Any contractor who has worked in healthcare environments knows the systems installation—whether electrical, fire alarm or security—poses many unique challenges. As an electrical contractor, you deal with the National Electrical Code (NEC) and National Fire Alarm Code (NFPA 72) on a fairly regular basis. You may have learned of the recently adopted NFPA 730, Guide for Premises Security and NFPA 731, Standard for the Installation of Electronic Premises Security Systems. But do you know about NFPA 99, Standard for Healthcare Facilities?

A proposed revision to this document will include requirements specifically relating to those responsible for security in healthcare facilities. Such individuals may use the criteria outlined in the new chapter to develop a security management program.

While the electrical contractor has no direct responsibility for developing the security management program, such a plan may well direct that a contractor install additional systems. The security management plan will need to include processes and procedures for controlling access to the healthcare facility.

Fortunately, the foundations found in NFPA 730 provide a basis for security management in healthcare facilities. The security plan must begin with a security vulnerability assessment (SVA). This assessment will clearly identify all potential issues that might negatively impact the security of the facility. In response to the SVA, the security management program will need to define and implement mitigating procedures to address issues, such as a security incident, hostage situation, bomb threat, criminal threat, labor action, disorderly conduct, workplace violence, restraining order enforcement, prevention and response to infant or pediatric abduction, control of situations involving VIPs or the media, and ensuring unimpaired access to and unimpaired egress from emergency areas. Each of these issues will require assistance from a professional electrical contractor to install systems used to implement the procedures.

The security management program will determine the extent of the electronic systems needed to ensure the maintenance of an appropriate level of security throughout the facility.

Protecting the facility assets, including property and equipment, will integrate with other important security systems. For example, the security management program must protect communications, data infrastructure and medical records storage areas from the unauthorized release of confidential information or the admittance of unauthorized personnel to critical areas. Physical access control and surveillance equipment (such as CCTV) or other security measures can accomplish this protection.

Video surveillance will provide an important component of both perimeter and interior security systems. Access control systems will help manage access in and out of security--sensitive areas. In addition to general building access control and parking control systems, many healthcare facilities will need specialty systems for the protection of pediatric and infant care areas. These special systems will control and limit access by the general public and monitor and track the location of pediatric and infant patients. In addition, to prevent infant abduction, the security management plan will call for the use of electronic monitoring, tracking and access control equipment. These systems also will provide an automated and standardized facility-wide alerting system to announce pediatric or infant abduction as well as provide for remote exit locking or alarming.

Additional protection for medication storage rooms and work areas often requires specialized video surveillance and motion detection.

The program also provides access control into and out of dementia or behavioral health units. Control of the movement of people through appropriate protection systems, such as physical access control and video surveillance for these areas, will provide protection for the patients and staff members.

NFPA 99 requires that the installation of electronic premises security systems meet the requirements of NFPA 731, Standard for the Installation of Electronic Premises Security Systems, and all security controls, systems and procedures also must comply with life safety requirements for egress. For example, NFPA 101 requires integration of the security systems with the security locking systems to ensure release during a fire. Integrating the security and fire alarm systems generally provides an accepted method of accomplishing this requirement.

NFPA 101 permits access-controlled egress doors provided the remote control of the locks allows for the rapid removal of occupants. It also permits an automatic release device to hold open any door in an exit passageway, stairway enclosure, horizontal exit, smoke barrier or hazardous area enclosure (except boiler rooms, heater rooms and mechanical equipment rooms). Generally these releasing devices connect directly to the fire alarm system. But they also may become a component of a security system that integrates with the fire alarm system. The automatic sprinkler system, fire alarm system and security system must initiate the closing action of all such doors throughout the smoke compartment or throughout the facility.

Doors in the means of egress may have an approved entrance and egress access control system, provided that such a system meets all the following criteria:

1. A sensor, called a request-to-exit device (RTE), must be provided on the egress side, arranged to detect an occupant approaching doors that are designed to unlock in the direction of egress upon detection of an approaching occupant or loss of power to the sensor.

2. Loss of power to the part of the access control system that locks the doors must automatically unlock the doors in the direction of egress.

3. The doors must be arranged to unlock in the direction of egress from a manual release device located 40 to 48 inches vertically above the floor and within 60 inches (1,525 mm) of the secured doors.

4. Any manual release device must be readily accessible and clearly identified by a sign that reads, “Push to Exit.”

5. When operated, the manual release device must result in direct interruption of power to the lock—independent of the access control system electronics—and the doors must remain unlocked for not less than 30 seconds.

6. Activation of the building fire alarm system, if provided, must automatically unlock the doors in the direction of egress, and the doors must remain unlocked until the fire alarm system has been manually reset.

7. The activation of manual fire alarm boxes that activate the building fire alarm system is not required to unlock the doors.

8. Activation of the building automatic sprinkler or fire detection system, if provided, must automatically unlock the doors in the direction of egress, and the doors must remain unlocked until the fire alarm system has been manually reset.

In addition to the increased security required by NFPA 99, each facility now must have clear and instant communications throughout the facility. New mass notification systems or expanded fire voice/alarm communications systems will need to integrate with the security systems, and they will have to be an integral part of the overall security plan.

All of these systems need to operate reliably and can become a part of the electrical contract if the professional contractor has learned the installation requirements for these systems. The professional contractor realizes that developing specialty areas with trained technicians will set him or her apart from the competition, as well as help to mitigate the impact of slow construction periods.

MOORE, a licensed fire protection engineer, frequent speaker and an expert in the life safety field, is a co-editor of the current National Fire Alarm Code Handbook. Moore is a principal with Hughes Associates Inc. at the Warwick, R.I., office.