Ft. Bliss Executive Summary

S5 Submission

Fort Bliss Hospital Replacement

United States Army Corps of Engineers (USACE) Fort Bliss Hospital Replacement - El Paso, TX

S5 Submittal - Project Manual EXECUTIVE SUMMARY

February 27, 2012

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1. EXECUTIVE SUMMARY

1.1. Introduction

1.1.1. Project Background

The Fort Bliss Hospital Replacement (FBHR) is designed to be a 1,132,460 square foot World-Class Medical Facility replacing the current William Beaumont Army Medical Center (WBAMC) in El Paso, Texas. Originally, conceived as an integrated facility combining the space requirements of the El Paso VA Medical Center (EPVAMC) and those of the existing WBAMC, the decision as of July 2010 was to carry forward with the project as a DoD only programmed facility. The project is being designed by the HDR office in Alexandria, Virginia and will be constructed through the Design-Bid-Build procurement process. HDR has endeavored to incorporate in this project state-of-art planning and design concepts including the latest research in Evidence-Based Design (EBD), Sustainability as well as design innovations promoting family and patient-centered care. The team objectives are as valid in S5 as they were in our S1, S2 & S4 submittals and include the following:

a. Develop a ‘State-of-the-Art’ World Class Military Medical Center.

b. Provide a sustainable, adaptable and flexible facility supporting the required healthcare delivery to military personnel and their families.

c. ‘Silver’ LEED Certification with ‘Gold’ LEED as the goal of the project.

d. Incorporate Evidence Based Design (EBD) and Patient/Family Centered Care concepts and design features.

e. Design an aesthetically pleasing facility within the southwest regional environmental context in cultural harmony with the Fort Bliss and El Paso communities.

HDR is committed to achieving with this design a World Class Medical Facility in support of our Warriors and their Families.

1.1.2. S5 Submittal

The S5 submittal advances the site design, building floor plans and elevations incorporating the proposed architectural, engineering systems and the required life safety systems. The submittal follows the S5 submittal requirements of the Medical Design Instructions (MDI) dated August 30, 2010

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as issued by USACE and the UFC 4-510-01 dated November 2009 and updated August 2011. Complete narratives of design intent as well as the architectural and engineering systems proposed follows the executive summary. The submittal addresses the following the following criteria that contribute to the overall design and production execution of the Hospital Campus:

A. Civil-Site Development

Located in the southwest region of the U.S., the site has rich physical site features as a result of its local climate, flora and fauna as well as importance as a military post. The development takes advantage of the views to the Franklin Mountains and 300+ days of sunlight by planning low rise structures in order to maximize daylighting in as many rooms as possible. The main entry and the outdoor courtyards provide opportunities for a pedestrian plaza as well as several gardens providing spaces for a meditation and contemplation.

All storm water is sent to an underground storm water system held on site by the use of eight retention ponds.

B. Secure Perimeter/Access Control Points

The site for the new hospital is located on federal property outside the secured perimeter of the Ft. Bliss garrison. The medical center complex has its own secure perimeter surrounded by a 10’ high fence with two Access Control Points (ACP). The ACP to the south is for POVs (Passenger Owned Vehicles) and the ACP to the north is for commercial and service traffic vehicles and staff. Commercial trucks will use the north ACP Monday thru Friday and unscheduled commercial vehicles will use the south ACP on the weekends and evenings.

The ACPs are being developed as a separate small business construction package and is undergoing a separate review process with USACE Ft. Worth District, USACE-Omaha Standards Division, Directorate of Public Works, Ft. Bliss Garrison and the Ft. Bliss Department of Environmental Security (DES).

C. Site Infrastructure

Site development for the project consists of two construction phases. The first phase is primarily outside the “loop” road surrounding the complex and the second phase is comprised of all site utility and drainage systems inside the loop road to the buildings. Phase 1 incorporates all major utility infrastructure including an electrical

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substation; a replacement water tower and booster pump located north of the 601 spur for an in-kind replacement of the East Biggs water tower. The existing water tower at the southeast corner of the site will be used for the FBHR campus. Other site infrastructure components include an 8 mile sewer line to be connected to the existing El Paso Water Utility (EPWU) sewer line to the south at Montana Ave.

