STE Innovation Award Gold Medalist: The Hardened Hospital

Founded by Congress in 1852 to treat people living with mental illness, Saint Elizabeth’s notably served as a hospital for wounded Union and Confederate alike, renowned writers, the biggest contributor to the Oxford dictionary, and three presidential assassins — with thankfully, only one having succeeded.

In April 2010, the Hospital moved into a new 450,000 square foot, state-of-the-art facility that incorporates best practices in patient mental health care with an environmentally sensitive design and sustainable strategies. The new building’s therapeutic design includes bright and airy living and treatment areas, green spaces off each patient unit, and enclosed courtyards. A 28,000 square-foot green roof is likely the largest on any psychiatric facility in the country.

With a combination of community outpatients, both civil voluntary and involuntary commitments, and a large population of forensic patients — those adjudicated as “Not Guilty by Reason of Insanity” — the hospital needed a unique security plan that integrated patient safety, staff security and community access while keeping mindful of the urban, southeast Washington setting.

Because of the nature of the crimes or special needs of highly sensitive patients, the security and safety systems, physical barriers and operations were critical and inseparable to the integration philosophy of the design, construction, engineering, commissioning, training, daily operations, and emergency event planning and strategy.

Balancing the needs of patient and staff safety alike, while ensuring a maximum level of physical security, became the focus of the new Chief Administrator of the hospital, Dr. Patrick Canavan, while forensic patient responsibility was headed by Dr. Joseph Henneberry, and Facility Management responsibility was offered by Mr. Gilbert Taylor. Henneberry and Taylor worked with Professional Systems Engineering LLC (PSE), a systems strategy and design firm, at Patuxent Institution, a large behavioral management facility in Maryland.

PSE was hired by the architect to design all physical security such as hard and soft fencing, protected openings, K-rated barriers and lighting, as well as all security electronics, perimeter detection, wireless duress and access control. With more than 25 years of experience in psychiatric, forensic and maximum-security facility operations and technologies, PSE produced a security program integrating the security and public safety functions.

I charged the design team with establishing facilities which met U.S. District Court requirements and facility accreditation. New plans were developed by Mark Shaw, AIA, and Eric Kern, AIA, of Einhorn Yaffee Prescott Architects on behalf of the District of Columbia, Department of Mental Health.

Requiring a close collaborative effort, the Project Executive for the Construction Manager — Gilbane Company’s Robert Poe with Project Manager William Millios — selected PSE to work directly with the hospital on transition requirements including fire code responsibility, master keying, mass evacuation and defend-in-place fire safety planning. PSE was also responsible for preparing fire and security evacuation maps, staff security and fire training. Jason Delp, Director of Projects and a partner with PSE, managed the integration of physical and electronic security while Thomas H. Pilson, IV, Director of Corrections and Public Safety, managed keying, life safety and security training. Frank Carpency, PE, CCP, Vice President with PSE during design, was responsible for security engineering from 2004 to 2005.

Seven Zones of Technology

The security program defined the security and public safety functions of the site into seven zones of security — protected from both internal and external breach.

Zone 1 is the housing unit into which the highest level, maximum security forensic patients are assigned. Generally speaking, an individual remains at this housing unit floor location except for therapeutic and recreational activities in a secure courtyard and visits for extended health care.

Zone 2 is the secure corridor using the Andover Continuum Access Control System from Schneider Electric, Critical Systems Division. Also covering personal protection are Senstar Flare RF wireless duress transmitters and receivers for the coverage of Zones 1 and 2 and virtually all facilities under patient control. The personal alarm system is able to locate personal duress transmitters with an indoor accuracy on the correct floor within 20 feet of the true location, and on the outside of the buildings, within 50 feet on all sides of the exterior walls. The alarm system must annunciate within three seconds of the activation of an alarm with better than 97-percent accuracy.

Zone 3 encompasses the building’s exterior envelope and includes further access controls including full-height stainless turnstiles and ADA access devices from Boon Edam. A full exchange-based electronic intercom system by TOA was provided for security use to provide private channel communications and full security compliance. Security Zone 3 also includes X-ray machines by L3; and metal detection meeting the FAA “Three Gun Rule,” and National Institute of Law Enforcement and Criminal Justice Standard 0601-00 with stainless multi-zone floor standing detectors and handheld detectors by CEIA USA.

CCTV is used in a deliberate security manner and consists of Pelco’s Integral Technologies, digital video Sentry Enterprise recorders, and server management systems using Bosch cameras.

Zone 4 includes liberal use of CCTV on the roof and on the exterior grounds along with specified security lighting, including high pressure sodium wall packs, floors, street lights and roadway luminaires — all by General Electric. Specifications required a minimum of 2 footcandles (FC) at ground level with a max:min ratio not exceeding 5 FC.

Zone 5 consists of a “soft fence” — DeTekion’s taut-wire detection system. Appearing as a physical fence, its “wires” are actually tensioned to allow actuation of alarms by slackening or stretching the tendons of the individual sensing cables. Alarms are received on separate system computers and registered on the access control system while CCTV integration provides alarm video and event storage.

