A massive, years-long reworking of the nation's military bases includes a streamlining of San Antonio's military healthcare system, a process that is expected to be completed before year's end.
The military base changes are occurring under the 2005 Defense Base Realignment and Closure law, which took effect in 2005 and is making wholesale changes to how healthcare is delivered by the military in San Antonio.
The BRAC process calls for the Army's Brooke Army Medical Center, Fort Sam Houston, Texas, which as of 2006 had 224 beds, to transform into San Antonio Military Medical Center, with 425 staffed beds. That growth will come from absorbing beds from the Air Force's 59th Medical Wing-Wilford Hall Medical Center, Lackland Air Force Base, Texas, which had 269 beds as of 2006, and is being converted into an outpatient ambulatory surgery facility. The move of inpatient care includes the transfer of more than 1,900 employees to be reassigned to what is now Brooke Army from Wilford Hall.
Another change entails the creation of the San Antonio Military Health System, a new division that will allow the two involved branches of the military to work together to monitor the area's military healthcare. Strictly speaking, the system board will not have governance responsibilities but will be an oversight body with a lot of influence, says Dr. Suzanne Cuda, co-director for the San Antonio Medical BRAC Integration Office. The organization “will provide oversight and coordination among all San Antonio military treatment facilities for credentialing and certification of medical personnel, business planning, acquisition strategy, healthcare operations, resource management, information management, logistics, and manpower,” according to a U.S. Army Medical Department website.
The revamping of San Antonio's military providers could have a big effect on the region. About 250,000 people are eligible for care in the military system, Cuda says.
The transition of offering inpatients care in just the Army hospital must be Sept. 15, and that should be on schedule if the remaining renovations go as planned, Cuda says. The project has involved moving and combining the various inpatient units in two hospitals into a single facility while upgrading the operation as they went along. That means some care units would be moved within the hospital, and at times, outpatient and administrative functions would go into temporary trailers, he says.
Cuda says that while the oversight of the construction, renovation and relocation projects has been a big responsibility and involved some delays, the military providers have had to do that while caring for patients returning from fighting in the Middle East, particularly during 2007-08 following a surge of soldiers sent to fight in Iraq.
Construction costs were expected to be $845.4 million—including the Fort Sam Houston Clinic—and $332 million for the initial outfitting and transition, for a total of $1.2 billion. Annual savings are expected to be $103.5 million starting in 2012.
Among the major construction projects are a 760,000-square-foot tower that will house a 25,000-square-foot burn unit, administrative space, an outpatient pediatrics clinic, an expanded emergency and trauma department; a surgical intensive-care unit; a critical-care unit and psychiatric nursing units, according to the Army.
The Army's San Antonio Military Medical Center after conversion will include 116 intensive-care unit beds, 33 operating rooms, a Level One trauma center and new Centers of Excellence in battlefield health and trauma, cardio-vascular care and maternal-child care.
At Lackland Air Force Base, military officials broke ground in April on the new Wilford Hall Ambulatory Surgical Center, which is expected to be completed in 2015. The current 54-year-old building will be demolished once the new building is operational, according to the Air Force. The three-story ambulatory surgical center will contain more than 40 outpatient clinics and services, according to the Air Force. Phase One of the construction includes the first of four wings that are part of a 681,000-square-foot facility, and a 1,000-car parking garage.
Although the emergency department in Wilford's current building closed July 1, the new Wilford will offer urgent care 24-7 for trainees and beneficiaries and will include medical, pediatric and surgical subspecialty clinics, as well as a Center of Excellence in eye care.