Walter Reed Army Medical Center: Realignment Under BRAC 2005 and Options for Congress

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The 2005 Defense Base Realignment and Closure (BRAC) Commission recommended that the
Department of Defense (DOD) establish a new Walter Reed National Military Medical Center
(WRNMMC) on the site of the current National Naval Medical Center (NNMC) in Bethesda,
Maryland. The President approved the recommendation in September 2005, and the Secretary of
Defense is required by statute to implement it within six years of the date of that approval.
Part of that recommendation is the realignment of the Walter Reed Army Medical Center
(WRAMC), which entails the transfer of many functions from organizations currently located on
its Georgia Avenue main post in the District of Columbia and Forest Glen annex in suburban
Maryland to other defense installations. The main post is scheduled to be closed. The Department
of State and General Services Administration have requested that title to portions of the main post
property be transferred to them.
This report details the BRAC Commission recommendation to create the WRNMMC, and the
concomitant realignment of the WRAMC. It describes the concerns raised by the community
before the BRAC Commission regarding the closure of the WRAMC main post and explains each
of the 13 parts of the overall recommendation. The report details the principal organizations
currently resident at WRAMC and indicates the fate of each. It describes the timing of the
necessary construction and moves, as currently planned by DOD. It also includes a discussion of
BRAC-related recommendations made by an Independent Review Group in their April 2007
report to the Secretary of Defense on patient care at WRAMC.
Appendix C includes legislative language regarding the creation of the WRAMC that has been ^th
proposed during the 110 Congress. Significantly, the proposed National Defense Authorization
Act for Fiscal Year 2008 (H.R. 1585) includes a provision (Sec. 712) that would establish a floor
for funding for WRAMC operations at the FY2006 level until new facilities are “completed,
equipped, and staffed.” Also, the Dignified Treatment of Wounded Warriors Act (S. 1606) would
require the Secretary of Defense to assess the feasibility of accelerating the construction of new
facilities needed before closing WRAMC (the planned realignment actually closes only the main
post, not the entire installation). If such acceleration is deemed feasible, he would then plan and
execute that construction. Both bills are on the Senate’s Legislative Calendar. Other proposed
bills that could affect the operation of WRAMC include H.R. 1417 (to prohibit the closure of
Walter Reed Army Medical Center notwithstanding the 2005 recommendations of the Defense
Base Closure and Realignment Commission), H.R. 2206 (U.S. Troop Readiness, Veterans’ Care,
Katrina Recovery, and Iraq Accountability Appropriations Act, 2007, enacted as P.L. 110-28 on
May 25, 2007), and S. 1044 (Effective Care for the Armed Forces and Veterans Act of 2007).
This report will be updated as necessary.

2005 Defense Base Closure and Realignment Commission Recommendation..............................1
Relationship to Other BRAC Recommendations......................................................................2
Existing Problems and the Independent Review Group............................................................3
DOD Justification for WRAMC Realignment and Community Resistance.............................4
The Walter Reed Military Installation.............................................................................................5
Main Post..................................................................................................................................5
Forest Glen Annex.....................................................................................................................5
Glen Haven Housing Area........................................................................................................6
Functions of Walter Reed Organizations.........................................................................................7
Walter Reed Army Medical Center (WRAMC)........................................................................7
North Atlantic Regional Medical Command.............................................................................7
North Atlantic Regional Veterinary Command.........................................................................8
Armed Forces Institute of Pathology........................................................................................8
Legal Medicine...................................................................................................................8
National Museum of Medicine and Health.........................................................................8
National Pathology Repository...........................................................................................9
Armed Forces Medical Examiner.......................................................................................9
Army Physical Disability Board.............................................................................................10
National Capital Multi-Service Market Office........................................................................10 ^th
2290 U.S. Army Hospital......................................................................................................10
Walter Reed Army Institute of Research..................................................................................11
Naval Medical Research Center...............................................................................................11
Armed Forces Pest Management Board...................................................................................11
Parallel Chains of Command at the Walter Reed Installation........................................................11
Implementation of BRAC Recommendation #169.......................................................................14
Options for Congress.....................................................................................................................20
Figure 1. Parallel Command Structure, Walter Reed Army Medical Center.................................12
Figure 2. BRAC Recommendation #169 Timeline.......................................................................15
Figure 3. Geographic Disposition of WRAMC Functions............................................................17
Appendix A. Commission Recommendation #169.......................................................................22
Appendix B. Creating the Walter Reed National Military Medical Center...................................26
Appendix C. Legislation Proposed During the 110^th Congress Regarding the Creation of
Walter Reed National Military Medical Center..........................................................................28

