Attachment III _ VA Parking Design Manual and Demand Model.pdf

VA Parking Design Manual

& Demand Model

Office of Construction and Facilities Management Washington, DC

Sect 4, Rev 11-01-2016

Sect 7, Rev 08-01-2014

April 2013

Parking Design Manual and Demand Model April 2013

TABLE OF CONTENTS

PART I - PREAMBLE TO THE PARKING DEMAND MODEL

Table of Contents

Acknowledgements

1.0 Original Pilot Sites

2.0 Expanded Pilot Facilities & SCI/D Demographics

3.0 Summary of VAMC and SCI/D Data

4.0 Parking Demand Matrix

PART II - USING THE PARKING DEMAND MODEL

Table of Contents

1.0 Instructions on Using the Parking Demand Model

2.0 Strategic Site Plan

3.0 Facility Data

4.0 Population Data

5.0 Parking Inventory

6.0 Current Peak Demand

7.0 Future Growth

8.0 Future Demand

9.0 Future Supply

10.0 Surplus or Deficit

PART III - PARKING DESIGN MANUAL

Table of Contents

Forward

Acknowledgements

1.0 Introduction

2.0 Campus organization

3.0 Construction Methodologies

4.0 Parking Geometrics

5.0 Access Controls

6.0 Surface Lot Design

7.0 Parking Structure Design

8.0 Operations and Maintenance

Parking Design Manual and Demand Model April 2013

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Preamble to the Parking Demand Model April 2013

PART I -TABLE OF CONTENTS

PART I - TABLE OF CONTENTS

ACKNOWLEDGEMENTS

INTRODUCTION

1.0 ORIGINAL PILOT INSTITUTIONS

2.0 EXPANDED PILOT FACILITIES & SCI/D

DEMOGRPAHICS

TX (Hub)

2.5 Bob Stump VAMC – Northern Arizona Health Care

System, Prescott, AZ (Spoke)

Reno, NY (Spoke)

3.0 SUMMARY OF VAMC AND SCI/D DATA

4.0 PARKING DEMAND MATRIX

FOREWORD

The material contained in the Parking Demand Model (PDM) is the culmination of a partnering effort with the Office of Construction & Facilities Management (CFM), Office of Facilities Planning at the U.S. Department of Veterans Affairs and the consultant team, led by DESMAN Associates.

The goal of the Parking Demand Model is to facilitate the planning process and to ensure the quality of VA facilities, while controlling construction and operating costs.

This document is intended to be used as a procedure by which the PDM should be used, as well as an initial tool for projecting parking need. The PDM documents current parking demographics at a number of VA Medical Centers (VAMC). The pilot and test institutions presented in this document were selected by VA and CFM as representative of the varying types of VA health care centers.

Since the parking facility is often the functional front door of a facility or campus, it is important to recognize opportunities for a welcoming presence. Parking facilities should be designed either as open surface areas with sufficient landscaping or as structures. These facilities may be utilitarian;

however, the structures and the surface lots should be designed to enhance the aesthetics of the facility and the campus. The goal is for parking to be a positive experience for all users.

Lloyd H. Siegel, FAIA Associate Executive Director Office of Facilities Planning

FOREWORD & ACKNOWLEDGEMENTS

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ACKNOWLEDGEMENTS

Credit is due to the following individuals whose guidance, advice, and effort made this publication possible.

Office of Construction & Facilities Management (003C)

Robert L. Neary, Jr. Executive Director Office of Construction & Facilities Management

Lloyd H. Siegel, FAIA Assoc. Executive Director, Office of Facilities Planning Donald Myers, AIA Director, Facilities Standards Service Lam Vu, PE Senior Electrical Engineer, Project Manager Zoltan John Nagy, AIA Senior Health Care Architect, Task Manager James Symankski, Jr., PE Senior Engineer/Sustainable Facilities Engineer

We especially appreciate the cooperation and assistance of stakeholders from the ten VAMC facilities that were used for field data collection and development of the parking demand model.

Veterans Integrated Service Network (VISN) & Medical Center (VAMC) Contributors

Brandi Fate VACO 10NR Director, CAMPS Steve Kuper VACO 10NR Management Analyst Edward L. Boogaerts VISN 20 Seattle Chief, Project Engineer Dean R.Morris VISN 21 San Francisco Senior Planner Dedric Boyd, COTR VISN 5 Washington DC Senior Project Manager John Wasyluk VISN 8 Tampa Facilities Management Alice G. Martinez VISN 22 Long Beach Program Support Assistant Kim Foss VISN 7 Augusta Senior Planner Stephen Musser VISN 3 Bronx Capital Assets Manager Cynthia Jwainat VISN 16 Houston Health Systems Specialist John Brecheisen VISN 12 Milwaukee Exec. Asst. to the Director Peter A. Yakowicz VISN 23 Minneapolis Capital Assets Manager Frank W. Palmisano VISN 17 San Antonio Administrative Officers David Sabol VISN 10 Cleveland Chief of Engineering Service Howard Rechtmann, M.I.B.A. VISN 8 Miami Project Manager, Engineering John S. Norwood VISN 22 San Diego Facility Planner Keith Repko VISN 15 St. Louis Chief, Facilities Engineering Lisa Lacey VISN 9 Memphis Capital Assets Manager Worcester P. Bong, PE VISN 18 Prescott Facilities Manager Paul di Bari VISN 21 Palo Alto Chief, Operations Section Michael Lesnet VISN 12 Hines Facility Planner Michael C. Tadych, LCSW VISN 21 Reno Associate Director

Private Sector Consultants

Michael Connor, Project Manager DESMAN, Inc.

John Judge, P.E., Senior Parking Designer DESMAN, Inc.

Ernest Bland, AIA, Principal EBA Ernest Bland Associates, P.C.

Yvonne Matinyi, Associate AIA, Project Architect EBA Ernest Bland Associates, P.C.

