Inactive

Request for Information only Please submit your capability statement by 4/12/23 @ 8am. Also, clarify what business type you are, Duns#, and SAMs UID. Thanks. Keysha Gorman

Inactive

Page 10 of 21 DISCLAIMER This RFI is issued solely for information and planning purposes only and does not constitute a solicitation. All information received in response to this RFI that is marked as... Page 10 of 21 DISCLAIMER This RFI is issued solely for information and planning purposes only and does not constitute a solicitation. All information received in response to this RFI that is marked as proprietary will be handled accordingly. In accordance with FAR 15.201(e), responses to this notice are not offers and cannot be accepted by the Government to form a binding contract. Responders are solely responsible for all expenses associated with responding to this RFI. PERFORMANCE WORK STATEMENT Strategic Planning Consult Services Background: The VA Capitol Health Care Network (VISN 5) was established in October 1995 and serves Veterans from economically and demographically diverse areas within Maryland, the District of Columbia, and West Virginia, plus portions of Virginia, Pennsylvania, Ohio, and Kentucky. VISN 5 network consists of eight medical centers and numerous Community Based Outpatient Clinics (CBOCs) located throughout Washington DC, Maryland, West Virginia, and surrounding areas. The support services will cover/support the main medical center and associated CBOCs. VAMC location for each VISN 5 Medical Center: VA Baltimore Medical Center 10 N. Greene Street, Baltimore, MD 21201 VA Loch Raven Medical Center 3900 Loch Raven Blvd, Loch Raven, MD 1218 VA Perry Point Medical Center 59 Avenue D, Perry Point, MD 21902 VA Beckley Medical Center 200 Veterans Avenue, Beckley, WV 25801 VA Huntington Medical Center 1540 Spring Valley Drive, Huntington, WV 25704 VA Clarksburg Medical Center 1 Medical Center Drive, Clarksburg, WV 26301 VA Martinsburg Medical Center 510 Butler Avenue, Martinsburg, WV 25405 VA Washington DC Medical Center 50 Irving Street, Northwest, Washington, DC 20422 The Community-Based Outpatient Clinics are health care facilities that enable the VA to make care more accessible in areas where many Veterans live, or in remote areas where other health care services are not available. There are also 3 Community Resource and Referral Centers located in Baltimore, Huntington and Washington, DC; 6 Community Living Centers located at Perry Point, Loch Raven, Beckley, Clarksburg, Martinsburg and Washington VAMCs; and 4 domiciliary located at Perry Point, Clarksburg, Huntington, and Martinsburg VAMCs. With an annual general purpose medical care budget in FY 23 of approximately $2.5 billion, VISN 5 employs over 12 thousand staff (including clinicians, administrators, and support staff) throughout the 49 sites of care and executes over $25M in support of Research Activities. Annually, VISN 5 executes over $40M on Medical Equipment, $155M on Pharmaceuticals, $211M on Medical Supplies, and over $275M in Specific Purpose programs including but not limited to Rural Health ($14M), Prosthetics ($122M), Whole Health ($3M) and trainees ($32M). In addition to the budget supporting VA-based care, VISN 5 executed $750M in support of Veteran care provided through community partners. The estimated eligible Veteran population in our geographic service area is 519,032 Veterans, and during FY22, we provided care to over 247,594 individual Veterans who had 3,026,344 outpatient visits. All VISN 5 staff are committed to providing safe, high-quality clinical care to Veterans, both on an inpatient and outpatient basis. Through the dedicated efforts of our staff, the VISN had six of its clinical programs recognized by the Veterans Health Administration as "VA Clinical Programs of Excellence." These are: The "Seriously Mentally III Program" (a Network-wide initiative) The "Health Care for the Homeless Program" (Washington DC VA Medical Center) The "Home Based Primary Care Program" (VA Maryland Health Care System) Epilepsy Center of Excellence (VA Maryland Health Care System) Maryland Exercise and Robotics Center of Excellence (VA Maryland Health Care System) Multiple Sclerosis (MS) Center of Excellence (Washington DC VA Medical Center) VISN 5 has one of two national centers for the study of war-related illnesses, the War-Related Illness and Injury Center, located at the Washington DC VAMC. VISN 5 also has a Geriatric Research, Education and Clinical Center (GRECC) and a Mental Illness Research, Education and Clinical Center (MIRECC) located at the VA Maryland Health Care System. Each of these programs serves as a national model for Veterans' health care. Objective: This Request for Proposals (RFP) is to identify a qualified firm for development of the VISN-wide Facility Master Market Plan (FMP), which shall encompass individual Master Plans for each of the six parent facilities, Beckley, Louis A. Johnson, Hershel Woody Williams, Martinsburg, VA Maryland, and Washington, D.C. The selected Firm will be required to produce written, graphic, and digital documentation of the Facilities Master Plans detailing anticipated work for the ten years Fiscal Year (FY) 2025-2035, including capital plans to align with the projected Veteran enrollment, case severity index, and requirements determined by the VISN. The VISN is requesting