open was to combine it with the NHGL, saying “that would obviate the need for a new naval hospital, it would decrease the cost for taxpayers, and it would ensure the survival of this institution” (Chicago Tribune, 2001). Kirk, a Naval Reserve officer, was assigned to the House Armed Services Committee, which helped him in working with the Navy to close a deal (Dunn, 2010). In June 2001, Kirk led a bipartisan group of congressional staffers on a tour of the NHGL and the NCVAMC to build further support for combining the facilities (Flink, 2001).

Local veterans groups favored a merger to save “their” hospital. At a rally at a Veterans of Foreign Wars post, for example, the head of the McHenry County Veterans Assistance Commission stated: “Surgery is their strong suit at Great Lakes; medical treatment is theirs at North Chicago. It would be a good thing for all of us” (Barnes, 1999).

The 2001 Veterans Integrated Service Network 12 Capital Asset Realignment for Enhanced Services Report

In response to the intense negative reaction of the various Chicago stakeholders to the 1999 VISN 12 options study, the House Committee on Veterans’ Affairs Subcommittee on Health asked the VA to develop and adopt objective, measurable criteria for formulating and evaluating options for restructuring the delivery of health care (U.S. House of Representatives, 2000). In response to that request, the VHA developed an improved evaluation framework and study methodology for assessing facility needs, called the Capital Asset Realignment for Enhanced Services (CARES) process. CARES addressed the deficiencies in the original VHA internal committee methodology and incorporated the “all or none” decision-making model of DoD’s BRAC process. The VA engaged Booz-Allen & Hamilton (BAH) to pilot the CARES process in VISN 12.

Meanwhile, as described above, the Navy was sponsoring studies of the follow-on to 200H, the obsolete NHGL building. Those studies explicitly considered alternatives that included shifting inpatient care to the NCVAMC.

BAH, using a private sector model to forecast demand through FY 2010, concluded that if no VAMCs had ever existed, that is, there was a clean slate, only two hospitals would be needed in the Chicago area, one near the existing West Side VAMC in downtown Chicago and the other 5–10 miles west of Hines. “We would not plan to construct an inpatient facility at North Chicago. … North Chicago is, however, a reasonable location for a multi-specialty ambulatory care clinic” (Booz-Allen & Hamilton, 2001, pp. 5–6). However, the four VAMCs did exist. BAH developed four options for the Chicago area, each featuring a different treatment of the West Side and Lakeside VAMCs. Each option treated the NCVAMC the



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