INTRODUCTION

The U.S. Department of Veterans Affairs (VA) constructs, leases, and operates a nationwide system of health care facilities dedicated to serving the nation’s Veterans. Providing adequate parking has become a major concern. VA must quantify, prioritize, and ultimately address present and future parking needs.

To date, the Department and its Veterans Integrated Service Network (VISN) and Medical Centers (VAMC) have used a spreadsheet-based model based on patient and staffing population volumes and auto use demographics to estimate current and future parking demand, and associated surplus or deficit conditions. The model was created in 1991. Changing patterns of demand and patient care are leading health care facilities to increase outpatient services, while decreasing traditional inpatient services. These changes create an unanticipated need for additional parking spaces, which the 1991 parking demand model (PDM) does not reflect.

The VA Office of Construction & Facilities Management (CFM) was instructed to retain a parking study expert to update the PDM. DESMAN, Inc. was initially retained by Cannon Design and the LA Group through its IDIQAE classification to work with CFM and its member institutions to investigate VA’s current parking criteria and methodologies for determining required parking spaces at new and existing facilities. New parking demand ratios would be developed that accurately calculate current and future demand in a variety of VAMC environments and best practice design standards for its parking facilities would be documented.

Key to developing the new PDM was the selection of ten (10) pilot facilities. These pilot institutions were selected by CFM as representative of the range of parking conditions and experiences throughout the VA health care system. Parking industry best practices were used to determine current parking demand and practical surplus or deficit conditions. This study involved requesting detailed facility, staffing, and patient population data through administrator survey forms, performing on-site parking inventory and peak parking occupancy surveys, administering point-of-access questionnaires to determine trip purposes, origin/destination, and travel mode data, gathering regional census data, conducting public transit route ridership research, and interviewing stakeholders at each of the ten (10) VAMCs. Stakeholder interviews involved one-on-one and group discussions regarding parking and commuting patterns that were unique and relative to each of the pilot facilities. The following lists pilot facilities that were surveyed.

Charlie Norwood VAMC, Augusta, GA Minneapolis VAMC, Minneapolis, MN James J. Peters VAMC, Bronx, NY San Francisco VAMC, San Francisco, CA Michael E. DeBakey VAMC, Houston, TX Puget Sound Healthcare System, Seattle, WA Long Beach VAMC, Long Beach, CA James A. Haley VAMC, Tampa, FL Clement J. Zablocki VAMC, Milwaukee, WI Washington DC VAMC, Washington, DC

In April 2011 DESMAN submitted to CFM an updated PDM along with a Preamble that presented the information that was collected from the pilot facilities. Upon review of that document, and in consultation with the Paralyzed Veterans of America (PVA), a veterans' service organization which has a unique expertise on a variety of issues involving special needs veterans, CFM retained DESMAN once again to revisit the study of parking supply, utilization, and demand for ten (10) additional VAMC’s. Unlike the original effort, this additional or expanded VAMC work included an investigation of Spinal Cord Injury/Disorder (SCI/D) patient parking needs. While the original pilot facility analysis did estimate the demand for all employee and patient groups, an analysis specific to SCI/D inpatients and outpatients was not performed. These additional services were retained under the guidance of EBA Ernest Bland Associates, P.C., an IDIQAE firm that developed SCI/D center design guidelines for CFM and has invaluable knowledge on space programming and SCI/D patient needs. At present, space guidelines for SCI/D patients require

1.5 spaces per hospital bed. As no empirical data exists to support these space requirements, PREAMBLE TO THE PDM 1

CFM and PVA selected these expanded pilot facilities for additional study as they represent a broad range of VAMC and SCI/D parking experiences.

VAMC Washington, DC (Spoke) VAMC Memphis, TN (Hub) Edward Hines Jr. VA Hospital, Hines, IL (Hub) VAMC Prescott, AZ (Spoke) Louis Stokes VAMC, Cleveland, OH (Spoke) VA HCS, San Diego, CA (Hub) Bruce W. Carter VAMC, Miami, FL (Hub) VAMC Reno, NV (Spoke) Jefferson Barracks Div. /St. Louis, MO (Hub) VA HCS Palo Alto, CA (Hub) Audie Murphy VA Hosp., San Antonio, TX (Hub) James J. Peters VAMC Bronx, NY (Hub)

It should be noted that the expanded pilot institutions include both “hub” and “spoke” facilities.

VA services are delivered through a hub and spoke system of care, extending from 24 regional SCI/D Centers offering primary care and specialty care by multidisciplinary teams (hubs) to the 134 SCI/D Primary Care teams (spokes) at local VA medical centers. While the definitions are duly noted, the methodology used to identify overall and SCI/D specific parking demand for hub and spoke facilities does not differ. It should also be noted that two of the ten expanded pilot facilities, Bronx, NY and Washington D.C., were studied during the initial assignment. However, and as noted in the introduction, SCI/D patient parking needs were not specifically defined in those earlier surveys.

Image Source: http://www.sci.va.gov/docs/VA_Spinal_Cord_Injury_Patient_Brochure.pdf

While spoke facilities are referenced in both the overall study of VAMC parking demand and demand specific to SCI/D patients, parking space requirements for SCI/D patient which are based on this research and published in the Part I Parking Demand Guide (PDG) will not extent to spoke facilities. Spoke facilities do not have dedicated SCI/D department building entrances, do not have SCI/D beds, and have less significant daily outpatient volumes. The VA’s policy regarding spoke facilities and SCI/D parking notes that it is not appropriate to single out one particular patient population at spoke facilities for dedicated parking as this sets a precedent that likely cannot be met for other patient populations with physical disabilities. For these facilities general handicap parking will be used by SCI/D patients.

