IREON Insights: Building clean air clinics for the future - by April Intrabartola

Within the past five years, Eastman Cooke & Associates has been more active in the construction of healthcare facilities than ever before. There was additionally a dramatic increase in adaptive reuse projects in the category early in the pandemic. At a time when so many building sites were embargoed, healthcare construction was rightfully deemed essential.

Built into these more recent projects were requirements initiated the year before in the 2019 Climate Mobilization Act, a.k.a. Local Law 97. For the world, it literally became a breath of fresh air; for those of us in the construction trades, it was a challenge!

Now as pandemic practices turn a new corner, there are new sets of protocols that are not only germane to healthcare facilities, but to all new construction in the city, as well as renovation and adaptive reuse projects.

Energy Sensitive

Local Law 97 mandates all buildings in New York City reduce their carbon footprints in graduating degrees by 2050, with the first deadline for reporting on properties 25,000 s/f and larger on May 1, 2025. The next deadline is in 2030, when GHG emissions must be reduced by 40%. By 2050, greenhouse gas emission reduction is required to exceed 80%. If these criteria are not met, property owners in all asset classes face penalties as high as $268 per each metric ton over the limit.

It is an ambitious and worthy plan. However, when you consider healthcare facilities typically consume twice as much energy per s/f as other commercial facilities—including office buildings, hotels, etc.—the construction of hospitals, clinics and medical offices must be precisely planned from inception to achieve best energy management mandates.

Long before there was a Climate Mobilization Act, many of us in the building industry were using low VOC materials and low emissivity glass, i.e., low E glass in windows, doorways, and paneling. Air filtration systems in commercial buildings were also being upgraded long before the pandemic, especially using HEPA filters in medical centers and clinics.

For example, we completed an extensive adaptive reuse project last year at 438 West 51^st St., comprising a core-and-shell conversion of a 28,700 s/f, five-story former 1905 warehouse, transforming it into a modern medical center for a multi-practice community healthcare practice, known as the Sovereign Medical Group. The project entailed upgrades of vital operating systems, the installation of new infrastructure systems, and a three-story roof extension. For the interiors, we also added individually timed heating and cooling controls on each floor that would maximize the efficiency of the system. If an operating room was not in use, the lights immediately shut off and temperatures would be controlled, which had a building-wide benefit, too.

Because medical facilities were considered essential construction projects in the early months of the pandemic, we worked on several in 2020 and 2021, concurrently. One of our more challenging adaptive reuse projects entailed the construction of two medical clinics for the American Endovascular & Amputation Prevention Group at East River Plaza, a shopping center at 505 East 116^th St. The two units comprised the Harlem Endovascular Center, a 4,200 s/f clinic in a former Sleepy’s store, and New York Endovascular & Amputation Prevention Center, a 5,000 s/f full-service surgical center, also in a space formerly occupied by a store. Both entailed interior fit outs in former retail spaces with large windows, and so our solution for achieving a significant level of energy efficiency included the installation of insulated thermal barriers, high efficiency HVAC systems, and centrally controlled lighting systems. Another added benefit for this practice was reduced operating costs.

Among our new construction projects last year was Central Assisted Living in Far Rockaway, Queens. The facility features spacious living quarters, comfortable amenities, and a requisite healthcare program. The center’s private apartments each have individual PTAC heating and cooling units, electric ranges, and ensuite ADA compliant bathrooms with good space flow. Most importantly, we used updated, low VOC materials, including paints, finishes and flooring. The building’s envelope additionally reinforces its energy efficiency, with an insulated and vapor resistant steel-stud exterior system, finished with fiber cement lap siding, high efficiency glazing systems, and ample roof and attic insulation.

As early as 2017, satellite clinics affiliated with major healthcare providers and hospitals and urgent care centers began proliferating across the New York Metro area, predating both Local Law 97 and the ensuing pandemic. Many of those early clinics and hospital centers are now facing the challenges of retrofitting to meet new decarbonization criteria based on the Climate Mobilization Act, as well as the aftermath of COVID. Air flow and air quality are every bit as important as energy management and sustainability, especially as we face skyrocketing construction costs.

As building standards and materials continue to improve, it is incumbent on those of us responsible for designing, constructing, renovating, and rebuilding healthcare facilities, to persist in using materials and processes reflecting the safest and most sustainable solutions available. It may be a new world order, but it is one that will keep this planet cleaner, safer, and more sustainable for generations to come.

April Intrabartola is the vice president of Eastman Cooke & Associates, New York, N.Y.

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