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

2. 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

3. VISN 5 - At a Glance Medical Center Locations Martinsburg VAMC
Baltimore VAMC
Perry Point VAMC
Representation & Key Facts
8 Senators
17 Congressional Districts
9 Vet Centers
Washington DC VAMC

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

5. VISN 5 - At a Glance Key Facts Veteran Centric 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
Veteran Centric

6. FY 12 Admissions (Acute and LTC) VA Maryland Health Care System
VISN 5 - At a Glance
FY2012 Care Delivery
Facility
Complex.
Acute Beds
Long Term Care Beds
Dom Beds
CBOCs
FY 2012
Uniques
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 System 1B
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
175
120 5
68,828
694,117
7,142
47,860

7. Transformation Strategy

8. Capital Investment Strategy
VISN-wide CAMP
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
VISN
Capital
Asset
Management Plan (CAMP)
VISN Strategic Plans
VHA Strategic Plan
VA Healthcare Delivery Model
VA Strategic Plan
Veteran Population & Enrollees

9. Strategic Capital Investment Planning (SCIP) process
* Pre Decisional Draft
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 9
June 4, James M. Sullivan

10. CAMP-SCIP Strategic Capital Focus Areas
Safety
End Homelessness
Virtual Hospital Expansion
Improve Environment of Care
Home Based Primary Care (HBPC) Expansion

11. CAMP-SCIP Strategic Capital Focus Areas
Expand VA/DoD Partnerships
Medical Equipment safety, standardization & replacement plan
Vehicle Fleet Plan
Energy Plan to reduce consumption
Increase Research Program Integration

12. Special Focus Areas Mission Critical Utility Sustainment Survey
Physical Security Vulnerability Assessments
Electrical Studies
Hurricane Readiness Study (Perry Point)
Steam Generation Special Studies (Perry Point & Martinsburg)

13. Existing Gaps Enrollees w/in Access Guidelines – Drive time:
Washington: 83%
VAMHCS: 80%
Martinsburg: 70%

14. Existing Gaps Wait Time Baltimore Baltimore - LR Perry Point
Martinsburg
Washington
VISN Total
Primary Care
(% Met)
83%
93%
89%
97%
91%
Specialty Care
96%
94%

15. FY22 Projection change from FY12 Baseline
Existing Gaps
Utilization
VAMHCS
Martinsburg
Washington
VISN Total
Supplies-Equip-Prosthetics
64%
87%
96%
78%
Amb: LTC Non-Institutional
69%
75%
70%
Amb: Dental Clinic
47%
37%
40%
42%
Pharmacy
30%
29%
33%
Amb: Med. & Othr Non-Surg Special.
31%
26%
32%
Amb: Mental Health Programs
23%
22%
Amb: Surgical Specialties
Amb: Prim Care-Geriat.-Urgent Care
18%
25%
28%
Amb: Laboratory and Pathology
20%
Amb: Radiology and Nuclear Medicine
16%
27%
Inpatient LTC
12%
-2%
43%
19%
Inpat. Resident. Rehab Mental Health Prog.
-10% 4%
-1%
Acute Inpatient Surgery
-12%
-8%
-17%
-14%
Acute Inpatient Mental Health
-33%
-48%
-31%
-35%
Acute Inpatient Medicine
-16%
-19%
- 19%
FY22 Projection change from FY12 Baseline

16. Existing Gaps Space Baltimore (SF) Baltimore-LR Perry Point
Martinsburg
Washington
VISN Total
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)
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
(48,542)
(11,831)
14,460
(35,048) (-13%)
LTC: CLC / Hospice
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
(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%)