Based on original and expanded pilot studies, a new PDM was developed along with this document entitled Part II Preamble to the PDM, which accompanies Part I PDG and Part III – Using the Demand Model. This preamble is used to: (1) document background data that was obtained during facility surveys; (2) illustrate the standard methodology employed in hospital/medical center parking demand studies; (3) present a justification of the determination of parking demand and peak parking demand ratios for key parking user groups, and (4) offer other VISN and VAMC capital asset managers and planners insight into peer institutions. Other VAMC

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http://www.sci.va.gov/docs/VA_Spinal_Cord_Injury_Patient_Brochure.pdf managers and planners may wish to use the parking demand ratios from one of these member institutions to model their current and future parking needs. As opposed to using a generic parking demand matrix, commuting patterns and auto utilization percentages used at the pilot facilities can be used at other VA facilities. Therefore, this preamble includes all initial and revised data on the ten (22) pilot institutions, including administrator survey form responses, auto use characteristics, persons-per-auto occupancy ratios, recommended peak hour parking demand ratios for each facility, and preliminary demand and surplus/deficit calculations.

It must be noted that during the course of these surveys, interviews, and requests for facility, patient and staffing information, it was discovered that VISN and VAMC facility planners and capital asset managers (CAMs) often use different population definitions and measurements.

The PDM cannot and does not adjust for deviations in base population volumes. The PDM requires that all inputs, particularly those related to outpatients and employees, be defined using the common terms and definitions referenced in the model (see PDM Instructions tab in the spreadsheet). Therefore, it is anticipated that some intuitive thinking will be required. Depending on the source and definition of base data, VISN/VAMC planners and CAMs may be required to interpret and reclassify the data to fit the requirements of the PDM. It is also anticipated that CFM will need to thoroughly understand the source of facility and population data, as provided by VAMC and VISN participants, to ensure accurate parking demand calculations.

The PDM model is simply an initial tool that VAMC and VISN planners and CAMs use to estimate current and future parking shortages in the aggregate. Local facility directors will reference this model when examining site specific opportunities for additional surface or structured parking.

Given the variety of site conditions, that opportunity may or may be achievable as determined by the model. Furthermore, the model does not address specific SCI/D space requirements as then needs are included in the overall calculation of inpatient and outpatient need. However, Preamble to the PDM does contain information gathered on SCI/D supply and utilization, including the demand for van accessible stalls. The result of this information and recommendations regarding the provision of SCI/D spaces is referenced in the Parking Design Guide (PDG). In short, the PDM is simply an initial measuring stick to be used to evaluate site specific parking development opportunities and limitations, and in the justification of VA capital funding. Once the funding and site opportunity are secure, VAMC and VISN planners and capital asset managers will still need to make appropriate decisions regarding the provision and management of SCI/D and other medical center user groups’ parking facilities.

The following presents a summary of findings for the extended pilot facilities and their influence on the existing PDM.

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PREAMBLE TO THE PDM 4

1.0 ORIGINAL PILOT SITES

1.1 CHARLIE NORWOOD VETERANS AFFAIRS MEDICAL CENTER, DOWNTOWN

DIVISION - AUGUSTA, GEORGIA

The Charlie Norwood Veterans Affairs Medical Center (Exhibit 1) is a two-division Medical Center that provides tertiary care in medicine, surgery, neurology, psychiatry, rehabilitation medicine, and spinal cord injury. The Downtown Division, which was the focus of this evaluation, is located in downtown Augusta and is bound by the Medical College of Georgia to the south and low density commercial buildings to the north, east, and west. The 686,000 square foot facility is located on 20 acres, has 155 beds (58 beds for medicine, 37 beds for surgery, and 60 beds for spinal cord injury), services an estimated 40,000 outpatients annually, employs nearly 2,200 people, and is affiliated with the Medical College.

Exhibit 1: Charlie Norwood VAMC Downtown Division Campus Map

The Downtown Division of Charlie Norwood Medical Center provides 811 parking spaces, distributed in 7 surface lots on campus. An occupancy survey conducted in August 2010 shows a typical weekday peak period occupancy of ninety-six percent (96%). A shuttle operates between the Downtown and Uptown campuses and alleviates some of the parking stress at the Downtown campus. Parking occupancy counts noted that of the 778 vehicles parked during the peak hour of use, 19percent displayed ADA handicapped placards and/or license plates.

A point-of-access survey was conducted to document auto use and auto occupancy (passenger) characteristics, as well as distance travelled for each of the major staffing, patient, and visitor groups that frequent the facility (Table 1 and Exhibit 2). Auto use and persons-per-auto data is used to determine the relationship between trip purpose and trip mode. Travel distances, which are based on employee and patient/visitors residential zip code data, illustrate auto-dependency of a certain percentage of a facility’s population. Ultimately, these factors are used to convert daily or peak shift staffing, patient, and visitor volumes into peak parking demand.

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Table 1: Charlie Norwood VAMC Downtown Division Auto Use and Persons-per-Auto Characteristics Population Group

Staffing Full-time Part-time Physicians Service Organization Volunteers Students

Patients Outpatients Inpatient Admissions ED Patients & Visitors

Visitors Inpatient Visitors Vendors Non-treatment Visitors

The Charlie Norwood VAMC was found to be

Augusta Persons

Auto Use per Auto

89% 1.05 89% 1.00 100% 1.00 90% 1.00 80% 1.00 80% 1.20

91% 1.00 90% 1.00 90% 1.00

90% 1.20 100% 1.00 90% 1.10 unique when compared to other pilot institutions in that sixty-three percent (63%) of employees and students live within a 10-mile radius of the campus, while thirty-three percent (33%) of patients and visitors live more than 50 miles away.

