BRAC Fallout: Walter Reed National Military Medical Center
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DID has covered the USA’s Base Realignment and Closure process before, a fairly unique effort whereby a commission draws up a list of bases to be closed, and the Congress must vote yes or no to the entire list. The result is that it becomes much harder (but not impossible) for Congressmen to protect each base, and easier to create a basing system whose priorities are shifted toward military rather than political needs.
The 2005 BRAC Commission’s recommendation to realign and consolidate facilities in the USA’s National Capital Region, in order to meet the medical and security needs of the 21st century, includes the realignment of all tertiary medical services currently located at Walter Reed Army Medical Center in Washington, DC to the National Naval Medical Center in Bethesda, MD. The new joint operational medical facility will be named the Walter Reed National Military Medical Center, and will be staffed by personnel from the Navy, Army and Air Force. The existing Walter Reed main installation is mandated to close by 2011, according to the BRAC law.
DID thought this was an interesting BRAC initiative to cover going forward as a Spotlight article… and then the controversies hit. In their aftermath, the first contract has now been issued for construction of the new facility. DID chronicles the contracts – and the controversies – in this DII public-access article.
Contracts & Key Developments
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Specific changes at the realigned Bethesda campus will likely include construction and renovation of approximately 800,000 square feet of clinical space, plus additional alterations and construction of support facilities. About 1,000 Army and Air Force personnel will join the staff at WRNMMC, and depending on the final decisions made at the end of the Environmental Impact Statement process, as many as 1,500 additional personnel could join the campus workforce. Those employees would work at supporting facilities such as barracks housing and the Navy Lodge.
See the NNMC’s BRAC page covering this process for more information and updates. Unless otherwise specified, The Naval Facilities Engineering Command in Washington, DC issued the contracts.
March 3/08: The Clark/Balfour Beatty Joint Venture in Bethesda, MD received a $109 million irst increment firm-fixed price contract to design and build the Walter Reed National Military Medical Center in Bethesda, MD. The contract will establish the Walter Reed National Military Medical Center at the current Bethesda, MD location of the National Naval Medical Center, as a result of the 2005 BRAC initiatives. Work will be performed in Bethesda, MD and is expected to be complete by July 2011.
This contract will be incrementally funded; this is the initial funding, and the total contract amount is not to exceed $641.4 million. The contract was competitively procured via the Naval Facilities Engineering Command e-solicitation website as a 2-Phase design/build, with 3 proposals received in Phase I. Another 2 proposals were submitted under Phase II, and a negotiation period followed with conclusion by submission of a final proposal (N40080-08-C-0007).
Feb 15/08: Army Surgeon General Lt. Gen. (Dr.) Eric Schoomaker, who also commands U.S. Army Medical Command, discusses the Army’s ongoing medical action plan at Walter Reed with the House Armed Service Committee’s Military Personnel Subcommittee. DefenseLINK report.
Oct 14/07: Keeping the lights on isn’t cheap. Reliant Energy Solutions East in Edison, NJ received a maximum $14.2 million firm-fixed-price contract to provide electricity to Walter Reed Army Medical Center in Washington, D.C. until Dec 31/08. There were 156 proposals and 13 responded to the Defense Energy Support Center (DESC) in Fort Belvoir, VA (SP0600-05-G-8037).
Oct 5/07: Small business qualifier APM LLC in Yorba Linda, CA received a $10.3 million firm-fixed-price contract for renovation and repair of several buildings at the Walter Reed Army Medical Center. Work will be performed in Washington, DC, and is expected to be complete by April 30/09. This was a sole source contract initiated on Aug 14/07 by the U.S. Army Corps of Engineers in Baltimore, MD (W912DR-07-C-0066).
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July 25/07: The President’s Commission on Care for America’s Returning Wounded Warriors presents a 29-page proposal to President Bush that suggests overhauling the disability-rating system and urges more attention be paid to returning Iraq and Afghanistan war veterans suffering from brain injuries. In the wake of reports that servicemembers at Walter Reed Army Medical Center here were receiving sub-par treatment, President Bush created the bi-partisan panel in March 2007, citing a “moral obligation” to provide the best possible care to men and women in uniform. DefenseLINK story | Main report [PDF] | Subcommittee report | 
YouTube Video.
April 19/07: IAP Worldwide Services, Inc. issues an update on Base Operations Support at Walter Reed, since it began work on Feb 4/07. The progress report describes work during the first 2 months of IAP’s contract throughout the 113-acre complex.
March 21/07: Philip W. Grone, deputy undersecretary of defense for installations and environment, tells a House Appropriations Committee panel that BRAC 2005 will require full funding to implement. The estimated 5-year cost for BRAC implementation has risen to $30.8 billion, up more than 60% increase from last year’s estimate of $18.3 billion. Grone attributes this to the fact that this round is 75% military construction, which usually sees costs rise in the move from analysis to implementation [DID: why?], plus additional requirements such as the Army’s need to improve quality of life for soldiers and families, and additional training ranges.
Problems with outpatient care and bureaucracy for wounded troops at Walter Reed have sparked debate about whether that decision should be overturned and Walter Reed should remain open. Grone says the FY 2008 budget request allocates about $481 million for the construction at Bethesda and a new hospital at Fort Belvoir, VA. While keeping Walter Reed open would save that money initially, Grone contends it would would have a negative long-term effect on savings from the consolidation, estimated at $170 million annually. DefenseLINK report.
