Health Facilities Capital Program Manual. Version 1.0

Transcription

1 Health Facilities Capital Program Manual Version 1.0

2 TABLE OF CONTENTS TABLE OF CONTENTS INTRODUCTION Health Facilities Capital Program Major Capital Projects Total Project Cost $5 Million or Greater Minor Capital Projects Total Project Cost Less Than $5 Million Infrastructure Maintenance Program Property Transactions Program Health Facilities Capital Program Organizational Roles Overview of Manual Guiding Principles Manual Objectives Scope of the Manual Intended Audience Manual Access Organization of the Manual Manual Amendments Responsibility for Manual Amendments Manual Amendment Process PROVINCIAL HEALTH PLANNING & CAPITAL MANAGEMENT Legislative Authority Alberta Health and Alberta Infrastructure Alberta Health Services Health Services Policy and Planning Context... 18

3 2.3 Memorandum of Understanding (MOU): Roles and Responsibilities Health Facilities Capital Program Governance and Management Health Facilities Capital Program Communications Framework CAPITAL PLANNING & PROJECT APPROVAL PROCESS Government of Alberta Annual Capital Planning Process Overview Components of HEALTH s submission into GoA s annual CPP Steps in Health Capital Planning and Project Approval Process Alberta Health Services Multi-Year Facility Infrastructure Capital Submission Purposes of the AHS Multi-Year Facility Infrastructure Capital Submission Description of the Alberta Health Services Capital Submission Needs Assessment Submission and Review of the Alberta Health Services Capital Submission Business Case ALBERTA INFRASTRUCTURE CAPITAL PROJECT DELIVERY Project Start-up and Planning Major Project Oversight Project Management Framework Project Organization and Approach Joint Decision Points and Key Documents Project Planning Documents Changes to Approved Project Parameters Site Selection, Land Acquisition and Divestiture of Assets Functional Program Project Funding Alternative Capital Funding... 60

4 Furniture and Equipment, Information Technology Planning and Procurement Project Procurement and Design Standards and Guidelines Procurement Planning Capital Project Design Process Leadership in Energy and Environmental Design (LEED ) Planning Project Construction Contract Management Roles and Responsibilities Contracting, Procurement and Supply Management and Information Technology Infection Prevention and Control Access Management Insurance and/or Risk Management Occupational Health and Safety Project Reporting Commissioning, Handover and Warranty Building Commissioning and Manuals Facility Handover Operational Commissioning and Move-in Planning Warranty Resolution Reimbursement of Alberta Health Services Facilities Maintenance and Engineering Expenses Evaluation and Project Closeout Project Performance Measures Best Practices and Lessons Learned Review Process Post-Occupancy Evaluation... 86

5 4.5.4 Building Performance Evaluation (BPE) Project Closeout MINOR CAPITAL PROJECT DELIVERY Organizational Roles and Responsibilities Tri-Party Oversight Alberta Health Services Alberta Health Infrastructure Project Funding Guidelines Pre-conditions for Grant Payments Grant Payment Process Eligible Minor Capital Project Costs Project Administration Funding Third-Party Funding Project Oversight Reporting Requirements Auditing Site Visits Contracting Principles INFRASTRUCTURE MAINTENANCE PROGRAM (IMP) Organizational Roles and Responsibilities Health Capital Joint Steering Committee Health Capital Joint Operations Committee Alberta Health Services Alberta Health Infrastructure... 97

6 6.2 Eligibility Criteria General Program Eligibility Criteria Ineligible Projects Eligible Facility Types Eligible Infrastructure Maintenance Program Project Costs Prioritization of Projects Development of an Infrastructure Maintenance Plan Project Activity in Current Fiscal Year (Year 1) Proposed Projects for Future Years (Years 2 and 3) Project Information Requirements Timelines INFRA Review Plan Approval and Payment of Grant Funds Project Oversight Reporting Requirements Auditing Site Visits Contracting Principles FURNITURE, EQUIPMENT AND INFORMATION TECHNOLOGY Organizational Roles and Responsibilities Tri-Party Oversight Alberta Health Services Alberta Health INFRA Equipment Classification Capital Project Eligibility Criteria

7 7.3.1 General Program Eligibility Criteria Ineligible Equipment Costs Business Case Development Project Organization and Communication Program Delivery Equipment Plans Equipment Plan and Budget Preparation Risk Management Plan Procurement Plan Delivery and Installation Plan Financial Administration Budget Oversight Budget Development Cost Information Equipment Reuse Unassigned Contingency CPSM Administration Allowance Variance Management Third-Party Contributions Auditing Grant Processes Grant Funding Agreement Grant Payment Process Reporting Requirements Program Delivery Equipment Installation Framework Diagnostic Imaging Requirements SCHEDULE

8 SCHEDULE APPENDICES

9 1.0 INTRODUCTION Chapter 1.0 provides an overview of the Health Facilities Capital Program (Capital Program) components and the roles of the key organizations involved in the Program. This Chapter also includes an overview of the Health Facilities Capital Program Manual (Manual) structure and describes the process for amendments to the Manual. The Manual has been developed collaboratively by Alberta Health (HEALTH), Alberta Infrastructure (INFRA) and Alberta Health Services (AHS) (the Parties). The Parties work together to build the right facilities in the right communities to meet Albertans health needs now and into the future. The Manual is developed in accordance with the priorities outlined in the Memorandum of Understanding and under the guidance of the Joint Steering Committee. It describes responsibilities, accountabilities and processes for the planning and delivery of the Program. This Manual supersedes the Health Capital Planning Manual, 3 rd Edition (Revised April 2005). 1.1 Health Facilities Capital Program The Capital Program refers to all health facilities capital programs and projects planned and funded through INFRA and managed jointly by the Parties, including: Major Capital Projects Total Project Cost $5 Million or Greater Capital Projects with Total Project Costs (TPC) of $5 million or more are normally delivered by INFRA. However, in some cases the Parties may agree that AHS will deliver the project. (See Chapter 4 for more information) Minor Capital Projects Total Project Cost Less Than $5 Million Capital projects under $5 million are normally delivered by AHS. However, in some cases the Parties may agree that INFRA will deliver the project. (See Chapter 4 for more information) Infrastructure Maintenance Program The Infrastructure Maintenance Program (IMP) is an ongoing funding program for the maintenance and renewal of health facilities. AHS is responsible for the delivery of IMP projects; however, some IMP projects may be delivered by INFRA for reasons of efficiency, Health Facilities Capital Program Manual Version 1.0 June 2013 Page 9

10 particularly where there may be efficiencies in implementing an IMP project in conjunction with a capital project. (See Chapter 4 for information on project delivery and Chapter 6 for more information on the IMP process) Property Transactions Program This program oversees the requirements and conditions that apply to the acquisition and disposal of land and/or buildings owned by AHS. 1.2 Health Facilities Capital Program Organizational Roles The lead organizations within HEALTH, INFRA and AHS and their roles in the Capital Program are described in Table 1 below. Staff from these organizations have participated in the development of this Manual. Table 1 Health Facilities Capital Program Organizational Roles 1 Organization HEALTH Financial and Corporate Services Division, Health Facilities Planning Branch INFRA Capital Projects Division, Health Facilities Branch AHS Capital Management Roles Provides health capital policy direction and capital planning oversight. Develops priorities and recommendations for strategic capital funding in support of AHS delivered health programs on behalf of the Province, in consultation with INFRA and AHS Develops Business Cases and implements approved major capital projects. Provides oversight of IMP and minor capital projects on behalf of the Province. Develops annual AHS Multi-Year Capital Submissions including Needs Assessments and proposals for health facility project projects necessary to support AHS operational priorities. Participates in capital program and project planning, and delivery. 1 Other supported Capital Management staff in AHS participated in the development of the Manual, including Contracting, Procurement and Supply Management (CPSM), Facilities Maintenance and Engineering (FM&E); and Information Technology (IT). Health Facilities Capital Program Manual Version 1.0 June 2013 Page 10

11 Manages IMP projects and Minor Capital Projects. Operates health facilities. 1.3 Overview of Manual This Manual provides a description of the processes and responsibilities for the management, planning and delivery of the Capital Program. Organizational roles and responsibilities are based on the Responsible, Accountable, Support, Consult, Inform (RASCI) Matrix agreed to by the Parties. (See Appendix 3) Guiding Principles There are five principles that guide the integrated three-party management, planning and delivery of health facility projects and programs: supports health service and operational needs; provide value for money through the use of sound fiscal and risk management principles and practices; demonstrate strong accountability in a flexible process; maintain patient safety; and protect the public interest Manual Objectives The following objectives guide the development and maintenance of the Manual: describe and clarify inter-organizational processes consistent with over-arching policy or funding eligibility requirements Capital Program; outline the responsibilities of the Parties, and the information requirements that support decision-making relating to Capital Program; and provide links to relevant documents and templates that are used during project or program planning and delivery of the Capital Program for health facilities Scope of the Manual This Manual focuses on capital project planning and delivery processes, the IMP process, and the inter-organizational decision-making involving the Parties for the Capital Program. Processes for decisions that are clearly internal to one organization and those processes that do not influence the actions or responsibilities of either of the other two entities are out of Health Facilities Capital Program Manual Version 1.0 June 2013 Page 11

12 scope. The reader may need to consult organization specific documentation to clarify or confirm internal project administration processes Intended Audience This Manual is a high-level reference document for all new and existing employees of HEALTH, INFRA and AHS who are engaged in the management, planning or delivery of the Capital Program Manual Access This Manual may be accessed through links available on INFRA s Internet website. HEALTH and AHS also provide links to the Manual through their respective sites. This document employs hyper-links to facilitate movement between sections. The Manual will be updated regularly through an annual review process (see section 1.4). Staff should use the manual that is available through the Internet as the reference document rather than a printed copy to ensure they are viewing the most recent information. Updates to the Manual (either annual or interim) will be made using tracked changes and will be left as such until the next annual update. In addition, updates will be listed inside the front cover with the corresponding Manual version number Organization of the Manual The information in this Manual is organized as follows: Chapter 1: Introduction - Background information and an overview of the Manual s contents. Topics include the purpose and scope of the Manual, intended audience, Manual access, and the amendment process; Chapter 2: Provincial Health Planning and Capital Management - Information regarding the context for provincial health capital planning and management, including an overview of important legislation, tri-party agreements, health service policy and planning documents and communications guidelines; Chapter 3: Capital Planning and Project Approval Process An overview of the AHS Multi-Year Facility Infrastructure Capital Submission (AHS Capital Submission) process and requirements, the HEALTH Capital Plan submission, and the Government of Alberta s (GoA) Capital Planning Process (CPP); Health Facilities Capital Program Manual Version 1.0 June 2013 Page 12

13 Chapter 4: Alberta Infrastructure Major Capital Project Delivery A description of the processes for project planning and design, project administration, project construction, and project review and closure for projects with TPC of $5 million or greater; Chapter 5: Minor Capital Project Delivery A description of the processes for planning of projects under $5 million which AHS is responsible for delivering; Chapter 6: Infrastructure Maintenance Program Guidelines - Specific guidance for the management oversight of the IMP process. Topics such as planning and reporting, eligibility criteria and urgent and emergent projects are covered; Chapter 7: Furniture, Equipment and Information Technology A description of the organizational responsibilities and processes for the management of capital equipment in support of capital projects; Chapter 8: Property Transactions A description of the requirements and conditions that apply to the acquisition or disposal of land and/or buildings owned by AHS; and Appendices A complete list of important supporting documents, including policy documents, committee Terms of Reference (TOR) and templates that are available through links in this Manual. 1.4 Manual Amendments Users are invited to submit amendments to the Manual at any time through their organizational representatives as listed below: Anna Ellert, Alberta Infrastructure ([email protected] ); Calvin Maxfield, Alberta Health ([email protected]); and Steve Fowler, Alberta Health Services ([email protected] ) Responsibility for Manual Amendments INFRA s Health Facilities Branch is responsible for: maintaining the Manual; coordinating annual and interim updates; and document version control. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 13

14 1.4.2 Manual Amendment Process There are two processes for amendments: annual updates; and interim updates. Annual updates The INFRA Health Facilities Branch uses the following process to update the Manual beginning in April: the Parties assign representatives to a Joint Operations Sub-Committee for the Manual (see section 2.4 for more information on the roles of committees); the Joint Operations Sub-Committee participates in ongoing review of amendments submitted by users and decides, in consultation with the submitter, if the recommended amendment requires immediate attention or if it could be deferred to the annual review/update process. (See Interim Updates below for more information); the organizational representatives canvas their organizations users on an annual basis to gather suggested amendments to the Manual; proposed amendments are analyzed by the Joint Operations Sub-Committee and submitted to the Joint Operations Committee together with a recommendation concerning their implementation; the Joint Operations Committee may refer matters that impact finance, organizational responsibilities or inter-organizational decision-making to the Joint Steering Committee. (See section 2.4 for more information on governance and management of the Capital Program); and upon approval, the updates are incorporated into the Manual and the Joint Operations Committee members inform their respective organizations that the Manual has been updated. Interim updates For emergent issues or for changes requiring immediate amendment, the following process is followed: the organizational representatives submit a request with supporting information and documentation to the Joint Operations Sub-Committee with a request for an immediate amendment; Health Facilities Capital Program Manual Version 1.0 June 2013 Page 14

15 the Sub-Committee reviews and clarifies the submission and will consult with the submitter as appropriate; if the submission requires an immediate amendment, a proposal is submitted to the Joint Operations Committee together with a recommendation concerning delivery; the Joint Operations Committee may refer matters that impact finance, organizational responsibilities or inter-organizational decision-making to the Joint Steering Committee. (See section 2.4 for more information on governance and management of the Capital Program); and upon approval, the updates are incorporated into the Manual and the Joint Operations Committee members inform their respective organizations that the Manual has been updated. The decision making/manual update process will be responsive and as timely as possible recognizing the emergent or urgent need for direction. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 15

16 2.0 PROVINCIAL HEALTH PLANNING & CAPITAL MANAGEMENT Chapter 2.0 provides an overview of the provincial context for the Capital Program. It identifies: key legislation that govern the roles of the Parties; the health services planning documents that guide the planning and development of the Capital Program; the processes that facilitate management oversight of the Capital Program as well as the roles and responsibilities of the three Parties; and the communications framework for dealing with requests for information about the Capital Program. 2.1 Legislative Authority Alberta Health and Alberta Infrastructure The legislated responsibilities of HEALTH and INFRA for the planning and management of the Capital Program and Projects are outlined in the Acts and Regulations noted below. Under these statutes and regulations, HEALTH is responsible for setting the strategic direction for the Provincial Health System, and for implementing policy, legislation, standards and funding for provincial health services. Health legislation, as related to health infrastructure, provides for the approval and operation of health facilities, the purchase and disposition of assets and properties, the design and construction of health infrastructure, and the provision of health capital grants. INFRA is responsible for provincial infrastructure design, construction and delivery. The Ministry has responsibility for the provision of services relating to the project planning, design, construction or renovation of a health facility. In many cases, specific regulations or sections contained within regulations are jointly administered by both HEALTH and INFRA. Hospitals Act Part 2 Operation of Approved Hospitals This act relates to the construction, renovation or alteration of real property (buildings, land) and requires that AHS obtain government approval for acquiring or changing physical plants. Under this Act, the Hospitalization Benefits Regulation 244/1990 governs the management of the Consolidated Cash Investment Trust Funds (CCITF) by AHS. Nursing Homes Act Parts 1, 2, and 3 relate to how nursing homes are owned, operated and contracted to the private section. Mental Health Act - Part 7 relates to the development of treatment centers and other facilities to provide mental health services. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 16

17 Public Works Act This act is administered by Infrastructure and governs the acquisition, disposition and management of facilities, the sale of lands and the provision of services relating to the design, construction, alteration, extension, upgrade, repair or demolition of public facilities, including health care facilities. Government Organization Act This act delineates the roles and responsibilities of all government departments, boards and agencies. The Infrastructure Grants Regulation #AR56/2003 provides the Minister of Infrastructure authorities to issue grants. The Health Grants Regulation #AR146/2002 and the Seniors Grants Regulation #AR192/2005 provide the Minister of Health authorities to issue grants. Regional Health Authorities Act This act enables the Minister of Health to make regulations respecting the provision of health services, the undertaking of capital construction projects and the operation of facilities. Financial Administration Act This act outlines the financial management requirements for government departments, agencies and boards in relation to capital and operating funds. As well, funds such as the Consolidated Cash Investment Trust Fund (CCITF) are governed under this act. Builders Lien Act This act applies primarily to work undertaken by AHS; however, it does apply to Infrastructure s work where the ministry is managing projects on AHS properties. It defines key contracting issues such as liens, claims and substantial performance Alberta Health Services Under the Alberta Public Agencies Governance Act (APAGA), the AHS Board is the governing body and regional health authority responsible for the delivery and operation of health services to Albertans and ownership and operation of health facilities that support the delivery of health services. As well, the Alberta Health Services Roles and Mandate Document provides enhanced clarity on roles, responsibilities and service delivery goals. Another key act is the Regional Health Authorities Act which provides AHS the authority to plan, operate and manage health facilities. Under this act, the Regional Health Authorities Regulation, AR 15/95, requires AHS to obtain the written consent of the Minister of Health to enter into a capital development project that has a value in excess of an amount specified by the Minister in a directive. It also requires AHS to comply with written policies and rules issued by the Minister. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 17

18 Relevant statutes and regulations can be found on the HEALTH web site for health-related legislation and the INFRA website for the Public Works Act. The Builders Lien Act can be found on the Service Alberta website. 2.2 Health Services Policy and Planning Context The Capital Program operates within a larger provincial health services planning context. Key health services planning documents that inform and guide the Capital Program are listed in the following chart. The Parties review and reference these documents as necessary during planning and delivery of the Capital Program. Table 2 Key Planning Documents by Organization HEALTH Organization Key Planning Documents* HEALTH Business Plan ** Becoming the Best: Alberta s Five Year Health Action Plan Creating Connections: Alberta Mental Health and Addictions Strategy Continuing Care Strategy: Aging in the Right Place INFRA INFRA Business Plan ** AHS AHS Health Plan & Business Plan ** * Additional GoA or ministry specific documents may need to be referenced to fully inform the planning process. Additional documents will be listed as they are approved by the Parties. ** These documents are updated annually. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 18

19 2.3 Memorandum of Understanding (MOU): Roles and Responsibilities The MOU (Appendix 2.1) is an agreement signed by the Ministers of HEALTH and INFRA, and the Board Chair of AHS. Building on the RASCI (Appendix 3), it outlines the roles and responsibilities of the Parties regarding planning and delivery of the Capital Program. The MOU agreement governs the processes and responsibilities described throughout this Manual and provides for resolution of disputes. The MOU will be reviewed every three years by the Parties (HEALTH, AHS and INFRA). 2.4 Health Facilities Capital Program Governance and Management Governance and management oversight of the Capital Program, including authorities and responsibilities are described in Table 3 below. A Health Capital Joint Steering Committee and a Health Capital Joint Operations Committee have been established according to the MOU. The membership of each committee comprises representatives from each of the Parties. These Joint Committees are integral to the over-arching governance structure for the Capital Program. Through these committees, the Parties collaborate to facilitate management oversight and inter-organizational decision-making. While respecting organizational authorities and responsibilities, the committees undertake the collective review, consultation and determination of courses-of-action that enable program level oversight and effective project management. Sub-committees have been established to manage specific tri-party activities and/or programs, such as the Capital Manual, Capital Planning, IMP, Standards and Guidelines and Furniture, Equipment and Information Technology Sub-Committees. See Appendix 2.2 and Appendix 2.3 for the TOR for the Joint Committees. Sub-Committee Terms of References are held in Appendix 2.4, Appendix 2.5, Appendix 2.6 and Appendix 2.7 Health Facilities Capital Program Manual Version 1.0 June 2013 Page 19

20 Table 3 Health Facilities Capital Program Governance Authority and Responsibility Levels Authority Responsibilities Reference Documents Ministers Chair AHS Board Deputy Ministers AHS CEO HEALTH and INFRA Assistant Deputy Ministers and AHS Senior VPs Executive Directors Health Facilities Planning (HEALTH) Health Facilities Branch (INFRA) VP Capital Management and Government Integration (AHS) Establish overarching roles and responsibilities of the Parties. Provides organization level oversight Provides a forum for executive level oversight including inter-organizational decision-making and issue resolution. Provides a forum for process and management oversight, and the resolution of issues concerning the Capital Program. Alberta Public Agencies Governance Act (APAGA) mandate and roles (see section 2.1.2) RASCI (Appendix 3) MOU (Appendix 2.1) Joint Steering Committee TOR (see Appendix 2.2) Joint Operations Committee TOR (see Appendix 2.3) 2.5 Health Facilities Capital Program Communications Framework The roles and responsibilities of the Parties for communications with stakeholders are as follows: INFRA takes the lead for sharing project-specific information; AHS takes the lead for sharing program-specific information; Key communications staff from all three organizations has been identified to interface with the media and lead messaging to the public and special interest groups. These staff work together to share project and program updates as well as manage media requests and responses; and All communication requests or needs should be directed to key communications staff within the organization where the request was received. In addition to communications with media and stakeholders, ongoing communications between HEALTH, INFRA and AHS are essential during all phases of a project s lifecycle. Project Managers, at the early stages of a project will develop a communications plan that Health Facilities Capital Program Manual Version 1.0 June 2013 Page 20

21 addresses the details of formal and organized communications between all parties involved in the planning and delivery of the facility. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 21

22 3.0 CAPITAL PLANNING & PROJECT APPROVAL PROCESS Chapter 3.0 describes the planning and approval process for major health facilities capital projects. It specifically addresses the AHS Multi-Year Facility Infrastructure Capital Submission and HEALTH s submission into Government of Alberta (GoA) annual Capital Planning Process (CPP). It identifies the roles and responsibilities of the Parties in the GoA s annual CPP. 3.1 Government of Alberta Annual Capital Planning Process This section describes the GoA annual CPP and the HEALTH Capital Plan submission to the CPP Overview Each year the GoA undertakes the CPP. The CPP is led by the Ministry of Infrastructure based on direction from TBF and is supported by the program ministries. The process typically begins in the spring of each year after the provincial budget is tabled. The CPP is used to inform the development of government s 3-year Capital Plan which is part of the annual provincial budget and also to inform the development of a long-term capital plan for government. Like all program ministries, HEALTH is responsible to prepare their submission into government s annual CPP based on directions provided by TBF and INFRA. INFRA supports HEALTH s submissions confirming facility solutions and project costing. The AHS Multi-year Facility Infrastructure Capital Submission is a very important document used by HEALTH to prepare their submission into government s annual CPP. (i.e., Infrastructure projects) Components of HEALTH s submission into GoA s annual CPP. HEALTH s submission into the GoA s CPP typically includes the following: updated cash flow information on existing projects; identification of the priority health capital projects, including related project costs, recommended for capital funding approval consideration; updates to the IMP requirements, typically over a five-year period; and a 10-year Capital Plan of all unfunded health capital projects. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 22