Exhibit 2: Charlie Norwood VAMC Downtown Division Number of Responses based on Distance Travelled

1.2 MICHAEL E. DEBAKEY VETERANS AFFAIRS MEDICAL CENTER, HOUSTON, TEXAS

Michael E. DeBakey VAMC serves as the primary health care provider for more than 108,000 Veterans in southeast Texas. Veterans from around the country visit the facility for specialized diagnostic care, radiation therapy, cardiovascular surgery, gastrointestinal endoscopy, nuclear medicine, ophthalmology, spinal cord injury, and other inpatient and outpatient services. Located on a 118-acre campus and built in 1991 (see Exhibit 3), the Medical Center is a state-of-the-art facility with 17 buildings, 420 hospital beds, a 21-bed family residential complex, and a 120-bed nursing home unit. Its spinal cord injury department is one of the oldest and largest within the VA system. It has nearly 3,800 full and part-time employees and attending physicians. Its affiliation

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with the University of Texas brings an estimated 2,500 students and interns annually. In addition to its treatment and research functions, the DeBakey campus also includes the Veterans Benefits Administration’s (VBA) regional office.

Exhibit 3: Michael E. DeBakey VAMC Campus Map

The Medical Center campus accommodates 3,768 parking spaces, distributed in 28 surface parking lots. During the August 2010 field surveys 3,777 vehicles were observed parked, many illegally. While the facility is located roughly 3 miles south of Houston’s central business district, it is adjacent to the Texas Medical Center (TMC), the largest medical center in the world with approximately 75,000 employees and over 5 million patients per year. Given the high fees for monthly and daily parking at TMC, VAMC facilities planners and administrators are faced with unique challenges when trying to reserve parking facilities for VAMC patients and visitors. At this facility, approximately seven percent (7%) of cars parked during the peak hour displayed handicapped tags or license plates.

A point-of-access survey was conducted to capture the mode of travel and the distance travelled data for DeBakey VAMC employees, patients, and visitors.

Table 3 summarizes the survey responses by the mode of travel used. Exhibit 4 summarizes the distance travelled based on residential zip code of employees and visitors.

Table 3: Michael E. DeBakey VAMC Auto Use and Persons-per-Auto Characteristics

Houston Population Group Persons

Auto Use per Auto Staffing

Full-time 79.0% 1.15 Part-time 65.0% 1.15 Physicians 44.4% 1.00 Service Organization 16.0% 1.15 Volunteers 23.8% 1.14 Students 69.6% 1.15

Patients Outpatients 83.9% 1.00 Inpatient Admissions 80.0% 1.00 ED Patients & Visitors 100.0% 1.00

Visitors Inpatient Visitors 67.9% 1.11 Vendors 100.0% 1.20 Non-treatment Visitors 69.6% 1.10

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Exhibit 4: Michael E. DeBakey VAMC Number of Responses based on Distance Travelled

1.3 LONG BEACH VETERANS AFFAIRS MEDICAL CENTER, LONG BEACH, CALIFORNIA

The Department of Veterans Affairs Long Beach Health-Care System is a tertiary care facility with 185 authorized hospital beds, 120 for spinal cord injury and 110 for Geriatric & Nursing. It employs 3,185 employees and non-medical staff, and serves an average of nearly 30,000 outpatients per month. The campus is situated in a suburban area, and is bound by the University of California to the north and west and by residential neighborhoods to the south and east. The 100-acre campus includes 32 buildings (see Exhibit 5).

Currently, there is extensive construction and renovation occurring that has caused a significant loss of parking.

Exhibit 5: Long Beach VAMC Campus Map

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Long Beach VAMC maintains 2,357 parking spaces for its employees and visitors. August 2010 surveys noted that ninety-five percent (95%) of the spaces were occupied. The supply of spaces on campus is unique from three major perspectives: 1) the large number of lots (28); 2) the wide range of different parking restrictions (27); and 3) its level of dependence on patient/visitor valet services.

In addition to the parking occupancy counts, a point-of-access survey was conducted to record travel mode and travel distance for employees, students, patients, and visitors. Table 4 illustrates the mode of travel characteristics of the Medical Center’s employees, patients and visitors.

Exhibit 6 illustrates the distance travelled based on residential zip code data.

Long Beach Population Group Persons

Auto Use per Auto Table 4: VAMC Long Beach Auto Use and Staffing Persons-per-Auto Characteristics

Full-time 74.8% 1.10 Part-time 75.0% 1.00 Physicians 100.0% 1.00 Service Organization 100.0% 1.00 Volunteers 56.9% 1.14 Students 83.3% 1.20

Patients Outpatients 81.8% 1.00 Inpatient Admissions 77.8% 1.00 ED Patients & Visitors 100.0% 1.00

Visitors Inpatient Visitors 100.0% 1.20 Vendors 100.0% 1.20 Non-treatment Visitors 77.4% 1.10

Though the public transit network that directly accesses the Medical Center does not immediately serve areas to the northwest, northeast, or southwest of the campus, the strong north, east, and west routes that do exist serve major residential areas. As thirty-five percent (35%) of employees and fifty-three percent (53%) of patients and visitors live within this 10 mile radius, resulting in relatively low auto utilization patterns (seventy-four percent and eighty-one percent respectively) for what would appear to be an auto-dependent, suburban environment.

Figure 6: VAMC Long Beach Number of Responses based on distance travelled

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1.4 CLEMENT J. ZABLOCKI VETERANS AFFAIRS MEDICAL CENTER, MILWAUKEE,

WISCONSIN

The Clement J. Zablocki VAMC is located on the western edge of Milwaukee. The Medical Center delivers primary, secondary, and tertiary medical care in 170 acute care operating beds, and accommodates over 500,000 visits annually through an extensive outpatient program. The nursing home care unit of 113 beds offers geriatric programming, and the 326 domiciliary beds are the focus of programs in substance abuse rehabilitation, psychiatric rehabilitation, and post traumatic stress disorder care. At present, the Zablocki Medical Center employs 3,626 employees and staff. The campus is unique (see Figure 7) in that it has 53 buildings, is located on a campus of 185 acres, and shares the property with Woods National Cemetery and a number of buildings on the Historic National Register. As such, though the campus has significant green space, property is unavailable for development and/or permanent surface parking expansion.