qualification statements and proposals from qualified firms with proven facilities master planning experience. The selected firm will work with the steering committee, take an active leadership role in the entire process, present to the Executive Leadership Council, and prepare final documents. These documents will include at a minimum: Facility Master Market Plans (book format), Thirty copies per parent site. The FMP shall minimally include all contents identified in Appendix E Sample FMP Service Components. Three (3) full color master site plans (one for each site), scale 1 = 100 . All Information, (documents, graphics, surveys, meeting minutes, etc.) provided on hosted website throughout the FMP process. See Sample Landing Page for Facilities Master Plan Website (Appendix F). Shall meet and/or exceed all accessibility requirements of section 508 of the Rehabilitation Act of 1973. Implementation Plan. See Sample Implementation Plan (Appendix G). Electronic copies of all documents Both hard and electronic submittals will be high resolution (no less than 300 dpi) Shall meet and/or exceed all accessibility requirements of section 508 of the Rehabilitation Act of 1973. On or about September 30, 2023, the VISN is expected to recommend the Executive Leadership Council approve the FMP. All information stored on the hosted website will be provided electronically to VISN 5 at the conclusion of the contract. SCOPE OF SERVICES: The VISN is seeking a qualified Firm to develop the VISN-wide FMP for the period of FY 2025- 2035. The FMP will establish the short and long-term facilities needs for the VISN based enrollee projection data, workload projections, case severity index, bed days of care, average daily census, ability to recruit and retain staff, community service availability data, and other factors developed through interviews with executives. The primary objectives are to determine current and future space and clinical service needs, identify the improvements (buildings/ facilities/ infrastructure, etc.) required, establish project priorities, formulate project costs and recommend a resource allocation plan. Facility Master Market Plan Goals: Based on the VISN s enrollee projections and other VISN-wide initiatives, create a FMP to support and enhance the VISN s clinical goals, other goals, and the VISN s programs. This includes the interdependency of the facilities within the VISN and shared market requirements and resources. Complete a review of existing facilities assessments and identify deficiencies, including program and service areas, circulation, utility and infrastructure systems, telecommunications, and health and safety conditions. Identify needs to add, renovate or repurpose facilities to accomplish VISN clinical initiatives. Evaluate future enrollment needs and project associated facilities needs. Identify projects scope and costs. Facilitate an evaluation of the benefits related to a broad array of options to meet current and projected facility needs. Develop a Facilities Improvement Project List to support projected Non-recurring Maintenance, Minor, and Major capital funding. Recommend options, all of which result in an alignment between the long-range facilities improvements and the capital investments to support the current and future clinical programs. Develop an implementation plan to fulfill the identified needs, coordinating the scope of work with funding resources in fiscal year intervals and create a 10-year planning schedule for work VISN-wide (See Appendix G Sample Implementation Plan). The Offers will assist the VISN beginning with the planning process through to the VISN s Executive Leadership Council acceptance of the plan. The planning process will require interactive meetings, planning charts, open forums, workshops and presentations. The Offers will gather input from the VISN and parent facility leadership and other constituencies through the VISN and parent facilities committees. During the FMP process, the Offers will be responsible for producing all meeting minutes and associated handouts in an electronic format for review by VISN staff prior to distribution. The final product will include, but not be limited to: A clinical and strategic master plan that illustrates potential plans to accommodate future clinical programs, as well as projected restructuring. Recommendations for all projects necessary to achieve final build-out along with comprehensive analysis and justifications. The Implementation Plan is a critical component of the final product. The Implementation Plan will coordinate all FMP projects with funding resources using fiscal year intervals. Provide a separate binder/electronic file including all backup documentation developed during the FMP process. Assign a team of individuals to the project who must minimally possess: Familiarity with clinical program planning in the large, complex, multi-state health care provider organizations, Technical planning expertise in clinical facilities, and health care landscape planning/design, including capability for long-range planning/design and infrastructure planning/engineering/design. Familiarity with private and public sector health care operations and offerings Familiarity with federal government budgeting, appropriations, and fiscal cycles Proposals should include a recommended approach to the planning process to obtain