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  East Texas Community Health ServicesEast Texas Community Health Services


Page Southerland Page, LLP
1100 Louisiana Street, #1, Houston, TX 77002

General Description

Location: Nacogdoches, Texas
Date Bid: Oct 2009 Construction Period: Oct 2009 to Dec 2010
Total Square Feet: 12,500 Site: 3 acres Number of Buildings: One
Building Size: First floor, 12,500; total, 12,500 square feet.
Building Height: First floor, 12’; total, 12’.
Basic Construction Type: Renovation.
Foundation: Existing. Exterior Walls: Existing. Roof: Existing.
Floors: Existing. Interior Walls: Wood stud drywall.
Projected and/or modeled energy usage: KBTU/SF/yr=$87.20.

Construction Team

Mechanical & Electrical Engineer: Page Southerland Page, LLP - 1100 Louisiana Street, #1, Houston, TX 77002
General Contractor: Moore Building Associates, Inc. - P. O. Box 153055, Lufkin, TX 75915

East Texas Community Health Services (ETCHS) is a federally qualified health center providing comprehensive primary health care for the underprivileged and medically underserved of Nacogdoches County, Texas and surrounding counties. When the organization outgrew its existing facilities, it acquired an adjacent building and chose Page Southerland Page as the architect/engineer.

This project converted 12,500 square feet of a former day care facility into a community clinic. The renovation required the removal of all walls except the main corridor walls in order to accommodate clinical areas. The exterior of the facility remains unchanged, focusing all the available funds on areas for patient care.

The new clinic includes thirty-one exam rooms, seven provider offices, and is divided into four nursing pods: pediatrics, women's services and two for general medicine. A typical pod contains a waiting area, nurse station, toilet, two provider offices and nine exam rooms' four exam rooms per provider plus one swing room. Each pod was designed to increase visibility between the staff and the patients in the waiting area. The clinic also contains a pharmacy, laboratory, administration area, staff lounge and space for a future x-ray unit.

Robin L. Moore, MPA, CEO of ETCHS, said, "I like the way the pods are set up, especially the privacy of the cubicles at the entry for Eligibility Discussions with the patients. We changed the process so patients can check-in at the front desk and go directly to their provider's pod to wait for their appointment. The staff is more sensitive to the number of patients they have since the waiting area is for one to two providers. Each pod is more accountable for their activity, and patients have a better view of the reality of the process."

A portion of the project was supported with funds from the Recovery Act Grant through the Health Resources and Services Administration. The use of federal funds required that the project meet or exceed the National Energy Standards, so a new HVAC system was selected which exceeds the old system by approximately 30%. The new HVAC system also divides the facility into 10 zones, providing better control by each nursing pod. The electrical system was also replaced, including the addition of a natural gas generator. All existing light fixtures were replaced with energy efficient units which also allowed the total number of fixtures to be reduced. Since there was no waterproof membrane below the existing slab, and due to the high moisture content in the slab on grade, ceramic tile flooring was used in the majority of the areas.

Page Southerland Page, Moore Building Associates, and the MEP subcontractors worked closely throughout the process to meet the owner's goals and the energy efficiency requirements while also identifying value added savings.

The interior color palette was chosen to be neutral and soothing, punctuated by artwork, colored panels and wood-grained laminate. The main corridor is terminated with a pair of glass doors to bring daylight deep into the building and provide views of the outdoors for every patient going to and from the pods.

Moore said, "We are very proud of this facility, and I appreciate Page Southerland Page. We started with a larger budget of 6 million, which had to be reduced to 1 million. Page Southerland Page helped us to see what could be, and gave us the start of the feel of a real clinic."

Product Information
Flooring: Mannington
Lighting: Lithonia

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