Figure 7: Clement J. Zablocki VAMC Campus Map

The Clement J. Zablocki VAMC provides 2,549 parking spaces, distributed in 31 surface lots.

The August 2010 survey noted ninety-one percent (91%) of the spaces were occupied during the peak hour.

Table 5 summarizes the results of a point-of-access survey conducted in August to study the mode of travel and distance travelled by employees, patients and visitors coming to the campus, while Exhibit 8 illustrates the distance travelled based on the residential zip code of survey respondents.

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Table 5: Clement J. Zablocki VAMC Auto Use and Persons-per-Auto Characteristics

Milwaukee Population Group Persons

Auto Use per Auto Staffing

Full-time 86.0% 1.10 Part-time 59.6% 1.26 Physicians 100.0% 1.00 Service Organization 100.0% 1.00 Volunteers 75.0% 1.00 Students 50.0% 1.20

Patients Outpatients 74.4% 1.00 Inpatient Admissions 25.0% 1.00 ED Patients & Visitors 71.4% 1.00

Visitors Inpatient Visitors 70.0% 1.40 Vendors 100.0% 1.20 Non-treatment Visitors 100.0% 1.10

Exhibit 8: Clement J. Zablocki VAMC Number of Responses Based on Distance Travelled

1.5 MINNEAPOLIS DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER,

MINNEAPOLIS, MINNESOTA

Minneapolis VAMC is a teaching hospital providing a full range of patient care services with state-of-the-art technology, as well as education and research. The VAMC provides comprehensive health care through primary care, tertiary care and long term care in the areas of medicine, surgery, psychiatry, physical medicine and rehabilitation, neurology, oncology, dentistry, geriatrics and extended care. The Medical Center is designated as one of the four poly-trauma VAMCs, and serves active duty personnel and Veterans for rehabilitation of injuries such as traumatic brain injury, blindness and amputation. This unit provides continued rehabilitation therapies to assist Veterans and active duty service members to reach their highest level of independence.

The Spinal Cord Injury/Disorder (SCI/D) Center provides acute rehabilitation, primary care, and sustaining care for Veterans with spinal cord injuries and disorders.

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The campus (see Exhibit 9) sits on 112 acres approximately 4 miles south of downtown Minneapolis, and contains 25 buildings totaling 1.8 million gross square feet. It is bound by residential neighborhoods to the north and west, Minneapolis/St.Paul International Airport to the south, and Fort Snelling State Park and the Mississippi River to the east. It employs nearly 3,700 individuals, services an annual outpatient population of nearly 600,000, and has 236 hospital and 70 nursing home beds.

Exhibit 9: Minneapolis VAMC Campus Map

The campus maintains 3,318 parking spaces distributed in 21 surface parking lots. Field surveys in August 2010 noted peak occupancy at 2,796 spaces (eighty-four ppercent). Of the total number of vehicles parked on campus during the peak period of parking activity, nearly eight percent (8%) displayed handicapped accessible hangtags and/or license plates.

A point-of-access survey was conducted to capture auto use and persons-per-auto data, with the results shown in Table 6. Exhibit 10 shows the distance travelled by employees and visitors based on the residential zip code data collected.

Table 6: Minneapolis VAMC Auto Use and Persons-Per-Auto

Characteristics

Minneapolis Population Group Persons

Auto Use per Auto Staffing

Full-time 87.7% 1.04 Part-time 42.9% 1.00 Physicians 100.0% 1.00 Service Organization 82.4% 1.04 Volunteers 76.2% 1.00 Students 100.0% 1.21

Patients Outpatients 83.1% 1.00 Inpatient Admissions 83.3% 1.00 ED Patients & Visitors na na

Visitors Inpatient Visitors 100.0% 1.64 Vendors 87.5% 1.00 Non-treatment Visitors 92.9% 1.64

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While forty-two percent (42%) of employees live within a 10-mile radius and a light rail station is located adjacent to the campus, it appears that these existing transit services are ineffective in discouraging employees from using their personal automobile. Nearly eighty-eight percent (88%) of full-time employees drive and park a vehicle on the campus.

Exhibit 10: Minneapolis VAMC Number of Responses Based on Distance Traveled

1.6 SAN FRANCISCO DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER, SAN

FRANCISCO, CALIFORNIA

The San Francisco Department of Veterans Affairs Medical Center serves an 8-county area of Northern California. Located on this site since 1934, the Medical Center consists of 124 authorized hospital beds and 120 nursing home beds. The 29-acre site includes 34 buildings with 933,000 gross square feet of space. The Medical Center currently employs 2,342 employees and non-medical staff, and served approximately 65,000 outpatients during FY 2008.

With views of the Golden Gate Bridge, the campus (see Exhibit 12) is bound by the Pacific Ocean to the north and west, Lincoln Park to the east, and high density single family residential neighborhoods to the south.

Exhibit 12: San Francisco United States Department of Veterans Affairs Medical Center Campus Map

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The Medical Center provides 1,225 parking spaces, distributed in 12 surface lots and one garage, of which 1,236 were occupied (illegal and double parking). Of all vehicles parked during the peak period of parking activity, six percent (6%) displayed handicapped hangtags and/or license plates.

A point-of-access survey was conducted to capture the mode of travel and the distance travelled data for Medical Center employees, patients, and visitors. Table 7 summarizes the survey responses by the mode of travel used, while Exhibit 12 summarizes the distance travelled based on the residential zip codes of employees and visitors.

