Along the picturesque southern shore of Back Bay in the city of Biloxi, Miss., is an expansive complex of buildings organized in a campus-like setting on more than 100 acres of land: the VA Gulf Coast Veterans Health Care System (GCVHCS).

Since the 1930s, the GCVHCS, which comprised the Biloxi VA Medical Center and the Gulfport VA Medical Center, provided primary and secondary medical, surgical, and long-term care services to more than 60,000 veterans along the Alabama and Mississippi Gulf Coast, and the Florida Panhandle.

In June 2004, plans were made to expand and combine the Biloxi and Gulfport campuses as part of VA’s Capital Asset Realignment for Enhanced Services (CARES) program. As these plans were taking shape, on August 29, 2005, Hurricane Katrina devastated the Gulf Coast region.

A tidal surge caused by the hurricane wrecked the Gulfport VA Medical Center, which was closer to the shore, and almost immediately forced the facility’s closing and transfer of its services to the Biloxi VA Medical Center.

“What we had hoped to do in an organized, systematic way, as far as putting the campuses together, suddenly had to be jumpstarted,” says Gary Butterfield, CARES project coordinator for the GCVHCS. “After Katrina happened, we doubled and tripled employees in the space available, and some patient services were put in temporary trailers. We also ramped up the project schedule to construct multiple buildings simultaneously.”

Following the event, the GCVHCS commissioned international architecture/engineering firm Leo A Daly, in a joint venture with Blitch Knevel Architects from New Orleans, to consolidate the Biloxi and Gulfport facilities and provide master planning, architecture, interiors, and engineering services for the following new facilities: a major clinical addition, blind rehabilitation center, mental health unit, community living center, and support facilities consisting of a laundry and dietetics building, a parking garage, and a utility plant.

Other team members included the CSA Group as landscape architects and Machado|Patano as civil engineers.

“A week after Hurricane Katrina, we did an assessment,” says John Andrews, AIA, vice president and senior project manager of Leo A Daly. “We started work soon after, in November.”

 

Clinical addition
At the heart of this $310 million project is a 150,000-square-foot, four-story clinical addition. Adjacent and connected to the existing hospital on all levels, the facility, which was completed in June 2012, houses a 20-bed universal patient room unit, an ambulatory outpatient surgery unit with four operating rooms, 30 primary care examination rooms, two multipurpose procedure rooms, and physician offices.

Also included are spaces for orthopedics, podiatry, ENT, general medicine, gastroenterology, women’s health, oncology, urology, pulmonary care, dermatology, ophthalmology, and audiology/speech pathology.

“A critical aspect of this clinical addition is that all our outpatient clinical services and ancillary support services are housed in the same facility,” Butterfield says. “Previously, we had primary care in one building and specialty care in another building, and they were all on different floors. Now, a veteran doesn’t have to try to find his way around.”

To preserve the architectural character and historical significance of the Biloxi campus, the Leo A Daly/Blitch Knevel Architects joint venture team collaborated with the Mississippi Department of Archives and History. Elements of the original Southern Colonial Revival Style, such as high ceilings; colonnades; arches; exterior materials such as brick, precast, and stucco; wide porches; and low-pitched roofs were integrated into the facility.

In addition to aesthetic appeal, flexibility and functionality served as the primary goals of the project team. The universal patient room unit, situated on the fourth floor to tie into the existing surgical inpatient unit, can function as an acute or medical/surgical unit, an ICU unit, or a step-down unit. Likewise, the ambulatory surgical care unit is sized appropriately to function also as an inpatient surgery unit, if necessary, in the future.

The ambulatory unit’s location on the first floor also makes it more accessible and less stressful to patients, who have to walk only a short distance to get treatment. Many of the specialty clinics on the second floor are organized in a similar style to allow for maximum efficiency and flexibility in operations.

“You could move an entire primary care or specialty care clinic to a different space in a short period of time without too much work,” says Gunner Riggert, AIA, Leo A Daly’s senior associate and project manager.

Due to its proximity to the Gulf, the clinical addition was designed with strengthened structural and architectural elements for hurricane protection. Roofing, door, and window systems were specified to comply with Miami-Dade hurricane requirements to ensure the building’s ability to withstand hurricane-strength winds and accompanying debris.

Products specified to meet this requirement were required to pass various tests, including impact and pressure load testing for high-velocity hurricane zones. Because of VA requirements and the importance of the structure, the clinical addition was also designed for blast resistance and progressive collapse mitigation.

The blast resistance required the roof and wall structures to be hardened, while the progressive collapse mitigation required additional steel reinforcement to limit the spread of damage during an extraordinary event.

“When we started the design process, this was one of the first VA campuses to be designed for progressive collapse,” says Amy Schaap, AIA, Leo A Daly’s associate and architect. “If an event takes out a column, the loads are transferred to other columns, thereby protecting the occupants in the building.”