23 INFRA may request additional information as part of the HEALTH s submission to GoA annual CPP. 3.2 Steps in Health Capital Planning and Project Approval Process The major steps in the planning and project approval process are as follows: proposed health capital initiatives are generated at the Ministry level as a response to an identified program need. One of the key sources for identifying the needs is the AHS Multi-Year Facility Infrastructure Capital Submission AHS develops their annual AHS Multi-Year Facility Infrastructure Capital Submission (AHS Capital Submission) and provides it to HEALTH and INFRA by May 31 of each year. Figure 2 provides the high-level workflow and responsibilities of the Parties for the Health Capital Planning and Approval Process; throughout the year AHS develops Needs Assessments for their unfunded priority health capital projects and submits them to HEALTH; through the Capital Planning Sub-Committee, HEALTH consults with AHS and INFRA to determine the next appropriate step for each Needs Assessment submitted. if a Needs Assessment is accepted by HEALTH, then Deputy Minister of HEALTH will write to Deputy Minister of INFRA requesting that INFRA prepare an appropriately rigorous Business Case or Business Case equivalent. INFRA leads the preparation of the Business Case, gets the appropriate sign-off from AHS and then sends it to HEALTH. Once a Business Case is completed, HEALTH, through the Planning Sub Committee, consults with AHS and INFRA to determine the next appropriate step for the Business Case. AHS submits their annual Multi-year Facility Infrastructure Capital Submission to HEALTH and INFRA. This submission identifies all unfunded priority health capital projects for which AHS is requesting capital funding approval consideration. Each of these unfunded priority projects must be supported by an appropriately rigorous Business Case in order to be eligible for capital funding approval consideration. HEALTH makes a submission into GoA s annual CPP as per direction provided by TBF. The information in the AHS Multi-year Facility Infrastructure Capital Submission and the supporting Business Cases provided to date are used to inform HEALTH s submission. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 23

24 INFRA, on behalf of government, leads the GoA s annual Capital Planning Process which informs the development of the government s 3-year Capital Plan within the annual Provincial Budget. Government tables the Provincial Budget. The Provincial Budget identifies any new health capital projects or new health capital programs. Legislature votes on estimates approximately 3 to 4 weeks after Provincial Budget tabled the Ministers of HEALTH and INFRA jointly write the Board Chair of AHS informing him/her of any approved health capital projects in the Provincial Budget and conditions of the approval. Figure 2 illustrates the health capital planning and approval process. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 24

25 Figure 2 Health Capital Planning and Approval Process ALBERTA HEALTH SERVICES (AHS) Prepares annual Multi-Year Facility Infrastructure Capital Submission, including Needs Assessment ALBERTA HEALTH (HEALTH) Reviews AHS submission and develops HEALTH Capital Plan ALBERTA INFRASTRUCTURE (INFRA) Prepares Business Cases as required for the HEALTH Capital Plan INFRA and HEALTH DEPUTY MINISTERS APPROVAL INFRA DM signs off on technical and cost information HEALTH DM reviews and approves the Capital Plan TREASURY BOARD Reviews cross-ministry capital plan submissions. Recommends priority health projects for inclusion in GOA Capital Planning Process (CPP) GOA CABINET APPROVAL AND ALLOCATION OF FUNDS Cabinet informs Treasury Board of approvals Treasury Board informs Ministers of HEALTH and INFRA. Ministers of HEALTH and INFRA inform AHS. 3.3 Alberta Health Services Multi-Year Facility Infrastructure Capital Submission Multi-year capital planning is the process of identifying current and future capital needs and developing strategies and proposals to address those needs. AHS develops a Multi-year Facility Infrastructure Capital Submission (AHS Capital Submission) that supports the AHS Health Plan, which outlines how AHS intends to deliver health services. The AHS Capital Submission is sent to HEALTH annually. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 25

26 3.3.1 Purposes of the AHS Multi-Year Facility Infrastructure Capital Submission The purpose of this submission is to: outline the overall planning and management of health infrastructure; communicate the capital expenditures needed to effectively maintain the existing asset base and modify it as needed to support service delivery strategies; provide the Ministers of HEALTH and INFRA with the information needed to recommend appropriate future funding levels for health infrastructure; provide a rational context to HEALTH and in turn to TBF, for annually assessing individual project recommendations relative to provincial capital proposals (including all the ministries capital submissions) and priorities; and when possible provide a preliminary estimate of operating costs for the proposed capital investments Description of the Alberta Health Services Capital Submission The AHS capital submission is updated and submitted annually to Alberta Health, at a minimum the information required as follows: Executive Summary The executive summary provides an overview of the AHS Capital Submission and identifies the highest priority projects being requested in an appropriate format for review and approval by AHS senior executive and the Board. Introduction This section describes the operational directives that will influence all capital initiatives. The objective of capital investment, and all capital projects, is to support service delivery needs. AHS is responsible for delivering a range of core health services, as set out in AHS' Vision, Strategic Plan and Health Plan. This, along with addressing existing infrastructure issues (safety, physical and functional obsolescence) is the central factor driving the CPP. The link between the AHS Capital Submission and its Health Plan should be clearly articulated by including: a descriptive overview of the mandate, core services and priorities in the health plan; an explanation of how the capital submission supports AHS Health Plan; and where relevant, a summary of how the AHS Capital Plan links to broader government strategic priorities. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 26

27 This information provides important context to government decision-makers. Major Health Trends This part briefly summarizes the health status of Albertans and the challenges and influences currently impacting the delivery of care. Overview of Infrastructure Asset Base This part of the submission provides an inventory of all infrastructure used by AHS, including owned, leased and contracted facilities. This inventory information: allows for more meaningful comparisons between assets; may help form the basis for ranking or prioritizing proposals; helps determine the nature, cost and timing (urgency) of work required; and supports the development of capital strategies that meet service needs in the most cost effective and efficient manner (e.g. by identifying and capitalizing on excess/underutilized capacity). AHS and INFRA jointly develop and annually update a comprehensive asset inventory. The land and building information for each asset includes: ownership status (e.g. owned, leased or contracted); location; structural type; size (land area, square meters, capacity); age (year of original construction for each component structure) and history (e.g. significant rehabilitation, repairs, additions, renovations); replacement value; current use; and any other significant issues. Data on structural type, size and age is submitted to INFRA and maintained in the Evaluation module of the Building and Land Inventory Management System (BLIMS). Replacement Values are typically calculated by INFRA s Project Services Branch. Appendices (e.g. Facility Condition Index (FCI) report, Real Estate Capital Asset Priority Planning (RECAPP) report etc.) may be included to provide additional descriptive or statistical detail. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 27

28 Capital Submission Parameters The AHS capital submission overview describes key program and service delivery strategies and objectives for the next three years or longer. The AHS capital submission must show evidence that capital strategies are directly linked to operational strategies. It should also identify and briefly describe the most significant factors underlying AHS needs for capital expenditures (e.g. demographics, technological change, program change, etc.) Capital Priorities Capital Submission Priorities translate the AHS strategic priorities into proposed short and long-term project plans by providing information on the major capital proposals and divestiture initiatives needed to implement the strategies outlined. This section describes in detail AHS' highest priority projects for provincial capital funding approval, listed in priority order, and including the following information for each proposal: the location and name of the facility or proposed location of a new facility; the ranking of the proposal relative to other proposals in the plan; a brief description of the proposed scope of work; a description of the link between the proposal and the capital strategies; a description of how the project is to be procured (e.g. by a traditional or an alternative capital funding approach); when possible an order of magnitude estimated capital cost of the project and the provincial contribution required (stated in constant dollars). This estimate would be developed in consultation with INFRA and would explain the impact on provincial capital funding requirements of any proposed alternative capital funding or alternative sources of funds (e.g. partnership with private, voluntary or public sector organization); when possible an order of magnitude, an estimate of the additional annualized operating cost, the reasons for the increase and an indication whether AHS can support the increased expenditure in future years' program and operating budgets. Alternately, an estimate of annualized operating savings following completion of the project and the reasons for such savings; summary of any investigative analyses or planning completed to date (master plan, feasibility study, Business Case, etc.) and related reports that are available for review; Health Facilities Capital Program Manual Version 1.0 June 2013 Page 28

29 identification of the funds required and the year in which funds are needed if a Needs Assessment has not yet been completed or if some other type of investigative study is needed; and if all preliminary planning is complete and the identification of the year in which approval for the project is being requested. Information of any future capital proposals that may need to be initiated in a two to three year horizon plus potential projects beyond that time frame (four to ten years). It is understood that these projects may lack detail and be subject to significant change. Asset Divestiture Plan This section provides an overview of any surplus or underutilized infrastructure and describes plans for its disposition or alternate use. Appendices The AHS Capital Submission must include, at a minimum, a Needs Assessment for each of the high priority projects identified in the document (may be submitted separately from the Capital Submission). Appendices may include summaries and status of projects identified in previous capital submissions. Supporting reports or studies for projects identified in the current Capital Submission may also be included Needs Assessment Purpose of a Needs Assessment AHS leads the development of Needs Assessments. A Needs Assessment provides an analysis of the clinical needs and is in turn used for the identification and development of health capital project proposals. It informs and supports proposals identified in the annual AHS Capital Submission, and is consistent with health service delivery plans (see section 2.2). A Needs Assessment involves: articulation of clinical needs; identification of gaps between current conditions and desired conditions; identification of problems, deficits, weaknesses, opportunities and strengths in service delivery; and identification of possible operational solutions to address the stated need or gap in service delivery. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 29

30 Components of a Needs Assessment A Needs Assessment includes the following components: problem or opportunity; background or current situation; strategic and environmental alignment; desired end-state; gap analysis (e.g. savings in staffing, time, costs, etc.); and risk assessment of alternative service delivery options. For a detailed description of each of these components see the Needs Assessment Template and Flow Chart (Appendix 5.1 and Appendix 5.2). Process for Approval of a Needs Assessment HEALTH is responsible for reviewing a completed Needs Assessment and where appropriate, requesting the development of a Business Case by INFRA. This includes: reviewing of each Needs Assessment to determine compliance with provincial health strategies and service delivery plans; and identifying priority Needs Assessments, congruent with provincial health strategies priorities Submission and Review of the Alberta Health Services Capital Submission The AHS Capital Submission is approved by AHS and then formally submitted by the Board Chair to the Ministers of HEALTH. The response is led by HEALTH with consultation with INFRA and signed by both Ministers. The response may comment on: the general acceptability of the AHS Capital Submission; whether or not all information requirements have been met; and individual proposed projects included in the AHS Capital Submission. Where the Ministers indicate that information requirements have not been met, the specified information should be forwarded as soon as possible to AHS senior executive. Upon receipt of the AHS Capital Submission, the Joint Operations Capital Planning Sub- Committee will initiate an assessment and review of the specific proposals identified in the AHS Capital Submission to determine or update the current status of the proposals, and to reach consensus on the appropriate next steps, as follows: Health Facilities Capital Program Manual Version 1.0 June 2013 Page 30

31 the Needs Assessment for the proposal is reviewed in consultation with AHS staff. Consensus is reached on the most appropriate next step; new proposals in the plan, not previously identified by AHS, will be assessed by HEALTH for compliance with provincial capital guidelines based on information provided in the Needs Assessment; proposals that comply will be prioritized; INFRA reviews and confirms the costing information for proposals that had been submitted for consideration in prior years; for higher priority proposals, recommendations will be prepared to proceed with the appropriate next step in the CPP; and a recommendation drafted by the Joint Operations Capital Planning Sub-Committee is presented to Joint Operations for their approval on which Business Cases are to be developed by INFRA. The timing for proceeding with the appropriate next step for an individual proposal may involve the consideration of issues that are not contemplated in the AHS Capital Submission. It is possible that the arguments for proceeding with a proposal are well documented and compelling, but other provincial infrastructure priorities may take precedence Business Case Purpose of a Business Case A Business Case is a systematic process to evaluate different options and develop a facility solution that meets the requirements identified in a Needs Assessment (see section 3.3.3). The Business Case includes associated risks or impacts and cost benefits of each option. HEALTH uses the results of the Business Case to develop its submission to the annual GoA CPP. Components of a Business Case A comprehensive Business Case includes the following components: executive summary; current situation; project description; strategic alignment; environmental analysis; alternatives; Health Facilities Capital Program Manual Version 1.0 June 2013 Page 31

32 business and operational impacts (including estimated projected incremental capital maintenance and operating costs); project risk assessment; cost/benefit analysis that incorporates both capital and estimated operating costs, including Furniture and Equipment/Information Technology (F&E/IT) estimated costs; conclusions and recommendations; implementation strategy; and appendices. For more information, see Business Case Template and Process Flow Chart (Appendix 6.1 and Appendix 6.2). As the process owner, INFRA leads the development of the Business Case in close collaboration with AHS. Each party is responsible for providing background data to support the Business Case development, according to their area of responsibility. For example, user requirements and operational costing data is supplied by AHS, while capital infrastructure development data is provided by INFRA. Process for Developing a Business Case The Joint Operations Capital Planning Sub-Committee prioritizes Needs Assessments for Business Case development. INFRA: determines the requirement for a consultant; obtains funding for the Business Case development; procures a consultant (if required); assembles a project team comprised of planning representatives from the Parties. The AHS Strategic Planner would be responsible for coordinating input from staff in other AHS operational areas such as FM&E, Financial Services (for operating costs), Zone Clinical Staff/User Groups and CPSM to address F&E/IT requirements; and schedules a start-up meeting with the project team and/or the consultant. INFRA/Consultant (if hired), in collaboration with the project team: schedules and facilitates project team meetings; develops a draft Business Case for review by the Parties; Health Facilities Capital Program Manual Version 1.0 June 2013 Page 32

33 in collaboration with AHS identifies the plausible alternatives and the corresponding infrastructure development; and in collaboration with AHS identifies and recommends the preferred facility solution option. The Business Case will include a set of assumptions/parameters upon which it is developed. Since such assumptions may directly impact the analysis and outcome of the Business Case, it may be necessary for the Business Case development team to consult with their respective organizations, including the affected AHS Zone/Provincial Program representative, to ensure the assumptions are both comprehensive and valid. HEALTH is responsible for providing correspondence to INFRA and AHS to formalize Business Case development decisions, consistent with the prioritized plan developed by the Capital Planning Sub-Committee and endorsed by the Joint Operations Committee. Process for Business Case Approval Since the Business Case may inform future capital submissions to the Ministry of TBF, the Parties must ensure sufficient review and rigor in the analysis of the information, including the cost/benefit analysis and selection of the preferred option. The Joint Operations Capital Planning Sub Committee reviews the Business Case and if there are issues with the Business Case it is brought forward to the Joint Operations Committee. If there is no issue with the Business Case it is sent directly to HEALTH after AHS and INFRA sign off. Once a Business Case has been completed, the Business Case is signed and dated by the Parties as follows: AHS (CEO or delegate) will sign the Business Case as recommended ; INFRA (DM or delegate) will sign as reviewer ; and HEALTH (DM or delegate) will sign as approver. See section 3.1 and section 3.2 for more information on the CPP. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 33

34 Process for updating a Business Case When a Business Case is updated from a previous version for inclusion to the AHS Capital Submission the facility solution and costing information will require verification against an updated Needs Assessment and the information updated where appropriate. On completion of the updates the business case will follow the same approval process as documented above. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 34

35 4.0 ALBERTA INFRASTRUCTURE CAPITAL PROJECT DELIVERY Chapter 4.0 provides a description of the processes for delivery of Major Health Capital Projects (Major Projects) following Project Approval (see Chapter 3). Major Projects are those for which INFRA has responsibility for delivery. See Chapter 5 for a description of Minor Health Capital Project Delivery (Minor Projects), for which AHS has responsibility. INFRA normally delivers projects that are greater than $5 million (see 4.0 Alberta Infrastructure Project Delivery), while AHS normally delivers projects that are less than $5 million (see Chapter 5). The Joint Operations Committee may consider amending these responsibilities should it be determined after appropriate review that efficiencies in project delivery will result. Here are four examples where project delivery authority may be amended: INFRA may deliver a project that is less than $5 million when an IMP project is combined with a capital project cost of less than $5 million but the TPC is greater than $5 million; INFRA may also be responsible for delivery of a number of projects within a site or building where each project would have a Total Provincial Support (TPS) less than $5 million but the cumulative TPS of all the projects is greater than $5 million; AHS may deliver a project that is greater than $5 million when there is a significant foundation contribution that increases the TPC to greater than $5 million, or where the contribution carries significant equipment procurement ; and AHS may also be responsible for delivery of a project greater than $5 million if it is co-located with or determined to have synergies with approved IMP projects. The typical phases of a Major Project are depicted in Table 4 and described within this section of the manual. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 35

36 Table 4 - Major Project Phases Project Start-up and Planning Project Procurement and Design Project Construction Commissioning, Handover and Warranty Evaluation and Project Closeout 4.1 Project Start-up and Planning Major Project Oversight Oversight for Major Projects, including the organizational roles, authority and responsibilities is described in Table 5 below. Table 5 Major Health Capital Projects Oversight Organizational Role Authority Responsibilities Project Co-Sponsor HEALTH DM Ensures the objectives and scope of the project are met Project Co-Sponsor AHS President and CEO Ensures the objectives, scope and approach of the project meet the organizational and program objectives of AHS service delivery plans Project Leader INFRA DM Accountable for delivery of the project according to approved scope and budget Client Organization AHS Capital Management and Clinical User Group Representatives Act as AHS representatives on the Project Steering Committee and Project Team Health Facilities Capital Program Manual Version 1.0 June 2013 Page 36

37 4.1.2 Project Management Framework Generally, a framework for all Major Projects must be developed that: establishes clear accountabilities; demonstrates how project objectives are linked to funding approvals; respects organizational authorities throughout the project life-cycle; and establishes a clear decision-making process. Specifically, the project management framework for Major Projects should: align with applicable TBF, HEALTH, INFRA, and AHS legislation, policies and procedures; include a Project Charter and organizational chart; identify inter-departmental arrangements or non-government participants and their roles and responsibilities; establish effective mechanisms for monitoring status and assessing performance, including: reasonableness checks; independent reviews when required; and technical peer teams when required. use processes and documents that embody the principles of sound project management, including: common templates and guidelines on document preparation; continuous risk management; standardized contracts; and standardized tools, techniques and methodologies. provide suitable Project Managers and technical expertise; and include a proactive communication plan Project Organization and Approach A project organization is created following project approval. This process involves HEALTH, INFRA and AHS assigning the necessary staff to undertake specific roles and responsibilities to complete the project. The project organization is comprised of the Project Director and Project Manager (assigned by INFRA), the Project Team that supports the Project Manager, and the Project Steering Committee. The members of the Project Steering Committee include representatives from existing functional organizations within INFRA, AHS and HEALTH. Each organization commits Health Facilities Capital Program Manual Version 1.0 June 2013 Page 37

38 to providing specialist resources to the Project Team and Project Steering Committee respectively. There are two lines of authority that are exercised by the Project Director/Project Manager. One line is exercised horizontally across the functional structures by the Project Manager in the day-to-day management of the project, through the Project Team. The other line is exercised vertically through the functional hierarchy of each organization to address organizational decision making. This second line is typically exercised through the Project Steering Committee and includes the AHS Zones/Provincial Programs. The dynamic of the two lines of authority is important to the decision flow as the Project Director/Project Manager will need to confirm that AHS, HEALTH and INFRA review and authorize decisions that impact the project, consistent with their roles and authorities. Each organization assigns key staff to the Project Team or Project Steering Committee in order to facilitate decision-making throughout the life cycle of the project. The staff must carry the authority to act on behalf of their respective organizations within their assigned roles. However, it is understood that confirmation from the authority within each organization may be necessary. Staff must be familiar with the processes and protocols that relate to their area of expertise or role within the project. For example, the Clinical Liaison works closely with the Project Manager and within the Project Team and carries certain authority on behalf of AHS to provide the necessary input to day-to-day project decisions. Although the Clinical Liaison does not retain sufficient authority to authorize amendments to scope or to approve a Functional Program on behalf of AHS, they are the key contact for INFRA, and are therefore responsible for facilitating those decisions from their organization and ensuring appropriate involvement by AHS staff. The general responsibilities for the five key project authorities are described below (Project Team, Project Steering Committee, Project Director, Project Manager and Clinical Liaison) Project Team The Project Team supports the Project Manager and is comprised of individuals who carry out the project work. This work may be a substantive technical role in achieving the objectives, or it may be work involved with the management of the project such as maintaining the project schedule. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 38

39 The general relationship of the Project Team is identified in Figure 3 below. The Project Charter (Appendix 4.1) identifies the members of the Project Team and details their respective responsibilities to the project. The TOR for the Project Steering Committee and Project Team (Appendix 4.2 and Appendix 4.3) are referenced in the Project Charter. Figure 3 Project Team Project Director (INFRA) Clinical Liaison (AHS) Project Manager (INFRA) Facilities Maintenance and Engineering (FM&E) Project Coordinator Contracting, Procurement and Supply Management (CPSM) and Information Technology (IT) Prime Consultant Functional Program Consultant Legend Construction Manager / Contractor Sub-Consultants (M&E, Structural, Civil, etc.) INFRA Project & Technical Services Direct Reporting Relationship Consulting Relationship Project Team members are drawn from INFRA and AHS (see Project Organization). The core members of the Project Team include the Project Manager (INFRA), Clinical Liaison (AHS Zone Capital Management), Facilities Maintenance and Engineering (FM&E) representative (AHS), Furniture and Equipment representative (AHS Contracting, Procurement and Supply Management), IT, Prime Consultant, Prime Contractor, and Design Consultants. Team membership may evolve in size and composition throughout the life of the project. Committee membership may also include subject matter experts such as INFRAS Technical Services or AHS Cancer Care or Infection Prevention and Control (IPC) staff. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 39

40 Project Steering Committee As outlined in Figure 4 below is a typical Steering Committee structure, the Project Steering Committee is comprised of key executive and functional members of HEALTH, INFRA and AHS. It provides resolution, feedback or guidance throughout the project on matters relating to scope, program priorities, schedule, cost and quality concerns. The Committee resolves issues brought forward by the Project Team that fall within the approved scope for the project. Figure 4 - Project Steering Committee Project Director (INFRA) Committee Chair (Co-Chair) (AHS Co-Chair) AHS Capital Management Zone Leads AHS Zone VPs/EDs AHS Zone Dyads/ Provincial Programs/ Clinical Leads HEALTH Representative Project Manager Clinical Liaison (AHS) LEGEND Direct reporting relationship Consulting relationship While the Committee is expected to resolve any conflict that may arise within the project, the Project Charter will include a conflict management framework and escalation mechanism for issues that cannot be resolved by the Committee. See TOR (Appendix 4.2) for a complete description of roles and responsibilities for the Project Steering Committee. To assist with joint decision-making, the Parties may agree to establish joint chairs for the Project Steering Committee involving both INFRA and AHS. Project Director The Project Director is assigned by INFRA and provides oversight and guidance to the Project Manager. The Project Director also chairs the Project Steering Committee, unless otherwise agreed amongst the Parties. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 40