the outcomes that are described within this RFP. This approach will balance VISN and parent facility goals, with deference to VISN-wide planning determinations., to include a passback process whereas facilities will develop plans with the contractor and submit those plans to VISN for concurrence. Contractor will work with facilities to develop and re-develop goals to meet VISN expectations on final product. The Offers should anticipate a minimum start-up period of two to three weeks for orientation meetings with the VISN s executive leadership team and the steering committee before the formal planning process begins. Defined Tasks: TASK 1: Process Development: Determine the overall process to engage all key stakeholders. Meet with the steering committee to ensure process meets desired outcomes to include: Data Analysis, Facility and VISN Strategic Goal Development, Pass back process for Facility Master Plan Development, Facility Master Plan Development, and Final Adoption. Develop a meeting schedule and coordinate to confirm meeting times and agendas. TASK 2: Program Definition/Data Collection: Use the VHA Support Service Center information as provided by VISN Staff on growth, capacity, and subsequent Program Reviews by the VISN to determine the type and amount of space and resources to provide clinical and administrative programs that would be needed as the VISN matures to the time horizon. Data will include Veterans with referral patterns to VISN 5, within VISN, amongst VISN 5 facilities, and potentially to VISN 5 in the future time horizon. Review data related to DoD/VA, and other federal agency and academic affiliate sharing and resourcing opportunities. The information will translate into space requirements, land use, adjacencies, capacity/massing, circulation, infrastructure and utility requirements, and partnership requirements. Data will also need to be provided by the offers to include non-VA community capability and capacity data. Including the inclusion of academic affiliates and community partners. TASK 3: Site Analysis including Massing Analysis and Future Expansion: The Offers will examine physical attributes and constraints, surrounding context, and existing and potential future program needs VISN-wide. As part of the capacity/massing study, identify potential building sites, identify sites necessitating the demolition of existing structures, identify potential site issues, and show associated utility service connections. The study will provide total site capacity information for potential development and will include non-owned sites, such as leased space. This will encompass all counties within the VISN 5 catchment area. TASK 4: Site Current Condition Analysis: The Offers will assess the condition of the existing campuses and all improvements including using the recently prepared VISN-wide Mapping, and Facility Condition Assessment reports to examine current campus infrastructure (both above and below ground), and other available assessments. Based on those studies and the Offers s independent confirmation of report accuracy, the Offers will propose clinical program development, renovation, modernization, new construction, and infrastructure projects. TASK 5: FMP Issues and Options: The Offers shall articulate key goals for the FMP utilizing the set of guiding principles previously approved as a framework for the FMP after completion of services as identified in Appendix E - Sample FMP Service Components. TASK 6: Present Draft FMP for Review: Develop the draft FMP to include the following at a minimum: Executive Summary inclusive of all projects listed and project phasing for the VISN as a whole. Beckley VA Medical Center Market Master Plan with proposed funding sources, detailed project descriptions, project budgets, and master plan schedule with timelines/Gantt chart. Louis A. Johnson VA Medical Center Market Master Plan with proposed funding sources, detailed project descriptions, project budgets, and master plan schedule with timelines/Gantt chart. Hershel Woody Williams VA Medical Center Market Master Plan with proposed funding sources, detailed project descriptions, project budgets, and master plan schedule with timelines/Gantt chart. Martinsburg VA Medical Center Market Master Plan with proposed funding sources, detailed project descriptions, project budgets, and master plan schedule with timelines/Gantt chart. VA Maryland Healthcare System Market Master Plan with proposed funding sources, detailed project descriptions, project budgets, and master plan schedule with timelines/Gantt chart. Washington, D.C. VA Medical Center Market Master Plan with proposed funding sources, detailed project descriptions, project budgets, and master plan schedule with timelines/Gantt chart. VISN-wide interdependency services Market Master Plan with proposed funding sources, detailed project descriptions, project budgets, and master plan schedule with timelines/Gantt chart. TASK 7: Adoption and Implementation: The final phase of the FMP process includes adoption and implementation with a formal presentation to the Executive Leadership Council on or about September 30, 2023. Anticipate no less than three draft reviews prior to final acceptance. INSTRUCTIONS, INFORMATION AND GENERAL CONDITIONS: The Veterans Integrated Service Network (VISN) is seeking to retain a qualified firm to provide Facilities