VA Capitol Health Care Network (VISN 5) Department of Veterans Affairs, VHA Construction Program Overview

VA Capitol Health Care Network (VISN 5)Department of Veterans Affairs, VHAConstruction Program OverviewPresentation to Society of American Military Engineers (SAME)28 February 2014

Presented By:Pedro E. Garcia, VISN 5 Capital Asset Manager (CAM)

Integrity Commitment Advocacy Respect Excellence

VETERANS HEALTH ADMINISTRATION

What we do

• Capital Asset Management Office:– Network oversight & support as needed:

• Construction projects and leases• Energy Program• Facilities Management Operations• Biomedical Engineering• RTLS Implementation• Vehicle Fleet Management & Acquisitions

– Capital Asset Master Planning• Partnership with Strategic Planning & IT Offices


VISN 5 - At a Glance

3

Martinsburg VAMC

Representation & Key Facts• 8 Senators• 17 Congressional

Districts• 9 Vet Centers

Washington DC VAMC

Medical Center Locations

Baltimore VAMC

Perry Point VAMC


VISN 5 – At a Glance

Pre-Decisional/Not for Public Release FY 2013 Mid-Year Budget Review – VISN 5 4

> Square Miles: 19,269> Veteran Enrollees: 227,183> States: 04*> VAMCs: 04> CBOCs: 18> Vet Centers: 12> State Veterans Homes: 01> VBA Regional Offices: 02> National Cemeteries: 06> State Veteran Cemeteries: 05*District of Columbia not included



5

Geography• 19,269 square miles• 4 States and the District of

Columbia• 4 Medical Centers• 18 CBOCs• 4 Community Living

Centers• 2 Domiciliaries

Representation & Key Facts• 8 Senators• 15 Congressional Districts• 12 Vet Centers• 1 State Veteran Home• 2 VBA Regional Offices• 6 National Cemeteries• 5 State Veterans

Cemeteries

Partners & Affiliates• 11 Public Housing Authorities• 8 Medical School Affiliates• 80 VSO Partners• 4 National Unions-10 Locals• Department of Defense

• 4 Co-located CBOCs w/ MTF

• 8 IDES Sites• 2 JIFs

Key Facts

Veteran Centric



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FY2012 Care Delivery

Facility Complex. Acute Beds

Long Term Care

BedsDom Beds CBOCs FY 2012

UniquesFY 2012

Outpatient Visits

FY 12 Admissions (Acute and

LTC)

FY 12 Acute BDOC

VISN 5 482 561 505 18 148,642 1,796,394 16,984 116,528

VA Maryland Health Care

System1B 236 263 193 6 53,169 639,305 6,719 53,025

Martinsburg VAMC 2 71 178 312 7 33,992 462,972 3,123 15,643

Washington DC VAMC 1B 175 120 0 5 68,828 694,117 7,142 47,860


Transformation Strategy

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Capital Investment Strategy

8

VISN-wide CAMP

Veteran Population & Enrollees

VA Strategic Plan

VA Healthcare Delivery Model

VHA Strategic Plan

VISN Strategic Plans

• Focus on identifying overall health outcome goals for enrolled patients relying on VHA for health care and eligible Veteran population and enrolled patient population.

• Recognizes that the VISN is the operational center for delivering healthcare to Veterans.

• Capital Assets are defined as:– Construction Projects / Leases– Medical & Non-Medical Equipment– Virtual Care Technologies– Information Technology– Vehicle Fleet

VISNCapitalAsset

Management Plan (CAMP)

VETERANS HEALTH ADMINISTRATION 9

Strategic Capital Investment Planning (SCIP) process

• 10-year Construction/Lease Plan: FY 2016 – 2025

• SCIP is intended to be an integrated comprehensive planning process for capital programs across all Administrations

• The overarching goal of SCIP is to establish an improved corporate approach to prioritizing all VA capital investments and to ensure investments are targeted to reduce existing gaps based on projected utilization/workload and other data-driven infrastructure gaps

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CAMP-SCIP Strategic Capital Focus Areas

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1. Safety

2. End Homelessness

3. Virtual Hospital Expansion

4. Improve Environment of Care

5. Home Based Primary Care (HBPC) Expansion


CAMP-SCIP Strategic Capital Focus Areas

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6. Expand VA/DoD Partnerships

7. Medical Equipment safety, standardization & replacement plan

8. Vehicle Fleet Plan

9. Energy Plan to reduce consumption

10. Increase Research Program Integration


Special Focus Areas

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• Mission Critical Utility Sustainment Survey