41 Specific responsibilities of the Project Director include: approving Project Steering Committee membership and TOR following consultation with HEALTH and AHS; verifying project objectives and establishing desired outcomes and timelines in consultation with HEALTH and AHS; overseeing project delivery to ensure methods are appropriate and cost-effective; implementing effective project monitoring processes and ongoing communication processes with Project Manager and AHS representatives (e.g. Capital Management Zone Vice President/Executive Director, Clinical Liaison, User Groups); working with the Project Manager, Clinical Liaison and consultants as needed to provide timely communications to media and stakeholders as required (see section 2.5). ensuring project delivery meets the baseline cost, scope and schedule as stated in the approved Project Charter, Business Case, Functional Program or other HEALTH and INFRA Ministerial approved scope documents; and approving timelines. In exceptional circumstances where an issue remains unresolved, the Project Director is expected to elevate the issue following consultation with the Project Steering Committee. Should an issue fall outside of the authority of the Project Steering Committee to resolve (such as scope changes without accompanying funding support) the Chair/Co-Chair of the Project Steering Committee will make representation to the Joint Operations Committee. This will include recommendations for resolution that are in the best interests of the three Parties. Project Manager The Project Manager is assigned by INFRA and is the senior project authority who leads the Project Team. The Project Manager has the responsibility and accountability for the delivery of safe, functional, high-quality, cost-effective, and sustainable facilities that meet AHS and HEALTH delivery needs. The specific responsibilities of the Project Manager include: establishing a complete and accurate list of the resources required for project planning, design and implementation; managing the project planning and design processes in a manner that ensures HEALTH and AHS needs are documented and met; Health Facilities Capital Program Manual Version 1.0 June 2013 Page 41

42 developing and approving in conjunction with AHS and HEALTH, important project planning documents, such as the Project Charter (see section for project planning documents); working with Clinical Liaison and other Project Team members to ensure project objectives are reached; developing detailed technical and performance specifications, logistics requirements, business management processes, and acceptance of deliverables (except furnishing and equipment); procuring and engaging outside consultants and contractors (e.g., cost consultants, Functional Programmers, urban planning specialists, architects and engineers) see Appendix 9 - Procurement Planning Process Flowchart; overseeing all aspects of project construction execution, control, monitoring, commissioning and closure; working with the Project Director, Clinical Liaison and consultants as needed to provide timely communications to media and stakeholders as required (see section 2.5); coordinating resolution of ongoing operational issues in existing facilities with AHS FM&E, AHS Infection Prevention and Control (IIPC), and User Groups; monitoring budgets, forecasting, cash flows, etc. and approve expenditures and change orders (within expenditure officer authority); working with CPSM on the planning and implementation of F&E components, and monitoring F&E expenditures; working with AHS IT on the planning and implementation of IT components; ensuring the Alberta and National Building Codes and INFRA s technical standards are utilized as key resources for scope documentation and project delivery; establishing and implementing processes for risk management and mitigation; documenting and controlling all project expenditures, contractual commitments and contract changes according to established guidelines; and ensuring training is provided to AHS on building systems and that AHS has the opportunity to verify the performance of the building systems prior to handover through effective building and operational commissioning processes. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 42

43 Clinical Liaison On behalf of AHS, the Clinical Liaison acts as the key functional authority for the operational requirement and as the link between the INFRA Project Manager and AHS Zones/Provincial Programs representatives. In this role the Clinical Liaison: assists in the coordination of resources and input on behalf of AHS through all phases of the project through to Project Close-out; represents the interests of AHS through all phases of the project represents/assists Zone/Provincial Program leadership in daily decision making on project related matters; coordinates the development, review, routing and sign-off of documents by AHS, except where F&E and IT are responsible for the process; coordinates project development work that defines the service requirements, including any preliminary studies and initial approvals; ensures that project objectives (scope), linked to a validated requirement (needs assessment) are established early in the project planning and maintained through to project completion; obtains the necessary functional inputs through a combination of negotiations with functional managers within AHS, and any direction or approvals that may be applied by AHS Capital Management or Zone/Provincial Programs Executive Leads; and works with the Project Director, Project Manager and consultants as needed to provide timely communications to media and stakeholders as required (see section 2.5) The Clinical Liaison supports AHS Capital Management, the Zone Dyads, Provincial Programs staff and Clinical Leads through the relationship outlined in Figure 5. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 43

44 Figure 5 AHS Project Support AHS Capital Management Zone VPs/EDs AHS Capital Management Planning & Design AHS Zone Dyads/ Provincial Programs/ Clinical Leads Project Manager (INFRA) Clinical Liaison (AHS) Facilities Maintenance & Engineering Contracting, Procurement and Supply Management (CPSM) and Information Technology (IT) Clinical & General Support Services/ Provincial Programs LEGEND Direct reporting relationship Consulting relationship Clinicians / User Groups Joint Decision Points and Key Documents The RASCI Matrix (Appendix 3) identifies key joint decision points and the organizational responsibilities and accountabilities attached to these decisions. The decision points mark a series of gates that the project must successfully pass. The decision points will normally require the preparation of decision documents under the leadership of the Project Manager, and supported by the Project Team, following a period of development and review. For some joint decision points, consultants manage the document development process, such as the Functional Program. The Project Charter identifies the responsibility for document preparation and the authority for key decisions. The decision gates include the following as a minimum, and depending on the nature of the project, there may be additional gates to confirm interim outcomes or subsidiary activities/plans: Project Charter; Project Management Plan; Health Facilities Capital Program Manual Version 1.0 June 2013 Page 44

45 Functional Program; Schematic Design; Design Development; Working Drawings; Building Commissioning; Handover; Operational Commissioning; and Close Out. The development of the decision documents will normally occur sequentially and must be identified within the project schedule. Where risks can be appropriately managed and depending on the nature of the project, there may be opportunities to overlap the development of the documents to expedite delivery. This implies that a document or process is initiated before a final decision is made on a previous document. While this may be possible, the Project Manager must take into account the risks/impacts of such a course. Project related decisions are made by the Project Team or the Project Steering Committee. When consensus is not reached or higher approval is required, the issue is elevated to the Joint Operations Committee or to a higher level through the Joint Operations Committee. Figure 6 provides a representation of the Joint Decision Process flow from the Project Manager through to a decision by the Joint Steering Committee. Where decision authority resides at a level lower than the Executive Sponsors, the decision process will end at that level. This process is used for decisions that are within the approved scope of the project. For the Joint Decision Process dealing with scope changes see section Health Facilities Capital Program Manual Version 1.0 June 2013 Page 45

46 Figure 6 Joint Decision Making Process Recommendation Ministers; Treasury Board and Finance; Cabinet Executive Sponsors (HEALTH DM, INFRA DM, AHS CEO) Review and decision Recommendation Approve or Inform Joint Steering Committee Review/decision back to Joint Operations Committee OR recommendation to Executive Sponsors where needed Recommendation Project Steering Committee (Zone/ Prov. Program) Review/decision back to PM OR recommendation to Joint Operations Committee where needed Recommendation Joint Operations Committee Review/decision back to Project Steering Comm. OR recommendation to Joint Steering Committee where needed Draft document and recommend decision to Project Steering Committee where needed Project Manager (PM) (and Team) The steps in the Joint Decision Process are as follows: the Project Team reviews the final draft document, after which the Project Manager submits the document to the Project Steering Committee for their review and discussion (for example, a Functional Program). The Project Manager must forward documentation to committee members sufficiently in advance of a scheduled meeting (as laid out in the project plan) to facilitate review not just by committee members but also by any supporting staff to the committee; the Clinical Liaison ensures that draft documents are circulated to the appropriate staff within AHS and that feedback is provided according to the timelines established by both the Project Manager and Clinical Liaison; and Health Facilities Capital Program Manual Version 1.0 June 2013 Page 46

47 the Project Steering Committee is charged with resolving project decisions that are within the scope and budget of the project. Sufficient time should be allowed in the project schedule for the document approval process, given the levels of review required and the number of organizations involved. While decision documents are approved by a single representative on behalf of their respective organizations, the signature signifies that all necessary reviews and approvals have been obtained within that organization. Inter-organizational decision making and problem resolution must observe project budget and schedule constraints to the extent possible and follow due process for any changes to approved project parameters (see section for more information) Project Planning Documents Project Charter The Project Charter is an essential document that is prepared as early as possible in the life of a project, generally immediately after Project Approval and the assignment of the Project Director and Project Manager. It establishes the project organization and provides guidance in the form of assigned responsibilities, broad project objectives and constraints. Reporting relationships and delegated authority are clearly defined and documented in the Project Charter for all members of a Project Organization. It is a living document that evolves with the project and is updated as the project and immediate objectives change. The initial document is drafted by the Project Manager, with significant input from Project Team members who are appointed as early as possible following Project Approval. The benefit of this team approach is that it takes advantage of the institutional and occupational backgrounds of the members of the Project Team. The Project Manager normally drafts those areas dealing with delivery questions, such as time, cost, risk, etc. The Clinical Liaison represents the operational requirements, the process for internal approvals, as well as the schedule. For more information, see Appendix Project Charter Template. Project Managers may truncate, add to, or combine sections of the document to provide the necessary clarity according to the uniqueness of the project. The Project Manager presents the completed draft to the members of the Project Steering Committee for their review and agreement. The final draft document is approved by the INFRA Project Director. The Clinical Liaison coordinates the sign-off for AHS. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 47

48 Project Management Plan The Project Manager establishes a Project Management Plan (PMP) early in the project life cycle in consultation with Project Team members. A project management plan provides basic information about the project, and describes the planning, execution, monitoring and control, and close-out of the project. For less complex projects the information provided by the PMP may be included within the project charter and the subsidiary plans. The Project Director consults with the Project Steering Committee and resolves any outstanding issues between the Parties before approving the Plan. Once approved, the Plan will provide a baseline to monitor progress and measure results. The Plan content will vary depending on the complexity of a project, and for some projects a plan may not be required based on the nature of the project. Templates for the plans are available to the Project Managers through INFRA s Project Implementation Management System (PIMS) site. The Project Management Plan is an executive summary of several detailed subsidiary management plans (see Table 6). Depending on the nature of the project some of the subsidiary plans may not be required or may developed and provided by consultants/contractors. Table 6 Project Management Plan INPUTS TO PLAN Approved project funding Needs Assessment Business Case Project Charter (Project Approved) Functional Program Framework Project delivery method Stakeholders analysis Initial risk analysis SUBSIDIARY PLANS Scope Management Plan Schedule Management Plan Procurement Management Plan Cost Management Plan Quality Management Plan Human Resources Management Plan Communications Management Plan Claims Management Plan Risk Management Plan Health Facilities Capital Program Manual Version 1.0 June 2013 Page 48

49 INPUTS TO PLAN SUBSIDIARY PLANS Health and Safety Management Plan (under development) Environmental Management Plan Close out Management Plan Building Commissioning/Handover Plan Move-In Plan (Note: AHS is responsible for developing) Operational Commissioning Plan (Note: AHS is responsible for developing) Scope, Budget and Schedule The Project Manager is responsible for the management of the scope, budget and schedule for the project. After forming a Project Team and developing a Project Charter, the Project Manager will confirm the scope, budget and schedule for the project and bring to the attention of the Project Steering Committee Chair any issues or ambiguities requiring clarification. While the Project Charter provides a broad outline of project scope, the Project Manager may elect to prepare a Scope Management Plan should the project carry a greater degree of complexity. A Scope Management Plan ensures the project includes all the work required to complete the project and excludes all the work not necessary to complete the project. The Scope Management Plan details how project scope will be defined, managed, controlled, verified and communicated to the Project Team and other stakeholders. It clearly defines who is responsible for managing the project s scope and acts as a guide for managing and controlling the scope Changes to Approved Project Parameters While the implementation objective is the delivery of quality projects, on time and within budget, circumstances may arise that necessitate a change in the scope (project objectives), schedule or budget of a project. A proposal to change these parameters may occur any time following the formal approval of a project through to the handover of the facility. Changes, Health Facilities Capital Program Manual Version 1.0 June 2013 Page 49

50 when approved, will modify the project objectives outlined within the Business Case or the last approved change for the project. It is important to note that TBF approves the overall scope and budget for a project following the submission of the Business Case as part of HEALTH s submission into GoA annual CPP. Minor Change Requests INFRA has the authority to approve and implement minor change requests that are consistent with the project objectives and within the approved project budget. The Project Manager prepares change requests with the support of the Project Team. The approval authority for change requests is delineated within INFRA s Expenditure Officer Authority Guidelines. The project s contingency fund provides the financial source for minor change requests. When a minor change request is contemplated, the Project Manager is responsible for ensuring that all impacted parties are consulted as appropriate, notably the Project Team and in particular the F&E/IT and the FM&E representatives. Changing the location of a wall or re-locating the entrance to a room would be examples of minor change requests. Such requests are not likely to impact the project objectives or budget. Major Change Requests (Scope Changes) To initiate a request to change the project objectives or budget, the organization seeking the change forwards a proposal in writing to the Project Director (the Change Proposal ). The process outlined below provides for the review and validation of plausible options and the assessment of any impacts. The Change Proposal must be feasible and achievable within the project even though additional funding may be necessary. The Proposal must be reviewed and supported by the Project Steering Committee. Where any scope or budget change is required to implement the Change Proposal, the Joint Operations Committee reviews the Change Proposal (following Project Steering Committee recommendation) and in turn provides a recommendation to the Joint Steering Committee regarding implementation. The Joint Steering Committee determines the next steps concerning an amendment to the project objectives or a request for additional project funding. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 50

51 An example of a major change request would be changing the functionality of a room from administrative space to an operating room. Such a request would impact the project objectives and/or budget. The Project Manager coordinates the Project Team s work to define the technical requirements and implications of a Change Proposal. The Clinical Liaison works with the Zone Medical Lead and Capital Management Lead to review and validate any changes to program requirements and their implications. The process for reviewing and approving a Change Proposal follows these steps: Identify Requirements: The originator of a Change Proposal must substantiate the request for change. This may require a revisit of the Business Case to analyze and update the program service delivery objectives of the project; Verification of Change Proposal Requirements: Through consultation with the Parties, the Project Manager reviews the Change Proposal and validates the requirement for change through the Project Steering Committee. This review and validation process must take into account any strategies that may mitigate the need or cost of the proposed change, including any synergies with other projects, programs or facilities. During the verification process, the Project Manager consults with INFRA s Health Facilities Branch planning staff and HEALTH who verify whether the proposed change is consistent with the Business Case and project objectives that were approved for delivery by the GoA; Review Cost and Technical Factors: Once the need for the Change Proposal is verified by the Project Steering Committee, the Project Manager prepares an assessment of the cost, schedule and any technical implications of the proposed change. The Project Manager is responsible for ensuring that all parties are consulted as appropriate, notably the Project Team and in particular the F&E/IT representative concerning any F&E/IT impacts; Project Steering Committee Recommendation: Since the Project Steering Committee does not retain the authority to make decisions concerning the implementation of a Change Proposal, the Committee must formulate a recommendation concerning their preferred course of action to the Joint Operations Committee. The Project Director prepares a recommendation to the Joint Operations Committee that details the objectives and options concerning the change, as well as any cost, schedule and technical implications; Health Facilities Capital Program Manual Version 1.0 June 2013 Page 51

52 Joint Operations Committee: The Joint Operations Committee provides executive review of the substantiation for the Change Proposal and the implications of any change. The core members of the Joint Operations Committee may consult with the members of the Project Steering Committee to assure themselves of the appropriateness of the recommendation. The Project Director attends the Joint Operations Committee meeting to present the Change Proposal on behalf of the Project Steering Committee. The Joint Operations Committee decides whether the change proposal needs to go to the Joint Steering Committee for approval or information. If further analysis is necessary before this recommendation is presented at Joint Steering, the Joint Operations Committee requests this review through the Project Director; Joint Steering Committee: The Joint Steering Committee reviews Change Proposals and determines the next steps. This may include referral to the organization with the authority to resolve the matter, such as HEALTH for decisions concerning policy and funding matters, INFRA for technical matters, or AHS in consultation with HEALTH for operating cost implications; and Treasury Board and Finance: Major changes that require substantial additional funding are elevated to the Executive Sponsor, the Ministers and finally to TBF for funding approval consideration Site Selection, Land Acquisition and Divestiture of Assets Site Selection For Major Projects involving new construction, the Business Case identifies preferred sites or locations for the project. This is based on the development of a set of criteria consistent with the objectives of the project, which may include: proximity to transportation and communication links; proximity relative to where residents would best be serviced by the facility, with attention to population centers and access; proximity to other community or health facilities that impact the delivery of healthcare services at the new facility; the size of the parcel of land and whether it is appropriate for the area plan and facility plan; adequate parking facilities; Health Facilities Capital Program Manual Version 1.0 June 2013 Page 52

53 topography and soil suitability (soil sampling or an environmental assessment prior to acquisition may be warranted); and site survey (may be appropriate prior to acquisition). Potential sites are reviewed with representatives from the Parties. In this process, the potential sites are evaluated against the project criteria and recommendations are made to acquire the preferred site. Final site determination and acquisition occurs following approval of the project by the Treasury Board. Health planning may identify long-term requirements for strategic land acquisitions to facilitate decisions that better take into account the criteria listed above. An example of this requirement could be a strategic project that requires several years of planning to meet a comprehensive geographic need that emerges due to population growth. AHS may identify strategic land acquisitions within its annual Capital Submission (see section Part 5). Land Acquisition and Management For renovation projects, the Project Manager is responsible to liaise with the FM&E lead from AHS to define the space allocation for the project. This allocation must be consistent with the terms, conditions and policies of the AHS site management authority and must be incorporated into the tender/contract documents. For projects that require site acquisitions, INFRA will consult with the AHS Capital Management and HEALTH Facilities Planning Branch prior to any decision on a site acquisition. Suitability of the site and its ability to facilitate the scope and program delivery requirements of AHS will be key considerations in the consultation. INFRA acquires the preferred property using capital funding from within the approved project budget. The Project Manager is supported by the INFRA Properties Division, Realty Services Branch, for land acquisition. The Properties Division is responsible for completing negotiations, finalizing the terms of sale and any contractual arrangements. The Project Manager also receives support from the Project Steering Committee which includes executive representation from AHS Capital Management. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 53

54 INFRA s role in land acquisition and management includes: negotiating the terms of the land acquisition consistent with current Provincial legislation; consulting with AHS on any terms that may impact AHS following the transfer of the land title from INFRA to AHS; managing the property through to its handover to AHS, including the payment of taxes, insurances or the maintenance of pre-existing facilities, along with any pre-existing leases that were established within those facilities (these expenses should be identified in the Business Case); engaging AHS on any matters that may impact regional or site specific service delivery or facility plans; and leading discussions with municipalities or developers to achieve the project parameters or negotiating site development requirements. Transfer of Title The title for the property will be transferred by INFRA to AHS at handover of the completed facility. See section for more information. Divestiture of Assets AHS is responsible for determining how it will use the land, buildings or facilities that it owns. AHS will consult with HEALTH and INFRA when considering disposition of an interest in land, a health care facility or a structure used for health care purposes. This ensures that any such transactions are compliant with current GoA legislation, policies and procedures Functional Program A Functional Program is an important step in the project planning process. It describes the scope of services to be addressed by the project and identifies important service or functional requirements that must be met. For each service or functional component, the Functional Program specifies necessary human, technical and building resources. The Functional Program is used to: provide instruction for the preparation of a Schematic Design; provide clarification for key stakeholders about the scope of the project; and provide project costing and estimated operating costs for the project. The steps in this process include: Health Facilities Capital Program Manual Version 1.0 June 2013 Page 54

55 procuring a programming consultant; determining the depth of analysis required for each component of a Functional Programming study based on the project's size, complexity and risk; developing a Functional Program that takes into consideration the following: the opportunity or challenge that the project is addressing; the strategic alignment between the project s goals and objectives; the major features of the project, its scope of work, space requirements and technical scope; the impact of the project on current operations; the financial operating requirements resulting from the project; and the financial capital requirements of the project and funding sources. gaining approval for the Functional Program by HEALTH, AHS, and INFRA Executive Sponsors. The components of a Functional Program are: executive summary; assumptions; planning parameters; activities/functions for each component within the project; staff workload/patient volumes; functional relationships; design criteria/physical requirements; schedule of accommodation (e.g., listing of rooms by program requirement, area, intended number of occupants, major equipment etc.); F&E/IT requirements and costs (e.g., equipment list); impact analysis, including impact on overall facility/system and on core, clinical and support services staff workloads and additional equipment needs from new or additional services; development options (Conceptual Development Plan); project cost plan; operating and incremental operating cost projections; and other considerations (e.g. additional items such as site development plan, operational impacts on parking and traffic studies may be included for projects that are large and complex in nature). Health Facilities Capital Program Manual Version 1.0 June 2013 Page 55

56 The Functional Programming components detailed above may not need to be completed for every project. Moreover, the information provided for each element is scalable to the nature and impact of a project. The overall length of the Functional Program should be kept to a minimum, ensuring that it stays on topic and presents only relevant information in a clear and concise manner. (Refer to Appendix 7 Functional Program Framework for more detail). Roles and Responsibilities INFRA is responsible for leading the development of the Functional Program, including the procurement of a Programming Consultant with funding support from the approved project budget (see Appendix 9 Procurement Planning Process Flowchart). Both HEALTH and AHS support INFRA in the development of the Functional Program. The Programming Consultant will report to INFRA and be responsive to AHS in the development of the Functional Program as it is important that the consultant, INFRA, AHS and HEALTH, as needed, establish a partnering approach. In procuring the Programming Consultant, INFRA invites AHS to participate in the development of the Request for Qualifications (RFQ), if needed, the Request for Proposals (RFP) and the review of the respondent submissions. The INFRA project manager ensures that the consultant establishes a sound methodology for the development of the Functional Program that facilitates the input of AHS Zone Capital Management staff, Clinical and Medical Zone Leads (Zone Dyads), Provincial Programs staff and Clinical Leads. The consultative process to developing the Functional Program includes the review and follow-up of any documentation that the consultant develops. It is important that the INFRA project manager consults with AHS and HEALTH concerning the identification of the planning parameters and priorities at the inception of the Functional Program, including the objectives, methodology, supporting information and reporting and review process. The Clinical Liaison will provide central coordination of resources and input on behalf of AHS (with the exception of F&E and IT) with particular attention to the input and interaction of both AHS zone and provincial representatives. As a component in the development of the Functional Program, AHS develops an F&E/IT Equipment Plan that is appended to the Functional Program upon its completion (see section 7.6). The Equipment Plan is used to establish the project s equipment budget. Approval of the Functional Program in turn approves the F&E/IT budget (see section ). Health Facilities Capital Program Manual Version 1.0 June 2013 Page 56