Author Contact Information..........................................................................................................33

In May 2005, the Secretary of Defense recommended to the 2005 Defense Base Closure and
Realignment Commission, also known as the BRAC Commission, the establishment of a new
Walter Reed National Military Medical Center (WRNMMC). Included in Commission
Recommendation #169 was the realignment of several of the functions currently carried out at
Walter Reed Army Medical Center (WRAMC). The Commission amended the Secretary’s ¹
recommendation before forwarding it to the President, who approved it on September 15, 2005. ²
The Commission recommended that the Secretary of Defense:
1. relocate all tertiary (sub-specialty and complex care) medical services to National Naval
Medical Center, Bethesda, MD, establishing it as the Walter Reed National Military Medical ³
Center Bethesda, MD;

2. relocate Legal Medicine to the new Walter Reed National Military Medical Center Bethesda,

MD;
3. relocate sufficient personnel to the new Walter Reed National Military Medical Center
Bethesda, MD, to establish a Program Management Office that will coordinate pathology
results, contract administration, and quality assurance and control of DoD second opinion
consults worldwide;
4. relocate all non-tertiary (primary and specialty) patient care functions to a new military
community hospital at Ft Belvoir, VA;

5. relocate the Office of the Secretary of Defense supporting unit at WRAMC to Ft. Belvoir, VA;

6. dissolve all elements of the Armed Forces Institute of Pathology (AFIP) except the National
Medical Museum (National Museum of Medicine and Health) and the Tissue Repository
(National Pathology Repository);
7. relocate the Armed Forces Medical Examiner, DNA Registry, and Accident Investigation to
Dover Air Force Base, DE;

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8. Absorb AFIP capabilities not specified in this recommendation into other DoD, Federal, or
civilian facilities, as necessary;

9. relocate enlisted histology technician training to Ft. Sam Houston, TX;

10. relocate the Combat Casualty Care Research sub-function (with the exception of those
organizational elements performing neuroprotection research) of the Walter Reed Army
Institute of Research (Forest Glen Annex) and the Combat Casualty Care Research sub-
function of the Naval Medical Research Center (Forest Glen Annex) to the Army Institute of
Surgical Research, Ft. Sam Houston, TX;
11. relocate Medical Biological Defense Research of the Walter Reed Army Institute of Research
(Forest Glen Annex) and Naval Medical Research Center (Forest Glen Annex) to Ft. Detrick,
MD, and consolidate it with U.S. Army Medical Research Institute of Infectious Diseases;
12. relocate Medical Chemical Defense Research of the Walter Reed Army Institute of Research
(Forest Glen Annex) to Aberdeen Proving Ground, MD, and consolidate it with the U.S.
Army Medical Research Institute of Chemical Defense; and

13. close the main post.

Each action will be addressed in detail later in this report. These and all other BRAC
recommendations must be completed within six years of their approval by the President. The
Department of Defense (DOD) has specified that all BRAC recommendations will be
implemented on or before September 15, 2011.
The realignment of WRAMC is one of a set of seven designed by DOD to make a significant ⁴
change in the makeup and character of the Military Health System (MHS). The 2005 BRAC
round, the fourth such carried out under the Defense Base Closure and Realignment Act of 1990,
is unique in its focus on interoperability among the military services, its transformation of defense
organization and infrastructure away from the legacies of World War II and the Cold War, and its
intention to reduce inter-service redundancy in facilities. According to DOD, these seven
recommendations, taken together, transform DOD clinical, education and training, Biomedical
Research and Development (R&D) capabilities:

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^ex^celleⁿ^ce.
In the midst of the planning for the realignment of WRAMC, reports appeared in the press
relating the experiences of several injured soldiers and their families who felt that they had been
offered inadequate housing and suffered inadequate administrative care at Walter Reed Army ⁶
Medical Center. Soon thereafter, Secretary of Defense Robert M. Gates commissioned an
independent panel (the Independent Review Group, or IRG) under the sponsorship of the Defense
Health Board to review rehabilitative care and administrative processes at both Walter Reed Army
Medical Center in the District of Columbia and National Naval Medical Center in Bethesda, ⁷
Maryland. The panel was established on March 1, 2007, and consisted of nine members,
cochaired by two former Secretaries of the Army, Togo D. West, Jr. (1993-1997), and John O.
Marsh, Jr. (1981-1989). The IRG submitted its report, which included a series of findings and
recommendations, to Secretary Gates on April 11, 2007.
The panel focused most of its attention on patient administrative and clinical practices at the two
installations. Nevertheless, several of their findings and recommendations dealt with BRAC and
facilities management issues. Among their recommendations, the members of the panel suggested
that:
1. Planned Base Realignment and Closure construction projects should be accelerated in
establishing the Walter Reed National Military Medical Center (WRNMMC) and of the new
Ft. Belvoir medical complex while fully funding existing operations.
2. Leadership should survey patients and family members to assess quality of services provided
and the condition of physical facilities at WRAMC and NNMC.
3. A senior facilities engineer should be assigned at WRAMC to assume the responsibility of
maintenance of non-medical facilities.
4. Tools for assessing the condition of existing facilities should be modernized; requirements for
facility and infrastructure maintenance, repair, and restoration should be prioritized and
appropriately addressed.

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In its report to the Secretary of Defense, the IRG focused on identifying additional problem areas
and making recommendations to help the military services and DOD in this process. The IRG
argued that the corrections suggested for WRAMC would require the attention of both the ⁸
Secretary of Defense and Congress. These recommendations are among those listed in the
“Options for Congress” section of this report.
The Department of Defense created its plan for the 2005 BRAC round as part of a worldwide ^st
adaptation of its installations to national security needs of the 21 century. Included among these
recommendations was one suggesting the creation of a new Walter Reed National Military
Medical Center on the campus of the current National Naval Medical Center in Bethesda,
Maryland, and the redistribution of military medical functions throughout the national capital
region and beyond.
DOD characterized this recommendation as part of the creation of a joint, modernized medical
support structure for the armed forces. In executing its various elements, DOD recommended
trimming excess military medical treatment capacity in the national capital area and relocating
much of the remaining routine care capacity to a new community hospital on Ft. Belvoir,
Virginia.
The local and professional medical communities expressed a number of concerns with the DOD ⁹
recommendation to the BRAC Commission before the realignment was finalized. The local
community argued that the recommended moves would break up an integrated, mission-oriented
principal military medical facility, would adversely impact the economy of the nation’s capital,
and could degrade homeland security in the national capital region. Community representatives
also expressed apprehension over the quantity of family housing available on or near the planned
WRNMMC. Insufficient housing, they contended, would obstruct the efforts of family members
to collocate with and support seriously injured service members being cared for at the relocated
facility. Witnesses suggested an alternative to the DOD recommendation – retaining the current
WRAMC in place and realigning the mission of the NNMC to avoid any potential disruption of ¹⁰
wartime casualty care.
The extended professional civilian medical community expressed its own concerns with the
proposed dissolution of the Armed Forces Institute of Pathology (AFIP), which is currently
located at the WRAMC Main Post. Several professional organizations and individuals from
various regions of the country submitted statements, testimony, and correspondence to the

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^th^{e 1}⁹⁹⁵^BRA^{C Co}^mm^is^sioⁿ^.
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^the^Com^m^{ission’s he}^a^r^ing^s^aⁿ^d^d^e^libe^r^a^{tions c}^aⁿ^be^f^oun^{d on the}^Com^m^ission’s^we^bsite^a^t^http^://w^ww^.bra^c^.^g^o^v^.