Phase 1 of the site infrastructure construction package was awarded August 2011 and is currently 33% complete. Phase 2 of the site construction will be awarded with the building package. There will be two parking construction packages, ACPs, Helipad and landscape packages to be awarded to small businesses.

D. Helipad

The helipad is located north of the FBHR facilities and south of the north ACP. The ambulance dispatch center located adjacent to the hospital emergency ambulance entry will have direct visual observation of the helipad. The helipad construction is also a small business package and not part of thsi S5 submittal It is being reviewed separately by the USACE Ft, Worth District, Biggs Army Air Base, Ft. Bliss, DAR, Ft. Bliss Directorate of Public Works, TSC-Technical Services Center, USAASE, FAA and the El Paso Airport Authority.

E. Future Growth

The campus master plan allows for future growth accommodating the required 25% expansion of all hospital facilties, two 2-2000 car parking garages for FBHR and the El Paso VA Medical Center (outpatient clinics and administration only) with a 1500 car parking garage. There is also potential for a shared VA/DOD supply warehouse, 100 unit intern housing, Fisher House, fire station and a AAFES convenience outlet on the site. Site utility stub tie-ins are provided along the loop road.

F. Architectural-Building Concept

The architectural design concept derives its scale, form and material expression from the site features and functional program requirements. The nature of the site as an open and undeveloped area in the southwest region compels the complex to assume a strong relationship to its natural setting. The arrangement of the inpatient, ambulatory and administrative services as separate buildings in a campus-like setting allows for the staff and patients to have multiple views and generous daylighting throughout the medical center. The organizing element for the buildings is circulation spine along the east-west axis that runs

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from the main entrance at the hospital east to the outpatient clinic entrance.

The exterior envelopment of the buildings is comprised of exterior natural stone, metal panel and terra cotta in a rainscreen system application. It also has a unitized curtain wall system with integral sunshade devices. The roof will be a inverted roof membrane assembly (IRMA) with pavers.

G. Sustainability Initiatives

The FBHR will be designed to sustainability standards enacted by the Federal Government and the US Army, including requirements set by the Energy Policy Act of 2005, Executive Order 13423, and the Energy Independence and Security Act of 2007. FBHR is seeking LEED certification for the campus as whole as well as LEED-HC (LEED for Healthcare) certification for the hospital and clinic buildings. LEED certification for the administrative, CIB and CUP, ACP Visitors Center buildings will applied separately as well. Minimum requirements for the project is Silver LEED certification and the goal is to achieve Gold. No additional funds are being expended for any of the buildings to attain Gold certification.

HDR provided an SROI (Sustainability Return on Investment) workshop resulting in an SROI dashboard that outlines several paths for energy, water and waste for sustainable technologies. The energy renewable path most promising is the use of a deep geothermal well providing the campus with over 60% renewable energy. The back-up for the geothermal system, per UFC requirements, will be 3 steam boilers.

The deep geothermal option is pending outcome of an exploratory well to be completed in October 2012. A Waster Water Treatment Plant (WWTP) on site was considered in an effort to reclaim water for a “purple pipe” system for irrigation, chilled water re-supply and buildings’ toilet flush system. The option was abandoned due to its long term maintenance and operating costs.

H. Evidence Based Design (EBD)

The project includes several research based initiatives utilizing EBD principles providing a path to healing environments to the maximum extent practicable as directed by the UFC 4-510-01. These initiatives have been focused on patient and family centered care, infection control, prevention of patient falls and staff injuries as well as researching state-of-the-art facilities utilizing smart room technologies, automated transport systems and healing gardens.