57 The final draft of the Functional Program is prepared by the Programming Consultant and submitted to INFRA for review by the team that participated in its development. Once the team concurs that the objectives of the Functional Program are met, the Project Steering Committee reviews and recommends approval. The Chair of the Project Steering Committee (Project Director) in turn forwards the completed draft and the Project Steering Committee s recommendation to the Senior Vice President, AHS Capital Management for final organizational review and sign-off on behalf of AHS. Following AHS approval of the Functional Program, the Project Director forwards the Functional Program and AHS sign-off to HEALTH for final approval Project Funding GoA Funding The annual HEALTH submission into GoA s annual CPP includes a description of the proposed or requested GoA funding support, as well as any other funding sources that will support the proposed project. In most cases, the GoA will provide the primary source of funding, known as the Total Provincial Support (TPS). Capital projects may also receive funding contributions from other sources, such as, charitable donations, other levels of government, third party stakeholders or debt financing by AHS that together make up the total project budget, also known as the Total Project Cost (TPC). INFRA is responsible for managing all project funding for the projects it is delivering, including that provided by the GoA as well as any other funding source. Project funding from other funding sources is described below. Other Funding Sources Other funding sources and specific management responsibilities are outlined in Table 7 below. Also see Appendix 11 Project Reporting Matrix for more information. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 57

58 Table 7 Management Responsibility by Funding Source FUNDING SOURCE Charitable Foundations: Various charitable foundations may seek to contribute funds to a project for the delivery of specific items. The foundation contribution will increase the TPC of the project. (See Appendix 11 for more information). MANAGEMENT RESPONSIBILITY AHS will coordinate foundation contribution proposals consistent with the terms that are outlined in an expenditure approval letter from the foundation board. The INFRA Project Manager will coordinate the signing of a foundation contribution agreement between AHS and INFRA that outlines the work to be undertaken and the cost of the work. (See Appendix 8 - Foundation Funding Contribution Agreement). The agreement identifies the terms that allow INFRA to control and expend the funding contribution for the delivery of specific items as part of the overall capital project, including the payment of invoices. Ancillary Funding, (e.g. retail pharmacies) AHS is responsible for funding revenuegenerating entities, typically accomplished through a debt funding arrangement with the Province. Ancillary funding increases the TPC for the project. INFRA Project Managers will coordinate the signing of a funding contribution agreement between INFRA and AHS for ancillary funding. (See Appendix 8 - Charitable Foundations/Ancillary Funding Template). This agreement will facilitate the management of the funds by INFRA, including the payment of invoices. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 58

59 FUNDING SOURCE IMP: Through authorization by the Joint Steering Committee, IMP projects and their associated funds may be implemented in conjunction with a capital project for reasons of efficiency (see Chapter 6). IMP contributions increase the TPC of the overall project. Universities and University Research: Funding contributions may be provided from research grants received through private contributions, or from private or public research organizations such as the Canadian Institute of Health Research. The funding contributions are normally directed to the delivery of specific items within the overall capital project. Research contributions increase the TPC of the project. MANAGEMENT RESPONSIBILITY Upon approval to proceed with an IMP funding contribution, INFRA s Finance Branch will coordinate the assignment of funds to INFRA s project budget, thus reducing the annual IMP grant to AHS. Research funding contributions will be managed in a manner similar to that established for charitable foundation contributions. Research foundations or similar bodies will have additional requirements for timelines and reporting that must be met. These requirements are typically in addition to what is requested by charitable foundations. The expenditure of funding from third-party contributions is reported by INFRA to AHS on a quarterly basis. Additional funding from third-parties, such as charitable donations, may come forward after a project has been approved by the GoA and this may impact project scope. When this occurs, Project Managers/Directors must ensure that the proposed change is administered according to section of the Manual. Additions to the scope and budget generated through a foundation contribution must be consistent with the overall objectives of the project. Any additions must not adversely impact the approved scope, schedule and budget, or existing facilities and their operations. Should a foundation contribution cause an increase in operating costs, such increases will require the prior consent of HEALTH and AHS. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 59

60 Alternative Capital Funding The primary interest for the GoA in Alternative Capital Funding (ACF) for project delivery is to explore ways in which private sector involvement in projects could reduce the provincial capital outlay, reduce overall costs and share risks by taking advantage of core competencies in the private sector. ACF encompasses a wide range of models with varying implications for risk transfer, ownership and operations. There are three primary alternative funding approaches within health capital projects: Public Private Partnership (P3) - A private sector partner provides infrastructure and/or services that have been traditionally delivered by the public sector. A key component of P3 arrangements is the sharing of the project risks (e.g., design, construction and concession) between the public and private sector partners according to who is better able to manage them. Under the GoA definition of a P3, the public sector contributes debt funding for the capital cost of the project which is repaid by the GoA over the life of the project, typically over a 25 to 30 year service delivery concession. It does not include outsourcing (private partner provides infrastructure on a short-term rental basis or operates and maintains AHS owned infrastructure) or design/build (fixed-price contract for design and construction) options. The development of a successful P3 arrangement will require attention to a large variety of issues through a detailed planning and analysis process. TBF is responsible for the standards and processes for the development and implementation of P3 procurements. Information on the processes and organizational responsibilities for the development of an ACF project are available through the TBF website at: While INFRA leads the development of a P3 Business Case for major capital projects, a project team that includes direct representation from AHS and HEALTH is essential to evaluate the merits of an ACF or P3 approach. The first step in the P3 evaluation is the Opportunity Paper which considers at a high-level whether the project attributes meet the prerequisites for a P3 delivery model. If the Opportunity Paper provides a positive assessment, INFRA will establish a dedicated Business Case development team in collaboration with HEALTH and AHS to consider the value of proceeding with a P3 procurement. The Business Case findings require review through an executive oversight committee comprised of the DMs of HEALTH, INFRA, TBF, Justice and Attorney General, and Health Facilities Capital Program Manual Version 1.0 June 2013 Page 60

61 the President and CEO of AHS. If the Business Case and project attributes provide value for money, including the proposed risk transfer and service delivery objectives, the executive committee may recommend to TBF that the project proceed as a P3. P3 procurements will require the development of detailed contract and service delivery specifications. HEALTH and AHS partner with INFRA as members of the project team in the development of the RFQ, RFP and project oversight following contract award. The procurement process is governed by TBF processes outlined at the above link; Health Authority Borrowing AHS borrows up front capital funds for specific projects, which is paid down by future GoA annual budget allocations; and User Charges Revenue mechanisms that can be used in combination with other ACF options, or not, involving the collection of charges from the users of a particular capital project. Typically, these funds are used to repay borrowing or commitments under an ACF project Furniture and Equipment, Information Technology Planning and Procurement F&E/IT planning and procurement is integral to the planning and delivery process for a Health Project. Organizational responsibilities and processes are outlined in Chapter Project Procurement and Design Standards and Guidelines The Standards and Guidelines sub-committee of the Joint Operations Committee has been established to: review current standards and guidelines that relate to health facility design; and provide advice and recommendations to the Joint Operations Committee concerning their implementation or amendment. Since standards and guidelines relating to health facility design and construction are directly applicable to service delivery and capital costs, all three parties will be members of the sub-committee. Key responsibilities of the sub-committee include the following: develop a common understanding on the use of standards and guidelines that would promote safe, high-performing and sustainable buildings; Health Facilities Capital Program Manual Version 1.0 June 2013 Page 61

62 develop a prioritized work plan for the purpose of formulating recommendations concerning the relevance and impacts or consequences of approval, including (as a minimum) the following documents: Infection Prevention and Control, including the Canadian Standards Association (CSA) documents including the Z317 and Z8000 (see section IPC); Grossing Factors and Net Areas; Building Performance Evaluation methodology and implementation; and Continuing Care Design Guidelines. identify impacts, opportunities and obstacles concerning the implementation of standards and guidelines Procurement Planning Procurement involves the selection of qualified consultants and contractors (proponents) for the various phases of major capital projects. The four main contractor/consultant types are: Programming Consultant (for Functional Program development); Prime Consultant (for design services and contract administration); Contractors or Construction Managers; and Commissioning Agents. Additionally, other technical consultants or contractors, including Value Management, Cost Management, Scheduling, and Risk Management consultants, may be engaged by INFRA based on the requirements of an individual project. Project Managers administer the procurement process in consultation with INFRA technical, procurement and Cost Management staff to ensure best practices. The procurement process is conducted in accordance with GoA legislation, trade agreements and departmental policies, processes and guidelines. While the procurement process typically includes the following steps, some steps may be omitted for less complex projects: development of a project delivery model and procurement plan; determination of potential proponents (e.g., consultants or contractors); solicitation of interest from potential proponents (through a Request for Information process); development of RFQ from interested proponents; development of RFP and tenders; evaluation of proponent submissions; Health Facilities Capital Program Manual Version 1.0 June 2013 Page 62

63 contract approvals and awards; and communication of the outcomes of the procurement process to the Project Team. Role of AHS in the Procurement Process AHS is responsible for informing INFRA of any policy, procedures, or guidelines that may need to be addressed in the tendering process, including RFQ, RFP, contracts, or specifications. AHS will also advise INFRA of any requirement for criminal records checks or any other such limitation to contractor access. AHS participates as a voting member of the Project Team as required for the development of RFQs and RFPs and review of proponent submissions for the four main contractor/consultant roles (see above). In their review, AHS identifies any contract work or conditions that conflict with AHS operational policy, procedures, or guidelines. HEALTH may be invited to provide feedback where appropriate. Communications Project Managers are responsible for coordinating with INFRA Communications any public announcements at tenders or contract awards. INFRA Communications will consult with HEALTH Communications and AHS Communications prior to making public announcements Capital Project Design Process Role of the Project Steering Committee in Project Design In addition to the responsibilities outlined in section 4.1.3, the Project Steering Committee assists the design process by providing high-level guidance to the Project Manager. The Project Steering Committee is responsible for: maintaining vision for the project; clarifying priorities for project design; making decisions when required concerning design options and recommendations brought forward by the Project Manager; escalating issues that cannot be resolved by the Steering Committee to the Joint Operations Committee as appropriate. (See Figure 6 Joint Decision Making Process); and assisting and collaborating with the Project Manager and Prime Consultant as needed throughout the design process. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 63

64 Development and Approval of Design Documents The Project Manager oversees the project from approval through completion, including the development of the design documents. This includes the procurement of consultants and contractors, and the direction and supervision of the project and consulting teams as appropriate, and according to the composition of the Project Team described in section In addition to the Project Manager and design consultants, the Project Team includes the AHS Clinical Liaison and AHS F&E/IT and FM&E representatives. The Project Team may also include INFRA technical resource personnel, user group representatives, cost consultants and commissioning consultants. (See section 4.1.3). Under the direction of the Project Manager, the team works together in: selecting the Prime Consultant(s) to develop the design documents; validating a design process with the Prime Consultant that: is structured, iterative, and incorporates ongoing consultation with AHS, HEALTH and other user groups or stakeholders; follows the design process as presented in Appendix 10 - Project Design Flowchart; monitors deviation from approved scope; and follows INFRA procedures and protocols and general industry best practices. developing a design schedule with the Prime Consultant that fits within the overall project schedule and key design milestones/checkpoints with particular consideration of the following: schematic design, which includes floor plans and general system descriptions, as summarized in the schematic design report; design development, which is a further development of the schematic design, documents the building plans, building systems design, F&E/IT requirements, and is summarized in the design development report; and contract documents, which include the drawings and specifications that make up the final documents the builder, will use to construct the facility. At the conclusion of each milestone, the Prime Consultant will submit the applicable design report and any supporting documentation to the Project Manager. AHS and HEALTH will each receive a copy for review and comment. AHS will be given an opportunity to review through the Clinical Liaison. The AHS Clinical Liaison is responsible for getting feedback, consensus Health Facilities Capital Program Manual Version 1.0 June 2013 Page 64

65 and ultimately providing AHS organizational sign-offs for the design documentation at each milestone. Before proceeding to the next design milestone, the Project Team: reviews design documents to ensure completeness and compliance with the project scope and user requirements; consults with other internal resources or consultants as needed to review the documents and solicit feedback (e.g., INFRA Technical Services Branch); and finalizes and approves the milestone design documents. The Project Team may incorporate design strategies such as integrated design, value management, value engineering, (see Appendix Glossary for definitions) and peer reviews, to ensure the design provides good value for money and meets the requirements of the program. Selection of design strategies will depend on the complexity and risk profile of the project. Design strategies will be done early in the design planning stage, before schematic design begins. This process will typically be led by the Prime Consultant, in consultation with the Project Team. Role of Clinical Liaison in Project Design In addition to the responsibilities outlined in section 4.1.3, throughout the design process, the Clinical Liaison is responsible for: coordinating the involvement of appropriate clinical and stakeholder/user groups within AHS, including collecting information and feedback about various components of the design; sharing relevant supporting information important to the development of the project design; validating that the desired clinical outcomes for the project are being achieved throughout the design process; facilitating the resolution of issues or conflicting interests within AHS, and obtaining consensus among AHS stakeholders (e.g., User Groups, FM&E, CPSM, IPC, Construction Safety); and acquiring all necessary design approvals on behalf of AHS, in particular at the key milestones for the project. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 65

66 4.2.4 Leadership in Energy and Environmental Design (LEED ) Planning INFRA endeavors to provide safe and healthy workplaces that respect the environment for current and future generations. The LEED Rating System for new construction is the tool used to implement, track and measure the sustainable design goals for new facilities. INFRA has set the achievement of LEED Silver as a minimum certification level for new building projects with a TPC equal to or exceeding $5 million. The Ministry also promotes the use of environmentally sustainable designs, practices and products for all projects, including those with a TPC of less than $5 million. For new construction projects over $5 million, the Ministry has identified the following mandatory LEED point targets: Energy and Atmosphere Credit 3 Enhanced Commissioning. INFRA will retain an independent Building Commissioning Authority early in the design process. See sections 4.4.1, and for further information on commissioning; Energy and Atmosphere Credit 1 Optimize Energy Performance target is a minimum of 6 out of 10 energy points; Energy and Atmosphere Credit 5: Measurement and Verification*; and Materials and Resource Credit 5: Regional Materials 1 point for 20% Regional Materials. * Note: Energy modeling and similar initiatives require particular attention to measurement and verification during the project Design Phase (see section 4.2.3). Representation to the Joint Steering Committee is required to amend the LEED Silver policy for a specific project. Any considerations on amendment to the policy will need to recognize the Ministry s interest in attaining the maximum possible LEED points within a sustainable building and facility budget. Further information on LEED is available on the Canada Green Building Council s (CaGBC) website at LEED Certification Process As identified in the design scope of work, the project design team will identify a LEED accredited professional who will be responsible for overseeing and coordinating the entire LEED process. The LEED professional reports to the INFRA Project Manager through the Prime Consultant. Their joint role includes: Health Facilities Capital Program Manual Version 1.0 June 2013 Page 66

67 registration of the project with the CaGBC using LEED Canada NC 2009 or the USGBC if using the LEED 2009 for Healthcare Rating System. (Registration should be made by the prime consultant s LEED professional on behalf of INFRA); development of a LEED plan; tracking of LEED point achievement; advice on design strategy and options; preparation and submission of documentation; and advocacy to the CaGBC for the Project Team. Commissioning activities include the building envelope as well as the mechanical and electrical systems. The design and performance of the building envelope is integral to achieving high-performance energy efficient buildings. See section 4.4 for more information on commissioning. Role of AHS in LEED Certification Process The INFRA Project Manager and design team will consult with the AHS FM&E representative throughout the LEED commissioning and measurement and verification processes. This will ensure building systems are compatible with AHS operational goals and objectives. 4.3 Project Construction Contract Management Contract management practices may vary depending on the type of construction delivery method (e.g. Design-Bid-Build, Stipulated Sum, Construction Management). The Construction Phase for a traditional Design-Bid-Build delivery model typically commences after design and tendering are completed and commensurate with awarding of the construction contract. However, under other models such as Construction Management, retaining the Contractor earlier in the project may be considered in order to provide logistical advice, preliminary and ongoing costing information, and input into the design, phasing, and scheduling of the work. Also, if the construction of the project is being fast-tracked, construction may begin before the design documentation is complete. Delivery models such as Design-Build or P3 will typically have a single contract with an entity that delivers the design, construction, and possibly other services. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 67

68 The goal of the construction phase is to produce a built facility that is fully compliant with the scope, the program and service delivery requirements and the contract drawings and specifications, regardless of the project delivery model used Roles and Responsibilities As in other phases of the project, the Project Manager is responsible for managing the Project Team during the Construction Phase of the project. Team members during this phase could include design consultants, construction contractors, specialty consultants, testing agencies, commissioning agents, as well as the Clinical Liaison and various client stakeholders (see section 4.1 Project Start-up and Planning). Under the direction of the Project Director, the Project Manager, along with the rest of the Project Team is generally responsible for: coordinating all work on the site; monitoring the schedule; managing project scope and the scope change process; monitoring and controlling the budget; monitoring and directing design consulting team and other consultants; monitoring and directing the Contractor; managing any conflict/disputes between parties that may arise; approving construction changes; approving billings; approving completion of milestones; managing the construction completion and facility handover phases; communicating with the Clinical Liaison on project progress, changes, decisions required, and project completion details; communicating with the Project Steering Committee on the project s progress; and developing and distribution of project reports. The Construction Phase is intensive in terms of the amount of administration and communication required amongst the parties. Timely decision making is essential. The Project Manager will seek information and decisions from appropriate parties in a timely manner to ensure ongoing control of the project schedule and budget. AHS personnel will play a key role in various stages of construction and will need to provide timely responses to change proposals and other requests from the Project Manager. The Health Facilities Capital Program Manual Version 1.0 June 2013 Page 68

69 Clinical Liaison continues to be the key contact for AHS, with the following specific responsibilities during construction: consulting with and involving AHS personnel as required or when requested by the Project Manager; obtaining decisions required from AHS user groups; and liaising with the Project Manager on the project schedule, and coordinating client take-over and operational commissioning. Facility Maintenance and Engineering (FM&E) AHS FM&E engagement in facility construction, handover and commissioning differs according to whether construction occurs in or adjacent to an existing facility or at a new location. A renovation site by definition is one which is located within, adjacent to or close to an existing facility, and therefore is likely to have a notable impact on existing AHS facility operations. For a renovation construction site, FM&E responsibilities include: facilitating access by the Contractor and Project Manager to AHS controlled spaces when work is taking place in an operating facility or site; coordinating with the Contractor and Project Manager on maintenance of the construction site, including arrangement of utilities tie-ins and building systems, with the assistance of the INFRA Project Coordinator; and coordinating with the Project Team for utilities shut downs, utilities tie-ins and building systems and other operational issues with ongoing maintenance and engineering activities in adjacent facilities. In contrast to a renovation site, a new construction site refers to those sites that are not connected to an existing facility and therefore are likely to have negligible or no impact on existing AHS facility operations. For a new construction site, FM&E responsibilities include: providing input into project planning and design process; incorporating physical or operational requirements as required throughout the construction period; identifying deficiencies in consultation with the Project Manager and ensuring maintainability after Handover (see section 4.4); participating in the System Commissioning Phase as required (see section 4.4); participating in the building commissioning of the new facility; and Health Facilities Capital Program Manual Version 1.0 June 2013 Page 69

70 receiving keys, operational manuals, attending training sessions, etc., at Project Completion and Handover. Project Manager The Project Manager is responsible for coordinating FM&E activities with AHS FM&E staff, including: construction assistance - coordination of construction activities within the operation of existing linked or adjacent facilities for renovation sites; and commissioning assistance - coordination of commissioning activities with AHS FM&E staff for both renovation and new construction sites. The Project Manager involves FM&E throughout the entire life cycle of the project, including design review, site inspections, verification/testing, review of Operations and Maintenance (O&M) manuals, and O&M training (see section for a description of commissioning process) Contracting, Procurement and Supply Management and Information Technology AHS Contracting, Procurement and Supply Management (CPSM) and Information Technology organizations will be responsible for the following during the Construction Phase: procuring F&E/IT that is purchased through the project budget, as well as items that are relocated from existing facilities; coordinating F&E/IT delivery and installation requirements with the Project Manager; and reporting the F&E/IT budget status to the Project Manager. See section for more details on CPSM s roles and responsibilities Infection Prevention and Control The design and construction of health capital facilities needs to account for Infection Prevention Control (IPC) policies and operational processes. Project Managers are responsible for ensuring that these are addressed through a consultative process with AHS, respecting AHS IPC policies and local hospital procedures. AHS is responsible for the provincial level IPC guidelines and HEALTH is responsible for the review of these guidelines. The Joint Operations Committee, Standards and Guidelines Sub-Committee will review IPC processes for consideration in health capital facility design. This effort will address AHS IPC policy as well as external sources e.g. CSA Z8000. See Section for more details on Standards and Guidelines. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 70

71 AHS is reviewing their province wide policy for IPC and will advise the Parties when a new policy document is ready for implementation Access Management The Prime Contractor is responsible for managing and coordinating access to the construction site. The Project Manager and the FM&E site lead liaise with FM&E personnel in the tendering stage to set specific site standards and requirements prior to preparation of the final contract documents. The general access standards and requirements are described below. Access Management for Renovation Sites For construction sites adjacent to an existing facility, the INFRA Project Manager liaises with the FM&E site lead at the tendering stage to identify/determine standards and requirements for: utility interface; cost recovery (e.g. for FM&E personnel, utility usage); site access for construction and INFRA staff; environmental management (noise, vibrations, air quality); any other site-specific requirements, safety protocols; and building systems. For renovation sites located within an existing facility the same process is followed; however, standards and requirements are more extensive and include: involvement of AHS FM&E personnel throughout the project; location of contractor space within the facility; contractor responsibilities throughout the project; contractor identification process; workplace health and safety protocols; occupational Health and Safety (OH&S) policies and procedures; security protocols and criminal records checks; fire and emergency procedures; IPC protocols; and any other site specific requirements. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 71

72 Access Management for New Construction Sites AHS personnel may require access to new construction sites for the following reasons: consultation during project planning, administration, construction and building commissioning; walk-through prior to Handover; storage, testing and/or installation of equipment or furniture prior to Handover (see section ); security of AHS equipment on site; and early commissioning activities, where practical. In these instances, AHS makes a request to the Project Manager who coordinates access through the Prime Contractor Insurance and/or Risk Management Health capital projects delivered by INFRA require insurance that is appropriate for the project delivery methodology and addresses whether the facility is new construction or a renovation project within existing AHS infrastructure. The primary insurance policies required for capital projects are Course of Construction and Wrap-up Liability. (See Appendix 1.1- Glossary for definitions). Risk Management Insurance Branch Responsibilities The Risk Management Insurance (RMI) branch of TBF collaborates with ministries and agencies throughout government to assist with identifying, measuring, controlling and funding the risk of accidental loss. The program is responsible for all government ministries and agencies subject to the Financial Administration Act. For Construction Management (CM) projects, RMI will arrange the purchase of project insurance on behalf of INFRA. For other delivery methods, and particularly for the Design-Bid-Build method, the Prime Contractor will be responsible to obtain project insurance during the construction phase prior to handover to AHS and is required to submit evidence of insurance for review by INFRA and RMI to ensure compliance with contract requirements. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 72