Commission, contending that the current AFIP is irreplaceable as a disease research and medical
education resource whose influence is felt far beyond the narrowly focused body of military
pathologists.
The Commission acknowledged the importance of many of the expressed community concerns
and objections. Nevertheless, the Commission judged that a new facility would offer the most
effective means to offer state-of-the-art treatment and endorsed the Secretary of Defense’s
assessments of military value. The Commission did require DOD to address expressed
community concerns regarding the perceived lack of family housing on the Bethesda campus of
the new WRNMMC. The Commission also recognized the importance the professional
community assigned to the services provided by the AFIP in the form of radiological resident
training, continuing medical education, and pathology consultations. The Commission’s decisions
regarding the redress of these deficiencies were folded into their final list of recommended
actions, which moved some functions to new locations and directed that the remaining
capabilities be absorbed into other DOD, federal, and civilian facilities. The Commission
concluded that DOD plans, as modified by the Commission, preserved the legacy of WRAMC,
provided for continued needed medical care during the moves, and safeguarded the clinical and
research functions being relocated.

“Walter Reed” has been the premier Army medical facility since its founding on its current site ^th
during the first years of the 20 century. In the decades since, hundreds of thousands of soldiers,
their families, and government officials have received medical treatment at the hospital.
The Walter Reed Military Installation consists of three separate sites: Main Post, Forest Glen
Annex, and the Glen Haven Housing Area. It is a Department of Defense (DOD) site
administered by the Department of the Army and provides military medical health care, medical
education and training, advanced biomedical research, and diagnostic pathology consultative
services. Together, the three sites cover 297 acres and contain more than 100 buildings, exclusive
of family housing, with 5.9 million square feet of floor space.
The Main Post is located at 7100 Georgia Ave. N.W. in the District of Columbia. The Main Post
occupies 113 acres of land, acquired in three parcels (in 1908, 1918, and 1922), and contains 73
buildings with 4.6 million square feet of floor space. The major, though not the only, facility
resident on the Main Post is the Walter Reed Army Medical Center (WRAMC). The Center
employs more than 4,000 military and civilian personnel, or approximately half of the Military
Installation’s total, and a number of supporting contractors. WRAMC occupies 1.3 million square
feet of usable floor space and provides primary, secondary, and tertiary medical care, medical
research, and medical education and training.
The Forest Glen Annex lies on 164 acres to the northwest of Silver Spring, Maryland, acquired by
the War Department in 1942. The site contains 33 buildings of 1.3 million ft.² of floor space. Its
principal occupants are the Walter Reed Army Institute of Research (WRAIR) and the Naval

Medical Research Center (NMRC). Both WRAIR and NMRC engage in medical research, and
both are located in the Daniel K. Inouye Building on the Annex.
The WRAIR employs more than 1,200 personnel and occupies 514,000 square feet of the
building’s floor space. Its activities include biomedical research in military-related infectious
disease, combat casualty care, operational medicine and medical chemical and biological defense.
The NMRC conducts research in infectious diseases, biological defense, combat casualty care,
bone marrow and diving and environmental medicine. A major focus is vaccine development. The
Center employs approximately 340 personnel and occupies 54,000 square feet of the Inouye
Building.
The Armed Forces Pest Management Board, described later in this report, is lodged in offices at
the Annex.
The Glen Haven Housing Area contains 204 family housing units and is located north of the
Capital Beltway (I-495) near Wheaton, Maryland. The site was acquired by the War Department
in 1942, at the same time as the Forest Glen Annex. The homes at Glen Haven are not
government-owned, having been privatized in 2004 as part of the Northeast Integrated (Phase I)
housing project that incorporates a total of 590 housing units at Glen Haven and at Ft. Detrick,
located near Frederick, Maryland. This housing complex was built and is owned, maintained, and
operated by GMH Military Housing, LLC, in a 50-year public-private partnership between a ¹¹
private developer and the Department of the Army.

¹¹^{For m}^o^re^inf^o^rm^a^{tion o}ⁿ^the^priv^a^tiz^a^tion^of^m^ilita^r^y^housⁱⁿ^g^,^s^e^e^{CRS Re}^port^RL³¹⁰^39,^M^ilitary^H^ousin^g
^Priv^atizati^oⁿ^Init^iativ^e^:^B^a^c^k^g^rou^nd^an^{d Issue}^s^,^by^D^a^nie^l^H^.^Els^e^.

