Base Realignment and Closure

San Antonio Military Medical Center

Air Force Association Briefing

Col Cuda, Co-Director, San Antonio Medical BRAC Integration Office

Col Hardin, Co-Director, San Antonio Medical BRAC Integration Office

James K. Gilman, MD, FACCBrigadier General, USA, MCTRICARE San Antonio Associate Market Manager

David G. Young III, MD, FACPBrigadier General, USAF, MC,CFSTRICARE San Antonio Senior Market Manager

BRAC Language

“Realign Lackland Air Force Base, TX, by relocating the inpatient medical function of the 59th Medical Wing (Wilford Hall Medical Center) to the Brooke Army Medical Center, Ft Sam Houston, TX, establishing it as the San Antonio Regional Military Medical Center, and converting Wilford Hall Medical Center into an ambulatory care center.”

One unified San Antonio Military Medical Center (SAMMC) with two integrated campuses: a North campus at Ft Sam Houston and a South campus at Lackland AFB. Providing the same level of wartime readiness support while delivering high quality, efficient, care for DoD beneficiaries in the San Antonio market.

SAMMC Vision

SAMMC North Campus

• 425 Inpatient Beds Inpatient/Ambulatory Surgery• Level 1 Trauma/ER • Medical and surgical subspecialties• 2240 personnel moving north from WHMC• Additional staff moves south to support mission requirements• Primary structure 953K SF: 644K SF new construction plus 309K SF

renovated space

* Building Gross Square Footage

** Departmental Gross Square Footage

SAMMC North

Parking Garage B

Intrepid Center &

Fisher Houses (Non BRAC)

Center of Excellence

Battlefield Health & Trauma

Clinical/Admin Addition Parking Garage A

New ER/ICU Tower

Over $550 million in new Milcon construction and renovation

• Beds– 303 Ward (Includes NICU)– 90 ICU – 32 Maternal Child Health

425 Inpatient

• Operating Rooms – 28 OR’s

• 2 new Trauma OR’s

• 1 Burn

• 2 OB

• 23 Ambulatory & Inpatient OR’s

SAMMC North- Beds & OR’s

Located at North Campus

Largest medical complex in DOD

SAMMC South Campus

• Ambulatory Care Center (ACC)• Basic Military Trainees• Primary care and medical specialties• Will occupy 4 floors of WHMC, approximately 700K SF;

approximately 131K SF will require renovation• 406 personnel efficiencies; 2,240 moving North

SAMMC-SouthRenovated Space for ACC

San Antonio

Trauma Centers

FY11 PredictedSAMMC Population

San Antonio MMOSan Antonio MMO

FY06 San Antonio PopulationEligible Beneficiaries = 213,168TRICARE Enrollment = 144,056• 50,672 BAMC• 60,876 WHMC• 23,289 Randolph• 9,219 NetworkNon-enrolled student population:• 9,000 Lackland BMTs • 4,500 FSH Students

Camp Bullis

North Central Federal Clinic

SAMMC South

SAMMC North

Randolph AFB

Assumptions• TRICARE Enrollment remains constant • Pediatric specialties and Internal Medicine to the North• No increase in retiree population• Enrollment starts at Federal Clinic in FY08

FY11 San Antonio PopulationEligible Beneficiaries = 221,651TRICARE Enrollment = 147,845• 58,048 BAMC• 57,480 WHMC• 23,289 Randolph• 9,219 NetworkNon-enrolled student population:• 9,000 Lackland BMTs • 9,003 FSH Students

City of Military Medicine

Pre & Post BRAC

Pre-BRAC

Post- BRAC

Specialty ClinicsInpatient Beds

Trauma & Surgery

Lackland AFB Ft Sam Houston

Outpatient ClinicsDiagnostic Services

Medical Center Medical Center

OperationalSavings

+=

Efficiencies

WHMC60,876 Enrollees

269 Beds1.6M SF

WHMC60,876 Enrollees

269 Beds1.6M SF

BAMC50,672 Enrollees

224 Beds 1.3M SF

BAMC50,672 Enrollees

224 Beds 1.3M SF

SAMMC South

57,480 Enrollees9,000 BMTs

Re-Use WHMC

SAMMC North

58,048 Enrollees9003 Students

425 Beds, 1.7M SF

Outstanding ResultsNEJM , 9 Dec 2004, Dr Gawande

War

# Wounded or Killed

# Killed in Action

% Lethality of War Wounds

Revolutionary War, 1775-1783 10,623 4.435 42War of 1812, 1812-1815 6,675 2,60 33Mexican War, 1846-1848 5,885 1,733 29Civil War (Union Force), 1861-1865 422,295 140,414 33Spanish-American War, 1898 2,047 385 19World War I, 1917-1918 257,404 53, 402 21World War II, 1941-1945 963, 403 291,557 30Korean War, 1950-1953 137,025 33,741 25Vietnam War, 1961-1973 200,727 47,424 24Persian Gulf War, 1990-1991 614 147 24War in Iraq and Afghanistan, 2001-present 10, 369 1,004 10

*Data from the Department of Defense, as of Nov 2004

Unsurpassed Homeland Security Planning

• Katrina/Rita: SA “model for nation”-Secretary Mineta

• Civil/military cooperation in response to WMD

• Community trauma & bio-terrorism planning efforts

• STRAC (SW TX Regional Advisory Council for Trauma)

• REMPSC (Regional Emergency Medical Preparedness Steering Committee)

• EHDG (EMS/Hospital Disaster Group)

• Local San Antonio Trauma Training

• Foundation for world-wide “critical care in the air”

Questions ??

Army BRAC Office Air Force BRAC OfficeNavy BRAC Office

AETC

MEDCOM

TMA

ISGJoint Basing

BAMC

MRMC

AMEDDC&S

Air Force Enlisted Training

Navy Enlisted Training

Brooks City Base

FSH

LAFB

BP 172BP 170 BP 174BP 169

WHMC

MJCSG

SAMMC

METC

ISR-BH