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I. Interior Design & Wayfinding

The interior design will feature a patient centered interior environment that balances each building’s spatial configurations, finishes and colors projecting an atmosphere of comfort and wellness. The interior design will complement the southwest region environment and the Fort Bliss community. Colors, fabrics, signage and furniture will strive to holistically harmonize with the architectural spaces and differing functions throughout the buildings.

By taking advantage of the large entry rotunda and its link to the bridge concourse, the design will provide effective cues for entry, reception and general wayfinding. Wayfinding systems will provide visual cues of color, patterns, signage, architectural elements and landmarks to assist the patient, family and staff finding their way throughout the facility.

The project has a robust art program that will have original works of art and sculpture in places that are appropriate for contemplative view.

J. Structural/ Interior Progressive Collapse

Through evaluation and economic analyses of 3 alternate structural systems, the moment resistant steel frame with the use of the Side Plate connection system will be used for all the structures greater than two stories. A concrete and metal deck composite floor system will comprise the flooring component of the structural system. The two story buildings or lower will have a conventional composite steel frame structure.

Since the clarification of the application of UFC 4-023-03 by the ECB “Progressive Collapse Design and Controlled Public Access” in February 2011, as well as discussions with the Wm. Beaumont Medical Center’s Provost Marshall, and HFPA, FBHR will not provide controlled access at the public entrances as defined by the latest ECB. Therefore no columns will be exempt from the column removal requirements at all floors. In order to accommodate possible future change of use or architectural redesign, the design assumes the removal of 100% of columns where progressive collapse prevention is required.

K. Seismic Design

Every structure, and portion thereof, including nonstructural components shall be constructed to resist the effects of earthquake

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motions as prescribed by the seismic requirements of the UFC, and related building codes and standards.

Seismic parameters vary for each of the buildings. The hospital and central utility plant are designated as occupancy category IV, seismic design category D, the outpatient clinic buildings as occupancy category III, seismic design category C, administration building, occupancy category IV building, seismic design category D because of the Emergency Operations Center (EOC) and the Clinic Investigation Building (CIB) occupancy category I, seismic design category C.

The hospital buildings, clinic buildings and the Administration building will be separated by expansion/seismic joints to be sized based on thermal movement and lateral drift from seismic and wind loads.

L. Mechanical

Mechanical equipment serving the Hospital resides in two areas, the the fourth floor and the basement level Mechanical Rooms. Air Handling equipment for the hospital building will be located on the fourth floor mechanical floor and will serve all floors above and below. All outside air servicing the air handling units are ducted through sand louvers located around the perimeter of the floor. The air handlers for the clinic and administrative buildings will be on the roof grouped together protected by wind and sand screens. The air will be conveyed by galvanized steel ducted supply and return throughout the facility.

Although the exploratory well results for the use of geothermal source for heat and hot water is not available for this submittal, if it were to be used, however, the central utility plant (CUP) would house the heat exchangers tied to the deep geothermal hot water production well, and back-up steam boilers. If a geothermal source is not used then the CUP will house all steam boilers with N+1 back-up. It will also house the deaerator, clean steam generator, condensate pumps, chillers, pumps, chemical feed systems, domestic water entry, fire service entry, fire pump and miscellaneous systems. The primary space and process cooling will be supplied by the chiller plant. Due to the size and complexity of the project and to take advantage of the LEED points available, enhanced commissioning for the design of all major systems will be completed as part of the project deliverables.

M. Plumbing

The facility will be served by two (2) independent water lines, one from the existing water tower on the site and the other at the East Biggs development water tower for 100% redundancy. The domestic water

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supply will enter the CUP and be distributed from there to the different buildings.

Generally, horizontal sanitary collection into the building drain will occur below the lowest floor that allows drainage by gravity. The building drain will exit by gravity to the sanitary sewer unless the floor is constructed below the gravity sewer elevation, then sewer ejectors will be necessary. Storm piping will generally be routed vertically from the drains to below the lowest floor that allows drainage by gravity where it will be collected horizontally and discharge by gravity to the drainage pits. Similar to the sanitary sewer, storm water being collected at levels below the elevation of the gravity drain will require sump pumps.