The various significant Walter Reed organizations Major Walter Reed Organizations
are listed at the text box at right. The organization ^{Main Post}
and function of each of these will be taken up in
order. ^{Walter Reed Army Medical Cent}^er
^{North Atlantic Regional Medical Command}
^{North Atlantic Regional Veterinary Command}
^{Armed Forces In}^{stitute of Pathology}
^{Army Physical Disability Board (1}^{of 3)}
WRAMC is a 261-bed military medical treatment ^{National Capital Multi-Service Market Office}
facility (MTF) that provides emergency medical ^{(TRICARE Management)}
care, primary medical care, surgical services, ²²⁹⁰^th^{U.S. Army Hos}^{pital (Army Reserve)}
orthopaedic and rehabilitative care, mental health ^{Forest Glen Annex}
services, allergy and immunology care, care in
various medical sub-specialties, and ancillary ¹³^{Walter Reed Army Institut}^{e of Research}
services. ^{Naval Medical Research Ce}^nter
^{Armed Forces Pest Ma}^nageme^nt^Board

The North Atlantic Regional Medical Command is one of six geographically defined units ¹⁴
subordinate to Army Medical Command. The commander of Army Medical Command
(MEDCOM) is “dual-hatted,” also holding the position of Army Surgeon General, who heads the
Army Medical Department (AMEDD) within the headquarters of the Department of the Army.
The Surgeon General holds the rank of lieutenant general in the Army Medical Corps, is the
medical expert on the most senior Army staff at the Pentagon, and is the medical advisor to the
Secretary of the Army, the Army Chief of Staff, and other senior executives in the Army structure.
Because the position of surgeon general is purely staff in its function, it has no command
authority over operational medical units. In his other role as Commander, MEDCOM, the general