73 Project Services Branch Responsibilities INFRA s Project Services Branch procurement staff and the Project Manager are responsible for: working with the RMI Branch of TBF to develop insurance and risk management wording, including the wording within RFPs, contracts, and the insurance policy documents; and liaising with AHS staff on matters of mutual concern. Project Manager Responsibilities Project Manager specific responsibilities include the following: prior to the issuance of an RFP for a CM, Design-Bid-Build or a Design-Build project, Project Managers need to liaise with both the INFRA Project Services procurement staff and with RMI concerning insurance requirements. This should be done sufficiently in advance of a tender to ensure insurance is arranged prior to start of construction; and prior to issuance of an RFP for a Prime Consultant, Project Managers also need to consult with Project Services Branch procurement staff and RMI to ensure adequate Errors and Omissions (E&O) insurance involving the Prime Consultant is coordinated in a timely manner for projects delivered through a Construction Management or a Design- Bid-Build contract. For Design-Build contracts, the E&O insurance responsibility rests with the Design-Build contractor. AHS Responsibilities AHS is responsible for the following: risk management and insurance for F&E/IT delivered to a facility under construction; property insurance for the facility and F&E/IT at Substantial Performance (or turnover); and the AHS FM&E representative to the project informs the AHS risk management and insurance staff of the date when AHS will need to add the facility to their property insurance policy (normally at Substantial Performance) Occupational Health and Safety Site safety is an important issue during the Construction Phase of the project, and the assignment of roles and responsibilities for safety is crucial to ensuring a safe working environment for all staff, contractors and consultants. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 73

74 Under the Occupational Health and Safety Act of Alberta (I OH&S Act), the owner of a building or site has responsibility for monitoring site safety on that site. The entity responsible for site safety on the site is referred to as the Prime Contractor under the OH&S Act, and an owner may assign the Prime Contractor responsibility to another party under the terms of a contractual arrangement, in which case the assigned Prime Contractor assumes the owner s responsibility for all safety on the site. The owner may assume the role of Prime Contractor but will usually designate, through the construction contract, the Contractor (or Construction Manager) as the Prime Contractor for all or part of the site or building. An important distinction needs to be made between a project involving a new building or site and one that is in an existing facility. In the case of a new facility, INFRA will typically own the property, and title will transfer to AHS at the completion (Handover) of the project. In this instance, INFRA normally assigns Prime Contractor responsibility to the Contractor during the course of construction. Where the property is already owned by AHS, no title transfer is required; however, formal acknowledgement in the form of a Handover letter (see Appendix 12.6) is required. In the case of a renovation project, construction work will take place in a facility or site that is typically in operation, and therefore, owned by AHS. AHS staff and patients may be present within the facility during construction activities. This situation requires a more careful delineation of responsibility for safety. AHS will retain overall Prime Contractor responsibility for the site and building even though this responsibility is typically assigned to the Contractor through the construction contract (for any areas within the building or site for which the Contractor has control). The Contractor will be subject to AHS safety policies when working in areas that are jointly occupied by the Contractor and AHS staff, and/or other personnel. The Contractor will be required to establish a safety plan that meets or exceeds AHS policies and OH&S regulations for the areas in which they have assumed Prime Contractor responsibility. Roles and Responsibilities - New Construction Sites The Project Manager s responsibility for OH&S includes the following: assigning Prime Contractor responsibility under the construction contract; checking that the Contractor possesses a current Certificate of Recognition from the Alberta Construction Safety Association; reviewing the Contractor s safety plan; Health Facilities Capital Program Manual Version 1.0 June 2013 Page 74

75 conducting construction start-up meeting with the Contractor to discuss roles and responsibilities, and review safety plans and procedures; and monitoring the Contractor s administration of the safety plan and receiving updates on the Contractor s safety meetings, issues and actions. AHS participates in discussions relating to OH&S during the Construction Phase prior to the building being turned over to AHS. Roles and Responsibilities Renovation Projects The roles and responsibilities concerning renovation projects for the INFRA Project Manager and AHS are outlined below: Project Manager INFRA, in addition to the responsibilities detailed above, the Project Manager s responsibilities include the following: ensuring clear delineation of areas for which the Contractor and AHS have Prime Contractor responsibility, as well as responsibilities of each party; facilitating discussion of building safety, access, safe work permit system, etc., between the Contractor, AHS and INFRA at the construction start-up meeting; and facilitating project safety meetings in conjunction with regular construction meetings or as required. AHS FM&E and Workplace Health and Safety Advisor: liaising with Project Manager and Contractor on safety issues affecting work in occupied spaces, and/or where there may be overlapping responsibilities; coordinating access to spaces that are outside the Contractor s control, issue work permits, etc.; participating in project safety meetings as required; and conducting safety walk-throughs of contractor area to ensure contractor is adhering to Safety Procedures Project Reporting Through the project lifecycle there are a number of reports that are required. These include quarterly reports and end of cycle reports. Refer to Appendix 11 Project Reporting Matrix. The matrix is currently under review. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 75

76 4.4 Commissioning, Handover and Warranty Building Commissioning and Manuals The Building Commissioning formalizes the review and integration of all project expectations during the planning and design, construction, testing/verification and turnover/occupancy phases through inspection and functional performance testing, as well as the oversight of operator training and record documentation. Building Commissioning is an all-inclusive, quality-oriented process for achieving, verifying, validating and documenting (for both new and upgrade/retrofit construction) that the performance of facilities, systems, and assemblies meets defined objectives and criteria in order to achieve the design requirements. For new construction, it includes all the subsystems such as heating, ventilating and air conditioning (HVAC), plumbing, electrical, fire/life safety, building envelopes, interior systems (e.g., laboratory units), cogeneration, utility plants, sustainable systems, lighting, wastewater, controls, and building security. INFRA may undertake different levels of Building Commissioning detail depending on the size, uniqueness and complexity of the project. Building Commissioning can also enable higher energy efficiency, environmental health and occupant safety, and improve indoor air quality by ensuring that the building components are working correctly and that the plans are implemented with the greatest efficiency. INFRA generally retains an independent commissioning authority (CA) to organize, direct and review the commissioning activities for the project. INFRA implements Building Commissioning plans during the planning, design, construction, testing/verification, acceptance and warranty phases of a capital project. AHS (FM&E) participates in the planning, design, construction, testing/verification, acceptance and warranty processes to acquire information that is necessary to facilitate facility turnover, as well as the ongoing operation and maintenance of building systems. The information acquired relating to the building and new systems is essential for the initial safe operation of the site and the ongoing efficient operation of the building throughout its life cycle. In addition, feedback that FM&E provides through the life cycle of the project supports the development of facilities that take into account maintenance and operations considerations, and minimize the likelihood of costly changes later. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 76

77 The Contractor is contractually responsible for developing operation and maintenance (O&M) manuals as part of the construction close-out process. The commissioning agent/team and the design team in turn review the manuals for clarity, adequacy of information and accuracy. The manuals provide a guide to the ongoing operation and maintenance of the building systems and are the basis of ongoing training for FM&E operational staff. Roles and Responsibilities The Project Manager is responsible for managing the Building Commissioning, including: engaging an independent CA as early as possible in the design process, often at the end of schematic design; establishing a commissioning team, consisting of the CA, Prime Consultant, sub-consultants, INFRA resources, Contractors and FM&E staff; overseeing the development of a commissioning plan, in collaboration with the commissioning team, design team, and FM&E personnel, following the completion of a schematic design report; with the assistance of the CA, ensuring the commissioning plan meets relevant standards, including LEED basic commissioning and enhanced commissioning requirements; ensuring the development of manuals and the provision of training on building systems for FM&E operational staff prior to Facility Handover; ensuring the project documentation meets the commissioning and O&M manual requirements of INFRA (refer to Alberta Infrastructure s Technical Resource Centre) for additional information on commissioning and O&M manual policy and processes); and establishing an agreement for the funding of the FM&E commissioning resources. FM&E is responsible for the following during the Building Commissioning: working closely with the independent CA as a member of the commissioning team; providing technical input to the Project Manager and consultants throughout the complete project cycle from design through warranty period; assisting in the development of a commissioning plan and test scripts that detail the extent of verification and testing of each building system and associated components; reviewing drawings and specifications during the design stage and providing comments to the Project Manager within a set period of time; Health Facilities Capital Program Manual Version 1.0 June 2013 Page 77

78 working closely with the Clinical Liaison to keep each other informed and share a common understanding of the project; participating in regular site and milestone reviews coordinated with the Project Manager and the Contractor, and providing a list of deficiencies; participating in inspections during construction, where appropriate; assisting in the development of a validation plan to confirm energy efficiency modeling, system key performance measures (KPIs) targets, etc. as per the project/system original design and engineering requirements; assisting in LEED measurement and verification planning, and managing and monitoring measurement and verification requirements throughout the year post occupancy; assisting and witnessing verification and testing of building systems and equipment; providing input and reviewing O&M Manuals; creating preventative maintenance schedules, preventative maintenance tasks and assist in identifying a critical spare parts inventory; attending FM&E O&M Training, including the coordination and scheduling of personnel for participation; supporting the development of training documentation for both operations and maintenance staff; reviewing record drawings from the contractor and consultants; ensuring new building systems and equipment are documented in AHS Integrated Infrastructure Management System (e-facilities); and working with the Project Manager and the CA to ensure all building systems have been successfully commissioned prior to handover of the project from the contractor. AHS (CPSM F&E and IT) is responsible for the following during Building Commissioning: coordinating commissioning of major equipment and IT systems that link into building systems; coordinating commissioning of equipment (Vendor and Diagnostic Imaging (DI)) (See Section 7.10); and In addition, AHS is responsible for acquiring final sign-off of installation and commissioning by regulatory agencies, such as: Authorized Radiation Protection Agencies (ARPA) and Canadian Nuclear Safety Commission (CNSC). Health Facilities Capital Program Manual Version 1.0 June 2013 Page 78

79 4.4.2 Facility Handover Facility Handover means the legal transfer of a facility in terms of the title, authority, insurance and liabilities and as agreed to by both parties. The Project Manager and Clinical Liaison are jointly responsible for managing Facility Handover, in consultation with FM&E personnel. Steps for Facility Handover At the design documentation stage, the Project Manager collaborates with FM&E personnel to clearly define the criteria/conditions to be met for Facility Handover. This information is included in the contract documents as appropriate; The criteria/conditions must specify the delineation of Prime Contractor responsibilities if the contractor and owner concurrently have Prime Contractor responsibilities over separate areas, and the extent of those responsibilities; The criteria/conditions will also specify details of holdbacks that may be applicable at Handover, and plans of dealing with any liens that may be in place; Approximately three months prior to the anticipated date of Facility Handover, the Project Manager will draft a Handover letter, outlining all the terms of the Handover. It will be submitted to AHS for review and comments, so that the terms of the Handover will be confirmed and agreed to prior to the effective date; and The Project Manager, in consultation with FM&E personnel, reviews the progress for adherence to the criteria/conditions at specific milestones, including Substantial Performance and Total Performance. The Handover process could vary by project depending on the client needs, the project complexity and the need for a phased handover of the facility. See Handover letter template Appendix 12.6 INFRA provides a copy of the handover letter to HEALTH Operational Commissioning and Move-in Planning Operational Commissioning is led by AHS (with INFRA participating), and details the clinical and non-clinical operational and move-in requirements. Planning begins in the Functional Programming stage, when operational elements are identified, including operational costing estimates. As the capital project proceeds, the Operational Commissioning Plan is further detailed and refined by AHS. Operational Commissioning may overlap with Building Commissioning as equipment is installed, and may even commence prior to Substantial Health Facilities Capital Program Manual Version 1.0 June 2013 Page 79

80 Performance. It involves activities such as orientation of staff, training in units/work areas prior to move-in, dry runs, and testing of procedures/equipment. Move-in planning refers to the specific details and schedule for moving staff and patients into a facility (possibly phased over a set period of time) in order to be fully operational. AHS and INFRA are responsible for the following during Operational Commissioning and the planning and execution of the move-in: Operational Commissioning AHS Roles and Responsibilities Coordinating involvement of appropriate clinical and support groups, including sharing relevant supporting information; Planning for move-in and start-up by user group(s) to be consistent with an approved operational budget and organizational objectives set out in the Functional Program; and Developing operational commissioning plans to guide clinical and support groups as the new facility goes into clinical operation. Operational Commissioning INFRA Roles and Responsibilities Ensuring facility and all building systems (e.g. Heating, Ventilation, Air Conditioning (HVAC), controls, security) are commissioned; Facilitating the Building Commissioning, including integration tests; Facilitating the turnover of project record drawings and O&M manuals; Facilitating the prerequisites to obtain occupancy permit(s); Facilitating Substantial Performance and Handover; Communicating the schedule for completion of Building Commissioning and Handover (phased or one step depending on complexity of project); Addressing deficiencies as noted; Providing timely communications on changes to completion schedules; and Coordinating early site access as required for clinical commissioning. Move-In Planning AHS Role and Responsibilities Coordinating the delivery and installation of equipment; Commissioning of equipment and IT; Ensuring the opening of services is coordinated linking commissioning to other planning and operational initiatives occurring within AHS; Health Facilities Capital Program Manual Version 1.0 June 2013 Page 80

81 Establishing move-in sequencing of staff and/or patients for a phased opening of a new facility together with sequenced shut-down of the facility being vacated so that each component is operational and ready for integration with the subsequent component to be moved; and Ensuring safety and clinical compliance for program moves with active patients. While INFRA does not have a direct role in the move-in planning or execution, both AHS and INFRA will be jointly responsible for resolving unexpected findings or warranty issues following move-in Warranty Resolution The warranty period starts at Substantial Performance unless stated otherwise in the warranty certificates. INFRA s Project Managers are responsible for managing the warranty resolution process. Warranty issues are identified and resolved either through an ongoing resolution process, or through a formal warranty evaluation process. These processes are described below. Ongoing Warranty Resolution Process This process may be streamlined under various circumstances with the agreement of both parties, particularly for items that are more routine in nature or otherwise straight forward. Also, in cases that are urgent, the parties may also agree, with prior authorization of the Project Manager, to have FM&E contact the contractor directly. Warranty issues are identified and resolved as they arise during the warranty period. The FM&E Facility Manager identifies potential warranty issues and brings them to the attention of the Project Manager. The Project Manager evaluates each issue with the FM&E Facility Manager and the consultants to determine if it requires rectification by the Contractor. If it is a warranty issue, the Project Manager contacts the Contractor to discuss and arrange rectification. The Project Manager, with the support of FM&E, meets with the Contractor to: describe the warranty issue; outline the expected outcomes of reconciliation; develop a timeline for reconciliation consistent with AHS operational requirements; and inspect or review the reconciliation (i.e., was the work satisfactory or issue resolved?). Health Facilities Capital Program Manual Version 1.0 June 2013 Page 81

82 Formal Warranty Evaluation Process Before the warranty period expires, the Project Manager initiates a formal warranty evaluation process as follows (see Appendix 12.1 Contract Acceptance Procedures Flowchart for additional information): the Project Manager calls a meeting with the FM&E Facility Manager, Contractor and consultants (the Review Team) to bring forward and discuss any outstanding warranty issues; the Review Team conducts a site review to identify and verify warranty issues; The Prime Consultant compiles a final list of all warranty items requiring resolution, with input from FM&E, INFRA and the Prime Contractor, and forwards the list to the Project Manager for review; the Project Manager reviews the list of items with the team to set priorities considering criticality, timelines, client needs, and operational impacts; the Prime Contractor then drafts a work schedule based on the prioritized list of warranty items, for agreement with the Team; the Prime Contractor works with FM&E to obtain access, coordinate operational planning, and determine health, safety and IPC procedures to be employed during the rectification work; the Prime Contractor notifies INFRA when the work is complete; the Project Manager coordinates a review of the completed work; and the Project Manager issues a Letter of Total Performance to the Prime Contractor on confirmation by the Prime Consultant that all warranty items have been resolved, providing that all other project deficiencies and prerequisites to Total Performance have been achieved Reimbursement of Alberta Health Services Facilities Maintenance and Engineering Expenses The processes and procedures surrounding the reimbursement of FM&E expenses are under review. In the interim the structure outlined below will be followed. FM&E costs that AHS incurs as a direct result of construction may be reimbursed by INFRA provided the work and the associated costs have been pre-approved by the Project Manager. Reimbursement of expenses may be approved where work has occurred outside of normal working hours or if there was proof that AHS back filled the position with a casual employee Health Facilities Capital Program Manual Version 1.0 June 2013 Page 82

83 or contractor. Work associated with routine operations that do not create an incremental cost to AHS are not eligible for reimbursement. To facilitate reimbursement, AHS will submit a summary of all labour costs (detailing name, location, work performed, hours worked and wage costs) and any material costs through an invoice to the project manager quarterly as a minimum. However, the Project Manager may request reporting from AHS on a monthly basis. The Project Manager reviews the AHS summary and authorizes reimbursement as appropriate. The following work may be considered for reimbursement when approved by the Project Manager (for only those activities that would not otherwise be performed by the Contractor): labour for shut downs/system tie-ins; labour/material for construction assistance to contractor (e.g. emergency response and remediation due to floods and other unforeseen issues); and labour/material for temporary installations/decanting due to construction. Examples of temporary installations and assistance that may occur as a direct result of construction include: locksmith supplying keys and cylinders, rekeying construction areas, and planning of the keying strategy; electronics assistance with automatic door operation; structural hanging and modifying doors, construction of temporary stands, installation of safety mirrors or shelving, T-bar ceiling removal, the installation or dismantling of scaffolds, creating signage holders, painting and wall repairs; electrical breaker installations, electrical circuit testing, receptacle relocations, power trend monitoring on transformers, creating tube system configuration diagrams and operation requirements, and switching order reviews; HVAC building automation and alarm point setup / review, and programming changes to damper operation; and signage creation of new signs, replacement of existing signs and creating labels. AHS participates in commissioning activities prior to the handover of the facility as described in section A request for the reimbursement of expenses associated with the assignment of staff to the activities outlined in section requires the prior-approval of the Project Manager. Work that does not create an incremental cost to AHS is not eligible for reimbursement. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 83

84 AHS may request funding of staff on a yearly basis prior to the handover of a facility for the purpose of assisting INFRA with design reviews and commissioning activities. Such requests would normally apply to large or complex projects and may involve the partial or full-time assignment of FM&E personnel. To request funding support from the project, AHS prepares a submission to the Project Manager substantiating their request including a summary of the proposed personnel assignment(s), their duties or responsibilities, duration of assignment and costs (standard industry wages should be utilized unless otherwise approved by INFRA). The Approval Process Form is in development 4.5 Evaluation and Project Closeout Project Performance Measures Performance measurement provides information necessary for setting project goals and tracking achievement toward those goals. Both outcome and process measures are important sources of information to guide decision-making about the construction and maintenance of capital projects. Outcome measures focus on the state of the target population or social condition that a project is expected to have changed. Process measures examine how well a program is operating and how well it performs its intended functions. Current Performance Measurement Process The current process focuses on the Physical Condition outcome performance measure (also known as an indicator). This process identifies the percentage of Alberta health facilities rated as being in good, fair or poor physical condition. HEALTH uses this information to assist in decisions about IMP funding (see Chapter 6 for more information). As well, physical condition information is used for capital and program planning. INFRA, in consultation with HEALTH and AHS is responsible for: establishing targets for this indicator; identifying and developing required changes to the methodology for measuring physical condition; developing a multi-year plan for facility evaluation; and completing annual updates of the multi-year plan. AHS and INFRA share responsibility for compiling annual Facility Condition Indexes (FCI) for all health facilities. The FCI is used to rate the physical condition of health facilities over 1000 gross square meters in size. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 84

85 Since 2008/09, FCIs have been assessed using two methods: INFRA contracts with independent consultants to conduct facility condition assessments over a five-year cycle, with one-fifth of owned buildings evaluated each year. The data collected is stored in an electronic database using a program called RECAPP; and for health facilities not evaluated by consultants through RECAPP, the FCI is calculated based on detailed five-year physical condition deficiency lists provided by AHS, supplemented with reviews by INFRA. The FCIs are used to determine the percentage of Alberta health facilities with good, fair or poor ratings. The results are integrated into the INFRA and HEALTH annual reports and GoA s Measuring Up report. Relationship of Performance Measurement to Other Evaluation Processes Several evaluation processes may be used as part of project review and closeout, including: best practices identification/lessons learned; Post-Occupancy Evaluation (POE); and Building Performance Evaluation (BPE). These processes may be incorporated into a broader performance measurement framework subject to consultation between INFRA, HEALTH and AHS. Both process measures (e.g., scope changes vs. Needs Assessment, planned vs. actual expenditures) as well as outcome measures (such as functionality relative to program needs) may be considered in ongoing development of performance measurement metrics Best Practices and Lessons Learned Review Process The term best practice refers to documented procedures and processes that have been shown to produce successful results. By identifying programs, activities and strategies that work well, all parties build on strengths for future project development activities. There are two components to a Best Practices review. They are: review of industry best practices by examining published academic papers and other literature documenting successful programs, activities and strategies in health capital project management; and lessons learned review at the end of specific stages of a health capital project to identify successes and opportunities for improvement. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 85

86 The Project Implementation Management System (PIMS) used by INFRA includes a listing of suggested procedures to incorporate best practices and lessons learned into the design and consultant selection phases of capital projects. A best practices review is important for health facility construction management and delivery because it assists managers and staff in continuously improving how they conduct their programs. INFRA will lead the ongoing process to identify industry best practices, document lessons learned in consultation with HEALTH and AHS Post-Occupancy Evaluation INFRA has developed a Post-Occupancy Evaluation (POE) pilot process for evaluating facilities once construction has been completed and the facilities are operating. This pilot process will be adapted by the Standards and Guidelines Sub-committee for implementation within a health care facility. Once drafted, the process will be reviewed by the Joint Operations Committee concerning implementation Building Performance Evaluation (BPE) A BPE process has been developed and has been successfully piloted. The process is currently undergoing review and will subsequently be updated. Implementation of the updated process will follow final review and approval by the Joint Operations Committee Project Closeout Closeout Project closeout occurs at the end of the project life cycle. It is the result of a culmination of activities that begin prior to the handover of a facility, ending with the cessation of all capital financial activity in support of the project. The closeout process includes closing final contracts, closing the project management office, archiving records and producing the Project Completion Report. The Project Manager is expected to attain project closeout within three months following the completion of the warranty period (normally one year following the achievement of substantial performance). While closeout should normally occur three months after the warranty period, unique project requirements that necessitate a phased commissioning process will influence the point where closeout may be possible. As well, significant scope changes that occur late in construction and near handover may delay commissioning and thus impact the date of closeout. For complex projects, F&E and IT procurement may continue for greater than one Health Facilities Capital Program Manual Version 1.0 June 2013 Page 86