Master Plan Development Services. The VISN plans to select a firm with specific experience with large, complex, multi-state health care provider organizations. The entirety of this RFP sets forth the VISN s requirements in detail. All responses should be submitted in accordance with the terms and conditions contained in the foregoing document. DEFINITION OF TERMS The designation of VISN refers to the VA Capitol Health Care Network, VISN 5, a subdivision of the Veterans Health Administration, U.S. Department of Veterans Affairs. Throughout this document, the term VISN shall be used to designate the rights and responsibilities of VISN 5. The term Offerors refers to Firms that elect to submit proposals for Facilities Master Plan Development Services. The term Offers shall be used to designate the rights and responsibilities of the successful firm responding to this RFP. The terms "Contract" and "Agreement" shall be used interchangeably within this document. PROPOSAL QUESTIONS/ REQUESTS FOR INFORMATION (RFI) All capabilities regarding this RFI should be sent, via e-mail to the attention of the assigned Contracting Officer Keysha.Gorman74@va.gov by 8:00am on April 12, 2023. PROPOSAL SUBMISSION It shall be the responsibility of the Offers to ensure that Proposals are received in the following way: Offers must submit proposal RFQ 36C24523Q0415 by 8am on April 10, 2023. Emphasis should be on brevity and clarity of contents. Proposals should be in 12-point type. Proposals submitted in response are to be labeled Form A, B, C etc. and be in the following order: Letter of Interest and Approach - Provide a cover letter per the requirements of PROPOSAL FORM A (Seven-page limit). Personnel and Staffing Resources - Provide answers to the questions in PROPOSAL FORM B. Related Experience and Methodology PROPOSAL FORM C (Seven-page limit). Fee and Rate Proposal PROPOSAL FORM D. General Terms and Conditions PROPOSAL FORM E. References PROPOSAL FORM F. Addenda Acknowledgement PROPOSAL FORM G. Facilities Master Plan Task Summary Schedule PROPOSAL FORM H. Appendices Sample Facilities Master Plan Service Components Sample Landing Page for Facilities Master Plan Website Sample Implementation Plan Oral, telephone, facsimile (fax machine) proposals will not be accepted Page 12 of 21 Proposal Evaluations: The VISN intends to interview firms and has tentatively scheduled interviews on at the VISN offices. Oral presentations will be evaluated and may be subjected to the selection criteria. The VISN requires the mandatory presence of the designated representatives identified in the proposals as being the ones who will be assigned to the VISN be present and prepared to respond to VISN inquiries. The decision to hold interviews and the scope or any limitations thereof shall be at the discretion of the VISN. Evaluation Criteria: The proposals shall be primarily evaluated based upon qualifications of the firm and personnel, innovativeness, demonstrated knowledge and experience with large, complex, multi-state health care provider organizations, and estimated fees. Selection Process: All proposals will be examined for merit and ranked by a screening committee according to quality and responsiveness. The top proposals will be placed on a short list of finalists and may be called for interviews. Team members giving the presentation shall consist of those who will actually direct, execute, and complete the project. The firm or firms selected as first choice will be notified and asked to negotiate final terms of the contract. Contracts will be forwarded to the Board of Trustees for approval and authorization to proceed. Content and Order of RFP Response Firm s proposal should be concise and contain the following sections in order as shown. RFP responses submitted in formats other than that prescribed below may, at the sole discretion of the VISN, be rejected. All sections identified below must be included for the RFP response to be considered complete and must be divided into tabbed sections. Contractor Performance: The following categories will be reviewed and utilized to evaluate contractor performance: QUALITY OF WORK The Offers shall be responsible for the performance of all work as specified herein and shall guarantee that work will meet or exceed the specifications as set forth herein. If it is determined by the VISN that such services and/or materials do not meet requirements of the VISN, the Offers shall be required to correct the same at their own expense. QUALITY OF PERSONNEL ASSIGNED TO THE WORK The Offers shall not employ on this account any unfit person or anyone not skilled in the work assigned to her/him and shall devote only its best qualified personnel to work under this contract. Should the VISN deem anyone employed under any contract which may arise as a result of this RFP to be incompetent or unfit to perform their duties and so inform the Offers, the Offers shall immediately remove such person from this work and such individual shall not again, without prior written permission of the VISN, be assigned to work under this contract. ACCESSIBILITY OF INFORMATION TECHNOLOGY: Offers hereby warrants that the Work to be provided under this Agreement complies with the accessibility requirements of Section 508 of the Rehabilitation Act of 1973, as amended (29 U.S.C§794d), and its implementing regulations set forth at Title 