¹²^T^e^x^t^{in the}^f^o^llowⁱ^ng^s^e^c^{tion is}^d^e^rⁱ^v^e^{d f}^r^o^m^inf^o^r^m^a^{tion pr}^ovⁱ^d^e^d^by^the^D^e^pa^r^t^m^e^{nt of}^D^e^f^e^ns^e^a^{nd the}²⁰⁰⁵
^D^e^f^e^ns^e^B^a^s^e^C^l^os^ur^e^a^{nd R}^e^a^lig^nm^eⁿ^{t C}^o^m^m^issⁱ^on.
¹³^S^e^rvi^{ces p}^r^o^vⁱ^d^ed^at^W^R^A^M^{C wi}^t^hⁱⁿ^t^h^{ese gen}^e^ral^cat^ego^rⁱ^e^{s are:}^P^rⁱ^m^ar^y^{Care (OB/}^G^YN,^P^e^dⁱ^at^ri^cs,^G^eⁿ^e^r^a^l
^In^t^e^rn^al^M^e^dⁱ^ciⁿ^e^,^O^p^t^o^m^e^t^r^y^,^W^e^l^lⁿ^{ess S}^e^rvi^ces,^an^d^P^r^ev^en^tⁱ^v^{e M}^e^dⁱ^ciⁿ^e^);^S^u^rgi^cal^S^e^rvi^{ces (}^G^eⁿ^eral^S^u^rgery^,
^N^e^ur^os^ur^g^e^r^y^{, C}^a^r^d^iothor^a^cⁱ^c^Sur^g^e^r^y^,^P^l^a^s^tic^Sur^g^e^r^y^,^Va^s^c^ula^r^Sur^g^e^r^y^,^O^phtha^lm^olog^y^,^U^r^ology^,^P^r^os^ta^te^C^e^nte^r^,
^Org^a^{n T}^r^aⁿ^spla^{nt Surg}^e^r^y^,^Re^f^r^a^c^tiv^e^E^y^e^Surg^e^r^y^,^a^{nd Bre}^a^s^{t Ca}^re^Ce^nte^{r); Orth}^opa^e^d^ic^{s a}ⁿ^{d Re}^ha^b^ilita^tioⁿ
⁽^O^r^t^ho^pa^e^d^ic^Sur^g^e^r^y^,^O^r^thotic^s^a^nd^Pr^os^t^h^e^tic^s^,^P^h^y^s^ic^a^l^Me^dicⁱ^ne^{, a}^nd^Phy^s^ic^a^l^a^{nd O}^c^c^upa^tio^na^l^T^h^e^r^a^p^y⁾^{; Me}^nta^l
^H^e^a^{lth Se}^r^v^ic^e⁽^S^oc^ia^{l W}^o^r^k^{, P}^s^y^c^hia^t^r^y^{, P}^s^y^c^hology^{, B}^e^ha^vⁱ^or^a^l^H^e^a^{lth, a}ⁿ^d^A^r^m^y^Subs^ta^nc^e^A^bus^e^P^r^og^r^a^m⁾^;
^Subs^pe^cⁱ^a^lty^C^a^r^e⁽^P^u^l^m^ona^r^y^Func^tio^ns^{, C}^a^r^dⁱ^o^log^y^{, O}ⁿ^c^o^log^y^/Hem^a^t^ology^{, A}^udiolog^y^,^D^e^r^m^a^t^ology^,
^End^o^c^rⁱⁿ^olog^y^,^G^a^s^t^r^o^eⁿ^te^r^o^log^y^,^Iⁿ^f^e^c^tious^Dⁱ^s^e^a^s^e^,^N^e^phr^ol^og^y^,^O^t^ola^r^yⁿ^g^o^logy^{, R}^h^e^u^m^a^tology^,^U^r^olog^y^,^P^o^dia^t^r^y^,
^an^d^P^e^di^at^ri^{c S}^u^b^s^p^eci^al^t^y^);^Aⁿ^ci^l^l^a^ry^S^e^r^vⁱ^{ces (M}ⁱⁿⁱ^s^t^r^y^a^{nd P}^a^s^t^o^r^a^l^C^a^r^e^{, C}^linic^a^l^Iⁿ^v^e^s^tig^a^tion,^Pa^thol^og^y^a^nd
^L^a^bor^a^t^or^y^Se^r^vⁱ^c^e^s^{, P}^h^a^r^m^a^cy^,^R^a^diolog^y^,^T^e^lem^e^dicⁱ^ne^{, D}^e^ploy^m^e^{nt H}^e^a^{lth C}^lin^ic^a^l^C^e^nte^r^{, Ma}ⁿ^a^g^e^{d C}^a^r^e
^Dⁱ^vⁱ^sⁱ^{on, a}ⁿ^{d N}^u^tr^iti^{on C}^a^r^e^aⁿ^d^Dⁱ^e^t^e^tic^s⁾^.
¹⁴^F^r^o^m^east^t^o^w^e^st^,^t^h^{ese i}ⁿ^cl^u^d^e^E^u^rop^e^,^No^rt^h^A^t^l^aⁿ^tⁱ^c^,^S^o^u^t^h^east^,^G^r^eat^P^l^aiⁿ^s^,^W^e^st^ern^,^and^P^aci^fⁱ^{c Regi}^oⁿ^a^l
^Me^dic^a^l^C^o^m^m^a^nds^.

does exercise command authority over the medical staffs at all of the Army’s fixed medical
facilities and other AMEDD commands and agencies.
Before 1994, Army medical facilities were decentralized in management and operation. The
Department of the Army began to consolidate their diverse medical operations into a single
MEDCOM during the mid-1990s and placed the Surgeon General at its head. Thus, the Surgeon
General, located in the Washington, D.C., area, now holds both that office and commands the
Army Medical Command. His AMEDD staff is collocated with him in the national capital, while
the MEDCOM staff is located at Ft. Sam Houston, Texas.
The headquarters of the North Atlantic Regional Medical Command is located on the main post
of the WRAMC. The region covers states from Maine to Minnesota and as far south as North
Carolina, and the regional commander exercises command authority over medical staffs at
facilities within that area.
The North Atlantic Regional Veterinary Command is the veterinary functional equivalent of its
Regional Medical Command counterpart. Its headquarters is sited in Building 1 of the WRAMC.
Army Veterinary Command (VETCOM) is commanded by a colonel of the Army Veterinary
Corps, and engages in animal care, food safety and defense against food-borne diseases, and
veterinary research and development. Each Regional Veterinary Command is collocated with its
MEDCOM counterpart.
The Armed Forces Institute of Pathology is a joint agency, employing approximately 820 and
specializing in pathology consultation, education, and research. It is located on the WRAMC
Main Post. A number of subdepartments operate within the Institute. In addition to their strictly
military functions, pathologists on the AFIP staff offer pathology consultations to civilian
colleagues through the American Registry of Pathology, a non-profit organization. Some AFIP
subsidiary organizations include:
Legal Medicine is an educational journal for physicians whose production staff is located within
the AFIP. The journal addresses issues at the intersection of medical practice and the legal system,
such as appearing as an expert witness at trials. Subscriptions to Legal Medicine can assist
physicians to satisfy professional requirements for continuing medical education.
The Army Medical Museum, predecessor to the National Museum of Medicine and Health, was
established on May 21, 1862. The Museum’s five major collections (Anatomical, Historical, Otis
Historical Archives, Human Developmental Anatomy, and Neuroanatomical) are estimated to
contain more than 24 million objects. Appropriated funding comes from the DOD Office of