March 10/07: The Washington Post report “Privatized Walter Reed Workforce Gets Scrutiny” discusses the situation at Walter Reed. An excerpt:
“Last year, IAP won a $120 million contract to maintain and operate Walter Reed facilities. The decision reversed a 2004 finding by the Army that it would be more cost-effective to keep the work in-house. After IAP protested, Army auditors ruled that the cost estimates offered by in-house federal workers were too low. They had to submit a new bid, which added 23 employees and $16 million to their cost, according to the Army.”
March 7/07: Following considerable publicity re: substandard conditions at Walter Reed, IAP releases its “Statement on Walter Reed Army Medical Center… following the company’s first month of providing base operations and facility maintenance work at the Walter Reed Army Medical Center (WRAMC).”
March 6/07: President George W. Bush announces the creation of the bi-partisan President’s Commission on Care for America’s Returning Wounded Warriors, headed by former Sen. Bob Dole [R] and former Health and Human Services Secretary Donna E. Shalala [D], currently president of the University of Miami. They will conduct a comprehensive review of military medical care, while a separate task force will assess short-term needs. DefenseLINK story.
March 2/07: US Defense Secretary Robert M. Gates announces that he has accepted the resignation of Army Secretary Francis J. Harvey in light of allegations of shortfalls in care of outpatients at Walter Reed Army Medical Center.
January 29/07: The Walter Reed Joint Venture of Hayes, Seay, Mattern & Mattern Inc. (HSMM) and Hellmuth, Obata & Kassabaum (HOK) in Roanoke, VA just received an $8 million firm-fixed-price contract for architectural/ engineering services, including preparation of the design/build Request For Proposal documents covering medical facilities and parking structures. These will be located at the Walter Reed National Military Medical Center, at the National Naval Medical Center in Bethesda, MD.
Work will be performed in Roanoke, VA and is expected to be complete by January 2008. This contract was competitively procured via the NAVFAC e-solicitation website, with 6 proposals received. Three of the offerors were slated, and interviewed (N40080-06-C-0026).
Nov 9/06: IAP World Services in Cape Canaveral, FL received a $25.8 million cost-plus-award-fee contract for Base Operations Support at Walter Reed Army Medical Center. Work will be performed in Washington, D.C., and is expected to be complete by Nov 3/11. Bids were solicited via the World Wide Web on June 4/03, and 1 bid was received by the U.S. Army Medical Command at Fort Sam Houston, TX (W81K04-07-C-0003).
Additional Readings
- Walter Reed Army Medical Center
- The Walter Reed Society, Inc.
- National Naval Medical Center
- 2007 President’s Commission on Care for America’s Returning Wounded Warriors
- Gannett’s Military Times – Military Times coverage of the controversy at Walter Reed. Links to all associated articles.
- US DefenseLINK (June 13/07) – Medical Models Cut Time, Risk for Walter Reed Patients. Walter Reed’s 3D Medical Applications Center uses technology originally designed for the manufacturing industry, in order to cut down on risky surgery time by as much as 6 hours.
- US DefenseLINK (May 21/07) – Leaders Have Restored Trust at Walter Reed, Official Says. The Defense Department’s top health official Dr. S. Ward Casscells, assistant secretary of defense for health affairs, praises general Army Maj. Gen. Eric B. Schoomaker for restoring the trust of patients and energizing staff members after taking command earlier in 2007.
- US DefenseLINK (May 2/07) – DoD Press Briefing with Secretary Gates, Mr. West, and Mr. Marsh on the Report of the Independent Review Group Care at Walter Reed and the National Naval Medical Center.
- US DefenseLINK (April 2/07) – Top Enlisted Soldier at Walter Reed Gets Back to Basics of Soldier Care. Frofiles Army Command Sgt. Maj. Althea Green Dixon had been Maj. Gen. Eric B. Schoomaker’s top NCO at Fort Detrick and Fort Gordon; she is now the new top NCO over the North Atlantic Regional Medical Command, and Schoomaker chose the 29-year career medical soldier to lead changes in wounded soldier care at the center and within the command.
- US DefenseLINK (March 18/07) – Gates Says Committed to Fixing Walter Reed Problems, Praises Medical Staff.
“Defense Secretary Robert M. Gates acknowledged today on CBS’s “Face the Nation” that he was “angered and offended” when he learned of problems at Walter Reed Army Medical Center… “I think I did something unheard of in this town. I actually thanked the reporters for bringing it to our attention.”
- WebMD, Mad About Medicine blog (March 14/07) – Walter Reed: Dot the “i”s, Cross the “t”s, and Dig the Graves by Dr. Ira Kirschenbaum. “The answer unfortunately has consequences for the care we receive at our own local hospitals where many hospital administrators spend most of their days filling out paperwork and glossing over inefficiencies to pass inspections from an agency called the Joint Commission on Accreditation of Healthcare (now referred as the Joint Commission). Every “i” is dotted and every “t” is crossed. Unfortunately, at the same time, every grave is being dug…”
- US DefenseLINK (March 7/07) – Gates, Pace Discuss Way Forward at Walter Reed
- US DefenseLINK (March 7/07) – Army Chief, Surgeon General Address Walter Reed Issues
- US DefenseLINK (March 6/07) – Officials’ Testimony Focuses on Fixing Health Care System. “The [Senate Armed Services] committee questioned top defense officials regarding reports of substandard living conditions and delays in outpatient services at Walter Reed Army Medical Center here. Army and defense leaders did not dispute the claims. The Army’s top officer, Chief of Staff Gen. Peter J. Schoomaker, compared the system’s bureaucracy to “running in hip boots in a swamp.”
- US DefenseLINK (March 5/07) – Witnesses Testify to Battles with Walter Reed Bureaucracy