N. Electrical

A new substation will be constructed adjacent to the project at the southeast corner of the site. It will derive dual normal power feeders from the existing 115kV El Paso Electric (EPE) transmission lines running along the eastern side of the site. The project will provide a secondary double-ended main-tie-main configured 13.8kV switchgear line-up adjacent to the CUP. The CUP switchgear will serve all power to the hospital and campus buildings. All electrical equipment in the buildings will be sized for 25% spare capacity should full expansion occur per UFC 4-510-01.

The project requires four (4) 2500 kW / 3000 kVA generator sets configured as N+1, and paralleled to a single switchgear lineup. Load shed capabilities will insure that total load capacity may be served in the event that any single generator fails to start or parallel. Generators have been sized such that any single generator has the capacity to handle the load for the emergency system per NEC 517.31.

Lighting design for the building(s) shall conform to or exceed the latest versions of UFC 4-510-01, UFC 3-530-01, and ASHRAE 90.1. LEED credits will be pursued in areas of lighting that are applicable for energy savings. Energy efficient design considerations shall include use of efficient lamps and luminaries snf automatic lighting controls that meet industry standard reliability, durability and maintainability requirements. Natural day lighting is used where economically feasible and consistent with each building functional program requirements.

O. Communications

As the campus is a green field site, no existing communications infrastructure is in place. As such, a new outside plant site communications systems is being planned and installed to support the

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new hospital. A Voice over Internet Protocol (VoIP) system will be the communications platform for the entire campus.

The Data Center will be on the fourth floor of the hospital building. It will serve as the dedicated space for network servers, routers, switches, storage devices, head end equipment and many other systems. Telecommunications Rooms will be provided on each floor to support voice and data distribution to work outlets.

P. Anti-terrorism/Force Protection (ATFP)

This project will comply with all 22 standards of the UFC 4-010-01 dated January 2007. The FBHR is classified as a Primary Gathering Building within a Controlled Perimeter based on its projected occupancy of more than 50 DoD personnel. The controlled perimeter will be comply with a 148 foot minimum stand off distance.

A blast analysis for typical window configurations has been performed for the preliminary window mullion and window support framing to meet

+ATFP requirements. All window options in the S5 submittal are considered acceptable and meet ATFP requirements.

Q. Life Safety/Fire Protection

FBHR will be constructed as a campus where all of the buildings are accessible by means of either interior circulation, except for a maintenance only utility tunnel between the CUP and the Hospital building as well as the free-standing CIB. Six distinct areas are identified as the Hospital, Circulation Spine, East & West Clinic buildings, Central Utility Plant (CUP), Administration/Education building and the Clinic Investigation Building. In accordance with the International Building Code, the Hospital, Circulation and Spine, and Clinics building will be defined as one building and the Administration building will be an adjacent building separated by a fire wall.

The Hospital, Circulation Spine, and Clinics buildings are designated as high-rise structures. All other buildings, including the adjacent Administration building will not be treated as high-rise structures. The Circulation Spine joining the the Hospital and Clinics circulation system is defined as an atrium for which a Life Safety Engineering Analysis has been prepared to verify its fire protection and life safety approach. The overall fire protection and life safety approach is in accordance with UFC’s 4-510-01 August 2011 update, 3-600-01, 1-200-01, the 2009 edition of the International Building Code, and the 2009 edition of NFPA 101, Life Safety Code. All buildings will be provided with

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automatic sprinkler systems as well as a combination fire alarm and mass notification system.

R. Construction Cost Estimate

Per the S4 cost estimate, the projected construction costs are less than the DD1391 budget and escalation requirements. The S5 preliminary cost estimate will be part of this submittal under separate cover. A final S5 cost estimate will be issued within four weeks of this submittal.