Health Affairs, with the remainder provided through grants, contributions, donations, and in-kind
gifts.
The National Pathology Repository, located at the AFIP, accepts, codes by pathologic diagnosis,
and stores medical material. It has catalogued more than 2.8 million medical cases since 1917,
including written records and more than 50 million microscope slides, 30 million paraffin tissue
blocks, and 12 million preserved wet tissue specimens. Approximately 60,000 new cases are
brought into the Repository each year. In addition, the Repository stores case files and specimens
from more than 20 closed military medical facilities.
The Armed Forces Medical Examiner System (AFMES) is a Department of Defense standard
system to conduct scientific forensic investigations for determining the cause and manner of
death of members of the Armed Forces on active duty or on active duty for training and, under
specific circumstances, civilians who die in areas of exclusive federal jurisdiction. The Office of
the Armed Forces Medical Examiner (OAFME) is a component of the Armed Forces Institute of
Pathology (AFIP), but is located at the AFIP Annex in Rockville, Maryland. Regional and
Associate Medical Examiners, appointed by the Armed Forces Medical Examiner with the
concurrence of the respective service Surgeon General, are stationed at designated military
medical treatment facilities within the United States and overseas. Subordinate departments
within the OAFME include:
The Repository stores deoxyribonucleic acid (DNA) reference specimens and maintains a
database to assist in their retrieval for human remains identification. It also purchases and
distributes DNA collection supplies to field sites for collecting specimens.
The Laboratory provides scientific consultation, research, and education services in the field of
forensic DNA analysis to the Department of Defense (DoD) and other agencies. It also provides
DNA reference specimen collection, accession, and storage of DNA material gathered from U.S.
military and other personnel.
The Division of Forensic Toxicology Post-Mortem and Human Performance Testing Laboratory
is the DoD’s centralized laboratory for routine toxicological examinations associated with
military aircraft, ground, and ship (sea) mishaps in which no fatalities occur (referred to as
incidents). Forensic Toxicology also assists in all military aircraft, ground and ship (sea) accidents
involving fatalities; selected military autopsies; biological specimens from the Air Force Office of
Special Investigations (AFOSI), Army Criminal Investigative Division (CID), and Navy Criminal
Investigative Service (NCIS) criminal investigations; blood for legal alcohol and drug tests in

medico-legal determinations; blood and urine in fitness for duty interrogations; and selected cases
of national interest.
The Washington, D.C., Physical Evaluation Board (PEB, also known as the Army Physical
Disability Board) is located in Building 7 of the WRAMC main post and is one of three similar
panels within the U.S. Army Physical Disability Agency. The Agency is not part of the Army
Medical Command, but is an organization within the Adjutant General Directorate of the Army
Human Resources Command. The PEB determines an injured individual’s physical fitness for
continued military service. If the PEB finds that a soldier is unfit for further service, the Physical
Disability Agency is responsible to find the appropriate level and type of compensation to be
awarded. If the soldier cannot continue on active duty because of a physical disability, the Agency
takes the appropriate actions to separate or retire him or her. Two other Army PEBs exist and are
located at Ft. Lewis, Washington, and Ft. Sam Houston, Texas.
Military and military-sponsored medical care has been consolidated under a Tricare system of ¹⁵
management. This Tricare system is divided into three regions, North, South, and West, and
subdivided into 13 Multiple Service Market Areas. The National Capital Area is one of these, and
the office of the Area Market Manager, created in 2004, is currently located within the Walter
Reed Army Medical Center.
The Area Market Manager is responsible for coordinating the development of a single, integrated
business plan for the provision of military medical care throughout his assigned district. The
National Capital Area contains nine major military treatment facilities that for which the Area
Market Manager drafts plans for appointing services, resource sharing and optimization, and the
sharing of DoD and Veterans Administration facilities.

