equipment, designed to ensure continuity of electrical power to designated areas and functions of a health care facility during disruption of normal power sources, and also to minimize disruption within the internal wiring system. [99:3.3.51]

NEC 692.53 fuel cell power source(s)

NEC 692.41(C) 692.56

fuel cell power systems

68

NEC 100 Def (Fuel Cell Sys)100 Def (Power Production Equip)230.82517.30(B)(2) TitleARTICLE 692 Title692.1692.2 Def (FC Output Cir)692.4(A) Title & Text692.4(B)692.4(C)692.6692.8(B)692.8692.8(C)692.9(A) 692.13692.31692.53692.56692.59692.60692.62700.12(G) Title & Text701.12(H) Title & Text708.20(H) Title & Text

Fuel Cell System:The complete aggregate of equipment used to convert chemical fuel into usable electricity and typically consisting of a reformer, stack, power inverter, and auxiliary equipment. (CMP‐4)

NEC 100 Def (EV) 100 Def (Fuel Cell) 200.3 Exc 692.8(A) 692.8(C) 706.2 Def (Flow Battery)

Fuel Cell: An electrochemical system that consumes fuel to produce an electric current. In such cells, the main chemical reaction used for producing

69

electric power is not combustion. However, there may be sources of combustion used within the overall cell system, such as reformers/fuel processors. (CMP‐4)

NEC 501.125(B) Info Note 505.22 Info Note 700.12(D)(2) 701.12(D)(2) 708.20(F)(7)

Internal combustion engines

NEC 225.30(A)230.2(A)701.1 701.2 (Legally Req)701.3(C)701.3(E)701.4(A)701.4(B)701.6(D) 701.10701.12(E)701.12(H)701.12(I)701.31701.32705.40750.20750.30(A)

Legally Required Standby System(s):Those systems required and so classed as legally required standby by municipal, state, federal, or other codes or by any governmental agency having jurisdiction. These systems are intended to automatically supply power to selected loads (other than those classed as emergency systems) in the event of failure of the normal source.

70

NEC 517.1 Def (Life Safety Br) 517.26 517.31(C)(1) 517.32(A) 517.33 Title & Text 517.33(C) 517.33(F) 517.42(A) 517.42(D) 517.43

life safety branch

NEC 710.15(A) microgrid power source

NEC 710.15(G) microgrid supply

NEC 700.12(H) Title & Text 701.12(I) Title & Text 705.2 Def (Microgrid Inter) 705.2 Def (Microgrid Sys) 705.50 705.60 705.70 712.10(B) 712.72

Microgrid System: A premises wiring system that has generation, energy storage, and load(s), or any combination thereof, that includes the ability to disconnect from and parallel with the primary source.

NEC 100 Def (Island Mode) 705.2 Def (Microgrid Inter) Info Note 712.2 Def (DC Microgrid) 712.2 Def (Primary DC Source) 712.4 712.30 712.57 712.65(A) 712.72

Microgrid:

71

NEC

Normal Electrical Service

NEC 517.30(C)(2) Info Note 517.35(B) 517.44(B) 695.14(F) 700.2 (Emergency Lum) 700.23 700.24

normal power

NEC

Normal Power Distribution System

NEC 517.2 (Critical Branch) 517.2 (Essential) 517.2 (Life Safety) 517.2 (Selected Recepts) 517.30(B)(2) 695.4(B)(3) 700.3(F) 700.7(B) 700.10(B) 700.17 701.7(B) 702.7(B)

normal power source

NEC

Normal Power Supply NEC 620.91(C) normal power system

72

NEC 517.30(A) 517.30(B)(1) 517.30(C)(2) 517.32(B) 517.35(B) 517.41(A) 517.41(B) 517.43 517.44(B) 695.3(C)(2) 700.5(A) 700.12(D)(1) 701.2 (Legally) 701.5(A) 701.12(D)(1) 702.5(E) 708.20(C) 708.20(F)(1) 708.24(A)

normal source

NEC 517.30(C)(2) 695.3(C)(2)

normal source(s) of power

73

NEC 225.34(B)410.130(E)(4)517.26 695.2 (On‐Site)700.2 (Branch‐Cir)700.2 (Em Sys)700.2 (Relay)700.12700.12(G)700.12(H)700.17700.18700.26701.12701.12(H)701.12(I)702.5(A)708.20(A)

normal supply

NEC 517.31(B)(1) 517.40(C) Info Note 708.22(B)

optional loads

NEC 702.7(A) optional standby power source

NEC 702.6(A) 702.6(B) 702.11(A) 702.11(B)

optional standby source

74

NEC 225.34(B) 625.48 626.27 700.4(C) 701.4(C) 702.2 702.4(A) 702.4(B)(1) 702.4(B)(2) 702.10

Optional Standby Systems: Those systems intended to supply power to public or private facilities or property where life safety does not depend on the performance of the system. These systems are intended to supply on‐site generated or stored power to selected loads either automatically or manually.