Zone 6 consists of an arched 15-foot fence using First Defence posts. Buried into the ground to prevent tunneling, the fabric is topped with 3/8 inch non-climbable fencing. The mesh is 14-gauge and is difficult to cut with normal hand tools. The fence framework has a high-yield strength of 50,000 psi with the posts meeting ASTM F1083 and complying with rated wind gusts of almost 100 mph. Gate operators in Zone 6 consist of Southern Steel operators with maximum security 9100A locks.

Zone 7 — the final zone — consists of a contraband fence using fence fabric extended to a 22 ft. height. This fence was requested by Dr. Henneberry, who had personal experience at former institutions with weapons and contraband breaching the secure perimeter. This effort provides practical resistance to weapons, drugs or other paraphernalia from crossing into the highly secure patient zones.

Extensive use of fiber transceivers by IFS, AFI and Black Box and fiber optic cabling by Corning was used as communication media for all external communications, which was significant. Digital communications were required for taut-wire monitoring, as well as fiber optic perimeter intrusion detection on the hard fence which is double-looped on the hard perimeter fence. All communications for alarm, monitoring, CCTV and controlled access are established on multiple graphical user workstations throughout the facility.

As digital video recorders are usually extremely sensitive to power shifts and especially loss of power, extensive use of localized APC uninterruptible power supplies are used throughout the project.

Every system within the seven security zones is integrated to establish a unified Command, Control and Communications hierarchy and for implementing new security and life safety strategies.

The Code Approval Process

With original specifications produced in May 2005, a revamping of the specs occurred in June 2006 due to delay in construction funding. While this was a straightforward process, the code approval process during construction from 2006 to April 2010 required substantial consulting engineering services, again performed by PSE. There were design reviews and permitting, functional code review of systems and equipment, fire safety planning, fire/incident evacuation planning with both mass evacuation and shelter-in-place meeting NFPA and IBC I-3, Condition IV requirements. By 2009, evacuation maps and training were also in the planning process.

The thousands of hours spent by Gilbane, the construction manager, the architects, engineers and security designers was impressive in order to open a facility with a smooth transition process.

“Many owners and even construction managers underestimate the amount of due diligence required for functional code review of systems and equipment,” says Jerry “Dutch” Forstater, CEO and chief engineer PSE. “The review of a complicated, massive structure such as Saint Elizabeth’s must account for HVAC control, fire alarm messaging, fire alarm zoning, horizontal exiting and smoke partition conformance, mass evacuation procedures and shelter-in-place compliance. All hospitals, small and large, need an effective program to manage critical events to provide a safe emergency management program.”

Training and Acceptance of New Technologies

With upwards of 1,000 people on site during active community periods and more than 600 occupants 24 hours a day, the facility sees 30 years of wear-and-tear in 10 years time compared to an average building. With this compression of life cycle comes substantial cost to maintain the systems to provide the utmost in reliability and patient control.

There are critical aspects to appropriate transitioning of new security technologies with staff that were transfixed with technologies dating to the 1960s that looked more like a group of old submarine turrets — with little information compared to what appears today in modern security control centers.

The elements of transition included commissioning of security and fire alarm systems to provide as close to 100-percent accuracy, reliability and functionality as possible. With this came the production of the security policies, procedures and post orders along with security training during two weeks of highly intensive shift training. As-records were provided in CAD format to be able to drill down and magnify site elements and equipment through a Help Desk, or Knowledge Center, as Gilbane Company calls it. PSE and Gilbane worked with our staff to provide these staff-sensitive transition services over the course of 18 months.

Leveraging Advanced Technology

Here are some of the advantages of innovating behavioral health by incorporating maximum security and life safety management:

• Multiple zoned security levels with contiguous life safety protection for mass evacuation and shelter-in-place.
• Clear and concise reporting, recording and response.
• Systems integration based on each system being independent from the access control and monitoring system to increase reliability in unexpected events.
• Improved patient care, staff safety and community/consumer involvement.
• Facilitation of mental health management to the community-at-large in the event of a natural disaster or terrorist action.

Return on Investment

For every opportunity, there is a cost. The opportunity was to provide an infrastructure and facility that replaced buildings that were from mid-20th century and even post-Civil War structures while incorporating new behavioral strategies. The return on investment probably cannot be measured against any strict rule based on its technology cost or other hard physical security or life safety cost. In fact, most facilities’ operational costs far outweigh the traditional “bricks and sticks” values placed on buildings.

Because the return on investment is both relative and easily justifiable, a percentage cost of approximately 9 percent of the project’s value for the physical security, electronic security, fire alarm and installation cost does not seem unreasonable. In this case, the hard costs for facility were $165 million with a system materials and installation cost approaching $15 million.
Saint Elizabeth’s and the Department of Mental Health’s management is ecstatic with the results of almost six years of planning, design and construction of an innovative facility. This is reflected in the unprecedented number of requests for tours to mark its success.

Richard Warsh is Director of Facility Planning for the Washington D.C. Department of Mental Health. The Security Innovation Award is an annual competition held by STE magazine. The winning projects are chosen by a panel of security industry experts. For more details or to learn about entering next year’s competition, contact editor Steve Lasky at steve.lasky@cygnus.com.

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