S. Value Engineering* Source-USACE VE Consultants

The following value engineering suggestions have been implemented:

1) Relocation of the Central Utility Plant $ 6,340,000* 2) Place Fuel Storage Tanks Above Ground $ 325,000* 3) Modify Parking Lots to Meet UFC Req. $ (249,000)* 4) Reduce the Number of Chillers from 6 to 5 $ 319,000*

Total Value Engineering Savings $ 6,735,000

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1.2. Design Charrette Synopsis

1.2.1. Overview In preparation for the June 2010 charrette, many conceptual approaches uniting siting strategies with functional arrangements for programmatic components were considered, resulting in a deeper understanding of factors for optimizing development at the site. The three concepts illustrated and discussed explore different strategies for site utilization as well as a range of possibilities for organization, scale, and access. In many cases, ideas embodied in certain concepts may be applicable to others.

The three concepts explore progressively more separated major building components of the medical campus. The progression increases in order of magnitude sequentially from the Compact, Campus and Neighborhood concepts. Each of the concepts employs a distinct strategy related to the parking and building entries they serve. This is a fundamental design consideration given the large amount of surface parking to be accommodated at the complex.

1.2.2. Compact Concept This concept utilizes a siting strategy that situates the medical complex toward the southwest corner of the site and creates a main entry plaza facing Northeast. The entry orientation and scale creates a strong visual presence along Highway 375 and offers protection from the highest velocity prevailing winds from the Southwest. Entrances to the site occur from the existing 601 Spur and a new road connecting to a proposed interchange at Highway 375. These roadways connect to two proposed access control points that will be designed to appropriately process vehicular traffic entering the secure perimeter of the site.

The relationship of the surface parking to the building complex in this concept is one in which a portion of the total parking (in this case, an amount assigned to staff parking) is located outside the secure perimeter. This may reduce the pressure of processing large numbers of vehicles in the access control points as well as simplify entrance to the site for the staff. This concept is further discussed in 5.4 and is applicable to the other concepts as well. The remainder of the surface parking (for patients and visitors) is arrayed across the front and sides of the building complex, with the intention of optimizing convenience and minimizing walking distances to entrances.

The Compact concept suggests that building components may be arranged as a consolidated, fully connected, large single building. The advantages of this approach are largely in implications for functional efficiency, but this

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concept is also likely to be the lowest cost as well as the most energy-efficient of the group.

The visual character of the Compact concept is likely to be that of a large, iconic structure with a great deal of visibility at distant views.

ADVANTAGES OF THIS CONCEPT:

Most Efficient Circulation

Smallest Site Footprint

Efficient Building Envelope

Most Centralized MEP Systems

Lowest Construction Cost

CONCERNS ABOUT THIS CONCEPT:

Least Convenient Relationship to Parking

Fewer Daylighting Opportunities

Concentrated Building Access

Largest Building Mass

1.2.3. Campus Concept This concept utilizes a siting strategy that locates the medical complex in the geographic center of the site. The entry concept is decentralized, with individual portals for inpatient and visitor (main hospital), outpatient, administration, emergency, and service located around the perimeter of the complex. Like the Compact concept, entrances to the site occur from the existing 601 Spur and a new road connecting to a proposed interchange at Highway 375. These roadways connect to two proposed access control points that will be designed to appropriately process vehicular traffic entering the secure perimeter of the site.

The relationship of the surface parking to the building complex in this concept is radial, with rings of parking completely surrounding the building complex. Allocation of parking may be tailored to the specific need at each of the building entrances, reducing walking distances and separating vehicular and pedestrian movement.

The Campus concept suggests that the various building components may be loosely grouped as a connected complex, but with considerable outdoor spaces interwoven in the placement of individual functions. Because the entrances are at the perimeter of the building complex facing surrounding parking areas, the outdoor spaces at the center of the development are


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envisioned as pedestrian-friendly naturalized environments. In this way, physical (and visual) access to nature from the building are enhanced.

