extra costs. Finally, customer satisfaction and support to frontline war fighters is hampered by the dual operating locations. Functions at the Bitburg Annex, include a 15-bed inpatient unit, outpatient clinics, OB and surgical services, ancillary support and administrative functions. An OB/Gyn clinic is housed in a modular facility attached to the main hospital and a stand alone dental clinic is also located at the Bitburg annex. The aging Bitburg facility does not meet current US building codes and modern medical space standards and is in need of major infrastructure upgrades including a complete overhaul of the electrical, communications, medical gas, and HVAC systems. Medical Services at Spangdahlem are provided in three separate buildings: the first houses primary care and dental services, the second houses flight medicine and mental health services, and the third houses bioenvironmental engineering and public health services. These facilities are located within the explosive quantity-distance (Q-D) zone meaning personnel are in danger of barm should an explosive incident occur at the flight line munitions loading area. Long range plans for the base include relocating support functions within the Q-D zones to newly acquired land well beyond the blast zone. The planned replacement inpatient facility at Spangdahlem AB will consolidate medical services and staff, improve customer morale and quality of life, improve overall safety, and reduce operations and maintenance costs. IMPACT IF NOT PROVIDED:

The 52nd Medical Group will continue operating inefficiently at two locations forcing duplication of staff and services. The environment of care for patients will continue to degrade at the aging Bitburg facility and accreditation could be jeopardized unless a costly upgrade project is undertaken. Primary Care services at Spangdahlem will continue to be located within a blast zone proximate to the flight hoe which could endanger building occupants. Operations and maintenance costs will continue to grow as the staff struggle to maintain an aging hospital in addition to various outpatient services buildings.

NATO SECURITY INVESTMENT:

This project is not eligible for NATO funding. The English square foot equivalent for this construction project is 139,058.

ADDITIONAL:

CG USAREUR's Conventional Forces Europe (CFE) planners have certified the end-state requirements for this installation. There will be continued occupancy by US troops and are no known troop reductions or additions planned for this installation. The Director, Defense Medical Facilities Office certifies that this project has been reviewed for joint use potential. Joint use construction is recommended.

B. Equipment associated with this project which will be provided from other appropriations:

Support all Naval commands and organizations ashore in the Naples area, using mainly leased facilities Agnano, Pinetemare and Bagnoli, and the military controlled compound at Capodichino Airport. Commands include Sixth Fleet task force commands and staffs for: 1) combat support force (CTF 63), 2) ballistic missile submarine force (CTF-64), 3) area anti-submarine warfare force (CTF- 66), 4) maritime surveillance and reconnaissance force (CTF-67), and 5) attack submarine force (CTF-69). Also supported is the Commander, Fleet Air Mediterranean staff, responsible for management of all Navy shore bases in the Mediterranean. US personnel assigned to the Allied Forces, Southern Europe (AFSOUTH) NATO command in Naples are also a responsibility. Communications Station, Naval Hospital, fleet landing on Naples waterfront, and Sixth Fleet flagship at Gaeta are also supported.

Deferred SRM: The service estimated cost to remedy the deficiencies in all existing permanent and
semi-permanent medical facilities at this installation is $ 2,449,000.

Form DD 1390 1 Dec 76

PREVIOUS EDITIONS MAY BE USED INTERNALLY
UNTIL EXHAUSTED

016

The United States Government will purchase a Long-term interest, of not less than 26 years, in a Medical/Dental facility (hospital) and approximately 10 acres of related land. The Medical/Dental facility is a three-story building comprised of 170,450 SF and a single-story Central Energy buildmg of 9,500 SF. The new facility will be a 20-bed inpatient facility, including four (4) labor/delivery/recovery/postpartumn suites, medical and dental outpatient clinics, surgical and delivery suites, Laboratory, Radiology, Pharmacy. Physical Therapy, Emergency, Magnetic Resonance Imaging room, Command and Administration, Central Material Services (CMS), Logistical and Support Services, and Food Service and Dining functions. The new facility also includes an ambulance shelter, water storage tanks for potable water and fire protection, parking spaces and other supporting facilities. The project is sited on leased land and at the US Naval Support Site, Gricignano, Italy. This project is designed within the criteria prescribed in MIL-HDBK-1191 and the Uniform Federal Accessibility Standards/Americans with Disabilities Accessibility Guidelines. Air conditioning: 1055 Tons.

This project will provide for the United States Government to purchase a long-term interest of no less than 26 years, in a Medical/Dental Facility and approximately 10 acres of related land. (CURRENT MISSION)

REQUIREMENT:

This project is required to provide healthcare to the military beneficiaries in support of the Naples Improvement Initiative (relocation from Agnano to Gricignano). This replacement project is in the third of four increments of support site facilities acquisition and will be designed to meet U.S. specifications.

CURRENT SITUATION:

On August 6, 1998, a lease construction contract with option to buy was awarded to provide an adequate new
Medical/Dental Facility at Gricignano, Italy to replace the existing inadequate leased facility located in the Agnano

area. The current, inadequate Naval Hospital is located more than 30 kilometers away from the two primary Naval Support Sites established by the Naples Improvement Initiative at Capodichino and Gricignano, Italy. The existing facility is incompatible with the day-to-day healthcare operations demanded within this high tempo military overseas catchment area. Due to known structural deformities and design deficiencies within the current Hospital facility, it is vulnerable to structural failure and collapse in the event of a major seismic episode such as those possible within Seismic Zone 3 locations. The lack of cost-effective engineering solutions to adequately address the risk of catastrophic building failure creates an unacceptable level of risk for patients and hospital staff. The current facility lacks medical gas systems and requires complete replacement of the HVAC systems. In addition, the current electrical distribution system is antiquated and cannot handle the power requirements and electrical loads in support of a modern healthcare environment Taken together, the structural deficiencies directly jeopardize the welfare of the military and family members serving in the Naples Theater of Military Operations. The distance and the lack of good transportation from the primary operating locations negatively impacts access to care.

IMPACT IF NOT PROVIDED:

Failure to execute the option to purchase a long-term interest in the Medical/Dental facility and related land will result in an initial payment of rent of $8,500,000 per year (FY03) subject to periodic cost-of-living adjustments, over a period of 26 years. This equates to purchasing a long-term facility and related land at a Present Value (PV) of approximately $120,000,000 not including utilities.

ADDITIONAL:

The 10 acre site of the Medical Dental facility is privately held land leased by the Navy for a period of 30 years, and expiring in 2028. Ownership of the Medical/Dental Facility will automatically be vested in the Lessor of the site, Mirabella, S.P.A., upon final expiration of the land lease. The purchase of a long-term interest in both the Medical/Dental facility and the 10 acres of related land will provide the United States Government with long-term control of the Medical/Dental facility beyond 2028. The Director, Defense Medical Facilities Office has reviewed this project for joint use. Joint use is recommended.