Yeah, no one really likes to think about money- being materialistic offends our design sensibilities. BUT, nothing gets built without incurring cost to both design and construct. And if there is no money to operate the facility, that isn't going to help much either. Fortunately, most healthcare projects have donors. Donors can actually be a powerful tool if you can involve them in the design process and really get them excited about the ideas that are the basis for the design. The dreaded grim reaper that is value engineering can be kept at bay for more cherished ideas if they have a dedicated source of funding and if said source is really excited about seeing those ideas in action. I have worked with thrifty hospitals who gave naming rights to every room in a new dapertment just to keep the design features they wanted in the project in a time of major construtcion escalation. But to realize the bigger ideas in their full glory, start working from the beginning with your client to pull onboard some donors whose personal experiences/links to the organization will be a goof fit for your project and design approach. They may even be able to bring some greater insights and buzz to what you are trying to accomplish. Cha-ching!