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Large mechanical renovations are always a challenge, especially when a building transitions into a new use. Add to that the invariable space and budget limitations associated with such projectsand the challenge becomes even more difficult. This was the case at Howard Regional Health Systems in Kokomo, Ind. The hospital had purchased an existing three-level, off-campus building to house a new outpatient behavioral health and disaster recovery data center that would serve as backup to the hospital’s main data center. A $20 per ft2 ($215 per m2) budget for the mechanical HVAC system with other critical owner requirements forced designers to consider some less than conventional alternatives to a traditional VAV scheme.