1. Section 106 Consultation Meeting Veterans Integrated Service Network 10 (VISN 10) Louis Stokes Cleveland VA Medical Center Jack Hetrick, FACHE Network Director Ronald Stertzbach, P.E. Capital Asset Manager August 9, 2011

2. Agenda 1. Department of Veterans Affairs (DVA) Organization 2. VISN 10 at a Glance 3. VA Appropriations 4. VISN 10 Operating & Capital Funding 2

3. Veterans Health Administration

4. VISN 10 at a Glance  VAMC: 4  VAACC:1  CBOC: 31  Owned Buildings: 212  Historic Buildings 105  Owned Land: 708 acres  FY 2011 Funding Allocation: $1.7 billion 4

5. VISN 10 at a Glance FY10 VISN VetPop, Enrollment, Market Share and Patients Veteran Population (Projected) Enrollees (Actual) Enrollment Based Market Share (Enrollees to VetPop) Patients (Actual) 836,357305,51336%199,308 5

6. VISN 10 at a Glance (Cont.) 5,752,376 GSF 6

7. DVA Fiscal Year 2011 Appropriations 7

8. VISN 10 Fiscal Year 2011 Funding Allocations 8

9. VISN 10 Fiscal Year 2011 Capital Budget 9

10. VA Construction Programs  Major Construction Project Cost > $10M for improvements to medical centers and/or new construction No upper limit CARES Tower – $ 102 Million dollars to relocate 233 patient beds from Brecksville to Wade Park and to create a Comprehensive Rehab Center Authorization / Appropriation (2 separate, required actions by Congress) Fund is “No Year” (available until expended; exception: specific statutory language, eg. hurricane supplemental) The VISNs submit major projects during Strategic Capital Investment Planning process (SCIP) VA Central Office prioritizes and selects projects based on criteria such as safety & security, VA’s major planning initiatives, increasing access, etc.  Minor Construction Project cost < $10M and must construct at least $500K in new building space (exception: Seismic can be 100% renovation) Project Examples:  Radiology Phase 1 & 2  Lab / Warehouse Phase 1 & 2  Parking Garage Expansion  Ambulatory Care Addition Phase 1 $ 2  PALMS project (out for bid)  Surgery Addition (out for bid)  Emergency Room Addition The VISNs submit minor projects during Strategic Capital Investment Planning process (SCIP) VA Central Office prioritizes and selects projects based on criteria such as safety & security, VA’s major planning initiatives, increasing access, etc. 10

11. VA Construction Programs (Cont.)  Non-Recurring Maintenance (NRM) Total Project Cost Limits:  Cannot exceed $500,000 in new building space  Cannot exceed $10M for renovations  No upper limit for project total on pure utility/building system projects or pure demolition Recent NRM Projects:  Canteen Renovations  Chapel Renovations  Renovate Connecting Corridor The VISNs submit NRM projects during Strategic Capital Investment Planning process (SCIP) VA Central Office prioritizes and selects projects based on criteria such as safety & security, VA’s major planning initiatives, increasing access, etc.  High Profile Clinical Improvements (HPCI) Projects that address specific clinical initiatives and add at least $500,000 in new building space Exception: High Cost Equipment Site Prep can be 100% renovation, but project total must be > $500K Recent HPCI Construction Projects: Palliative Care Renovations Maximum project total cost is $5M The VISNs submit minor projects during Strategic Capital Investment Planning process (SCIP) VA Central Office prioritizes and selects projects based on criteria. 11

12. Planned Capital Projects 12

13. Facility Condition Assessment (FCA) D’s & F’s FY 2010 FCA Correction Costs  Chillicothe- $112 million  Cincinnati- $ 34 million  Cleveland- $105 million  Dayton- $ 55 million  Columbus- $ 0 million VISN 10 Total- $306 million 13

14. Questions 14