2011 VA/DoD Joint Venture Conference October 2011

1. 2011 VA/DoD Joint Venture Conference October 2011

2. Joint Executive Council

3. 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

4. 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

5. 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

6. Construction Challenges 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

7. 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

8. Legislative Initiative General VA 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 Minor VA 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)

9. 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

10. Joint Infrastructure Planning Results: Potential to increase joint capacity

11. 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 Capacity population, workload/utilization, & purchased care

12. 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 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.

13. 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

14. Long-Term Data Sharing Pilot Program Potential Locations Ireland Army Community Hospital, KY Fort Knox, KY VA Healthcare Center Navy Medical Center Portsmouth, VA Hampton, VA VA Medical Center McConnell Air Force Base Medical Treatment Facility Wichita, KS VA Medical Center

15. CPC Schedule of Activities(Notional)