The visual character of the Campus concept is likely to be that of a lower, broader multi-part composition with potentially a more approachable appearance. Multiple, separated entrances will offer less constricted access.


Desirable Relationship to Groundscape and Nature

Good Potential for Daylighting

Protected Outdoor Spaces for People

Clear Separation of Entrances and Convenient Parking

Smaller Building Scale


Long Travel Distance

Extensive Exterior Envelope

Some Redundancy Necessary

More Challenging Wayfinding

1.2.4. Neighborhood Concept This concept utilizes a siting strategy that separates the building components as three distinct structures. Each of the three (“Hospital”, “Clinic”, and “Office Building”) is arranged so that entrance access and visual identity is unique to that structure. Thus, the idea of individual destinations for each function at the site is clearly communicated. Entrances to the site occur from the existing 601 Spur and a new road connecting to a proposed interchange at Highway 375. These roadways connect to two proposed access control points that will be designed to appropriately process vehicular traffic entering the secure perimeter of the site. An organizational boulevard links the two ACP’s and provides access to all three building components.

The relationship of the surface parking to the buildings in this concept is one of the key advantages of the site strategy. Because each of the three buildings occupies a separated site, smaller, more discrete parking zones may be formed for each, greatly reducing walking distances to building entrances as well as the visual impact of paving.

The Neighborhood concept suggests that building components with differing purposes may be constructed with specialized and specific characteristics for each, and then be placed in individual locations more convenient and easily accessed.

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The visual character of the Neighborhood concept is likely to be that of a decentralized development with multiple sites. The identity of the buildings themselves will be more individualized and they will be of far smaller scale than integrated concepts, perhaps offering a more humane and approachable image.


Most Convenient Parking

Smaller Building Scale

Clearly Delineated Entrances

Clear Visual Access to Destination


Servicing and Circulation Challenging Due to Separation

Some Redundancy Necessary

Extensive Exterior Envelope

More Challenging Wayfinding

1.2.5. Charrette Outcome and Direction Forward The conclusion of the charrette involved an active group discussion in order to develop a consensus of opinion as to the direction forward. The merits and concerns for each of the three concepts that were presented were reviewed, and various perspectives were presented. The outcome of these discussions was a consensus that a “hybrid” concept should be pursued, which would combine the most favorable attributes of the Compact concept and the Campus concept. Those attributes are:

FROM THE COMPACT CONCEPT;

Integrated Functions

Efficient Movement and Adjacencies

Consolidated Systems

Staff Parking Outside Secure Perimeter

Efficient Building Envelope

Likely Lower Cost


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Inpatient Tower Above Diagnostic and Treatment Functions / Clear Main Entry

FROM THE CAMPUS CONCEPT;

Outdoor Spaces Integrated with Buildings

Maximum Exposure to Daylight, Views, and Natural Setting

Multiple Distinct Building Entrances

Convenient Relationship of Parking to Destination

The development of the hybrid concept, and the variations of this concept which were explored, has eventually evolved into the current planning and development model. The current model does incorporate many of the desired attributes which were identified and further defined during the planning charrette process.

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1.3. Current Area Development Plan Synopsis The site for the Fort Bliss Hospital Replacement Project is located east of the El Paso International airport, approximately seven miles to the northeast of downtown El Paso. It is separated from Fort Bliss Garrison by the 601 spur, and is therefore outside the secure perimeter of the Garrsion. It necessitates the establishment of a new secure perimeter or cantonment around the Hospital Campus (site). The site is located in an undeveloped area near ongoing construction related to the brigade expansion of Fort Bliss and is approximately 260-acres in size. The site topography is relatively flat with a gentle gradient sloping from the northeast to the southwest.

The development plan for the overall site includes vehicular access control points near the northwest and the southeast corners of the site. The northwest access (North ACP) is currently planned primarily for commercial traffic with limited public and staff access. The southeast access point (South ACP) is intended to be the primary access point for the public, patients, and a portion of the staff. Each of these access points will require facilities for secure processing of vehicles and occupants.

