Construction Planning Committee

2011 VA/DoD Joint Venture ConferenceOctober 2011

DoD/VA JOINT EXECUTIVE COUNCIL (JEC)

Construction Planning Committee (CPC)

DoD/VA HEALTH EXECUTIVE COUNCIL (HEC)

Communications Working Group (WG)

Last updated 3/8/11

DoD/VA INTERAGENCY PROGRAM OFFICE (IPO)

DoD/VA BENEFITS EXECUTIVE COUNCIL (BEC)

Pre-Discharge WG

Information Sharing / Information Technology

WG

Communication of Benefits & Services WG

Medical Records WG

Acquisition & Medical Materiel Management WG

Contingency Response WG

Continuing Education & Training WG

Credentialing Policy Ad Hoc WG

Deployment Health WG

Evidence-Based Clinical Practice Guidelines WG

Financial Management WG

Health Professions Education WG

Information Management Information Technology

WG

Interagency Clinical Informatics Board

Joint Facility Utilization & Resource Sharing WG

Psychological Health/ Traumatic Brain Injury WG

Patient Safety WG

Pharmacy Ad Hoc WG

Disability Evaluation System WG

Pain Management WG

DoD Recovery Coordination Program (RCP)*

Federal Recovery Coordination Program (FRCP)*

* Programs with JEC oversight

Separation Health Assessment WG*

Joint Executive Council

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CPC History and Current Charter

• Established in 2005 by VA/DoD Joint Executive Council (JEC)

• Serves as clearinghouse for joint VA/DoD capital asset initiatives recommended by any element of the JEC structure or Department-specific body

• Considers short-term & long-term strategic capital issues that are mutually beneficial to both Departments

• Provides a framework for capital guidance to elements of JEC

• CPC Meets Quarterly

• Two Sub Work Groups (Meets Monthly)– CPC Projects & Planning Work Group– CPC Budget, Policy and Legislation Work Group

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Why is CPC Important ?

• Window of opportunity for capital investment and facility related collaboration in multiple markets

• DoD and VA have a mandate* from Congress to consult with each other on all construction efforts and to evaluate sharing opportunities

• Reporting requirement to the JEC

• Significant Congressional Interest - reporting requirements (GAO, IG, HAC, SAC)

• VA/DoD Joint Strategic Plan (JSP) defines specific outcomes for CPC

*Pub. L. 108–375, div. B, title XXVIII, § 2811, Oct. 28, 2004, 118 Stat. 2128

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Construction Challenges

Significant differences in VA/DoD construction planning and programming currently impede Joint construction collaboration

• Although both are large, complex entities, they are organized differently and employ business processes unique to each

• Funding thresholds and funding timelines do not align well

• Neither Department has full-time staff specifically devoted to fostering improved capital collaboration

• More flexibility/authority for joint projects needed

• United States Code – DoD governed by Title 10, VA by Title 38

Example: Fort Bliss, Texas - Hospital Replacement Project

• DoD awarded the construction project in OCT 2009 with a construction completion targeted for MAR 2015

• VA funding for “All In” Concept of Operations to allow for separate Out-Patient areas and Combined In-Patient and Ancillary Services unable to be secured to meet DoD construction timeline

• Still a possibility to include VA when funding available

• Space Available on Medical Campus for future VA connection or stand alone facility

Construction Challenges

Legislative Initiative

Background

Current statutes constrain or preclude the Department of Veterans Affairs (VA) and Department of Defense (DoD) from capital investment in shared medical facilities for joint:

Planning and Design Major Construction

Leasing Minor Construction

Action

VA and DoD Offices of General Counsel drafted “like” legislation to overcome authorization, budget and appropriation limitations

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Legislative Initiative

GeneralVA has submitted language to OMB for consideration in the FY 13 Budget to change the definition of a shared medical facility and for authority to plan, design, construct, or lease a shared medical facility

DoD will submit language to allow DoD to enter into agreements with VA for planning, designing, construction, and/or leasing of shared facilities