NEC 142 Locations… power source(s) NEC 100 Def (Island Mode)

705.2 Def (Microgrid) 705.12(B)(3) 705.60 Title 705.65 Title 705.70

primary power source

NEC

Primary Source NEC 705.50

706.16(C) primary source of power

NEC 700.12(D)(1) Title701.12(D)(1) Title708.20(F)(1) Title prime mover‐driven

75

NEC 700.12(D)(2) 701.12(D)(3) Title

public gas system

NEC 700.12(D)(2) 701.12(D)(3) 708.20(F)(3)

public utility gas system

NEC

Public Utility Source NEC 701.7(A) required standby

power source NEC 701.6(D)

701.12(A) 701.31

required standby source

NEC 661 Locations… Service: The conductors and equipment connecting the serving utility to the wiring system of the premises served. (CMP‐10)

NEC 695.2 (On‐Site Standby) 695.3(B)(2) 695.3(D) 695.4(B)(1) 695.4(B)(2) 695.4(B)(3) 695.6(A)(2) 695.6(C) 695.14(F) 700.3(F)

standby generator

NEC 701.12 701.12(F)

standby power

76

NEC 701.7(A) 702.7(A) 702.6(B)

standby power source

NEC 230.82517.26 Info Note517.30(B)(3) Info Note620.91620.91(B) 620.91(C)700.1 Info Note #4700.3(E) Info Note701.1 Info Note #1 & #3701.3(E) Info Note701.6(C) Info Note701.6(D) Info Note701.12(D)(2) 708.1 Info Note #3708.6(E)708.21 Info Note

standby power system

NEC 701.6(A) 701.6(B) 701.6(D) 701.12(A) 701.31 702.4(B)(2) 702.5(A) 702.6(A) 702.6(B) 702.11(A) 702.11(B)

standby source

NEC 517.29(B) Title & Text Info Note 517.31(a) Fig nfo Note 517.31(b) Fig

type 1 essential electrical system

77

NEC 517.29(B) 517.32(B) Title

type 2 EES

NEC 100 Def (Pwr Production Eq) 517.41(B) 517.30(B)(1) 690.12(A) Info Note 692.59 694.2 Def (Diversion Charge) 694.2 Def (Diversion Load) 694.7(C) 706.2 Def (Diversion Charge) 700.3(F) Exc

utility service

NFPA99 6.7.1.1, 6.7.1.2, 6.7.1.2.2.1, 6.7.1.2.3.1, 6.7.1.3.4.2,6.7.1.5.1 alternate power source(s)

NFPA99 6.2.4.3, 6.7.1.1.2, 6.7.1.1.3, 6.7.3.3, 6.7.5.1.4.4, table 6.9.4.1 alternate source(s)

NFPA99 not used auxiliary power supply NFPA99 not used Electric

Power...Electric Power Production and Distribution Network.Power production, distribution, and utilization equipment and facilities, such as electric utility systems that are connected to premises wiring and are external to and not controlled by an

78

interactive system. (CMP‐13)

NFPA99

emergency power NFPA99 6.7.2.1.2.14, 6.7.3.6 emergency power

source NFPA99 6.7.2.1.2.1 (A)(1), 6.3.2.6.4 emergency power

supply NFPA99 6.7.1.2.3.1 (B), 6.11 emergency power

supply system NFPA99 not used emergency power

system NFPA99 not used emergency source of

power NFPA99 6.7.1.2.3.6, 6.7.1.3.6(2) emergency source(s) NFPA99 not used emergency supply NFPA99 not used emergency supply

source NFPA99 6.7.5.1.2.1 emergency system NFPA99 used extensivly (19) equipment branch NFPA99 used extensivly (39) Essential Electrical

System: A system comprised of alternate sources of power and all connected distribution systems and ancillary equipment, designed to ensure continuity of electrical power to