87 year following the turnover of a facility. The procurement timeline should be taken into account when determining a target close-out date. Standard Close The Project Steering Committee will review projects that have completed Operational Commissioning to ascertain whether closeout can be achieved within three months after the end of the warranty period. For projects that will close within this period the following process applies: complete the Overall Project Status Checklist (PIMS); conduct and document lessons learned sessions; complete the Project Completion Report; close the project office; release unneeded funds for reallocation; and change the project status to complete. Note: Projects that are terminated without achieving Substantial Performance (or Interim Acceptance), or the completion of the warranty period, must still follow the closeout process delineated herein. Project Completion Report The Project Completion Report formally documents the project outcomes/performance against the approved project goals and objectives. To support continuous improvement and renewal/change, the report contains an important section on "lessons learned". The Project Manager is responsible for the preparation of the Project Completion Report. The Project Completion Report shall provide an evaluation of the project in terms of: attainment of overall project objectives and the resources required; achievement of target dates and costs throughout the project; responsiveness to user needs; quality of workmanship; adherence to policies, standards, guidelines and specifications; deficiencies and problems; and recommendations which might affect future projects ("lessons learned"). Health Facilities Capital Program Manual Version 1.0 June 2013 Page 87

88 For projects that terminate early, an Outstanding Issues section shall be added to the Project Completion Report that includes the following: a description of the outstanding work that was not completed and how this work will be addressed (the work plan); a breakdown of the resources allocated for the completion of the outstanding work; and a synopsis on how the remaining funds were allocated to complete the outstanding issues. Note: Projects that terminate prior to Substantial Performance or the completion of the warranty period must clearly state what happened to cause the termination and where that leaves the "need" that was not met. Furniture, Equipment and Information Technology AHS provides a final report on the F&E/IT procurements as outlined in Chapter 7. These reports are reviewed by INFRA and appended to the closeout report that is prepared by the Project Manager. The Project Director (INFRA) is responsible for reviewing the Project Completion Report. Prior to the final review and acceptance by INFRA a draft copy will be circulated for review and comment to the AHS and HEALTH representatives on the Project Steering Committee. Recommendations for process change may be reviewed as lessons learned, or if significant and necessitate immediate consideration, shall be brought to the attention of the Joint Operations Committee by the Project Director. Projects that terminate with unresolved issues will complete the Project Completion Report and the accompanying work plan for subsequent review and approval by the Joint Steering Committee. The Project Completion Report is to be placed on the official project file at INFRA. The lessons learned from individual projects are to be entered into the Consolidated Lessons Learned Library for review and adaptation as appropriate. Project Completion Report Template Project staff will use the PIMS template (to be developed) when completing the Project Completion Report. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 88

89 5.0 MINOR CAPITAL PROJECT DELIVERY Chapter 5.0 provides an overview of the administrative processes that apply when AHS delivers Health Capital Projects. While AHS will normally deliver projects with a TPC less than $5 million (Minor Capital Projects), there may be circumstances where the GoA will authorize AHS to deliver projects with a TPC exceeding $5 million. In either case the provisions of this chapter will apply when AHS delivers any capital project. Projects that meet the eligibility criteria for funding under the IMP are not eligible for approval as a Minor Capital Project (see IMP eligibility criteria section 6.2.1). TBF approves funding for Minor Capital projects subsequent to the submission of a capital funding proposal by HEALTH. The capital planning and submission processes for Minor Capital Projects follow those delineated in Chapter 3.0 of this manual. For efficiency TBF may approve a program funding envelope to facilitate the planning, approval and delivery of several projects within a pre-approved funding program. Examples of program funding include the Capital Transition Initiative (CTI) and the Safe Communities (SafeCom) programs. TBF may also impose restrictions on the use of program funding, such as a maximum TPS (not to exceed). TBF delegates to the Minister of HEALTH the authority to plan and prioritize project proposals within a program. To proceed to the delivery stage, individual projects that are funded from program funds require the joint approval of the Ministers of HEALTH and INFRA. The above process related to program funding applies whether the project is delivered by AHS or by INFRA. 5.1 Organizational Roles and Responsibilities To effectively oversee the organizational responsibilities for the management of Minor Capital Projects, the following governance is in place Tri-Party Oversight The Joint Operations Committee and the Joint Steering Committee provide oversight and issue resolution associated with the planning and delivery of the health capital projects and programs (see Chapter 4.0). AHS, HEALTH and INFRA are represented on both committees. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 89

90 Decisions to Amend Delivery Authority The Joint Operations Committee may recommend to the Joint Steering Committee that AHS deliver a project with a TPS greater than $5 million. The Joint Steering Committee may approve the recommendation or elect to recommend a course of action to the Ministers of INFRA and HEALTH as appropriate. Where this occurs, a grant funding agreement approved by the Minister of INFRA will be required to flow the money to AHS, for the project delivery. Conversely, the Joint Operations Committee may recommend that INFRA deliver a project with a TPC less than $5 million. In reviewing such proposals, the Joint Committees should consider whether efficiencies in project delivery or other synergies will result. Efficiencies may result from similarity with other projects, or the co-location of two or more projects Alberta Health Services Unless otherwise directed by the GoA, AHS is responsible and accountable for the planning (needs assessment and Functional Program) and delivery of Minor Capital Projects, or any other project that the Ministers authorize for delivery by AHS. AHS is responsible for managing the projects, including the key responsibilities that follow: prepare Needs Assessments and identify prioritized health facilities capital project proposals, consistent with the CPP outlined in Chapter 3.0, for funding consideration by HEALTH; prepare a Business Case, for subsequent review by INFRA and approval by HEALTH (for some projects, the Business Case is undertaken by INFRA as the project scope and cost is unknown, and the Business Case will confirm if it is a major or minor capital project); manage the delivery of Minor Capital Projects, including the Functional Program, design, construction and commissioning activities and the procurement of F&E/IT, in accordance with the provisions of the Grant Funding Agreement (Appendix ); deliver projects within the budget approved by the Ministers of HEALTH and INFRA (any unapproved increases in the budget will be borne by AHS); and provide project reports to INFRA per section Where a surplus is identified in a project, AHS may propose to the Ministers of HEALTH and INFRA that the funds be applied to another project or an unfunded proposal. Reassignment of surplus funding requires the joint approval of the Ministers. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 90

91 5.1.3 Alberta Health HEALTH s key responsibilities for Minor Capital projects include: review Needs Assessments and approve Business Cases related to AHS funding proposals; submit Minor Capital Funding proposals, including program funding requests that include multiple projects, to TBF consistent with the CPP delineated in Chapter 3.0; for a project proposal that meets TBF criteria for program funding, manage the prioritization of such proposals and jointly approve program funding, with INFRA, for their delivery; and communicate individual project funding decisions to AHS jointly with INFRA Infrastructure INFRA s key responsibilities for Minor Capital Projects include: review the Business Case, for subsequent approval by HEALTH (for some projects, the Business Case is undertaken by INFRA as the project scope and cost is unknown, and the Business Case will confirm if it is a major or minor capital project); provide oversight of approved health capital funding, including Minor Capital Projects, to ensure that projects are implemented in accordance with any terms or limitations concerning the project approval (scope, schedule, cost); prepare a Grant Funding Agreement, subject to prior funding and delivery authorization by the Ministers, to facilitate the transfer of funding from INFRA to AHS; receive, review and approve project reports from AHS; and provide technical advice, upon request, to assist with problem evaluation or the assessment of alternate solutions, and respond to questions regarding planning and project approvals. 5.2 Project Funding Guidelines Pre-conditions for Grant Payments The payment of grant funding to AHS for approved Minor Capital Projects will be subject to confirmation that a Grant Funding Agreement has been signed by the Minister of INFRA and AHS. Approval of the Grant Funding Agreement is contingent on the following pre-conditions: completion of a Business Case cost assessment Health Facilities Capital Program Manual Version 1.0 June 2013 Page 91

92 prior approval of a funding source, pursuant to any conditions as stipulated by TBF, including the sufficiency of the funding to meet the scope, schedule and cost requirements of the project, as outlined in the Business Case; and receipt of a Joint Ministerial approval (letter), authorizing the delivery of the project by AHS Grant Payment Process grant payments will be deposited into the AHS Consolidated Cash Investment Trust Fund (CCITF) account; funding will be flowed from INFRA to AHS based on the cash flow approved by the Ministers of HEALTH and INFRA; issuance of any further grant funding for a particular fiscal year will be subject to receipt of ongoing quarterly expenditure reports from AHS (see reporting under section 5.3.1); AHS is responsible for any overages to the capital project budget allocation delineated in the Grant Funding Agreement unless prior approval is received from the Ministers of HEALTH and INFRA; and funds remaining upon project completion are to be returned to the GoA, unless otherwise authorized to redirect the funds by GoA per section Eligible Minor Capital Project Costs Minor Capital Project funding may include the following types of eligible costs: functional program, design, construction and commissioning; fees for consultants and inspection agencies; installation, replacement, upgrading or repair of building systems equipment where such costs are a direct result of the capital project and not subject to routine replacement or upgrade within the building s maintenance and life cycle management program; the purchase of program delivery equipment required as the direct result of a capital project for the purpose of delivering new health programs, or to expand existing programs (see section 7.3 for greater detail on F&E/IT eligibility criteria); the upgrade or replacement of existing program delivery equipment and furniture that cannot, as the direct result of the project, practically or cost effectively be reused; project insurance that is a direct result of project construction, as required, excluding insurance deductibles; decanting if required as a result of the project; Health Facilities Capital Program Manual Version 1.0 June 2013 Page 92

93 hazardous materials abatement costs; project administration costs (see section 5.2.4); and other such costs identified by AHS and approved by INFRA Project Administration Funding Within the budget approved by the Ministers, AHS may budget up to three per cent (3%) of TPS expenditures for project administration. If the actual project expenditures are less than those identified in the Ministers TPS approval, the administration funding is based on the actual expenditures rather than the approved TPS. Project administration expenditures are also subject to the following: the expenditures must be for incremental costs incurred by AHS project management employees who are directly responsible for the delivery of the eligible project; eligible project administration costs can include the cost of manpower and employee benefits, and employee travel costs (within province) incurred as a direct result of managing the project, and the preparation of audited project financial statements; project administration expenditures are not to be used to pay for expenses that AHS incurs prior to receipt of the Ministers approval letter; and project administration expenditures are not to be used to offset costs/expenses that AHS is already incurring within its normal operations, such as existing project or planning staff, facilities, equipment, or supplies which are funded out of operations. Project administration may only cover incremental project and personnel costs that are directly attributable to the project Third-Party Funding The Grant Funding Agreement transfers to AHS only the GoA funds (TPS) that directly support an approved project. In circumstances where the TPC includes both the TPS and additional third-party funding, such as charitable foundations, AHS will be responsible directly to that party for any arrangements relating to the party s capital contribution to the project and the works to be delivered on their behalf. Third-party contributions may be added to the TPC after a project has been approved by the GoA; however, such contributions may not increase the cost of the GoA approved scope. In addition, any scope beyond that approved by the GoA is allowable if the increase is funded by the third-party contribution. Additions to the scope and budget generated through a thirdparty contribution must be consistent with the overall objectives of the project. Should a Health Facilities Capital Program Manual Version 1.0 June 2013 Page 93

94 foundation contribution create an increase in the project s capital or operating costs (beyond the third-party contribution), such increases will require the prior consent of HEALTH (capital and operating) and INFRA (capital). 5.3 Project Oversight Reporting Requirements AHS must submit a report for all Minor Health Capital Projects each fiscal year, on a quarterly basis. Consistent with the Grant Funding Agreement, the reports must include the following information: project title, location, facility name and AHS project number; year project was approved; status of project; any other funding source applications or usage (e.g., foundation funding or operating funding); updated/current budget amounts for project carried forward from previous years; expenditures, variances from projected expenditures, and future cash flow requirements; and specific reference to any supporting documentation that is available if requested, such as consultant reports, inspection reports, drawings or any other relevant information (e.g., the title and date of specific reports). The quarterly reports must be submitted to INFRA by AHS on or before the following dates: July 31st (for the period of April 1 to June 30); October 31st (for the period of July 1 to September 30); January 31st (for the period of October 1 to December 31); and April 30th (for the period of January 1 to March 31) Auditing AHS may be required, at the request of the GoA, to produce for review and audit any accounts, records and/or documents related to the work undertaken and the associated expenditures for all Minor Capital Projects. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 94

95 5.3.3 Site Visits On an ongoing basis, INFRA representatives may select and visit a number of facilities to discuss and review specific completed and in-progress Minor Capital Projects. The selection of these projects will be at the discretion of INFRA; however, the visit must be conducted without interference to the project, operations or programs delivered in the facility. HEALTH may also request INFRA to undertake site visits of certain projects. The main objective of these site visits will be to confirm that projects were, or are being undertaken as approved. It is expected that issues on specific projects will be communicated to INFRA prior to any site visit. AHS must be provided at least 48 hours notice of a site visit by INFRA to facilitate the required access to the site and the project under review. INFRA s access to sites and projects will be subject to approval by AHS of all entry to patient care areas, all necessary protection of patient privacy and confidentiality, and all safety considerations. In all cases, INFRA staff will be accompanied by AHS staff while in the facility on site visits Contracting Principles AHS is required to comply with the following contracting principles when implementing Minor Capital Projects: all calls for proposals or tenders for capital projects shall be carried out in accordance with the rules, regulations and laws governing such activities and in accordance with current best practices; contracting activities must comply with interprovincial trade agreements and any other legislation applicable to Alberta; and procurement activities must be fair and conducted with openness, integrity, transparency and accountability to the public. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 95

96 6.0 INFRASTRUCTURE MAINTENANCE PROGRAM (IMP) Chapter 6.0 describes the purpose of the IMP and the roles, responsibilities, accountabilities, processes and policies associated with the delivery of the program. The purpose of the IMP is to undertake projects that are intended to protect the integrity of eligible health facilities across the province through planned repair, replacement and maintenance. Funding is provided to AHS through the GoA s Capital Plan with the primary objective of improving the physical condition of health facilities and reducing deferred maintenance. Maintaining health facilities at an acceptable condition also enables the efficient and effective delivery of health services and programs. Minor functional upgrading projects are also eligible under this program under the criteria noted within these guidelines. These guidelines provide a tool for decision making by HEALTH, INFRA and AHS, and document the program management processes from the initial approval stage through to the close-out of the projects. The processes delineate the organizational level responsibilities and promote ease of administration. When situations fall outside of the intent of these program guidelines, AHS should confirm program eligibility with INFRA and the eligibility of functional projects with HEALTH. 6.1 Organizational Roles and Responsibilities To effectively oversee the organizational responsibilities for the management of the IMP and approved IMP projects, the following governance structure is in place Health Capital Joint Steering Committee Provides strategic direction to the Health Capital Joint Operations Committee, including overseeing the management of all health capital programs and projects Health Capital Joint Operations Committee Establishes and provides overall direction to various sub-committees including the IMP Sub-Committee; receives updates on the status of the Three-Year IMP Rolling Plan and resolves issues on delivery, processes, resourcing, etc.; and leads the annual review of the IMP Guidelines and recommends updates to the Health Capital Joint Steering Committee. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 96

97 6.1.3 Alberta Health Services Consistent with the responsibilities and accountabilities outlined herein, manages the IMP funding envelope allocated by government for infrastructure maintenance in health facilities; manages the delivery of eligible IMP projects; identifies annual priority maintenance projects and submits to government; maintains and updates an annual Three-Year IMP Rolling Plan; supports the facility evaluation program undertaken by INFRA to monitor the condition of all health facilities; and performs routine and preventative maintenance within the operating budget to avoid situations that result in deterioration or state of disrepair/unsafe conditions Alberta Health Reviews AHS Three-Year IMP Rolling Plan and advises INFRA of any projects which do not align with HEALTH s Business Plan, GoA s Capital Plan or AHS Business Plan; and approves functional projects identified in AHS Three-Year IMP Rolling Plan as priorities Infrastructure Manages health capital funding programs including the IMP funding and is accountable to ensure documented value for investment; approves Three-Year IMP Rolling Plans submitted annually by AHS taking into account any feedback from HEALTH concerning the suitability of proposed functional projects; receives, reviews, and approves IMP program and project reports from AHS; provides technical advice, upon request, to assist with problem evaluation or the assessment of alternate solutions and responds to questions regarding eligibility prior to the inclusion of a project or expenditure in the IMP plans; and monitors the condition of health facilities and reports condition information to Albertans. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 97

98 6.2 Eligibility Criteria General Program Eligibility Criteria The following criteria apply to funding under the IMP: the primary purpose of the program is to undertake projects that are intended to repair, upgrade or replace base building systems and building service equipment, including but not limited to the following systems and functions: HVAC, roofing, fire alarms, electrical, plumbing, security, nurse call, life safety, medical gas, elevators, building envelope, communications (excluding IT maintenance, upgrading and replacement); hazardous materials removal, site services and roadways; and energy efficiency initiatives. engineering studies that investigate maintenance-related engineering issues and target cost efficiencies (e.g., studies on roofing requirements); engineering and costing studies that are essential to inform the scope and cost of other related IMP projects; emergency projects requiring the immediate repair or replacement of the failed facility components needed to keep the facility safely in operation (see section 6.3 regarding contingency for emergency projects); demolition of facilities if separate approval has been provided by the Minister of HEALTH and the facility is not being replaced with a Major Capital Project; the total cost for all phases of the project (TPS) is less than $5 million; the value of a project must be greater than the minimum costs stated below: campus size is less than or equal to 40,000m 2 minimum cost is $5,000; campus size is between 40,000m 2 and 100,000m 2 minimum cost is $10,000; and campus is larger than or equal to 100,000m 2 minimum cost is $50,000. the repair, upgrade or replacement of existing program delivery equipment or furniture is not the primary objective of the project; and functional upgrades or renovation projects which will reduce deferred maintenance and/or enhance the functionality of existing clinical or health service delivery space, e.g., the capital upgrade of a renal dialysis room. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 98

99 6.2.2 Ineligible Projects The following projects and initiatives are not eligible for funding under the IMP. This list is not exhaustive and AHS should confirm project eligibility with INFRA if the intent is outside the criteria noted in section above: development of master plans, service plans and Functional Program s; projects which are debt-financed by AHS such as parkades; projects within retail or AHS tenant space; projects that involve routine preventative or operational maintenance; projects over $5 million; projects that are part of a Major Capital Project or are in new space; and IT equipment maintenance, upgrading or replacement Eligible Facility Types Health facility infrastructure owned, contracted or leased by AHS is eligible for IMP funding, including the following: hospitals owned and operated by AHS under the Hospitals Act or Mental Health Act; hospitals leased to AHS or a voluntary organization and operated under the Hospitals Act or Mental Health Act; hospitals owned and operated by a voluntary organization under the Hospitals Act and having an Equity Agreement in place with the Minister of HEALTH; nursing homes owned by the Province and operated by AHS under the Nursing Homes Act; nursing homes owned and operated by AHS under the Nursing Homes Act; health facility infrastructure owned by the Province and leased to AHS to accommodate or support the delivery of health programs and services operated under health legislation; health facility infrastructure owned or leased by AHS and used to accommodate or support the delivery of health programs and services operated under health legislation; nursing homes owned by a private corporation or voluntary organization that will be developed under an infrastructure partnership arrangement between AHS and the private or voluntary organization and that will be operated by that private or voluntary organization under the Nursing Homes Act. Eligibility for IMP funding for such facilities is Health Facilities Capital Program Manual Version 1.0 June 2013 Page 99

100 subject to conditions as outlined in an agreement between AHS and the partner organization; health facility infrastructure used for addiction services which are either operated by AHS or operated by a third-party under contract by AHS; health facility infrastructure used for emergency medical services which are either operated by AHS or operated by a third-party under contract to AHS; and Supportive Living Facilities owned and operated by AHS Eligible Infrastructure Maintenance Program Project Costs A project funded from the IMP may include the following types of eligible costs: construction costs; fees for consultants and inspection agencies; installation, replacement, upgrading or repair of building systems equipment; for functional projects only: the purchase of program delivery equipment required as the direct result of a project for new programs, or to expand existing programs; the upgrade or replacement of existing program delivery equipment and furniture that cannot, as the direct result of the project, practically or cost effectively be reused; and the cost of transferring or moving any existing program delivery equipment and furniture that can be reused. project insurance which is the direct result of project construction, as required, excluding insurance deductibles; decanting if required as a result of the project; hazardous materials abatement costs; project administration costs (see definition under section 6.7) of three per cent (3%) per project based on the current year actual expenditures for the project; and other such costs identified by AHS and approved by INFRA. 6.3 Prioritization of Projects AHS utilizes their allocation of IMP funding to implement their highest priority projects. For all proposed projects, excluding functional projects, AHS will rank these projects based on the risk assessment methods identified by the RECAPP system. The RECAPP system of Health Facilities Capital Program Manual Version 1.0 June 2013 Page 100

101 prioritization assists with determining which critical needs should be addressed within the allocated funding. The determinants that influence prioritization are grouped into the following categories for ranking: High Priority (Priority 1) Life, Health and Safety Needs: The imperative to address these types of projects is based on identification of issues that need to be addressed to mitigate a real potential or imminent risk to the life, health and/or safety of facility occupants and users. They may include structural and support failure, major building system failures, or requirements directed under current building codes which have been documented by an order issued by an authority having jurisdiction; Medium Priority (Priority 2) Immediate Needs: The imperative to address these types of projects is based on identification of issues that need attention in order to prevent them from escalating to Priority One, which will lead to serious or prolonged deterioration of a facility or its systems, affect the operability of a facility or its systems, or will adversely affect program delivery; and Low Priority (Priority 3) General Needs: These types of projects have been assessed as non-urgent and can be planned over a period of time without undue risk to the facility occupants or facility operability. They are generally components which are amenable to replacement or upgrading based on their life cycle. In addition to the above-noted project types, AHS may determine that functional upgrading to existing sites is needed to support program delivery needs. In this case, consideration will be given to functional upgrading on a case-by-case basis if the following criteria are met: High-priority maintenance projects (Priority 1 above) identified as critical have been addressed in AHS Three-Year IMP Rolling Plan; Functional projects will reduce deferred maintenance and/or will enhance the functionality of existing clinical or health service delivery space; and Projects have been identified as a high-priority from a functional upgrading perspective in AHS Three-Year IMP Rolling Plan. In addition, provision of a contingency for emergent projects must be identified within AHS Three-Year IMP Rolling Plan to cover potential unforeseen situations that affect facilities or program operations such as the immediate repair or replacement of failed facility components required to keep the facility safely in operation. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 101