Vehicular circulation within the secure perimeter (inside the ACPs) of the Hospital Replacement Campus is primarily defined by a loop road which circumscribes the buildings and parking lots. The majority of the surface parking and associated vehicular and pedestrian circulation occurs within this loop road. Parking is provided here for staff, patients, and visitors. Stormwater management will be accommodated by retention ponds which are located strategically around the perimeter loop road.

Approximately 62 percent of the total staff parking allocation will be located west of, and adjacent to, and outside the secure site perimeter. Staff members who park in this west parking lot may by-pass the North and South ACPs via a series of secure turnstile gates which then lead to a dedicated pedestrian route and wheelchair accessible to the north staff entrance of the Hospital.

A helipad is located to the north of staff parking lots and ring road and has visual and direct emergency vehicle access to the emergency department.

The main entrance to the facility is located on axis with the approach road from the South ACP and is contained within a large arrival plaza framed by the Hospital, clinics, and administration building on the west, north, and east respectively. This entrance is the primary entrance to the facility, and can provide convenient public access to the Hospital, clinics, and administration building alike. The entry plaza is also large enough to have formal ceremonies.

The outpatient entrance is located on the east side of the site leading to administration building and clinic buildings, leading directly into the public circulation promenade linking the buildings.

Service access is provided to the loading dock located on the west side of the site with controlled gate access prior to entry. Controlled access is gained by camera and remote operation controlled by the dock master.

The central utility plant (CUP) and the clinical investigations (CIB) buildings are located north of the hospital. The CUP is located 250 feet directly north of the Hospital building and the CIB 160 feet north of the clinic buildings.

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Illustrative Site Plan

There are two major pedestrian circulation spines which cross the site and link parking and the main facilities in a north-south orientation. One of these originates in the southwest parking lots and leads northward to the entry arcade along the east side of the Hospital building and the other originates in the outpatient parking lots on the east and the staff parking lot on the west. The pedestrian path leads to a staff only entrance door with electronic locks released only with a hospital ID badge.

The planning strategy supports future expansion of patient beds and major ancillary departments per UFC 4-510-01. The clinic buildings are planned to expand to the north with the use of standard clinical modules used for the project. The administration building may expand by adding additional building modules to the south. The diagnostic and treatment areas, the Hospital building, may expand by adding additional space to the north and to the south. This will facilitate the

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expansion of building components which are most likely to change like surgery, imaging, and emergency services.

The Med/Surg nursing units, ICU and ICU step-down can grow in place by relocating and reconfiguring the existing spaces on these floors to increase beds up to 25% of bed capacity. Conceptually planned for the campus are supporting facilities including AFSES and convenience store, Fisher House, Resident Housing, Fire Station, Logistics Warehouse and the replacement of the VA in El Paso and an associated 2000 car parking garage. .

Conceptual Expansion Plan

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Appendix

Stacking Diagram

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Basement Floor Plan

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First Floor Plan

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Second Floor Plan

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Third Floor Plan

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Fourth Floor Plan

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Fifth Floor Plan

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Sixth Floor Plan

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Seventh Floor Plan

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Hospital First Floor Expansion Plan

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Hospital Second Floor Expansion Plan

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Hospital Third Floor Expansion Plan

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Hospital Seventh Floor Expansion Plan

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Clinic & Administration Buildings First Floor Expansion Plan

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Clinic & Administration Buildings Second Floor Expansion Plan

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Clinic & Administration Buildings Third Floor Expansion Plan

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Clinic & Administration Buildings Fourth Floor Expansion Plan

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Area Tabulations - Page 1

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Area Tabulations - Page 2

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View Towards Main Entry Plaza

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View at Main Entry Lobby

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View at Dining Area

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View at Outpatient Clinics Lobby

Documents

Ft. Bliss Executive Summary