Table 7: San Francisco VAMC Auto Use and Persons-per-Auto Characteristics

San Francisco Population Group Persons

Auto Use per Auto Staffing

Full-time 71.0% 1.16 Part-time 69.6% 1.26 Physicians 84.0% 1.24 Service Organization 81.8% 1.27 Volunteers 78.9% 1.00 Students 82.8% 1.14

Patients Outpatients 49.4% 1.00 Inpatient Admissions 80.0% 1.00 ED Patients & Visitors na na

Visitors Inpatient Visitors 85.7% 1.20 Vendors 100.0% 1.00 Non-treatment Visitors 80.0% 1.00

Exhibit 12: San Francisco VAMC Number of Responses based on Distance Traveled

The Medical Center’s geographic location significantly limits the coverage and effectiveness of direct public transit service alternatives. As a result, a larger-than-anticipated percentage of employees drive and park a vehicle on the campus, in spite of the area’s low density but urban characteristics. However, the employee-based can/vanpool program appears to be quite successful, as a significant number of full/part-time employees and physicians arrive as passengers.

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1.7 PUGET SOUND HEALTHCARE SYSTEM, SEATTLE, WASHINGTON

VA’s Puget Sound Health Care System (HCS) is a distinguished leader in teaching, research, and patient care, while earning prestigious recognition as part of the largest health care network in the country. Puget Sound HCS serves more than 70,000 Veterans living in the Pacific Northwest. As a teaching hospital, the Puget Sound system provides a full range of services, with state-of-the-art technology as well as education and research.

The 1.12 million gross square foot facility (see Exhibit 13) occupies 34 acres and includes 18 buildings providing 274 hospital beds, 38 nursing unit beds, and 20 family resident suites. Puget Sound HCS employs 3,145 employees and non-medical staff, and served approximately 71,600 outpatients in FY 2008. The campus is located roughly 3 miles south of downtown Seattle in a suburban area, and is bound to the north and west by a golf course and to the south and west by low density residential neighborhoods.

Exhibit 13: Veterans Affairs Puget Sound Healthcare System Campus Map

The Puget Sound Healthcare System provides 2,037 parking spaces for its employees and visitors. As per an occupancy survey conducted in August 2010, the peak period occupancy is ninety-seven percent (97%).

To understand the mode of travel and the distance travelled by the employees and visitors to the Medical Center, a point-of-access survey was conducted.

Table 8 summarizes the mode of travel and persons-per-auto occupancy data.

Table 8: Veterans Affairs Puget Sound HCS Auto Use and Persons-per-Auto

Characteristics

Seattle Population Group Persons

Auto Use per Auto Staffing

Full-time 77.3% 1.16 Part-time 80.0% 1.15 Physicians 75.0% 1.00 Service Organization 66.7% 1.33 Volunteers 66.7% 1.11 Students 59.3% 1.38

Patients Outpatients 67.7% 1.00 Inpatient Admissions 46.7% 1.00 ED Patients & Visitors na na

Visitors Inpatient Visitors 88.5% 1.20 Vendors 100.0% 1.00 Non-treatment Visitors 90.0% 1.00

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Exhibit 14 shows the distance travelled by employees and visitors to the facility based on residential zip code data. It is apparent that a large number of people working or receiving treatment at the Puget Sound Health Care System live within a 20-mile radius of the hospital.

Exhibit 14: Veterans Affairs Puget Sound HCS Mode of Travel Puget Sound HCS Number of Responses based on Distance Traveled

1.8 JAMES A. HALEY VETERANS AFFAIRS MEDICAL CENTER, TAMPA, FLORIDA

James A. Haley VA hospital is the busiest of the four poly-trauma facilities in the nation. Services are available to more than 116,000 Veterans living in a four-county area of Florida. As a teaching hospital, James A. Haley VAMC provides a full-range of services, with state-of-the-art technology as well as education and research. James A. Haley VA hospital accommodates 415 hospital beds, 35 domiciliary beds, and 118 nursing home beds. The Medical Center employs 6,253 employees and non medical staff, and in FY2008 treated over 55,000 outpatients.

The 1.29 million gross square foot campus (see Exhibit 15) occupies 53 acres and 39 separate buildings. It is affiliated with and adjacent to the University of South Florida, and is connected to that campus via a pedestrian bridge over Bruce Downs Boulevard. It is located in a predominantly low density residential neighborhood that is approximately 9 miles from Tampa’s central business district.

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Exhibit 15: James A. Haley VAMC Campus Map

James A. Haley VAMC provides 2,801 parking spaces, distributed in 11 on site lots and 4 offsite lots. Included in the off-site inventory are 300 spaces that the Medical Center leases from a shopping mall, located approximately three-quarters of a mile away. Designated as patient and visitor overflow parking, it employs a shuttle to transport patients, visitors, and some employees to the Medical Center. Of the total supply of spaces including lease lots some 2,398 vehicles were parked, and of that number, 231 had handicapped hangtags and/or license plates (ten percent).

A point-of-access survey was conducted to record the mode of travel and the distance travelled by each of the Medical Center’s user groups. Table 9 summarizes the mode of travel, while Exhibit 16 illustrates the distance travelled based on residential zip code data of employees and visitors.

Table 9: James A. Haley VAMC Auto Use and Persons-per-Auto

Characteristics

Tampa Population Group Persons

Auto Use per Auto Staffing

Full-time 87.0% 1.12 Part-time 89.0% 1.05 Physicians 91.7% 1.00 Service Organization 75.0% 1.00 Volunteers 70.8% 1.00 Students 100.0% 1.00

Patients Outpatients 72.9% 1.00 Inpatient Admissions 42.9% 1.00 ED Patients & Visitors 100.0% 1.00

Visitors Inpatient Visitors 71.4% 1.40 Vendors 100.0% 1.00 Non-treatment Visitors 50.0% 1.00

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Exhibit 16: James A. Haley VAMC Number of Responses based on Distance Traveled

2.0 EXPANDED PILOT SITES & SCI/D DEMOGRAPHICS

As noted in the introduction, the analysis of parking demand generated by expanded pilot facilities increases the sample size of data used to create the PDM, and therefore, the relative accuracy of the model, and provides insight for the first time into SCI/D patient parking needs.

