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Date ArticleType
9/7/2017 Regulatory
Indiana Health Care Facilties Task Force Meeting

The Indiana Health Care Facilities Task Force held its second meeting on August 21, 2017.  Lori Davenport, Director of Regulatory Clinical Affairs, is one of the members of the Task Force.

The most recent session of the Indiana General Assembly resulted in Senate Enrolled Act 112. Under this legislation Indiana Code 16-19-4.5 was added to create the Indiana Health Care Facilities Task Force. The membership of the Task Force was established by Indiana Code 16-19-4.5-4. Indiana Code 16-19-4.5-3 sets out the duties of the Task Force as follows:

“(1) Study and review the current surveying process for hospital and health facility licensure and explore ways tomake the process of hospital and health facility licensure more efficient through use of third party accreditation authorities.
(2) Study, review, and update the American Institute of Architects guidelines for the design and construction of hospitals and health care facilities.
(3) Study, review, and update National Fire Protection Association standards for hospitals and health care facilities.
(4) Submit a report to the governor and the legislative council setting forth the task force's findings and recommendations not later than August 31, 2018. A report to the legislative council under this subdivision must be in an electronic format under IC 5-14-6.”

The focus of the second meeting centered around the FGI Guidelines produced by the Facility Guidelines Institute, an independent, not-for-profit organization dedicated to developing guidance for the planning, design, and construction of hospitals, outpatient facilities, and residential health care and support facilities. The FGI Guidelines are updated every four years, with the newest guidelines set to be released in November 2017 for the years 2018 through 2021. The FGI Guidelines will be separated into three manuals for hospitals, outpatient facilities, and residential support facilities.

Currently, 38 states have adopted some version of the FGI Guidelines, with half of those states automatically updating their guidelines as new FGI Guidelines are released (19 of those states will therefore utilize the 2018 FGI Guidelines upon release). Indiana utilizes the 2001 FGI Guidelines. A map of the states utilizing FGI Guidelines can be found here.

In addition to FGI Guidelines, the Institute issues formal interpretations, guidance interpretations, and bulletins to further explain updates, serving as a resource not only to architects, providers, and health care systems, but also to regulating authorities. The Institute also issues white papers on best practices and other topics, which often serve as precursors to legislative changes. The Institute is funded by sale of the FGI Guidelines.

Following an overview of the FGI Guidelines and Institute, the Task Force determined that Gary Vance (American Institute of Architects – Indiana) and Julie Halbig (Indiana Hospital Association) will gather the following information from the Institute:
(1) How do states “automatically” update their FGI Guidelines, i.e. through statutory language or administrative rule(s)?
(2) What are some examples of “automatic” language?
(3) What hurdles have some states faced in implementing “automatic” language?
(4) What notice mechanisms have states put in place to update regulated parties?
(5) Have the 2018 FGI Guidelines been approved by CMS (there was some concern that CMS had not confirmed that the 2018 FGI Guidelines were as strict as CMS’s requirements)?

Answers to the above questions will be presented at the next meeting, with a possible recommendation being developed by the October meeting. Should the Task Force consider adopting updated guidelines, both Indiana State Department of Health (“ISDH”) Commissioner Jerome Adams and Assistant Commissioner Terry Whitson agreed that the 2018 FGI Guidelines should be adopted, rather than the 2014 FGI Guidelines.

The next Task Force meeting will take place on September 18, 2017 at 1 PM in the Yoho Board Room at the ISDH Office (2 North Meridian Street, 3rd Floor, Indianapolis, IN 46204). The Task Force will be accepting public comments prior to its September meeting regarding updating Indiana’s FGI Guidelines, with specific regard to the Task Force recommending adoption of the 2018 FGI Guidelines and “automatic” renewal. Public comments may be submitted to Terry Whitson at twhitson@isdh.in.gov. The September meeting will also feature representatives from The Joint Commission to review and discuss their hospital accreditation process.