Truman Veterans Hospital construction project to break ground Aug. 10

COLUMBIA — Picnic tables and a small basketball court sit empty at Pershing Park, and the grassy area is now populated not with patients and doctors, but with bulldozers and construction equipment as Truman Veterans Hospital prepares to erect its newest addition.

The project of a World War I veteran who became a hospital volunteer, the patch of green space behind the veterans hospital has been used by patients and doctors as recreation space since the hospital opened in 1972.

Nearly 30 years later, after a legal battle that held up construction for four months, the veterans hospital is set to break ground in Pershing Park on Aug. 10 beginning construction on a $25 million project — its biggest ever.

Conceived in 2004, the project includes a 27,000-square-foot addition to the existing building and 12,000 square feet of renovations.

The new building will house an operating room suite with five operating rooms, two of which will be general purpose, two dedicated to heart surgery and one dedicated to special procedures. The old operating rooms will be gutted to house the new post-anesthesia care unit and pre-operation room, said Nathan Witt, chief volunteer officer for the hospital.

It will be the second major construction project for the veterans hospital in its 37-year history. The original building opened in 1972 and cost $15 million, seeing its first patient on April 4 of that year.

In 1975, it was legally named Harry S. Truman Memorial Veterans' Hospital. Over the years, millions of dollars have been pumped into the veterans hospital, but this project carries the biggest price tag of any single project at the facility thus far.

Since the hospital opened, the money spent on it has mainly gone toward modernization of care and new equipment. Public Affairs Officer Stephen Gaither said that as medical technology has changed, so has the landscape of the hospital.

The last major groundbreaking was in November 1995 for a construction project that created the new ambulatory care building adding 106,000 square feet onto the north side of the hospital. The two-story ambulatory care center was dedicated March 20, 1998, and cost $15.1 million.

Along with the $25 million for the new operating rooms, the veterans hospital will spend another $10 million for smaller projects: $6 million to relocate its imaging department, $2 million on its medical laboratory and another $2 million to renovate its research space.

The new operating suite is being funded with money allocated by the Department of Veterans Affairs. The $25 million will cover the entire project, including brick and mortar, utility systems and approximately $4 million for new equipment, Witt said.

"My staff is extremely excited about being one of the cutting-edge hospitals in the area," said Nurse Manager Marie Hulett.

Each new operating room will be integrated into a system allowing the hospital to route information to anywhere in the facility and any other hospital that uses the same system, Hulett said. The new system will give doctors easier and faster access to patients' medical information. The new operating room systems will also allow for more minimally invasive procedures, which Hulett said are more cost-effective and less traumatic to patients.

One such procedure is endovein harvesting, a procedure that involves opening the leg from the ankle to the knee to remove a vein that can then be surgically implanted in the chest to divert blood around a blocked coronary artery to get more oxygen rich blood to the heart muscle.

With the new technology, this can now be done with only a few incisions into the patient's leg, and this equipment takes up a lot of room, Hulett said. Extra space is needed to store all of the equipment needed for heart surgery.

"There is so much equipment involved in doing open heart," Hulett said. "The heart-lung perfusion machine is huge and takes up a lot of room."

As the only veterans hospital in the Heartland Network — including Missouri, Kansas, and parts of Illinois, Indiana, Kentucky and Arkansas — that has a referral center for open heart surgery, the veterans hospital does at least 250 heart surgeries per year, Hulett said.

One piece of space-saving equipment to be used in the new operating rooms are boom stands that will be able to run all of the equipment cables through one device. With the wires up off the floor, Hulett said there will be a lot more room at the table for surgeons.

A bid contested

The project was held up by a five-month court battle between the Department of Veterans Affairs and a construction company challenging the legality of the bidding process.

A Tennessee-based company, Totolo/King Joint Venture, filed a complaint on Feb. 19 with the U.S. Court of Federal Claims, claiming the Department of Veterans Affairs did not follow the proper regulations during the bidding process, resulting in a full and open competition for the project instead of restricting the competition to minority-owned small businesses. Totolo/King Joint Venture is a Service-Disabled Veteran-Owned Small Business.

James Krause, the federal contract lawyer representing Bill Totolo, said bids can be contested on a number of grounds, and contract law is "highly complex and highly convoluted."

The rules set up by the “Veterans First Program” in 2006 are designed to create an increase in contracting opportunities available to veteran minority-owned small businesses — like Totolo/King Joint Venture. The rule in question states that if two or more responsible small business interests respond to the notice, the bid must then be closed off to allow only small businesses to participate in the bidding process.

Three small businesses responded to the Veterans Affairs notice, but Veterans Affairs Contracting Officer Frank A. Clemons nevertheless recommended they allow the bid to be open to full competition. Clemons stated he searched a federal database of service-disabled veteran-owned small businesses and found none had the resources or the experience to complete the job required at the Truman Veterans Hospital. Veterans Affairs approved Clemons’ recommendation.

In her decision, Judge Christine Odell Cook Miller found Totolo was not able to prove the decision to compete for the project fully and openly was arbitrary — the Truman Veterans Hospital is classified as a “demonstration project,” so it is exempt from the regulations Totolo cited in his claim.

Construction Challenges

River City Construction LLC of Peoria, Ill., ended up getting the job. The company was given the notice to proceed on July 13. Kelly Hequembourg, the project manager for River City Construction, said for the last five months they have been sitting and waiting while lawyers did their work.

River City Construction has worked on many medical buildings. Hequembourg said working on hospitals carries its own set of challenges.

"We will have to work with the hospital to make sure, if they've got surgeries going on, that we are not up against the building doing demolition or drilling or something that causes vibrations," Hequembourg said. "There is a lot of coordination between both the hospital and the contractor to ensure the safety of patients."

Gaither said the veterans hospital has taken measures to ensure that patients are not inconvenienced by the construction. He said the audiology department, which tests veterans for hearing loss and impairments, was worried problems might arise from the construction noise. Although he said it wouldn't be clear until construction begins, he thought the noise would not be a problem.

There will three phases to the project, Hequembourg said. Phase one will be the new addition, and phases two and three will involve the renovation of the existing building.

The projected completion dates for each phase are: phase 1 on Nov. 16, 2010; phase 2 on Aug. 27, 2011; and phase 3 on May 14, 2012.

Another challenge facing the construction project is the limited space. Pershing Park is the only area to store equipment, but most of the area will be taken up by the new building, leaving very little room to store equipment and supplies.

"It is a very intense scheduling process to make sure that we get materials when we need them, and not have them sit there for two weeks and be in the way," Hequembourg said.

Hequembourg said River City faced the same problems on its recently completed project at University Hospital and is familiar with the kind of planning that it takes to do this kind of job.

As for Pershing Park, it will see new life. Gaither said there is funding within the project to remake Pershing Park in what remains of the green space behind the veterans hospital.