79

designated areas and functions of a health care facility during disruption of normal power sources, and also to minimize disruption within the internal wiring system. [99:3.3.51]

NFPA99 not used fuel cell power source(s)

NFPA99 not used fuel cell power systems

NFPA99 6.7.1.5, 6.7.1.5.1, Fuel Cell System: The complete aggregate of equipment used to convert chemical fuel into usable electricity and typically consisting of a reformer, stack, power inverter, and auxiliary equipment. (CMP‐4)

NFPA99 not used Fuel Cell: An electrochemical system that consumes fuel to produce an electric current. In such cells, the main chemical reaction used for producing electric power is not

80

combustion. However, there may be sources of combustion used within the overall cell system, such as reformers/fuel processors. (CMP‐4)

NFPA99 used extensivly (30) health care microgrid NFPA99 6.7.1.3.5, 6.7.1.3.8.1, Internal combustion

engines NFPA99 not used Legally Required

Standby System(s): Those systems required and so classed as legally required standby by municipal, state, federal, or other codes or by any governmental agency having jurisdiction. These systems are intended to automatically supply power to selected loads (other than those classed as emergency systems) in the event of failure of the normal source.

NFPA99 used extensivly (15) life safety branch NFPA99 not used microgrid power

source NFPA99 not used microgrid supply

81

NFPA99 not used Microgrid System: A premises wiring system that has generation, energy storage, and load(s), or any combination thereof, that includes the ability to disconnect from and parallel with the primary source.

NFPA99 not used Microgrid: NFPA99 6.2.4.2 normal electrical

service NFPA99 6.7.1.1, 6.7.6.2.1.6(E)(1)©, normal power NFPA99 6.4.3, 6.5.2 normal power

distribution system NFPA99 6.7.3.2, 6.7.3.5, 6.7.3.6, 6.7.3.7 normal power source NFPA99 6.11.1 normal power supply NFPA99 not used normal power system NFPA99 6.7.1.1.2, 6.7.2.1.2.14, 6.7.2.2.2, 6.7.3.3, 6.7.3.7, 6.7.5.1.4.4, 6.7.5.3.1, 6.7.6.2.1.6 ( E) (1), 6.7.6.4.1,

6.10.3.2 normal source

NFPA99 6.7.1.1.3 normal source(s) of power

NFPA99 6.7.5.1.2.2(3), 6.7.6.2.1.5(B)(3) normal supply NFPA99 6.7.1.2.2.3 (A), 6.7.1.2.2.3(B), 6.7.1.2.2.3( C), 6.7.1.2.2.4 optional loads NFPA99 not used optional standby

power source NFPA99 not used optional standby

source

82

NFPA99 not used Optional Standby Systems: Those systems intended to supply power to public or private facilities or property where life safety does not depend on the performance of the system. These systems are intended to supply on‐site generated or stored power to selected loads either automatically or manually.

NFPA99 6.3.1 power source(s) NFPA99 6.7.2.2.10, 6.7.2.1.2.17 (A), 6.7.2.1.4.2 primary power source NFPA99 6.7.2.1.2.1 (2), 6.7.2.1.2.4, 6.7.2.1.2.7, 6.7.2.1.2.8(A), 6.7.2.1.2.8 (B) primary source NFPA99 6.7.2.1.2.1(A), 6.7.2.1.2.8 primary source of

power NFPA99 6.7.1.3.6, 6.7.2.1.2.9(A) prime mover NFPA99 not used prime mover‐driven NFPA99 not used public gas system NFPA99 not used public utility gas

system NFPA99 6.7.2.1.2.1( E) public utility source NFPA99 not used required standby

power source NFPA99 not used required standby

source

83

NFPA99 not used in this context Service: The conductors and equipment connecting the serving utility to the wiring system of the premises served. (CMP‐10)

NFPA99 not used standby generator NFPA99 not used standby power NFPA99 not used standby power source NFPA99 not used standby power system NFPA99 not used standby source NFPA99 6.5.1, 6.5.2 type 1 essential

electrical system NFPA99 6.5.1, 6.5.2 type 2 EES NFPA99 6.7.1.1.3 utility service

NFPA 101

7.2.3.12 Emergency Power Supply System (EPSS)

NFPA 101

7.2.3.12 standby power generator

NFPA 101

7.9.1.1(5) standby generator

NFPA 101

7.9.2.2 emergency power

NFPA 101

used extensivly (43) standby power

NFPA 101

11.3.4.2, 11.8.5 emergency and standby power

84