The working group concluded that consolidating acute medical and surgical services at the naval hospital was possible and desirable. From the Navy’s perspective, the benefits included

  1. expansion of its services for its beneficiary population,
  2. increased accessibility to care,
  3. an opportunity for a portion of the local staff to remain in place during mobilization,
  4. more efficient use of the existing facility, and
  5. cost savings to the government and the Navy beneficiary population (GAO, 1980, Enclosure 1, p. 6).

From the VA’s perspective, the naval hospital was more modern and better addressed the population’s health care needs. The VA could close two 50-year-old psychiatric inpatient buildings that were expensive to maintain and operate and move the patients into the main hospital facility, Building 133, which was 20 years old, after renovation that would be less costly than upgrading the building to acute-care standards.

VA and Navy officials also noted that such a major sharing agreement could set a precedent and provide a model for additional VA/DoD sharing arrangements. The officials also pointed out, however, that the VA/DoD sharing act (Public Law 97-174) did not address a number of administrative and personnel issues that would have to be resolved.

  • How would the consolidated hospital be managed? Who would control the joint medical/surgical service and ancillary service? Would the Chief of Medicine, for example, be from the VA or the Navy?
  • With different employee pay and benefit systems, which agency would control the consolidated service arrangement?
  • With dissimilar forms and records, which ones would be used?
  • How would the upward mobility of VA employees working in the Naval facility be affected?
  • How would union actions be addressed for VA employees working in the Naval facility?
  • How would the Navy maintain command and control over military people working side-by-side with essentially civilian VA employees subject to different rules and regulations? (GAO, 1980, Enclosure 1, p. 17).

The same issues confronted the planners of the Lovell FHCC and, in some instances, had to be resolved by special legislation (see Chapter 3).

By the time the GAO reported on the situation, both the Navy surgeon

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