17. Existing Gaps Facility Conditions Baltimore Baltimore-LR Perry Point
Martinsburg
Washington
VISN Total
Mechanical
$11,560,626
$412,515
$30,581,539
$18,094,656
$32,236567
$92,985,902
Architectural
$2,467,454
$1,760,714
$15,967,860
$19,420,911
$26,633,020
$66,249,958
Electrical
$6,558,633
$1,239,357
$17,186,080
$14,743,610
$12,419,329
$52,147,009
Plumbing
$501,663
$547,481
$12,485,858
$5,291,173
$8,497,247
$27,323,421
Hazmat $0
$2,161,299
$6,240,973
$2,404,566
$10,806,838
Transport
$1,730,373
$3,298,934
$1,311,007
$777,686
$7,117,999
Energy
$32,221
$4,088,983
$1,662,639
$5,783,842
Water
$838,831
$1,342,459
$1,752,421
$208,568
$4,142,279
Sanitary
$1,284,712
$2,233,478
$3,518,190
Access
$54,098
$241,416
$1,162,034
$993,196
$392,961
$2,843,707
Storm Water
$123,615
$1,853,769
$90,470
$35,650
$2,103,505
Structural
$1,276,847
$312,655
$1,589,502
Steam Gen
$365,762
$68,761
$434,523
Info. Tech.
$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

18. Water Efficiency (Gallons/Facility SF – Renewable Energy (kWh)
Existing Gaps
Baltimore
Baltimore-LR
Perry Point
Martinsburg
Washington
VISN Total
Sustainability
(# of Bldgs Required) 1 7
(met w/ 8) 6 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 – 43
(182%) 17
(38%)
(met) 10
(30%) 70
(69%)
GHG Emission
(Metric Tons –
4,048
(27%)
3,980
8,111
(53%)
3,709
(20%)
19,828
Renewable Energy (kWh)
5,162,685
3,809,385
4,438,451
5,793,609
19,204,130

19. Existing Gaps Patient Privacy Parking
Functional & Other
Patient Privacy
Parking
Sterile Processing System (SPS) Criteria
OR Criteria
EoC Patient Safety & Security Compliance
NFPA – OSHA Criteria
ADA Access Criteria

20. FY 2015 / 2016 Forecast Vision for FY 2014
Project
Location
Estimated Size
Construct CLC Residential Houses
(Major)
Perry Point
Under $100 M
New or Expanded CBOCs
TBD
CLC & Hospice Expansions
DC, LR, MB
Under $ 10 M
Medical / Psych Ward & ICU Renovations
DC / BT
Construction 47-Bed Domiciliary
Martinsburg
Upgrade Fire Alarm System
Under $ 20 M
Upgrade Electrical Distribution
DC, MB
Under $ 5 M
Upgrade Chiller Plant / Boiler
DC / Perry Point
Vision for FY 2014

21. FY 2014 Forecast Vision for FY 2014
Project
Location
Estimated Size
Multi-Award Task Order Contract (MATOC)
VISN-wide
$5 M
Equipment Planning
Under $ 1 M
Construct Dementia Unit (CON)
Martinsburg
Under $ 10 M
Managed Care / ED Improvements &
Enrollment Center (CON)
Baltimore
Construct Two 12-Bed CLC Residential
Wings (DES)
Construct Dental & Audiology Outpatient
Center (DES)
Vision for FY 2014

22. FY 2014 Forecast (Cont’d) Vision for FY 2014 Construct Warehouse (DES)
Project
Location
Estimated Size
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
Install New Emergency Generators
Martinsburg
HVAC Maintenance, Upgrades & Retro-
Commissioning
BT, LR, PP, DC, MB
Retrofit CLC for ADA Compliance
Under $ 1 M
Vision for FY 2014

23. FY 2014 Forecast (Cont’d) Vision for FY 2014 MRI Site Prep Perry Point
Project
Location
Estimated Size
MRI Site Prep
Perry Point
Under $ 1 M
OR Hybrid Conversion
Martinsburg
Linear Accelerator Site Prep
Washington
Under $ 2 M
Nurse Call Replacements
PP, MB
Under $ 5 M

24. Additional Information Capital Asset Management
Pedro Garcia
VISN 5 Capital Asset Manager
Steve Reinert
VISN 5 Energy Manager
Ann Valliyakalayil
VISN 5 RTLS Manager / Biomedical Engineer

25. Additional Information Contracting
Scott Sands
VISN 5 Director of Contracting
Donyale Smith
VISN 5 Deputy Director of Contracting

26. Additional Information Contracting (cont’d)
Kandi McDonald
Construction Team Manager – MD/Martinsburg, WV
ext. 2920
Harry Parker
Construction Team Manager - DC
ext

27. Questions