In less than five years, the Spokane Veterans Affairs Medical Center has launched or planned construction projects with a total value approaching $50 million on its 38-acre campus at 4815 N. Wellesley, in North Spokane, says Cheryl Wood, the hospital's chief of engineering services.

Wood says the U.S. Department of Veterans Affairs has ramped up construction funding here as veterans' needs for services have risen, due in part to veterans who've returned from tours in Iraq and Afghanistan.

"Between design and construction, we've been averaging between $22 and $25 million a year for projects in the last couple of years," she says, adding that it takes at least three years for larger projects to come to fruition once design funding is approved.

Spokane VAMC served 27,877 veterans and handled 1,388 surgeries in 2011, says Bret Bowers, a spokesman for the hospital. Also in 2011, the hospital and its clinics had 304,297 outpatient visits.

Spokane VAMC's upgrade and expansion projects have helped boost its staff to 815 employees today, up from 760 in 2008, Bowers says. Spokane VAMC's operating budget, currently at $154 million, also has been increasing by 2 percent to 4 percent annually during the last five years, Bowers says.

While the eight-story hospital building has little room to expand outward without encroaching on other structures on campus, previously constructed single-story additions to the main building have room to expand upward, especially on the west side of the main building, Bowers says.

In Spokane VAMC's largest upcoming funded project, Kevcon Inc., of Escondido, Calif., has submitted an apparent low bid of $8.3 million for a multifaceted project that will include two second-floor additions with a combined total of 15,000 square feet of floor space. Burton Construction Inc., of Spokane, submitted the second-lowest bid of $9.5 million.

One of those additions will house a 6,000-square-foot endoscopy and gastrointestinal unit, which will be constructed above the entrance on the east side of the main hospital building. The other addition will include a 9,000-square-foot central processing suite to be constructed above the recent specialty care and pharmacy addition on the west side of the main building.

The endoscopy portion of the project will include two procedure rooms in addition to its current space. The central processing department, which provides support functions including collecting, cleaning, sterilizing, and distributing medical instruments, will move from its current space on the top floor of the main hospital building.

The contract for the project, which was designed by Spokane-based NAC|Architecture, is expected to be awarded in early July through the Walla Walla, Wash., office of Veterans Affairs, so construction can begin this summer. Work is to be completed within 19 months of the contract award.

Wood says Spokane VAMC has received approval to begin the design phase next year to expand and update the eighth-floor inpatient surgery space, a project estimated at $6.3 million. The expansion to five operating rooms from three would occupy the additional space the central processing department will vacate when it moves to the planned second-floor addition.

Construction on the operating rooms likely would begin in 2015, Wood says.

Current construction

The hospital this month has started moving some of its mental health services into its new outpatient mental health building. The contractor is putting finishing touches on that $6.5 million, 18,000-square-foot facility just north of the main hospital building. Burton Construction Inc., of Spokane, is the contractor on the project, and Integrus Architecture PS, also of Spokane, designed it.

Spokane VAMC has scheduled a formal opening date of Aug. 17 for the facility.

It's the newest outpatient mental health facility for Veterans Affairs, which recently announced a nationwide recruitment, education, and training campaign to attract mental health professionals, he says. The building has room for a staff of 92 people, and expanded services that currently are housed on the seventh floor of the main hospital building. Spokane VAMC currently has 83 mental-health clinicians and support staff serving veterans in Eastern and Central Washington, North Idaho, and northwest Montana.

A $2.5 million, 7,200-square-foot audiology building located southwest of the main hospital building also is scheduled to be completed this summer. The audiology building will house two audio suites and two fitting rooms, which is twice the facilities it has in its current site in the basement of the hospital's outpatient clinic.

The audiology building also will have larger labs, room for a speech therapist, a conference room, and eight offices.

The Sandy, Utah, office of Colorado Springs, Colo.-based DWG & Associates Inc. is the contractor on the project, and Architects West Inc., of Coeur d'Alene, designed it.

Work started last week on a $1.6 million perimeter fence project, Wood says. The seven-foot security-grade fence will have the appearance of wrought iron pickets with flagstone support pillars.

"It will look like a gated community," she says.

The fence line will run along the east and south edges of the campus, paralleling Assembly Street and Wellesley Avenue. The chain-link fence on the west and north sides of the hospital grounds will remain.

The project will include an updated entry monument and some landscaping, Wood says. It also will include the installation of signage that will spell out "VA Medical Center" in large, backlit letters on the top-floor exterior of the main building, Bowers adds.

Northwest Technologies Inc., of Boise, is the contractor on that design-build project.

A $1.6 million electrical system upgrade project is under way, following the recent completion of a larger $5.5 million backup power project. The current project involves installing new controls, called switch gear, for the hospital's primary electrical distribution system.

The completed project included installing an auxiliary power supply station with three generators. Two generators can supply all of the hospital's power needs in an extended outage, and the third generator ensures additional backup power, Wood says.

Two Post Falls electrical contractors have formed a joint venture, CMEC Arch Electric JV LLC, to install the upgrades.

On the horizon

Looking into the future, Wood says she plans to request design funds to upgrade the hospital's boiler.

The boiler, which is the hospital's source of heat and hot water, was installed when the main hospital building was constructed in 1950, and while it's a point of pride that the plant maintenance staff has kept it operating dependably and efficiently considering its age, it's starting to show some wear, Wood says.

Wood says the Community Living Center, a 36-bed assisted-living center with hospice services on the hospital grounds, also likely will be due for upgrades within the next few years.

Last year, Veterans Affairs called for proposals for private partnerships to provide permanent housing for homeless veterans on 3 acres of vacant land east of the hospital. While that concept hasn't come to fruition, Bowers says the hospital currently has resources available to subsidize housing for 15 eligible homeless or unemployed veterans.

Spokane VAMC soon will select a site to expand its Coeur d'Alene community-based outreach clinic, Bowers says. The hospital has said it's looking for a location with at least 13,000 square feet of space to serve a rising veteran population there that needs a growing number of services. The Coeur d'Alene clinic currently occupies 8,500 square feet of space at 2177 N. Ironwood Drive.

Spokane VAMC also operates a community-based outreach clinic, in Wenatchee, Wash., and five rural clinics serving veterans in Eastern Washington, North Idaho, and northwest Montana. The community-based clinics are staffed by Spokane VAMC personnel, and rural clinics are staffed by contracted providers.

Completed projects

Following a $2.4 million remodel and heating and cooling improvements on the sixth floor of the hospital, VAMC recently opened its same-day surgery suite there. MTM Contractors Inc., of Spokane, was the contractor on the project, and NAC|Architecture designed it.

The most recently completed major structural project was the $5.5 million, 10,000-square-foot pharmacy and specialty-care addition on the west side of the main building, which Spokane VAMC opened in the fall of 2010. The building has doubled the hospital's pharmacy area and has provided space to centralize the hospital's specialty care services, which include traumatic brain and spinal cord injury care, arthritis care, podiatry, and dermatology.

MTM was the contractor on that project, and Omaha, Neb.-based HDR Inc. designed it.