As population data and auto use characteristics represent the foundation of the PDM, this section of the preamble presents the basic facility size, parking inventory/utilization, auto use demographics, and origin/destination data but it also introduces information on SCI/D beds, treatment units, and inpatient and outpatient volumes.

2.1 WASHINGTON D.C. DEPARTMENT OF VETERANS AFFAIRS MEDICAL CENTER.

WASHINGTON, DC (SPOKE)

The Washington DC Veterans Affairs Medical Center treats over 50,000 inpatient veterans and has over 500,000 outpatient visits each year. Washington DC VAMC is a tertiary care teaching facility that provides acute, general, and specialized services in medicine, surgery, neurology, and psychiatry, as well offering nursing home care treatment. In addition, the Medical Center oversees one satellite Substance Abuse Clinic and three Veteran Centers.

The 34-acre campus includes 7 buildings with 968,000 gross square feet of space (see Exhibit 17). It is affiliated with medical schools at Georgetown University and Howard University, and is contiguous to but unaffiliated with Washington Hospital Center and Children’s National Medical Center, a 926-bed medical complex with approximately 6,000 employees conducting 400,000 outpatient visits annually.

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Exhibit 17: Washington DC United States Department of Veterans Affairs Medical Center Site Plan

The Medical Center provides 2,045 parking spaces to its employees and visitors in various on-site and off-site locations. The on-site parking consists of 10 surface lots and 1 garage.

Washington DC VAMC provides additional off-site employee and visitor parking in the Old Soldiers home campus, which is accessed via shuttle bus. A parking occupancy survey conducted in August 2011 recorded a peak period occupancy of eighty-eight percent (88%), with 1,808 of the total 2,045 spaces being occupied.

A survey of peak period handicapped placards, hangtags, and license plates found 27 such designed vehicles parking in non-ADA accessible spaces. This volume would be in addition to the 64 vehicles found in ADA accessible spaces. Of the 1,808 vehicles parked during the peak hour 91, or five percent (5%), displayed ADA placards.

A point-of-access survey was conducted to understand the mode of travel adopted and distance travelled by the VAMC employees and visitors. Table 10 presents the travel mode characteristics based on the survey responses and Exhibit 18 illustrates, both numerically and graphically, the distance travelled based on residential zip code data.

Table 10: Washington DC VAMC Auto Use and

Persons-per-Auto Characteristics

Population Group Auto Use

Persons per Auto

Staffing Full-time 61% 1.27 Part-time 38% 1.00 Physicians 100% 1.00 Service Organization ---- ---- Volunteers ---- ---- Students ---- ----

Patients Spinal Cord Injury ---- ---- Outpatients 54% 1.06 Inpatient Admissions 100% 1.00 ED Patients ---- ----

Visitors Inpatient Visitors 100% 1.00 Vendors 100% 1.00 Non-treatment Visitors 67% 1.00

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As the campus is adjacent to other major employers, is in an area of high traffic congestion, and has excellent access to bus and rail public transportation, employee and outpatient auto utilization percentages and employee-per-auto ratios, i.e., car/vanpool participation, are representatively low.

Exhibit 18: Washington DC VAMC Number of Responses based on Distance Travelled

As Washington DC VAMC is a spoke facility with no dedicated SCI/D treatment rooms, no separate building access point, and no reserved parking spaces, the point of access questionnaire was unable to differentiate between SCI/D patient travel characteristics and non- SCI/D characteristics. However, subjective information on patient volumes, duration of stay, and parking need were obtained through conversations with staff and the PVA representative.

Washington DC VAMC provides clinic/outpatient access/treatment services twice per month (second and fourth Wednesdays) with treatment hours between noon and 4 PM. Presently, the clinic sees three (3) SCI/D patients during a typical day, treatment services/observations are comprehensive, and visits generally are all day (4 hours). Based on conversations with SCI/D and PVA staff all SCI/D patients arrive with a family member via personal automobile. The medical center does not have dedicated/reserved SCI/D parking spaces.

Like the original pilot facility surveys, information regarding overall treatment services, staffing, outpatient volumes, and bed capacity/average occupancy for Washington DC VAMC were provided by the local capital asset manager/facility manager via an administrator survey form.

2.2 EDWARD HINES JR. VA HOSPITAL, HINES, ILLINOIS (HUB)

Edward Hines, Jr. VA Hospital, a hub facility, is located 12 miles west of downtown Chicago on a 147-acre campus, offers primary, extended and specialty care and serves as a tertiary care referral center for VISN 12. Exhibit 19 presents the site plan as provided by CFM. Specialized clinical programs include blind rehabilitation, spinal cord injury, neurosurgery, radiation therapy and cardiovascular surgery. The hospital also serves as the VISN 12 southern tier hub for pathology, radiology, radiation therapy, human resource management and fiscal services. With 53 buildings, 134 hospital beds, 74 domiciliary beds, 135 nursing home beds, a Fisher House and

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nearly 2.4 million gross square feet of space the medical center served over 70,000 patients in Year 2010.

Exhibit 19: Edward Hines Jr. VA Hospital Campus Map

The Medical Center provides 3,403 parking spaces to its employees and visitors in various on-site lots. A parking occupancy survey conducted in February 2012 recorded a peak period occupancy of eighty-four percent (84%), with 2,855 of the total 3,403 spaces being occupied.

It must be noted that the designation, allocation, and enforcement of patient/visitor and employee spaces is quite vague. Therefore, employees could be parking in visitor spaces and vice versa.

Occupancy surveys also recorded the number of parked vehicles displaying handicapped placards/hangtags. During the peak hour of parking utilization 190 vehicles displayed the placards, of which, 19 were found parked in non-ADA accessible spaces.