102 6.4 Development of an Infrastructure Maintenance Plan To enable effective planning of maintenance needs, AHS will undertake an internal project review process that involves identification and prioritization of all eligible projects throughout the province, and submit a Three-year IMP Rolling Plan to INFRA. The plan will be updated annually and will include information on active and proposed projects. As well, a contingency for emergent projects will be identified. AHS Three-Year IMP Rolling Plan will be comprised of the following: Project Activity in Current Fiscal Year (Year 1) Projects approved and underway in previous years that will continue into the current fiscal year; projects planned for the current fiscal year; and a proposed contingency for emergent projects and the amount of emergent contingency carried forward from the previous year(s) Proposed Projects for Future Years (Years 2 and 3) All proposed projects that are anticipated to commence in years two and three of the plan; projects that will carry forward from previous years; and a proposed contingency for emergent projects Project Information Requirements For each year of the plan, the following project information is required: project title, location, facility name and AHS project number; a description of the project, including justification for the project, the impacts of not implementing the project, the scope and cost; updated/current budget amounts for projects carried forward from previous year(s); anticipated annual cash flow requirements; any other funding source applications or usage, e.g., foundation funding or operating funding; and specific reference to any supporting documentation that is available if requested, such as consultant reports, inspection reports, drawings or any other relevant information, e.g., the title and date of specific reports. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 102

103 To be considered for approval, these projects must meet the IMP eligibility criteria described in section 6.2 of these guidelines Timelines AHS is to submit its Three-Year IMP Rolling Plan to INFRA for review and approval by December 31 for the subsequent fiscal year INFRA Review Following receipt of AHS Three-Year IMP Rolling Plan and prior to approval, INFRA will undertake a review as noted below: Year One (1) of the Plan: analyzing expenditures on approved projects that are underway; seeking clarification from AHS when needed; resolving issues to ensure there is agreement on the status, scope, cost, delivery schedules, etc.; reviewing the plan to ensure that an appropriate contingency has been set aside for the two future years to address emergency situations; and reviewing other areas of the plan, as required. Years Two (2) and Three (3) of the Plan: analyzing each of the projects to ensure they adhere to the intent and eligibility criteria of the program and these guidelines; and requesting HEALTH to review any projects of a functional nature and provide written feedback to INFRA. INFRA will then work with AHS to resolve any outstanding issues resulting from the ministries reviews of AHS Three-Year IMP Rolling Plan Plan Approval and Payment of Grant Funds Plan Approval: Following INFRA s review of AHS Three-Year IMP Rolling Plan, written notification will be sent to AHS advising of the ministry s support for the plan and that it will be implemented within the funding approved by GoA. Once the provincial budget has been approved and announced, and the annual amount of program funding is known, the Minister of Infrastructure (or his designate) will provide written notification to AHS indicating: Health Facilities Capital Program Manual Version 1.0 June 2013 Page 103

104 the total amount of approved IMP funds budgeted for the upcoming fiscal year, including information on any significant changes to anticipated funding levels for the following two years; and formal approval of the plan, incorporating any changes that may have been made during the reviews undertaken by INFRA and HEALTH. Approval of the annual IMP Plan by INFRA is not intended to preclude AHS from revising its Plan during the year, should project priorities or needs change. Examples of these changes may include the transfer of funds between projects in the Plan, the use of surplus funds from completed projects in the Plan to initiate new projects, emergency projects or the addition of new maintenance projects. Written notification will be provided by AHS to INFRA for any revisions to the current year plan and these revisions will be identified within the quarterly report. If any new maintenance projects exceeding $1 million are added to the current approved plan, AHS must submit a request to INFRA for review and approval. All communications about the IMP funding are the responsibility of INFRA. Communications directly related to a specific projects or its delivery are the responsibility of AHS. Payment of Grant Funds The release of annual IMP funds to AHS will be based on confirmation of the following: the annual approved program budget has been announced by GoA; the annual submission of the AHS Three-Year IMP Rolling Plan, including actual expenditures for the prior fiscal year, has been submitted by AHS to INFRA and has been reviewed and approved by INFRA and HEALTH; and a grant agreement, prepared by INFRA, has been signed by AHS and INFRA. Following completion of the above and pending budget availability, grant funding of 80 per cent (80%) of AHS annual anticipated cash flow requirement for Year One of their Three-Year IMP Rolling Plan, will be advanced to AHS by INFRA. Issuance of any further grant funding for a particular fiscal year will be subject to receipt of ongoing quarterly expenditure reports from AHS (see reporting requirements under section 6.5.1) and confirmation of the actual expenditures to December 31, together with the forecast cash flow requirements to March 31st. If expenditures are in line with projected cash flows for fiscal quarters 1 to 3, INFRA may release further funds depending on budget availability. Final release of the annual IMP funding allocation to AHS will occur once final annual expenditures have been submitted to INFRA by AHS. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 104

105 6.5 Project Oversight Reporting Requirements AHS must submit a report on all IMP projects to INFRA on a fiscal year quarterly basis. The format of the report in terms of layout will be AHS responsibility; however, GoA requires the following content for each project: project title, location, facility name and AHS project number; year in which the project was approved; for completed projects - original estimated budget, expenditures as at the end of the prior fiscal year and the final cost, as appropriate; for ongoing projects - current year expenditures, anticipated cash flow requirements for current year (i.e., expenditure forecast), cash flow for the next two years; and for emergency projects: confirmation that INFRA was advised of the urgent need to proceed with each of the emergency projects; total year-to-date project expenditures; and specific project information for those emergency projects undertaken with IMP funds. Each year the quarterly reports, following approval and sign-off by AHS executive management, are to be submitted to INFRA by AHS on or before the following dates: July 31st (for the period of April 1 to June 30); October 31st (for the period of July 1 to September 30); January 31st (for the period of October 1 to December 31); and April 30th (for the period of January 1 to March 31) Auditing AHS may be required, at INFRA s or HEALTH s request, to produce for review and audit any accounts, records and/or documents related to the work undertaken and the associated expenditures for all IMP projects Site Visits On an ongoing basis, INFRA representatives may select and visit a number of facilities to discuss and review specific completed and in-progress IMP projects. The selection of these projects will be at the discretion of INFRA. HEALTH may also request INFRA to undertake site visits of certain projects. The main objective of these site visits will be to confirm that Health Facilities Capital Program Manual Version 1.0 June 2013 Page 105

106 projects were or are being undertaken as approved. It is expected that issues on specific projects will be communicated to INFRA prior to any site visit. AHS must be provided at least 48 hours notice of a site visit by INFRA and will provide the required access to the site and the project under review. INFRA s access to sites and projects will be subject to AHS approval of all entry to patient care areas, all necessary protection of patient privacy and confidentiality, and all safety considerations. In all cases, INFRA staff will be accompanied by AHS staff while in patient care areas. 6.6 Contracting Principles AHS is required to comply with the following contracting principles when implementing IMP projects: all calls for proposals or tenders for projects funded under this program shall be carried out in accordance with the rules, regulations and laws governing such activities and in accordance with current best practices; contracting activities must comply with the Agreement on Internal Trade (AIT), and other agreements such as the New West Partnership Trade Agreement (NWPTA), and any other legislation applicable to Alberta; and procurement activities must be fair and conducted with openness, integrity, transparency and accountability to the public. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 106

107 7.0 FURNITURE, EQUIPMENT AND INFORMATION TECHNOLOGY The planning for and acquisition of Furniture and Equipment (F&E) and Information Technology (IT) that supports the clinical needs of a healthcare facility is crucial to the success of a health capital project. Both F&E and IT (F&E/IT) planning is therefore integral to healthcare facility planning, and the management of its procurement and installation requires careful coordination with the facility construction and commissioning activities. This chapter describes the organizational roles and responsibilities for managing the related activities across the project s life-cycle to successfully integrate F&E/IT within the health facility. The general outline for this chapter is as follows: Organizational Roles and Responsibilities; Equipment Classification; Capital Project Eligibility Criteria; Business Case Development; Project Organization and Communication; Program Delivery Equipment Plans; Financial Administration; Grant Processes; Program Delivery Equipment Installation Framework: Diagnostic Imaging (DI); and IT. 7.1 Organizational Roles and Responsibilities A detailed F&E/IT RASCI matrix attached as Appendix 13 describes each of the Parties roles, responsibilities and accountabilities concerning the planning, procurement, installation, and commissioning of F&E/IT. Although this section summarizes key responsibilities, the reader should consult the RASCI for greater detail regarding the variety of activities that occur throughout the project life cycle. The key high-level organizational responsibilities and accountabilities follow. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 107

108 7.1.1 Tri-Party Oversight The Joint Operations Committee and the Joint Steering Committee provide oversight and issue resolution associated with the planning and delivery of the health capital projects (see Chapter 4.0). AHS, HEALTH and INFRA are represented on both committees. The Project Steering Committee provides the guidance and issue resolution as outlined in section The Committee also assists in ensuring F&E and IT requirements are appropriately managed through the lifecycle of the project Alberta Health Services AHS is responsible for the following: paying all costs and expenses, for equipment delivered by AHS, related to the F&E/IT planning, procurement, delivery, coordination of installation, testing and commissioning of the approved program delivery equipment within the approved budget commensurate with the terms of the F&E/IT Grant Funding Agreement; selecting the technical solutions and specifications for program delivery equipment that will achieve the clinical or programmatic operating objectives; communicating all equipment-to-facility integration requirements to the Project Manager to facilitate the design and construction of space that supports equipment installation; defining the project s IT system requirements and for procuring, delivering, installing and commissioning of IT systems that is not delivered through the construction contract; reporting the status of the F&E/IT budget and forecast cash requirements to INFRA in accordance with the provisions of the Grant Funding Agreement; returning any surplus funds to the GoA following the completion of the F&E/IT financial activity. (This may occur subsequent to the building warranty period); and funding the costs of the ongoing repair, upgrading and replacement of an operating facility s F&E and IT from their facility operating budgets Alberta Health At the time of approving the Business Case and the Functional Program, HEALTH will also approve of the furnishings, equipment and IT list to ensure alignment with the approved clinical program requirements. HEALTH will also approve the budget allocated for the furnishings, equipment and IT procurement (i.e. baseline budget). In addition, INFRA and HEALTH will review the annual, or ongoing, equipment plans for furnishings, equipment and information technology for alignment with the approved budget. HEALTH will approve any Health Facilities Capital Program Manual Version 1.0 June 2013 Page 108

109 changes required to the aggregate approved baseline budget. The reason for these approvals is because of the potential to negatively impact clinical program delivery and/or result in additional startup or ongoing operational costs. HEALTH also defines the eligibility criteria for the funding of program related F&E/IT from a Health Capital Project s equipment budget. HEALTH supports INFRA and AHS with regard to changes in scope, consistent with Section INFRA INFRA is responsible for the following: ensuring that planning for F&E/IT is incorporated within the project s planning, delivery and commissioning activities; approving access to contingency funds within the equipment budget; providing budget accountability through the management oversight of the project F&E/IT budget following a project approval by TBF; providing management oversight for the installation and commissioning of IT equipment that is delivered through the construction contract; and preparing the Grant Funding Agreement and approving the transfer of funding to AHS in support of F&E/IT requirements for Health Capital Projects delivered by INFRA. 7.2 Equipment Classification F&E that is funded through the capital project budget is classified into two general categories: Building Systems Equipment is defined as equipment needed to provide environmental conditions and/or services in the building. Building systems equipment includes any IT equipment that is delivered by INFRA through the construction contract. Schedule 1 at the end of this chapter provides examples of building systems equipment; and Program Delivery Equipment is defined as the F&E and IT required to enable the occupant to deliver health services. The hardware that supports the delivery of health services is defined as program delivery equipment, including the computers, servers, and printers, but excludes the purchase of software. Schedule 2 provides examples of program delivery F&E/IT. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 109

110 * Note that building systems equipment does not include furniture, equipment and IT that is classified as program delivery equipment, as identified through the term F&E/IT. 7.3 Capital Project Eligibility Criteria The following section describes the eligibility of the F&E/IT for capital funding from a project budget, or F&E/IT funding within an IMP project. The eligibility section of the 2005 Health Capital Planning Manual has been incorporated into the Health Facilities Capital Program Manual pending future amendment that will follow a policy decision that updates or changes the criteria General Program Eligibility Criteria Approved projects may include funds for program delivery Furniture and Equipment (F&E) and IT in the following circumstances: when a new health facility is constructed, for the initial purchase of eligible program delivery equipment and furniture; equipment acquisitions may include initial sustainment supplies to cover an equipment warranty period. The project should not be responsible for supplies, other than initial start-up costs related to equipment commissioning and initiation of operations; when an existing health facility is redeveloped (i.e., replacement, expansion, upgrade or renovation) and the redeveloped facility includes accommodation for new or expanded programs, for the initial purchase of program delivery equipment and furniture required for new programs or needed to expand an existing program; when existing program delivery equipment and furniture cannot practically or costeffectively be reused as the direct result of an approved construction project, the project budget may include funds for replacement costs; when existing program delivery equipment and furniture that can be practically or costeffectively reused, the project budget may include the costs of transferring or moving the items; when new equipment is installed, the training costs directly supporting the initial use of the equipment (initial start-up training) is covered under the F&E budget. AHS is responsible for the arrangement or contracting of training services (typically within the equipment acquisition contract). Training costs associated with travel to vendor facilities are limited to initial train the trainers training and clinical engineering staff; and Health Facilities Capital Program Manual Version 1.0 June 2013 Page 110

111 when F&E/IT is delivered to an alternate facility that in turn causes the tear down and removal, move and stand-up at the intended facility, associated costs may be eligible if these costs have the required prior-authorization of HEALTH and INFRA. Capital projects will not be approved solely for the purchase, repair, upgrading or replacement of program delivery F&E and IT. Building Systems Equipment purchases are included in the capital project budget and are the responsibility of INFRA Ineligible Equipment Costs ongoing repair, upgrading and replacement of program delivery F&E/IT; all equipment and furniture items that are not essential for the delivery of health programs. Examples include staff lounge appliances, patient/resident room televisions, entertainment units, musical instruments, gift shop fittings and fixtures, wall hangings, plants and other decorative accessories; all minor equipment and operational commissioning items such as forceps, retractors, instruments, hand tools, linens, china, cutlery, calculators, stationery and all consumable and disposable supplies; all equipment and furniture related to commercial activities such as retail or food service operations, vending machines or in-house coin-operated laundry processing; all vehicles, including automobiles, vans, trucks buses and ambulances; routine and preventive maintenance of the building and the building systems equipment; the acquisition of support contracts or ongoing upgrades to equipment or software unless such services are incidental to the procurement of the equipment and do not increase the procurement cost; and ongoing sustainment supplies once an equipment warranty period has expired. AHS is responsible for funding any expenses associated with the ongoing life-cycle management of all F&E/IT that are not eligible for capital project funding. TB&F Capital Planning Manual stipulates that F&E and IT under $5,000 is not eligible for capital funding. HEALTH is reviewing how this is to be applied to Health Capital Projects. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 111

112 7.4 Business Case Development INFRA will initiate a call for AHS participation when commencing the development of a Business Case. AHS will appoint F&E and IT planning staff who will work through the AHS Strategic Planner to support the identification of equipment requirements, at a high level, for the alternatives that the Business Case will contemplate. It may be necessary for AHS to consider province wide equipment programs, such as Diagnostic Imaging (DI), to determine whether a Business Case solution is consistent with AHS service delivery plans. The equipment requirements and their supporting costs facilitate the development of a high level equipment budget for the project that can be included in the Business Case. The Business Case may be used to support a capital funding submission for funding from within the Government s Capital Plan. If approved, the F&E/IT component of the funding request will become the initial F&E/IT budget assessment for the project, pending further review of the budget at the Functional Program stage. The Business Case should consider the budgetary needs that may result from unique, emergent or divergent technical requirements of the intended service delivery methodology. While a variance may occur in the cost analysis that is performed in the Business Case, the intent remains to scope the clinical requirement and therein refine the corresponding costs to the extent possible. 7.5 Project Organization and Communication Following a project approval, AHS assigns a representative from each of the CPSM and IT departments to the Project Team. These representatives will be responsible to both AHS and INFRA for the coordination of equipment requirements in consultation with the Clinical Liaison and Project Manager, or where appropriate any other executive decision makers within AHS, to gain necessary equipment or program approvals. These representatives participate in the Project Team meetings and the Project Steering Committee at the call of the Project Director, or as agreed in the Project Charter. Timely communication between the Project Manager and AHS is paramount to ensure the synchronization of the equipment delivery and installation schedule with the construction schedule, as well as the mitigation of risks which could lead to schedule delays and higher costs. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 112

113 CPSM and IT are each responsible for keeping the Project Manager abreast of equipment issues that may impact on the scope, budget or schedule of the project, including the design and construction of the facility, integration or installation of equipment within the facility, or the commissioning of the facility. Project Managers will co-ordinate and agree with AHS to the reporting frequency if it differs from the documented standard, to facilitate timely decision making and to manage risk. The Project Manager is responsible for ensuring that CPSM and IT are aware of any changes to the project that may impact on the following: equipment budgets; design decisions that may impact equipment selection or installation; construction schedules that may impact the delivery, installation or commissioning of equipment; and change proposals and scope changes that may impact the Equipment Plan or the delivery, installation or commissioning of equipment. 7.6 Program Delivery Equipment Plans Equipment Plan and Budget Preparation During the development of the Functional Program the CPSM and IT representatives will each develop a draft listing of the equipment that is proposed for the project in support of the program requirements. AHS is responsible for ensuring that any necessary consultation occurs between the user groups and equipment planners. CPSM and IT will also survey any existing F&E/IT that is eligible to be transferred to a new or replacement facility and incorporate the eligible equipment within the draft listing. Project Managers will need to work closely with both CPSM and IT to plan for sufficient time to finalize the assessment of existing facilities for transfer eligibility. Where the scope of the project considers a large existing health facility, additional time may be required for AHS to assess the existing equipment. The F&E and IT lists together comprise the draft Equipment Plan. The draft Equipment Plan will include the forecast equipment procurement cost estimates for each line item within the Equipment Plan. The Equipment Plan takes into account the requirements for each program area that will be integrated within the new Health Capital Project. The Equipment Plan must provide the following information: Health Facilities Capital Program Manual Version 1.0 June 2013 Page 113

114 description of proposed equipment and number of items to be procured, reported by program area; forecast acquisition cost of each major component as well as a summation of the costs; and identification of eligible equipment/components to be transferred from an existing facility to a replacement facility. AHS prepares a draft F&E/IT budget proposal based on the final draft of the Functional Program and the supporting draft Equipment Plan. The Project Manager appends the draft Equipment Plan to the final draft of the Functional Program prior to its furtherance for final review and sign-off by AHS. An F&E/IT Budget template is provided at Appendix 14 Budget and Cash Flow Project Reporting Template. Once AHS signs-off the Functional Program and returns it to the Project Director, INFRA forwards the Functional Program with all the attachments to HEALTH. HEALTH reviews the draft Equipment Plan and draft F&E/IT budget proposal for consistency with the project scope and objectives. In approving the Functional Program and accompanying project budget, HEALTH confirms the sufficiency of funding to support the procurement of the F&E/IT consistent with the clinical need as stated in the Functional Program. Once the Functional Program has been approved, INFRA informs AHS in writing of the F&E/IT budget allocation for the project, after which AHS may continue with detailed planning of the F&E/IT. The change management process described in Section must include F&E and IT requirements. The Equipment Plan may be amended during design development and construction through to the end of the project; however, amendments to the Equipment Plan must be consistent with the scope of the project and within the assigned budget, unless the changes are contemplated through the change process outlined in section of the manual. Changes to the Equipment Plan may occur following further consultation by CPSM and IT with the clinical liaison and various user groups during the design phase. Additions to the Equipment Plan that are contemplated after Functional Program approval require the priorauthorization of the Project Manager to ensure consistency with the scope, technical requirements and overall budget. Where amendments may consider the use of contingency funds, the Project Manager is the approving authority for the use of the contingency funds, whether from general contingency or previously unassigned (see section 7.7.5). Project Health Facilities Capital Program Manual Version 1.0 June 2013 Page 114

115 Teams are encouraged to streamline this process to ensure that it does not impede routine decisions in the best interest of the project. Minor changes, such as the exchange of Equipment Plan line items with more up to date equipment that is consistent with the original intent, should be considered routine if within the F&E/IT budget. The process of approval is intended to be consultative and may be iterative over the design phase of the project, but may also occur during the procurement of equipment due to the occurrence of variance (see section 7.7.7). As the design phase evolves there may be changes that impact on the equipment requirements of the project. Where such changes necessitate additions to the previously agreed Equipment Plan and increase the forecast cost to complete, the PM will address the associated financial concerns with CPSM and/or IT. The Project Team, including the F&E and IT representatives, may consult the Project Steering Committee should issues arise concerning user group requirements and department/program area sign off. Increases to the budget for F&E or IT, as well as any changes in the forecast procurements that create an expansion or reduction of scope must be brought to the Project Steering Committee for consideration concerning their alignment with the approved scope and budget Risk Management Plan While the Project Manager is responsible for the project s overall risk management plan, AHS will be responsible for developing a subsidiary risk management plan with a focus on specific F&E/IT risk categories. These specific risk categories include: site risk; integration risk; and design & procurement risk. A review of site risks should include identification and discussion of the following items at a minimum: storage and marshaling space (or lack thereof); receiving procedures and constraints while site is under construction; access and safety procedures while site is under construction; waste management requirements (LEED or other); and physical location. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 115

116 A review of integration risks should include identification and discussion of the following items at a minimum: equipment transfers; installation responsibilities; in contract responsibilities; and commissioning responsibilities. A review of design and procurement risks should include identification and discussion of the following items at a minimum: early work requirements for complex equipment in areas such as digital imaging, medical device reprocessing, surgical suite and interventional. IT early work requirements include determination of uninterrupted power supply solutions and securing access to appropriate data transmission lines; long lead time items; and building system tie-ins. Other common types of F&E/IT risks such as resource availability, schedule compression, late changes, funding constraints and vendor issues should also be included in the F&E/IT risk management plan, if warranted. At a minimum, these risks should be discussed with the Project Manager on a regular basis and escalated as required. The F&E/IT risk management plan should include probability and impact assessments of the identified risks, and define methods to mitigate the risks to the extent possible. To address residual risks (known risks that cannot be fully mitigated) as well as uncertain events or conditions that could adversely affect the delivery of the project, it is a requirement that a budget contingency be included as part of any F&E/IT project budget (see section Budget Development). A five percent (5%) F&E/IT Budget Contingency is considered sufficient to address the typical project risks discussed previously; however, a higher contingency percentage may be warranted when a project is being delivered in: remote locations; multi-phased, fast-tracked or design-build procurements; health care facility where new, emergent technology is being installed; Health Facilities Capital Program Manual Version 1.0 June 2013 Page 116