• Physical Security Vulnerability Assessments

• Electrical Studies

• Hurricane Readiness Study (Perry Point)

• Steam Generation Special Studies (Perry Point & Martinsburg)


Existing Gaps

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Access

• Enrollees w/in Access Guidelines – Drive time:

– Washington: 83%

– VAMHCS: 80%

– Martinsburg: 70%


Existing Gaps

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Baltimore Baltimore - LR Perry Point Martinsburg Washington VISN Total

Primary Care (% Met)

83% 93% 89% 97% 93% 91%

Specialty Care(% Met)

91% 93% 93% 96% 96% 94%

Wait Time


Existing Gaps

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VAMHCS Martinsburg Washington VISN TotalSupplies-Equip-Prosthetics 64% 87% 96% 78%Amb: LTC Non-Institutional 69% 64% 75% 70%Amb: Dental Clinic 47% 37% 40% 42%Pharmacy 30% 29% 42% 33%Amb: Med. & Othr Non-Surg Special. 31% 26% 37% 32%Amb: Mental Health Programs 23% 37% 22% 26%Amb: Surgical Specialties 22% 26% 29% 26%Amb: Prim Care-Geriat.-Urgent Care 18% 25% 28% 23%Amb: Laboratory and Pathology 20% 25% 25% 23%Amb: Radiology and Nuclear Medicine 16% 27% 27% 23%Inpatient LTC 12% -2% 43% 19%Inpat. Resident. Rehab Mental Health Prog. -10% 4% -1% -2%Acute Inpatient Surgery -12% -8% -17% -14%Acute Inpatient Mental Health -33% -48% -31% -35%Acute Inpatient Medicine -16% -19% -19% - 19%

Utilization

FY22 Projection change from FY12 Baseline


Existing Gaps

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Baltimore(SF)

Baltimore-LR(SF)

Perry Point (SF)

Martinsburg(SF)

Washington(SF)

VISN Total(SF)

Common/Swing/Construction 281,070 49,860 (246,032) 107,905 218,748 411,551 (18%)Outpatient Specialty Care 30,530 7,614 14,107 34,391 90,020 176,662 (30%)Outpatient Mental Health 6,865 2,141 (24,301) 36,222 76,158 97,085 (32%)Primary Care 59,249 7,255 (18,162) 23,474 20,835 92,650 (24%)Research 103,936 (15,250) 0 0 4,419 93,104 (35%)Ancillary/Diagnostic 26,316 (9,490) (15,033) 39,884 28,766 70,442 (15%)

Acute Inpatient Mental Health 10,965 0 (48,542) (11,831) 14,460 (35,048) (-13%)LTC: CLC / Hospice 0 53,515 (75,497) (44,224) 18,833 (47,373) (-11%)Administration (18,414) 16,138 (48,250) 10,454 21,533 (18,539) (-5%)

Acute Inpat. Med. & Surgery 11,215 0 (7,624) 8,002 (29,804) (18,211) (-10%)

Support/Infrastructure 19,036 8,500 (156,580) 32,613 84,391 (12,041) (-2%)

Total: 530,768 120,283 (625,914) 236,890 548,257 810,282 (13%)

Space


Existing Gaps

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Baltimore Baltimore-LR Perry Point Martinsburg Washington VISN Total

Mechanical $11,560,626 $412,515 $30,581,539 $18,094,656 $32,236567 $92,985,902Architectural $2,467,454 $1,760,714 $15,967,860 $19,420,911 $26,633,020 $66,249,958Electrical $6,558,633 $1,239,357 $17,186,080 $14,743,610 $12,419,329 $52,147,009Plumbing $501,663 $547,481 $12,485,858 $5,291,173 $8,497,247 $27,323,421Hazmat $0 $0 $2,161,299 $6,240,973 $2,404,566 $10,806,838Transport $1,730,373 $0 $3,298,934 $1,311,007 $777,686 $7,117,999

Energy $0 $32,221 $0 $4,088,983 $1,662,639 $5,783,842

Water $0 $838,831 $1,342,459 $1,752,421 $208,568 $4,142,279

Sanitary $0 $0 $1,284,712 $0 $2,233,478 $3,518,190

Access $54,098 $241,416 $1,162,034 $993,196 $392,961 $2,843,707

Storm Water $0 $123,615 $1,853,769 $90,470 $35,650 $2,103,505

Structural $0 $0 $1,276,847 $312,655 $0 $1,589,502

Steam Gen $0 $0 $365,762 $68,761 $0 $434,523

Info. Tech. $0 $0 $13,791 $353,200 $17,507 $384,498

Total: $22,872,846 $5,196,150 $88,016,752 $73,726,209 $87,619,217 $277,431,174

Facility Conditions


Existing Gaps

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Baltimore Baltimore-LR Perry Point Martinsburg Washington VISN Total

