FGI in Texas

Texas is one of only four states that does not use Facility Guidelines Institute (FGI) standards in any official capacity. FGI provides guidance on health and residential care facility planning, design, and construction in the United States. 

Since 2007, Texas has utilized its own design and construction requirements for the licensing of healthcare facilities in the state of Texas. Originally issued and enforced under the Texas Department of State Health Services, the requirements are now enforced by the Texas Health and Human Services Commission (HHSC).

Despite some modifications, the state’s healthcare industry codes can’t keep up at the same pace as FGI, which is updated in four-year cycles, with the next release scheduled for this year.

FGI has been used as a reference for healthcare facilities and has been used as an alternate path for licensing for state funded institutions for certain facility types, and for the past few years, the state of Texas itself has teased that it will be incorporating FGI guidelines in the future. What could this transition look like and when would it go into effect? 

Let’s take a deeper dive into how FGI standards within the state of Texas. 

In this article we will discuss:

  • What is FGI?
  • The History of FGI in Texas
  • The COVID Setback
  • Where Are We Now?

What is FGI?

The Facility Guidelines Institute (FGI) is an independent, not-for-profit organization that provides guidance on health and residential care facility planning, design, and construction in the United States. FGI consolidates all of its documents in one convenient place to be utilized by all.

FGI is comprised of 10 Board of Directors and 8 Staff members. Every four years, the organization assembles a panel of qualified healthcare experts from all across the United States to debate, discuss, and revise FGI’s documents. 

According to FGI’s website, “The Guidelines consensus process includes public input, research, and thorough debate of issues affecting the planning, design, and construction of the health care and residential health, care, and support built environment.”

As it stands, FGI is the industry’s most recognized standard for healthcare planning and design. 

Currently, 43 U.S. states have adopted some editions of the Guidelines, while three more states have not adopted, but allow use of the Guidelines as an alternate path to compliance. Texas is among the last four states to not use the Guidelines in any official capacity, although FGI documents can be used for reference.

History of FGI in Texas

In 2019, Texas first announced that it was planning to adopt a version of the FGI guidelines with amendments. This announcement came as no surprise to most health systems and AEC professionals. 

Due to the growth of healthcare systems in Texas, there became a push to adopt FGI to make it consistent across national organizations and to provide healthcare facilities in Texas the opportunity to gain efficiencies in the program requirements due to the differences in the current HHSC and FGI guidelines. 

The COVID Setback

The Texas healthcare industry was on pace to adopt FGI guidelines with amendments in 2020; however, no one could have predicted that a world-wide pandemic would make its debut at the beginning of the year. COVID-19 presented unique challenges that put those plans on hold. 

The biggest challenge that contributed to the delay was the need for consistency. Hospitals and clinics were facing an unknown virus with unknown repercussions. Hospital administration and staff were figuring out medical solutions and solving overcrowding issues on a daily basis. The need for consistency during COVID-19 was paramount, and understandably so, the planned transition to FGI took a backseat. 

Where Are We Now?

Where does that leave us now? COVID-19 is still a major medical concern and plays a huge role in healthcare considerations moving forward. Looking towards the future of healthcare in Texas, the state will now incorporate the FGI guidelines into its current licensing requirements.

HHSC plans to issue the new guidelines sometime late 2022 or early 2023, barring any setbacks or time delays. The changes to the healthcare guidelines and codes will not happen all at once. In fact, the adoption will happen gradually over the next few years giving healthcare entities and AEC professionals adequate time to get familiar with the new system.

By Samantha Bower, Marketing Specialist

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