Legislation on Sizing Military Medical Facilities Needed To Correct Improper Practices, Save Money, and Resolve Policy Conflicts

HRD-81-24: Published: Dec 17, 1980. Publicly Released: Dec 17, 1980.

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An examination was made of the extent to which the Department of Defense (DOD) should plan to provide space in its new and replacement medical facilities for retirees and dependents of retired and deceased members. This factor has important policy implications, because it will affect the cost of constructing and operating medical facilities in the future and the medical benefits available to military beneficiaries.

DOD should have the flexibility to plan the size of new military hospitals and clinics based on considerations of cost effectiveness, staff availability, realistic workload projections, and teaching and training requirements. Under existing legislation, only teaching and training requirements are considered in planning space for retirees and dependents of retired and deceased members in new or replacement medical facilities. New legislation could correct the services' current improper sizing practices, save money in the long run, and align the sizing policy with the policy for providing staff and other medical resources to facilities once they are built. Construction which would provide greater capacity would be consistent with DOD responsibility to provide adequate medical facilities to meet its responsibilities in a war or national emergency. Currently, the military services are required to limit the size of new hospitals and clinics to accomodate active-duty members and their dependents, plus additional capacity not exceeding 5 or 10 percent to meet training and teaching requirements. The three military services presently do not fully comply with DOD hospital sizing limitations. Either enforcement of the requirement or modification of the law is indicated.

Matter for Congressional Consideration

  1. Status: Closed

    Comments: Please call 202/512-6100 for additional information.

    Matter: Congress should amend title 10, section 1087, U.S. Code, to allow for the sizing of military hospitals and clinics based on (1) life-cycle cost-effectiveness; (2) staff availability; (3) realistic workload projections; and (4) teaching and training requirements.

Recommendations for Executive Action

  1. Status: Closed

    Comments: Please call 202/512-6100 for additional information.

    Recommendation: The Secretary of Defense, pending enactment of new legislation, should direct the Secretaries of the Army, Navy, and Air Force to uniformly apply the size limitations required by law and DOD instructions to both inpatient and outpatient facilities when programing space in new hospitals and clinics.

    Agency Affected: Department of Defense

  2. Status: Closed

    Comments: Please call 202/512-6100 for additional information.

    Recommendation: The Secretary of Defense, pending enactment of new legislation, should consider, as part of the review, whether the five and ten percent factors are the most appropriate factors to apply to outpatient and inpatient facilities.

    Agency Affected: Department of Defense

  3. Status: Closed

    Comments: Please call 202/512-6100 for additional information.

    Recommendation: The Secretary of Defense, pending enactment of new legislation, should revise DOD Instruction 6015.16 as necessary based on the results of the review of the five and ten percent factors.

    Agency Affected: Department of Defense

  4. Status: Closed

    Comments: Please call 202/512-6100 for additional information.

    Recommendation: The Secretary of Defense, pending enactment of new legislation, should review the five and ten percent factors used in sizing military medical facilities, as suggested in the conference report on the military construction appropriations bill for fiscal year 1977, to determine if these percentages are still valid for meeting teaching and training requirements.

    Agency Affected: Department of Defense

 

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