36, Code of Federal Regulations, Part 1194. Products covered under this provision include, without limitation, the following: Software applications; operating systems; web-based intranet and internet information and applications; telecommunications products; video or multimedia products; self-contained closed products such as copiers; source codes and desktop and portable computers. Offers agrees to respond promptly and resolve any complaints regarding accessibility of its products or services that are brought to its attention. Offers further agrees to indemnify and hold harmless the VISN from and against any claim arising out of Offers s failure to comply with these requirements. Offers acknowledges that failure to comply with these requirements shall constitute a breach and be grounds for termination of this agreement or cancellation of the order. Government Furnished Property : It is anticipated that Government furnished property, material, and facilities will be required for contractor performance of this requirement. The required Government-furnished property has been reviewed and it has been determined that no apparent problems exist that will inhibit the successful performance by the prospective contractor. The appropriate clauses will be included. Clause 52.245-1 will be included in the contract. Government Furnished Information: It is anticipated that Government-furnished information will be required for contractor performance. The availability of this information and the required delivery schedule to meet schedules required for contractor's performance have been reviewed and determined that no apparent problems exist that will hinder the successful performance by the prospective contractor. A list of the Government-furnished information anticipated follows: government project information. Inherent Government Function: The contracted employees shall not perform inherently governmental functions as defined in the Office of Federal Procurement Policy (OFPP) Letter 92-1, Inherently Governmental Functions and FAR 7.5, Inherently Governmental Functions. It should also be understood that no government employee will be supervising any contract employee and no contract employee will be supervising any government employee under this contract. Lastly, the contractor shall represent themselves as a contracted employee when engaged in official communications regarding government related program matters. Page 14 of 21 PROPOSAL FORM A LETTER OF INTEREST AND APPROACH (Maximum of 7 Pages) Letter of Interest and Approach The RFP response should be introduced with a Letter of Interest that presents a statement of interest, firm s approach, and philosophy for implementing these services, and a brief description of the firm including qualifications for providing the requested services. Describe what is unique about the firm as it relates to this specific project. The firm will work closely with the VISN and parent facility leadership teams to ensure accurate, timely, and sufficient information necessary to complete the project. Accordingly, please respond to the following questions: Describe specific techniques to be employed. Outline the anticipated work plan and schedule. Provide a Task Summary Schedule. (Proposal Form H). Describe how your team will work with the VISN and facility leadership and staff to manage and keep the project on schedule in order to present the final product. The response to this section should specifically address how the team would balance the reality of deadlines with the VISN s commitment to participatory (shared) governance and deliberative processes. Each response should illustrate examples of data they collect and how they use this data appropriately to benefit the VISN. How will you work with the VISN and parent facility committees to ensure you have the information necessary to be successful? Also, how will you ensure that the information provided to the VISN will be accurate, timely, and sufficient? List any additional components of the Facilities Master Plan Development Services that you will not be providing and that you will be expecting from the VISN, if different than specified under the "Scope of Services" section of this RFP. What strategies will be used to assure appropriate participation from the VISN, the parent facilities, and other constituencies? In developing the FMP, you will have quantitative inputs such as enrollment projections and the existing space inventory that can be used to derive a quantitatively-based FMP. You will be provided with quantitative inputs from the VISN VHA Support Service Center, but will also need to provide quantitative inputs from non-VA care capacity and capability. There will also need to include an environmental scan and initiatives resulting from program review. Please provide examples of how you have balanced the quantitative and qualitative factors in preparing a FMP for another large, complex, multi-state health care provider organization, specifically, what will be needed in order to create a data-driven, visionary FMP. Page 15 of 21 PROPOSAL FORM B PERSONNEL AND STAFFING RESOURCES (Two page maximum per team member) Provide total number of professional staff currently employed by the firm. Present the hierarchy of the team in an organizational chart. Clearly identify roles and responsibilities and include resumes and profiles