 

Blind rehabilitation center
As a pioneer in blind care, the VA has been instrumental in establishing more than 10 state-of-the-art blind rehabilitation centers (BRC) around the country. Biloxi VA Medical Center’s BRC, which was completed in July 2011 as a brand-new program, is a recent addition to that list. Approximately 63,000 square feet in area, this two-story facility holds 26 inpatient beds and is designed specifically to rehabilitate and train blind and visually impaired veterans during a six-week residential program.

To this end, each resident has a private bedroom with a bathroom. Some of the bedrooms are designed like a studio apartment and also include a kitchen, computer desk, and a resident wardrobe for personal items. A number of classrooms train patients in various skill areas, including orientation and mobility, communication skills, activities of daily living, manual skills, visual skills, computer access training, and social/recreational activities.

Rooms for various activities such as cooking, laundry, power tools, wood and metal shops, leather/weaving, sewing, and home repair enable residents to practice their skills. Common spaces are also provided for dining, socializing, and recreational activities.

“The BRC has been well received and held in high regard,” Butterfield says. “This is where we get the life-changing success stories about veterans who go in and receive their training, and when they come out, they’re more independent.”

 
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Mental health unit
The mental health unit, completed in September 2011, is a continuation of the VA’s efforts to provide treatment for veterans returning from wars in Iraq and Afghanistan, and to heal the most common mental health problems such as depression, substance abuse, and post-traumatic stress disorders.

This 98,000-square-foot, two-story building contains a 64-bed inpatient unit and attached outpatient clinic. Divided into four wards with 16 beds each, the facility includes residential treatment units focused on post-traumatic stress and substance abuse as well as acute psychiatric units. Almost half of the building space is allocated for outpatient mental health treatment, with 22 group therapy/conference rooms and staff offices.

Designed with an emphasis on “dignity with care,” the facility is intended to be safe, warm, and friendly for patients and staff. All patient areas and rooms have a clear line of sight and include high ceilings, anti-ligature hardware, toilet accessories, fixtures, and furniture. Floors, walls, and ceilings also have a homasote backup for soundproofing and preventing abuse by patients.

The building also incorporates antiterrorism/force protection and progressive collapse measures. Three enclosed outdoor healing gardens, two covered porches, and common spaces such as day rooms and lounges allow patients to go outside without having to leave the unit, while also giving them an opportunity to mingle with other veterans.

“Everything that you do when you design a mental health facility is driven by the concept of safety,” says Gary Lundgren, AIA, Leo A Daly’s vice president and senior project manager. “At the same time, you also want to ensure that veterans have a sense of dignity when they’re in the facility and don’t feel like they’re living in a confined place.”

 

Community living center
One of the unique facilities of the Biloxi VA Medical Center campus built using contemporary VA design guidelines is the community living center. During the programming phase, the facility was originally conceived as a traditional extended care facility with residents living in a hospital-like setting. As the project progressed, the VA decided to switch to the concept of small residential households within neighborhoods.

“We realized that the standards for long-term care were changing and decided to make the facility more residential in nature,” says Tess Finnegan, CARES analyst for the GCVHCS. “It was a cultural transformation for the VA.”

As such, this 105,000-square-foot, two-story facility, completed in October 2011, houses 96 residents in eight 12-bed houses. Each house includes dining and kitchen facilities with several food preparation and serving options, living areas with bookshelves and a fireplace, as well as spaces for recreation. Additionally, each house has a unique theme that’s distinct in color and detail to help residents identify their environment.

Named after rivers, including the Mississippi, Niagara, Potomac, and Rio Grande, the themes also give residents a sense of place and comfort. Furthermore, the houses are connected to one another through community spaces, much like an enclosed mall setting. These include a chapel, offices, exam rooms, dental/podiatry rooms, a beauty/barber shop, and a multipurpose room with an outdoor deck and coffee bar for large assemblies. The entire facility also overlooks the bay, providing great views to the residents.

“It’s like a big family of 12 with a small staff,” says Ron Blitch, FAIA, FACHA, president of Blitch Knevel Architects. “This concept is much more humane and therapeutic, and it has taken off throughout the VA system.”

 

Other improvements
Several support facilities have also been built or are currently under way as part of the project. These include a utility plant addition and a parking garage for 975 vehicles, completed in April and May 2011, respectively. The design of a laundry and dietetics building, only the second LEED silver certified building of its kind in the country, was completed in August 2012, and construction of the facility is expected to begin at the end of the year.

The new facility, which will process laundry from across the campus and other off-site VA facilities throughout the region, will utilize steamless technology laundry equipment to reduce the building’s energy and water consumption. A covered walkway and landscape project, which includes a central lawn and a memorial for veterans, will tie the campus together and provide the finishing touches to the project.                

Jay Srinivasan is a corporate senior public relations manager/writer for Leo A Daly and can be reached at jsrinivasan@leoadaly.com.