VA Health Care

The Department of Veterans Affairs (VA), concerned that its Martinez, California, medical center could prove unsafe in a major earthquake, announced the emergency closure of the facility in August 1991. VA said that it intended to replace the 359-bed, full-service hospital, which served more than 400,000 veterans in northern California, with a facility on the campus of the University of California at Davis. In March 1992, however, VA told Congress that it was reconsidering its decision to move to Davis. Other options VA was looking into included working with the Air Force to add on to the medical center at Travis Air Force Base in Fairfield, California; building a VA medical center in Sacramento; and renovating the Martinez medical center. This report discusses factors that should be considered in selecting the site(s) for the replacement medical center(s). GAO reviews (1) past site selection analyses done by the Martinez medical center, VA's Western Region, and others and (2) earlier GAO reports on site selection and the sharing of medical facilities and services.

GAO found that: (1) the cost data VA used in its initial site selection analysis was imprecise; (2) VA cost estimates for renovating the medical center were too high in the original site selection analysis because they were based on the assumption that the renovations would be done while the building was occupied; (3) an architectural firm under contract with VA estimated that it would cost $15 million to seismically upgrade the medical center; (4) partially renovating the medical center to correct the seismic and life safety deficiencies and most serious functional limitations should be considered as a long-term solution; (5) adding a wing to the David Grant Medical Center at Travis Air Force Base, would likely be less expensive than constructing a new hospital; (6) two smaller medical centers might best meet the needs of veterans in the two major population centers; (7) the potential for medical school affiliations appeared to be the strongest for sites in Davis, Sacramento, and Travis Air Force Base which are close to the University of California at Davis; (8) VA did not consider the environmental impact of the alternative sites in its site selection analysis; (9) a joint venture would allow VA to offer services and programs that would not be available in a stand-alone medical center; (10) Department of Defense (DOD) medical facilities in the Bay Area and in Sacramento that serve active and retired military needed repair; and (11) a joint venture with DOD and VA might be a cost-effective way to meet the health care demands of veterans.