117 a procurement period where a higher probability of inflation or currency fluctuations are anticipated; and a limited vendor supply market. A contingency percentage in excess of five percent may be approved following consultation with the Project Manager Procurement Plan AHS is responsible for the preparation of a Procurement Plan for each project that defines how the Program Delivery Equipment will be procured, and the process that will be undertaken to appoint suppliers or vendors contractually. The timeframe for procurements will need to align with the construction schedule to minimize the likelihood for storage of equipment and components. While AHS manages the procurement of the F&E/IT according to their own administrative and financial processes, AHS is required to comply with the following contracting principles: all calls for proposals or tenders shall be carried out in accordance with the rules, regulations and laws governing such activities in the Province of Alberta; contracting activities must comply with interprovincial trade agreements and any other legislation applicable to Alberta; and procurement activities must be fair and conducted with openness, integrity, transparency and accountability to the public Delivery and Installation Plan AHS is responsible for the preparation of a Delivery and Installation Plan that details the planned delivery and installation milestones for the Program Delivery Equipment. The Delivery and Installation Plan also addresses known/unique requirements concerning delivery and installation that could impact the design and/or construction of a project. Additionally, the Plan denotes responsibility for installation of certain equipment components either by AHS, the vendor, the manufacturer, a third-party contractor (if known), or the Contractor, as appropriate. The Delivery and Installation Plan is a living document that is first established following approval of a Master Equipment List and updated throughout the life cycle (quarterly or as agreed to by the Parties) of the project through to the installation of all equipment. Prior to the handover of the facility, AHS (both CPSM and IT) is responsible for coordinating the F&E Health Facilities Capital Program Manual Version 1.0 June 2013 Page 117

118 and IT Plans with both the Project Manager and the Contractor. After handover, CPSM and IT continue to coordinate their plans with the Project Manager and Contractor. The delivery schedule will also assist the Project Manager in coordinating final room preparation with the Contractor. CPSM, IT and the Project Manager are responsible for ensuring the coordination of delivery schedules with the construction and handover schedule. Delivery schedules need to coincide with facility availability to minimize storage, whether on-site or at an off-site storage facility. The Delivery and Installation Plan must also take into account the move of F&E/IT from an existing facility, or to and from storage. AHS and the Project Manager may coordinate a staging area within the facility, prior to handover that allows for the entry of equipment into the facility as well as the preparation of the equipment for set-up. Any agreement with the Contractor to allow access to a new facility prior to handover requires the approval of the Project Manager. For existing facilities that are being renovated or expanded, AHS and the Project Manager will coordinate such requests with the site manager and the Contractor (see section 4.1.7). AHS should arrange for equipment deliveries to arrive following the handover date to the extent possible. Project Managers must keep their CPSM and IT planners apprised of any changes to the forecast handover date, understanding that any late notifications of change will have an impact on delivery schedules, risk and cost. CPSM will arrange for an approved agent of AHS to receive and sign for any F&E deliveries prior to the handover of the facility to AHS. AHS IT will also coordinate and receive any IT deliveries that arrive prior to the handover of the facility to AHS. Delivery of F&E/IT prior to building handover, or early delivery, will be arranged with the Contractor so as to minimize impact to the construction site and through the Project Manager. AHS will be responsible for damage to F&E/IT that is delivered prior to building handover, regardless of the cause of the damage, even though the building has not been turned over to AHS (or for renovation projects, where the space has yet to be turned back to AHS by the contractor). CPSM and IT will arrange for vendors to install and test equipment following building handover unless otherwise approved by the Project Manager prior to handover. INFRA will ensure that any rooms that require special design and construction to meet equipment specifications are substantially complete to facilitate vendor installations according to the agreed upon delivery and installation schedules. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 118

119 7.7 Financial Administration Budget Oversight A project s approved F&E/IT budget represents the amount designated within the TPS for the planning, procurement, move-in, installation, testing, start-up training (included in the purchase price) and commissioning of necessary Program Delivery Equipment consistent with the approved project scope, excluding ongoing service agreements that AHS may enter into with an equipment supplier or vendor. The approved budget must be used for only the Program Delivery Equipment identified in the approved Equipment Plan unless otherwise approved by the Project Manager (as outlined in section 7.6.1). AHS may not reassign grant funds to another project unless approved by the Ministers of INFRA and HEALTH. The F&E and IT budgets that are approved by INFRAS for AHS procurements represents a maximum allocation of GoA funding that AHS may not exceed. Any surplus funds that occur following the acquisition, delivery, installation and commissioning of the equipment shall be returned to the GoA by AHS. Any budget surplus that can be reasonably identified earlier in the project life cycle should be removed from the F&E or IT budget at the earliest opportunity to facilitate the assignment of such funds to other priority project activities. The determination of surplus funds is normally determined following the assessment of variance within the F&E and IT budgets and the forecast cost to complete all F&E or IT work, in accordance with section An assessment will normally occur at major project milestones or such other times as mutually agreed between the project manager and CPSM and/or IT (for example, completion of design, and completion of all user group equipment list sign offs). To facilitate oversight and budget management, AHS will provide reports to INFRA as outlined in section Budget Development The budget template (Appendix 14 Budget and Cash Flow Project Reporting Template) delineates the information requirements for the F&E/IT budget. The reader should consult the template for greater detail concerning the budget information requirements. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 119

120 After a project has been approved by the Minister, the budget identified within the Business Case becomes the baseline budget. Any subsequent adjustments to the budget are reported on the budget template by adding column(s) to indicate the revisions. Certain line items of the budget may require supporting information to substantiate the budget amount, including: unassigned contingency; move, storage, installation and marshaling expenses; and budget contingency. The program area requirements are delineated by program and supported by the listings and cost information within the Equipment Plan. The budget includes provisions for Budget Contingency and an Unassigned Contingency (see section for details on Unassigned Contingency). The purpose of the Budget Contingency is to accommodate within the budget ceiling any unforeseen risks or expenses, equipment changes that increase procurement costs, technology upgrades, or unfavourable changes in currency exchange rates (if procurements involve the use of foreign currency). Over the project life cycle the Project Manager may authorize AHS use of funds from the Budget Contingency as part of their F&E/IT budget. The Budget Contingency and Unassigned Contingency will not be forwarded under the grant funding process unless such funds have been approved for expenditure by the Project Manager. Contingency relating to IT budgets should be addressed on a project basis with the contingency typically held by the Project Manager Cost Information Standardized reporting through the use of templates applies to the preparation of estimates and budget information for all projects. Requisitions and actual cost to procure (purchase order value) are based on final invoice costs. The F&E and IT budget estimates utilize procurement costs that are forecast to occur in each fiscal year of the project schedule. The cost estimate takes into account inflation and other economic factors affecting the period covered by the estimate. The Equipment Plan must take into account any pricing agreements or existing contracts (standing offers) versus posted or retail prices, including inflation and foreign exchange rates. Where appropriate, the Equipment Plan must indicate the inflation and exchange rate factors that have been utilized in the forecast cost estimates. At the Functional Program stage, when the draft Equipment Plan is developed, the forecast acquisition costs will observe standing offer prices where available or, where a reduced price Health Facilities Capital Program Manual Version 1.0 June 2013 Page 120

121 can be reasonably forecast, on the most up to date pricing information. This will allow for greater accuracy in the preparation of the budget estimates. The variance management process outlined in section will apply to the overall management of actual versus forecast costs. AHS typically procures through Canadian registered corporations or agents whereby both the contract and financial transactions utilize Canadian dollars. When procurements utilize foreign currencies, the Equipment Plan will identify those items that are forecast for off-shore procurement, and the F&E/IT budget will identify the proposed exchange rate model that will apply to the foreign currency. AHS will manage the exchange rate risk within the variance management outlined in section Equipment Reuse Where applicable, the F&E/IT budget must also take into account equipment transfer from existing facilities, including the sequencing for the transfer of equipment, and the impact to clinical services when equipment is unavailable for extended periods (contingency plans). Off-site storage costs may only be covered within the F&E budget ceiling where such costs are reasonable and occur as a result of a slippage in the building handover date, or no storage space is available on site. A listing of the F&E/IT to be transferred from an existing program area to a renovated or new program area (or building) is delineated within the equipment list that is developed as part of the Functional Program Unassigned Contingency Since it may not be possible to identify all items of equipment at the point of Functional Program completion, AHS may propose within the F&E/IT budget an unassigned contingency for the purpose of funding F&E requirements relating to a program that cannot be sufficiently defined at the Functional Program stage. The unassigned contingency allows for the completion of F&E program planning by AHS during the design development stage with the understanding that funding from the unassigned contingency will only be used for essential program requirements. In proposing the unassigned contingency, AHS must provide substantiation for the amount being requested including, where appropriate, which program areas are not sufficiently planned. A confidence level for each program area may be employed to identify the relative Health Facilities Capital Program Manual Version 1.0 June 2013 Page 121

122 risk that additions may be contemplated for a given area during the design phase, including the amount of the unassigned contingency that may be appropriate for each area. It is expected that all F&E/IT requirements can be fully identified soon after the completion of detailed design; therefore, Project Managers will set a date following the completion of detailed design for a final review of the unassigned contingency (following consultation, unused funds may be identified as surplus and returned to the capital project budget). The date for this review should typically fall within three months following the completion of detailed design CPSM Administration Allowance The process, procedures and value of the allowance provided to CPSM to administrate F&E project work is under review. In the interim, the structure outlined below will be followed. Within the F&E portion of the budget AHS may allocate a proportion to the cost of CPSM project administration (not including IT). The maximum amount that may be allocated to administration expenses is three percent (3%) of the actual amount of F&E expenditures funded within the TPS (does not include third-party funding sources). If the actual F&E expenditures are less than those identified in the F&E budget approval, the project administration funding is based on the actual expenditures rather than the approved budget. Administration expenditures are also subject to the following: administration funding is specific to the project and cannot be applied to other projects or programs without the prior-approval of INFRA; expenditures must be for costs incurred by CPSM employees or contracted staff who are directly responsible for the delivery of the eligible project, including the cost of manpower and employee benefits, employee travel costs (within province) incurred as a direct result of managing the project, and the preparation of documents for audit proposes ; administration funding is not to be used to pay for expenses that AHS incurs prior to receipt of the Ministers project approval letter; administration funding is not to be used to offset costs/expenses that AHS is already incurring within its normal operations, such as existing project or planning staff, facilities, equipment, or supplies which are funded out of operations. Administration may only cover incremental project and personnel costs that are directly attributable to the project; and Health Facilities Capital Program Manual Version 1.0 June 2013 Page 122

123 administration funding will be monitored through the submittal of quarterly expenditure reports or as specified in applicable grant agreements Variance Management Budget variance will occur over the life cycle of the project, from project approval (based on Business Case) through to the completion of all F&E/IT procurements. AHS will monitor and report to the Project Manager the variance in the F&E and IT budgets according to the reporting requirements outlined in section Variance in the estimated cost to complete procurements may occur when costs are greater or less than forecast. AHS will manage the variance across the various departments/program areas with the intent of remaining within the approved budget. The total variance across the departments will take into account (sum) the positive and negative variance that may occur within each department/program area of the Equipment Plan. Once this total variance meets the approved budget, not including contingency, AHS may request that the Project Manager assign to AHS the use of contingency funds to complete the procurement of the equipment listed in the Equipment Plan. Variance may also occur when line items are added or removed from the Equipment Plan. AHS requests the prior-authorization of the Project Manager to add items to the approved Equipment Plan. For items that are removed from the Equipment Plan and replaced by another (exchange), or where no replacement occurs, AHS will inform the Project Manager in a timely manner to ensure that project construction, technical, and budget implications are promptly addressed. As exchanges may occur due to updates in technology or physician requirements, the Project Manager will make every effort to work with AHS to accommodate the changes within the overall F&E/IT budget. Deletions from the Equipment Plan should not be taken as an opportunity to replace or add line items, unless such additions are a bona fide requirement and approved by the Project Manager. Increases to the estimated cost of procurement that occur due to scope changes will follow the process outlined in section of this manual Third-Party Contributions Third-party organizations such as charitable foundations may contribute funds to a project for the procurement of specific F&E or IT. In such circumstances, AHS is responsible directly to Health Facilities Capital Program Manual Version 1.0 June 2013 Page 123

124 that party for any arrangements relating to the party s contribution to the project and the F&E and IT to be acquired on their behalf. Third-party contributions may be added to the TPC after a project has been approved by the GoA, with those contributions having a potential impact on the project scope and schedule. Additions to the scope and budget generated through a third-party contribution must be consistent with the overall objectives of the project. Should a contribution create an increase in the project s capital or operating costs (beyond the third-party contribution), such increases will require the prior consent of HEALTH (capital and operating) and INFRA (capital). When foundation contributions create an increase in capital project costs, prior authorization by the PM is necessary before the equipment can be included within the project. The calculation of the admin allowance does not take into consideration third-party contributions Auditing AHS may be required, at INFRA s or HEALTH s request, to produce for review and audit any accounts, records and/or documents related to the work undertaken and the associated expenditures for all Health Capital Projects. 7.8 Grant Processes Grant Funding Agreement The Grant Funding process is currently under review and will require consultation between INFRA and AHS Finance departments Grant Payment Process The payment of grant funding to AHS relating to a specific project will be subject to confirmation that a Grant Funding Agreement has been signed by the Minister of INFRA. Approval of the Grant Funding Agreement is contingent on the following pre-conditions: receipt of each project s Equipment Plan and F&E/IT budget proposal from AHS; review and acceptance of the Equipment Plan and F&E/IT budget proposal by INFRA; approval of the Functional Program by HEALTH, including the accompanying Equipment Plan and F&E/IT budget proposal; and receipt by AHS of a letter from the Minister informing AHS of the Grant Funding Agreement and the authorization to transfer funds from INFRA to AHS. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 124

125 Once the pre-conditions are met, the following process will be followed for all grant payments: eighty percent (80%) of the forecast funding, by quarter, will be transferred from INFRA to the AHS CCITF account based on the F&E/IT cash flow approved by the Minister of INFRA (or designate), with such cash flows based on each project s cash requirements reported using the template at Appendix 14 Budget and Cash Flow Project Reporting Template and outlined in Section 7.8.3; the issuance of any further grant funding for a particular fiscal year will be subject to the receipt of ongoing quarterly expenditure and forecast commitment reports from AHS (Appendix 14 Budget and Cash Flow Project Reporting Template); AHS, acting within its authority, may choose to fund any expenses that are in excess of the approved F&E or IT project budget allocations; and funds remaining upon the close-out of F&E and IT procurement activities are to be returned to the GoA Reporting Requirements For each project, AHS (CPSM and IT) must submit an Equipment Plan, Budget Report that includes a Cash Report, and the Delivery and Installation Plan to the Project Manager on a quarterly basis (or, concerning the Delivery and Installation Plan, as agreed with the Project Manager). The reports are required for each of the F&E and IT portions of the project and include the following information: project title and facility name; updated/current budget amounts; expenditures, variances and forecast expenditures; quarterly cash flow requirements for the current fiscal year (updated in January 31st for the following fiscal year); future yearly cash flow requirements beyond the current fiscal year; estimate to complete the Equipment Plan (both F&E and IT). INFRA will transfer funds on a quarterly basis to AHS based on the cash flow identified in the Cash Report. Cash flow projections are based on the quarter in which procurement invoices are expected to be paid by AHS as well as the CPSM administration costs outlined in section The Procurement Plan provides the projected procurement dates. Health Facilities Capital Program Manual Version 1.0 June 2013 Page 125

126 As a component of the quarterly Cash Report, AHS will report each project s expenditures against the funding that had been transferred to AHS. AHS may update previous cash flow projections based on actual procurements and expenditures, and project scheduling information. INFRA may adjust future quarterly cash flows according to project schedule changes (design or construction), or delays in the forecast F&E/IT delivery dates as provided by AHS. The template at Appendix 14 outlines the specific information requirements of the quarterly Budget and Cash Reports. Quarterly reports must be submitted to INFRA on or before the following dates: July 31st (for the period of April 1 to June 30); October 31st (for the period of July 1 to September 30); January 31st (for the period of October 1 to December 31); and April 30th (for the period of January 1 to March 31). AHS will prepare a Project F&E and IT Close-out Report following the completion of all procurement activity and related financial transactions (see section 4.5). The Close-out report will be provided to both INFRA and Health and will include a listing of all F&E and IT purchases by unit or device type, and a budget summary that includes expenditure reporting specific to the project expenditures and budget allowance for CPSM administration costs. The final report should normally be completed within one year following the date of facility handover, or four months following the completion of clinical commissioning, whichever occurs last (for entire scope of project), or as otherwise agreed between the Parties. 7.9 Program Delivery Equipment Installation Framework This section is under development. AHS is responsible for informing the Project Manager and the Prime Consultant of any equipment specifications that will impact on room design, including utility requirements Diagnostic Imaging Requirements This section is under development. RASCI Risk Register Project Manager responsibilities; CPSM/IT responsibilities Health Facilities Capital Program Manual Version 1.0 June 2013 Page 126

127 SCHEDULE 1 Examples of Building Systems Equipment Capital projects may include funding for, the installation, replacement or repair of building systems and building systems equipment. Building systems equipment refers to equipment needed to provide adequate environmental conditions and/or services in the building. The following examples of building systems equipment are provided to clarify funding eligibility. This is not intended to be an all-inclusive list of building systems equipment. Fire Protection and Building Security building security systems such as CCTV cameras, card access readers, video loop recorders, motion detectors and wandering control devices; automated building control and monitoring systems; fire alarm systems including pull stations, enunciators, locator panels, protection systems for food preparation equipment and firefighting devices (not including hand-held extinguishers); lightning protection system; and radiation protection partitions and shielding for magnetic and RF interference. Communications paging systems including antennas, transmitters, amplifiers and hand-held paging receivers; intercom systems including dedicated handsets; telephone systems including exchanges, switches, switchboards, computerized control and monitoring, hardware and software and handsets; nurse call systems including bedside devices, central stations, presence stations, enunciators, computer hardware and software; central dictation systems including hand/headsets, data storage, system control hardware and software, but not including word processing hardware and software; Electronic Data Communication systems including conduit, raceways, cabling, conductors, wall connectors, access flooring and foot grills but not including software, workstations (PCs) and peripherals (i.e., printers, scanners); and Schedule 1 June 2013 Page 127

128 cable television distribution system including antennae, control cabinets, switches distribution devices, amplifiers and mounting brackets, but not including TV receivers, TV projection systems or satellite dishes. Internal Conveyance elevators, pneumatic tube systems, dumbwaiters, car rails and similar materiel transport systems. Mechanical basic building support systems such as heating, ventilation, refrigeration and plumbing (including toilets, sinks, tubs, shower stalls, water fountains, eyewash stations and related fixtures and fittings); built-in, custom metal fabrications such as exhaust hoods/cabinets, chemical fume hoods, and range hoods; central wet/dry mop systems; medical gas systems including compressors, cylinder manifolds and distribution piping, but not including medical gas flow meters at patient care sites; water treatment systems including chemical softeners, de-ionizers, stills, RO systems and distribution piping, but not including local-use devices for pure water production. Built-in therapy pools and related mechanical/electrical services, but not including mobile extremity tanks. Architectural Specialties Service columns and modular service units providing medical gases, electrical power and communications. Electrical electrical switchgear, distribution panels, breakers, motors, starters and motor control centers; specialty lighting systems, fixtures and fittings in operating room theatres, trauma rooms, minor procedure, examination and LDRP rooms; transformers providing special voltages to diagnostic imaging equipment, but not including transformers and other electrical devices normally supplied as part of an imaging system; central clock systems; and Schedule 1 June 2013 Page 128

129 essential exterior electrical systems and devices including lighting, security and parking control. Schedule 1 June 2013 Page 129

130 SCHEDULE 2 Examples of Program Delivery Equipment Program delivery equipment is equipment that is installed in a health facility to allow the occupant to deliver health programs. The following examples of program delivery equipment and furniture are provided to clarify funding eligibility. This is not intended to be an allinclusive list. Diagnostic Radiography suites/units Processors Imaging Imaging units, mobile Multi-loaders Camera systems Racks/holders, apron Sensitometers Illuminators/viewers Immobilizers File systems ID systems Screens Densitometers Carts, file/film Injection chairs/tables Seating, task Dispensers, film Shelving, mobile/high density systems Central Sterilizers Sealers Sterile Washers/disinfectors Work tables Supply Decontaminators Shelving units/carts Patient Beds/cribs/bassinets Wheelchairs Rooms Bedside tables/dressers Walkers Overbed tables Patient lifts Seating Commodes Desks Wardrobes Monitors, bedside Regulators Shower curtains Drapes and track Privacy curtains and track Window furnishings Food Services Stoves/ovens/ranges Food/tray carts Fryers Peelers/slicers Appendices June 2013 Page 130

131 Steam kettles/cookers/ tables Toasters, mixers Refrigeration units, reachin Lowerators Dishwasher systems Disposal units Conveyors Microwaves Pot wash counters/sinks Beverage dispensers Racks, pot Tables, preparation/ cook/work Emergency Physiologic monitoring system Defibrillator/Monitors Simulators, ECG Monitors, ECG Cast cutters Ophthalmoscopes Stethoscopes, ultrasonic Infusion pumps/stands Seating, task/reception Stretchers, trauma/ exam/bed/ transport Vacuums, cast cutter Eye equipment Lights, examination Warmers Pressure infusers Oximeters Instrument stands Cabinets, instrument Mayo stands Carts, resuscitation/crash/plaster/ traction/supply Examination tables Administration Computers, PC/servers Desks/workstations Printers Photocopiers Shelving units/bookcases Audio visual equipment Fax machines Furniture panel systems Shredders File cabinets Postage metres Pagers Tables, conference/end Credenzas round Seating, desk/waiting/steno/ conference Appendices June 2013 Page 131

132 APPENDICES Appendix 1.1 Appendix 1.2 Appendix 2.1 Appendix 2.2 Appendix 2.3 Appendix 2.4 Appendix 2.5 Appendix 2.6 Appendix 2.7 Appendix 3 Appendix 4.1 Appendix 4.2 Appendix 4.3 Appendix 5.1 Appendix 5.2 Appendix 6.1 Appendix 6.2 Appendix 7 Appendix 8 Appendix 9 Appendix 10 Appendix 11 Appendix 12.1 Appendix 12.2 Appendix 12.3 Appendix 12.4 Appendix 12.5 Appendix 12.6 Appendix 13 Appendix 14 Glossary ( some definitions to be reviewed) Acronyms Memorandum of Understanding (MOU) - To be approved Joint Steering Committee Terms of Reference Joint Operations Committee Terms of Reference - To be approved Standards and Guidelines Sub-Committee Terms of Reference IMP Review Sub-Committee Terms of Reference Capital Planning Sub-Committee Terms of Reference F&E/IT Sub-Committee Terms of Reference RASCI Matrix Project Charter Template Project Steering Committee Terms of Reference Project Team Terms of Reference Needs Assessment Template Needs Assessment Flow Chart Business Case Template Business Case Flow Chart Functional Program Framework Charitable Foundations/Auxiliary Funding Template Procurement Planning Flowchart - To be updated based on PIMS charts Project Design Flowchart Project Reporting Matrix - To be updated Contract Acceptance Procedures Flowchart Letter of Year End Warranty (with Deficiencies) Template Letter of Interim Acceptance Template Letter of Final Acceptance Template Letter of Total Completion Template Handover Template RASCI Chart F&E Budget and Cash Flow Project Reporting Template Appendices June 2013 Page 132