for all individuals assigned to the project team to minimally include: Identify person/s who will be principally responsible (Project Executive) for working with the VISN. Identify the specific tasks, responsibilities, and deliverables for each individual. List the proposed team member s current and anticipated availability during the contract period. Years of experience with a focus on large, complex, multi-state health care provider organizations and qualifications relative to the proposed role. Brief biography, education, training, professional certifications, and work experience history. Highlights of the skills identified with their respective tasks. Indicate whether or not individual is currently a direct employee of the firm. If a direct employee, indicate how many years with the firm. If the individual is not a direct employee, indicate how many years of collaboration the Firm has had with the individual and identify projects. Page 16 of 21 PROPOSAL FORM C RELATED EXPERIENCE AND METHODOLOGY (Maximum of 7 Pages) Provide a summary of the Firm s experience in relation to the services contemplated in this RFP. Describe how the Firm will provide services and fulfill the requirements and expectations of the VISN. Proposal is limited to 7 pages. Information provided in pages over the 7 page limit will not be reviewed. Provide a summary of your Firm s experience working with large, complex, multi-state health care provider organizations and the related experience of the staff assigned to this project. Based on the RFP Scope of Services, clearly specify any work that would be considered additional services and identify how those services are billed. The Firm will provide a website to host the FMP. The site will be hosted at the Firm s cost during the contract term and shall be kept current relative to the ongoing FMP efforts. Describe the type of information you plan to include on the website. (If available, provide graphic examples/ screen shots as an attachment and outside the maximum page allowance). The website shall meet and/or exceed all accessibility requirements of section 508 of the Rehabilitation Act of 1973. Indicate the Firm s proximity to the VISN and availability to accomplish the work. It is expected that many of the development activities will need to be conducted in person at the VISN office and at each of the parent sites. List projects in chronological order in which team members were involved. Indicate whether project was completed by Firm or by a team member when employed by another firm. Submit one complete example of a similar FMP developed within the last five years (as an attachment and outside of maximum page allowance). Page 17 of 21 PROPOSAL FORM F REFERENCES Each Offers must be able to present current and/or past evidence of satisfactory experience in providing Facilities Master Planning services requested. List all large, complex, multi-state health care provider organizations that you or your firm has contracted with in the last five (5) years. Include the name of the institution, contact person, email address and phone number of individuals who can evaluate work that has been completed by the consultant(s)/firm/team member(s) in the past five (5) years. The VISN has prioritized collegiality and collaboration, and assessing how consultant(s) will function within that culture will be a critical evaluation component. Add additional pages as needed. REFERENCES Name of Entity: Contact Person: Address: City: State: Zip: Phone Number: Fax: Email: Dates of Services: From: To: Types of Services Provided: Page 18 of 21 PROPOSAL FORM H Facilities Master Plan Task Summary Schedule Offers shall provide the projected start and completion date in the chart below for the defined Tasks 1-7 as identified in the Scope of Services section of this RFP. TASK # TASK TITLE START DATE COMPLETION DATE 1 Process Development 2 Program Definition/Data Collection 3 Site Analysis including Massing Analysis and Future Expansion 4 Site Current Condition Analysis 5 FMP Issues and Options 6 Present Draft FMP for Review 7 Adoption and Implementation APPENDIX E Sample Facilities Master Plan Service Components Facilities Master Plan Scope of Work Review Previous Market Assessments and Strategic Plans Interviews VISN Level Analysis-Review Executive leadership team Parent facility Level Analysis-Review Executive leadership team Facility Research Pre Planning Studies Current Strategic Capital Investment Program (SCIP) Entries Previous assessments Sustainability & Energy Conditions Assessment Scheduled Maintenance Current Information Space Inventory, Capital Asset Inventory (CAI) Five, Ten Year Plans Project Proposals Parent facility Meetings-VISN wide Needs Assessment Leadership Teams Clinical Stakeholders Facilities, Maintenance & Operations Historic Spending Patterns VISN Construction Committee High Cost High Tech Committee Parent Facility Resource Management Boards Scheduled Maintenance/NRM/Minor/Major Other Facility Analysis Key Issues, Opportunities and Challenges Clinical Operations Access Expansion of Services Capability and Capacity of Non-VA providers National Planning Strategy Compliance Drive time and transportation Assessment Addressing Aging Facility Needs Infrastructure Seismic Building Envelope Technology Security/Workplace Safety Education, Research, and Emergency Preparedness Mission Supp...