1. Base Realignment and Closure San Antonio Military Medical Center Air Force Association Briefing Col Cuda, Co-Director, San Antonio Medical BRAC Integration Office Col Hardin, Co-Director, San Antonio Medical BRAC Integration Office James K. Gilman, MD, FACC Brigadier General, USA, MC TRICARE San Antonio Associate Market Manager David G. Young III, MD, FACP Brigadier General, USAF, MC,CFS TRICARE San Antonio Senior Market Manager

2. BRAC Language “Realign Lackland Air Force Base, TX, by relocating the inpatient medical function of the 59th Medical Wing (Wilford Hall Medical Center) to the Brooke Army Medical Center, Ft Sam Houston, TX, establishing it as the San Antonio Regional Military Medical Center, and converting Wilford Hall Medical Center into an ambulatory care center.” One unified San Antonio Military Medical Center (SAMMC) with two integrated campuses: a North campus at Ft Sam Houston and a South campus at Lackland AFB. Providing the same level of wartime readiness support while delivering high quality, efficient, care for DoD beneficiaries in the San Antonio market. SAMMC Vision

3. SAMMC North Campus 425 Inpatient Beds Inpatient/Ambulatory Surgery Level 1 Trauma/ER Medical and surgical subspecialties 2240 personnel moving north from WHMC Additional staff moves south to support mission requirements Primary structure 953K SF: 644K SF new construction plus 309K SF renovated space * Building Gross Square Footage ** Departmental Gross Square Footage

4. SAMMC North Parking Garage B Intrepid Center & Fisher Houses (Non BRAC) Center of Excellence Battlefield Health & Trauma Clinical/Admin Addition Parking Garage A New ER/ICU Tower Over $550 million in new Milcon construction and renovation

5. Beds –303 Ward (Includes NICU) –90 ICU –32 Maternal Child Health 425 Inpatient Operating Rooms –28 OR’s 2 new Trauma OR’s 1 Burn 2 OB 23 Ambulatory & Inpatient OR’s SAMMC North- Beds & OR’s Located at North Campus Largest medical complex in DOD

6. SAMMC South Campus Ambulatory Care Center (ACC) Basic Military Trainees Primary care and medical specialties Will occupy 4 floors of WHMC, approximately 700K SF; approximately 131K SF will require renovation 406 personnel efficiencies; 2,240 moving North

7. SAMMC-South Renovated Space for ACC

8. San Antonio

9. Trauma Centers

11. FY11 Predicted SAMMC Population FY06 San Antonio Population Eligible Beneficiaries = 213,168 TRICARE Enrollment = 144,056 50,672 BAMC 60,876 WHMC 23,289 Randolph 9,219 Network Non-enrolled student population: 9,000 Lackland BMTs 4,500 FSH Students Camp Bullis North Central Federal Clinic SAMMC South SAMMC North Randolph AFB Assumptions TRICARE Enrollment remains constant Pediatric specialties and Internal Medicine to the North No increase in retiree population Enrollment starts at Federal Clinic in FY08 FY11 San Antonio Population Eligible Beneficiaries = 221,651 TRICARE Enrollment = 147,845 58,048 BAMC 57,480 WHMC 23,289 Randolph 9,219 Network Non-enrolled student population: 9,000 Lackland BMTs 9,003 FSH Students City of Military Medicine

12. Pre & Post BRAC Pre- BRAC Post- BRAC Specialty Clinics Inpatient Beds Trauma & Surgery Lackland AFBFt Sam Houston Outpatient Clinics Diagnostic Services Medical Center Operational Savings + = Efficiencies WHMC 60,876 Enrollees 269 Beds 1.6M SF WHMC 60,876 Enrollees 269 Beds 1.6M SF BAMC 50,672 Enrollees 224 Beds 1.3M SF BAMC 50,672 Enrollees 224 Beds 1.3M SF SAMMC South 57,480 Enrollees 9,000 BMTs Re-Use WHMC SAMMC North 58,048 Enrollees 9003 Students 425 Beds, 1.7M SF

13. Outstanding Results NEJM, 9 Dec 2004, Dr Gawande

14. Unsurpassed Homeland Security Planning Katrina/Rita: SA “model for nation”-Secretary Mineta Civil/military cooperation in response to WMD Community trauma & bio-terrorism planning efforts STRAC (SW TX Regional Advisory Council for Trauma) REMPSC (Regional Emergency Medical Preparedness Steering Committee) EHDG (EMS/Hospital Disaster Group) Local San Antonio Trauma Training Foundation for world-wide “critical care in the air”

15. Questions ?? Army BRAC Office Air Force BRAC Office Navy BRAC Office AETC MEDCOM TMA ISG Joint Basing BAMC MRMC AMEDDC&S Air Force Enlisted Training Navy Enlisted Training Brooks City Base FSH LAFB BP 172 BP 170BP 174 BP 169 WHMC MJCSG SAMMC METC ISR-BH