Northwest Washington. A consolidation promises economies and sparks community opposition.
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A historical account is given of the Houston Academy of Medicine--Texas Medical Center Library within its Texas Medical Center setting in Houston, Texas. Outlined are planning, financing, and construction of the new library, which consists in part of new building and in part of renovated interiors of an old building originally completed in 1954. A concise picture is given of the new library's interiors, showing its functional success for users and employees alike. An architectural summary is appended showing gross and net footages, source of funds, costs and capacities.
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It's put-up-or-shut-up time for healthcare providers in 1996. Two years ago, everyone talked about fixing the healthcare system. Not much happened. Last year, providers and politicians concentrated on squeezing medical costs. According to some of Modern Healthcare's key beat reports, this year it's back to the basics of running a business.
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In 1987, the Health Care Financing Administration proposed adding capital cost reimbursement to the prospective payment system. A data base was developed from which an index was calculated to adjust for geographic variation in construction cost. Findings from the data base, along with a description of trends in health care facility construction from 1970 through 1986, are presented. Spending (in constant 1986 dollars) and volume of health care facility construction declined from 1970 to 1986. Construction cost per square foot increased until 1983, followed by a decline to pre-1980 levels after the 1983 implementation of the prospective payment system.
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The health sector is particularly vulnerable to naturally occurring events. The vulnerability of the health infrastructure (hospitals and clinics) is of particular concern. Not only are such facilities vulnerable structurally, but their ability to continue to provide essential functions may be severely compromised, thus leaving the stricken population without essential services. This paper summarizes a more detailed document, Guidelines for Vulnerability Reduction in the Design of New Health Facilities published by the Pan-American Health Organization (PAHO)/ World Health Organization (WHO). The current document summarizes these Guidelines emphasizing how they may be used, by whom, and for what purpose. Potential users of the Guidelines include, but are not limited to: (1) initiators of health facility construction projects; (2) executors and supervisors of health facility construction projects; and (3) financing bodies in charge of funding health facility construction projects. The Guidelines include: (1) implications of natural phenomena upon the health infrastructure; (2) guidelines for vulnerability reduction for incorporation into development project cycles; (3) definitive phases and stages within the phases for development projects including: (I) Projects Assessment (needs assessment; assessment of options, the preliminary project); (II) Investment (project design, construction); and (III) Operational Activities (operations and maintenance). In addition, investment in damage reduction measures, policies and regulations, training and education, and the role of international organizations in the promotion and funding of mitigation strategies are addressed.
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Healthcare organizations issuing tax-exempt bonds to finance the acquisition, construction, or renovation of their facilities often neglect to invest bond proceeds to gain the maximum allowable return. Bond indentures--documents that contain all the terms and provisions of the financing plan--generally spell out a number of options for investing bond proceeds.