Best Practices for Project Management, Design, and Construction of ...

and help in determining the cause of any delays that may occur during the plan review
process. This is a natural component of integrated project delivery.
• Retain a designer based on factors other than just a presentation by a firm’s marketing
representative. If any team members working on your project leave the design team during
your project, stipulate in your contract that the replacement will have similar design and
OSHPD experience and that the hospital owner has final sign-off on a replacement being
assigned to your project.
Best Practice 5b: Develop a full understanding of the regulatory environment that affects
your project.
OSHPD has control over construction of your acute care building and certain aspects outside of it,
but it may not be the only public agency involved given the nature of your project. All construction
that adds floor area to your hospital will require some level of review by your local planning
department for a California Environmental Quality Act (CEQA) and land use review, and it is
possible for multiple jurisdictions to be involved in non-OSHPD permitting. Lastly, all projects
should be completed with the ultimate goal of achieving licensure by the California Department of
Public Health.
Determine the entire breadth of regulatory oversight with your design and legal consultants before
undertaking your project. Incorporate the time required for all reviews, approvals and permits
when setting you project schedule.
Land Use Approvals and CEQA
No land in California is zoned for hospital use. New hospitals, or additions to existing facilities
must go through a local review and approval process intended to create an entitlement to build a
new hospital building. The local planning department will review your application to determine
what local approvals might be required. The entitlement process may take longer than the
OSHPD plan review and permitting process, and as such, may become the critical path toward
commencement of construction. Because of the complexity of entitlement issues, many hospitals
will retain a qualified land use attorney with experience, preferably but not necessarily one with
experience in working with the particular jurisdiction in question.
At a minimum, the local planning department will review your land use application to determine
consistency with adopted general or specific development plans that include the property in
question to determine what modifications to those documents might be necessary to support the
proposed project. The planning department is also responsible for environmental review under
CEQA. A preliminary review will be conducted to determine the potential effects to the
environment; the initial review may result in a declaration that there are no impacts (“Negative
Declaration”), that impacts can be reduced to nothing by requiring the project to undertake
prescribed mitigations (“Mitigated Negative Declaration”) or that the project may have significant
impacts that require a full or partial Environmental Impact Report (EIR).
Development, review and approval of an EIR is a public process under the control of the local
planning department and is intended to give the public opportunity to raise concerns about the
(OSHPD Best Practices) Page 91 DRAFT FINAL, Sept. 2011