A point-of-access survey was conducted to understand the mode of travel adopted and distance travelled by the VAMC employees and visitors. Table 11 exhibits the travel mode characteristics based on the survey responses, and Exhibit 20 illustrates, both numerically and graphically, the distance travelled based on residential zip code data. The data includes responses for patients as they entered the SCI/D wing.

Table 11: Edwards Hines Jr. VAMC Auto Use and Persons-per-Auto

Characteristics

Population Group Auto Use

Persons per Auto

Staffing Full-time 81% 1.00 Part-time 75% 1.00 Physicians 55% 1.00 Service Organization 60% 1.00 Volunteers 67% 1.00 Students 96% 1.04

Patients Spinal Cord Injury 26% 1.10 Outpatients 64% 1.10 Inpatient Admissions 50% 1.00 ED Patients 100% 1.00

Visitors Inpatient Visitors 81% 1.00 Vendors 56% 1.40 Non-treatment Visitors 75% 1.17

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Exhibit 20: Edwards Hines Jr. VAMC Number of Responses based on Distance Travelled

Information regarding treatment services, staffing, outpatient volumes, and bed capacity/average occupancy for the SCI/D department was not provided using the administrator survey form.

However, some qualitative information was obtained during the stakeholder interviews.

2.3 JAMES J. PETERS VETERANS AFFAIRS MEDICAL CENTER, BRONX, NEW YORK

(HUB)

The James J. Peters VAMC located in Bronx, NY within VISN 3 is a tertiary care facility classified as a Clinical Referral Level 1 Facility. It is a teaching hospital providing a full range of patient care services, with state-of-the-art technology. Comprehensive health care is provided through primary care, tertiary care, and long term care in the areas of medicine, surgery, psychiatry, physical medicine and rehabilitation, neurology, oncology, dentistry, geriatrics, and extended care.

The facility has 1.43 million gross square feet contained in 8 buildings, with 258 authorized hospital beds and 120 nursing home beds. This Medical Center also operates several regional referral points, including Spinal Cord Injury (SCI) and VISN referrals for medical/surgical subspecialties. At present, the James J. Peters Medical Center employs 2,135 employees, and serves approximately 28,400 patients annually. The facility occupies nearly 30 acres, and is situated between Interstate 87 to the north and high density residential apartment buildings to the south, east, and west.

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Exhibit 21: James J. Peters VAMC Site Plan

Bronx VAMC provides 1,091 parking spaces for employees and visitors. The occupancy survey conducted in February 2012 also noted a total of 86 vehicles with handicapped placards and/or license plates during the peak hour of use. Of that total, 27 were found in non-ADA accessible spaces.

A point-of-access survey was conducted to capture the mode of travel and distance travelled data for VAMC employees, patients, and visitors. Table 12 summarizes the survey responses by the mode of travel used, while Exhibit 22 summarizes the distance travelled based on residential zip code for employees and visitors.

Table 12: James J. Peters VAMC Auto Use and Persons-per-Auto Characteristics

Population Group Auto Use

Persons per Auto

Staffing Full-time 56% 1.00 Part-time 56% 1.10 Physicians 63% 1.00 Service Organization 64% 1.10 Volunteers 24% 1.25 Students 75% 1.33

Patients Spinal Cord Injury 77% 1.00 Outpatients 44% 1.04 Inpatient Admissions 50% 1.00 ED Patients ---- ----

Visitors Inpatient Visitors 55% 1.00 Vendors 33% 1.50 Non-treatment Visitors 28% 1.00

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Exhibit 22: James J. Peters VAMC Number of Responses based on Distance Travelled

Detailed population information regarding staffing, patient, and bed occupancy volumes have been provided for both the entire Medical Center and the SCI/D department and will be presented in an upcoming section of this report.

2.4 AUDIE L. MURPHY MEMORIAL VA HOSPITAL, SAN ANTONIO, TEXAS (HUB)

The South Texas Veterans Health Care System (STVHCS) is comprised of two inpatient campuses: the Audie L. Murphy Memorial VA Hospital in San Antonio and the Kerrville VA Hospital in Kerrville, Texas. This study focuses on patient/staff volumes and parking activity on the Audie L. Murphy campus.

The Audie L. Murphy Memorial VA Hospital is a quaternary care facility, which is affiliated with the University of Texas Health Science Center at San Antonio. Comprehensive health care is provided through acute medical, surgical, mental health, physical medicine and rehabilitation, geriatric, and primary care services. The Hospital is comprised of a Spinal Cord Injury Center, a Community Living Center, a Domiciliary, and a Substance Abuse Residential Rehabilitation Treatment Program. The Hospital also provides quaternary services including bone marrow transplantation, open-heart surgery, magnetic resonance imaging and positron emission tomography. The facility has one of three National Institutes of Health sponsored clinical research centers in the VA.

This hub facility, as illustrated on Exhibit 23, is situated on 30 acres, has 820,000 gross square feet contained in 5 buildings, with 251 authorized hospital beds, 244 nursing home beds, 66 domiciliary beds, and a 30 bed SCI/D unit. At present, the Hospital employs some 3,000 individuals and supports a student population of nearly 2,000 each year. Hospital outpatient volumes exceed 60,000 annually.

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Exhibit 23: Audie L. Murphy Memorial VA Hospital Site Plan

Audie L Murphy Memorial Hospital provides 2,011 parking spaces for employees and visitors.

That number includes 368 spaces that the Hospital leases from a hotel and church located off site. Occupancy counts conducted in January 2012 recorded some 1,805 occupied spaces (ninety percent). This figure includes 67 vehicles that displayed handicapped placards/plates but were parked in non-ADA accessible spaces. As a percentage of all park vehicles ADA vehicles represent twelve percent (12%) of that total.

A point-of-access survey was conducted to understand the mode of travel adopted and distance…