Sustainability (# of Bldgs Required) 1 1 7

(met w/ 8)6 1 16

Energy Efficiency (Btu / Facility SF –

% Gap met)42,860 (57%)

Combined w/ Baltimore

67,993 (68%)

35,648 (31%)

12,136 (8%)

158,637 (36%)

Water Efficiency (Gallons/Facility SF –

% Gap met)43

(182%)Combined w/

Baltimore17

(38%)0

(met)10

(30%)70

(69%)

GHG Emission (Metric Tons –% Gap met)

4,048 (27%)

Combined w/ Baltimore

3,980 (27%)

8,111 (53%)

3,709 (20%)

19,828 (31%)

Renewable Energy (kWh) 5,162,685

Combined w/ Baltimore 3,809,385 4,438,451 5,793,609 19,204,130

Energy


Existing Gaps

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Functional & Other

• Patient Privacy

• Parking

• Sterile Processing System (SPS) Criteria

• OR Criteria

• EoC Patient Safety & Security Compliance

• NFPA – OSHA Criteria

• ADA Access Criteria


Vision for FY 2014

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Project Location Estimated Size

Construct CLC Residential Houses (Major) Perry Point Under $100 M

New or Expanded CBOCs TBD TBD

CLC & Hospice Expansions DC, LR, MB Under $ 10 M

Medical / Psych Ward & ICU Renovations DC / BT Under $ 10 M

Construction 47-Bed Domiciliary Martinsburg Under $ 10 M

Upgrade Fire Alarm System Perry Point Under $ 20 M

Upgrade Electrical Distribution DC, MB Under $ 5 M

Upgrade Chiller Plant / BoilerDC / Perry

Point Under $ 10 M

FY 2015 / 2016 Forecast


Vision for FY 2014

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Multi-Award Task Order Contract (MATOC) VISN-wide $5 M

Equipment Planning VISN-wide Under $ 1 M

Construct Dementia Unit (CON) Martinsburg Under $ 10 M

Managed Care / ED Improvements & Enrollment Center (CON) Baltimore Under $ 10 M

Construct Two 12-Bed CLC Residential Wings (DES) Martinsburg Under $ 10 M

Construct Dental & Audiology Outpatient Center (DES) Martinsburg Under $ 10 M

FY 2014 Forecast


Vision for FY 2014

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Construct Warehouse (DES) Perry Point Under $ 10 M

Renovate Sterile Processing (DES) Washington Under $ 5 M

Renovate Rest Rooms BT, DC Under $10 M

Misc. Halls & Walls Projects BT, LR, DC Under $ 5 M

Install New Emergency Generators Martinsburg Under $ 5 M

HVAC Maintenance, Upgrades & Retro- Commissioning

BT, LR, PP, DC, MB Under $ 10 M

Retrofit CLC for ADA Compliance Perry Point Under $ 1 M

FY 2014 Forecast (Cont’d)


Vision for FY 2014

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MRI Site Prep Perry Point Under $ 1 M

OR Hybrid Conversion Martinsburg Under $ 1 M

Linear Accelerator Site Prep Washington Under $ 2 M

Nurse Call Replacements PP, MB Under $ 5 M

FY 2014 Forecast (Cont’d)


Additional Information Capital Asset Management• Pedro Garcia

– VISN 5 Capital Asset Manager– [email protected]– 410-691-7814

• Steve Reinert– VISN 5 Energy Manager– [email protected]– 410-691-0603

• Ann Valliyakalayil– VISN 5 RTLS Manager / Biomedical Engineer– [email protected]– 410-691-7302

mailto:[email protected]




Additional Information Contracting• Scott Sands

– VISN 5 Director of Contracting– [email protected]– 202-579-6098

• Donyale Smith– VISN 5 Deputy Director of Contracting– [email protected]– 410-303-9640




Additional Information Contracting (cont’d)

• Kandi McDonald– Construction Team Manager – MD/Martinsburg, WV– [email protected]– 410-642-2411 ext. 2920

• Harry Parker

– Construction Team Manager - DC– [email protected]– 202-745-8000 ext. 58408




Questions

27

Documents

VA Capitol Health Care Network (VISN 5) Department of Veterans Affairs, VHA Construction Program Overview