MinorVA and DoD are both pursing language to allow for authority to transfer/receive funds and construct joint minor projects within its respective dollar threshold ($10M VA and $2M DoD)

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Legislative Initiative

Leasing

VA and DoD both will submit language for authority to transfer/receive funds and lease a shared medical facility

Major

VA and DoD will both seek authority to transfer/receive funds with the specific project authorization and appropriation language

Planning & Design

VA and DoD will both seek authority to transfer/receive planning and design funds

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Joint Infrastructure PlanningFY10-12

Current Endeavors FY13

Under ConsiderationFuture

Opportunities

Eglin, FLDoD Hospital (Eglin Hospital)VA CBOC (VA CBOC)

Beaufort, SCDoD Hospital (Beaufort Naval Hospital)VA CBOC (Beaufort VA Clinic)

Leavenworth, KSDoD Clinic (Ft Leavenworth Health Clinic)VA CBOC (Wyandotte CBOC)

Chicago, IL VA Hospital (James A Lovell VA Medical Center)

DoD Clinic (Navy Great Lakes)

Oahu, HIJoint Market Integrated DoD/VA Solution being considered

San Antonio, TXVA CBOC (Tejeda VA Clinic)DoD Clinic (Fort Sam Houston Clinic)

Anchorage, ALDoD Hospital (Elmendorf Hospital)VA CBOC (Anchorage Vet Center)

Fort Knox, KYDoD Hospital (Ireland Army Community Hospital) VA CBOC (Fort Knox Primary Care Clinic)

Killeen, TXDoD Clinic (Fort Hood Clinic)VA CBOC (Copperas Cove Clinic)

Panama City, FLVA CBOC (VA Panama City Beach Clinic)DoD Clinic (Panama City Navy Clinic)

Patuxent River, MDDoD Clinic (Naval Health Clinic Patuxent River) VA CBOC (VA CBOC)

American Lake, WAVA CBOC (Lakewood Clinic)DoD Clinic (JB Lewis McChord)

Aurora, COVA Hospital (Denver VA Medical Center)DoD Clinic (Buckley AFB Primary Care Clinic)

Results: Potential to increase joint capacity10

Re-Alignment of VA/DoD Infrastructure Planning

Challenge: There is no formal agreement or mechanism for sharing data, requirements, gaps, etc. to systematically identify dual presence and possible joint opportunities. VA/DoD also have different timelines, authorizations, approval processes, and levels to navigate

VA requirement

DoD requirement

Joint Opportunity / Increased Capacitypopulation, workload/utilization, & purchased care

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Re-alignment PlanShort-Term

Objective: Identify and increase collaborative opportunities for joint capital asset planning through data sharing

Timeline: September 2011 – November 2011•Agree upon available data elements to be shared (e.g., population, utilization/workload, purchased care)

•Matching data elements will then be shared between Departments for availability during the FY 14 SCIP & CIDM process

•Identify mechanism/means to share the data (manual vs. automated)

Outcome: •Evaluate the ability to utilize planning elements to identify joint opportunities and increased capacity•Gain experience/lessons learned to understand value of this approach

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This is NOT an attempt to create a single process but instead is a way to share readily available data to better inform our capital investment planning processes.

Re-alignment Plan Long-Term

Goal: To more closely align the SCIP and CIDM processes by integrating common data elements that can be used in capital investment planning to increase capacity

Timeline: December 2011 – December 2012•To explore VA and DoD facility planning, efforts, capability, tools and discuss long term opportunities for synergies

•Implement data sharing processes (manual / automated)

•Provide shared data to local planners for identifying the possibility of future joint projects early in the process

•Explore the possibility of completing a cost efficiency analysis of planning, design, lease and construction of joint healthcare facilities  13

Long-Term Data Sharing Pilot Program Potential Locations

Ireland Army Community Hospital, KYFort Knox, KY VA Healthcare Center

Navy Medical Center Portsmouth, VAHampton, VA VA Medical Center

McConnell Air Force Base Medical Treatment Facility

Wichita, KS VA Medical Center

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CPC Schedule of Activities(Notional)

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