The 2290^th U.S. Army Hospital, an Army Reserve unit that was created in 1963, is physically
located at 1850 Baltimore Road in Rockville, Maryland. Its mission when called to active duty is
to move to the Walter Reed Army Medical Center and augment the hospital personnel there in
order to accommodate surges in patient load.

¹⁵^T^r^ic^a^r^e^is^the^Uⁿ^ite^{d Sta}^t^e^s^m^ilita^r^y^’s^he^a^{lth c}^a^r^e^plaⁿ^f^o^{r a}^c^tiv^e^{and re}^tire^d^m^ilita^r^y^pe^rs^onne^{l a}ⁿ^{d t}^h^eⁱ^{r de}^pe^nde^nts^,
^s^upple^m^eⁿ^ting^the^s^e^rv^ic^e^s^a^v^a^ilable^a^t^m^ilita^r^y^a^nd^P^u^blic^H^e^a^lth^Se^rv^ic^e^f^a^c^ilitie^s^.^{It is}^m^a^nag^e^{d by}^the^T^rⁱ^c^a^r^e
^M^aⁿ^a^ge^m^eⁿ^t^Actⁱ^vⁱ^t^y⁽^T^M^A^{) u}ⁿ^d^{er t}^h^{e au}^t^h^o^rⁱ^t^y^o^f^t^h^{e Off}ⁱ^{ce o}^f^t^h^{e A}^s^si^st^an^t^S^ecret^ar^y^o^f^De^fen^s^{e fo}^{r Heal}^t^h^A^f^f^aⁱ^r^s
^(OS^D^/^H^A⁾^.^T^rⁱ^{care rep}^l^aced^{a p}^r^evi^o^u^s^p^r^o^g^ram^,^Ch^a^m^p^u^s^,ⁱⁿ¹⁹⁹³^.^F^o^r^m^o^{re i}ⁿ^f^o^rmatⁱ^oⁿ^on^T^rⁱ^care,^{see CRS}^Rep^o^r^t
^R^L³³⁵³^7,^M^ilit^ary^M^e^dic^a^{l C}^a^re^{: Que}^s^tions^an^{d A}ⁿ^swe^r^s^{, by}^Rⁱ^c^h^a^r^{d A}^.^B^e^s^t^J^r^{., a}^{nd C}^R^S^R^e^por^t^R^S²²⁴⁰^2,
^Iⁿ^c^r^e^a^s^e^s^{in Tr}^ic^ar^e^C^o^s^t^s^:^Bac^k^gr^ou^nd^a^{nd O}^p^tio^ns^f^o^r^C^o^ngr^e^s^s^{, by}^Ric^h^a^r^{d A}^.^Be^s^t^J^r^.

The Walter Reed Army Institute of Research (WRAIR) is the Army’s largest, most diverse, and
oldest medical laboratory. It is a subordinate command in the Army Medical Research and
Materiel Command, which in turn is subordinate to Army Medical Command. As of mid-2005,
WRAIR employed 1,286 military and civilian personnel. WRAIR conducts research on a range of
military medical issues, including naturally occurring infectious diseases, combat casualty care,
operational health hazards, and medical defense against biological and chemical weapons.
WRAIR is the Department of Defense’s lead agency for infectious disease research and research
in support of both military and civilian medical product development. WRAIR also hosts five
post-doctoral residency programs. WRAIR is located in the Daniel J. Inouye Building on the
WRAMC Forest Glen Annex.
The Naval Medical Research Center (NMRC) conducts basic and applied biomedical research in
infectious diseases, biological defense, combat casualty care, bone marrow, and diving and
environmental medicine. The major focus at NMRC is the development of vaccines against
malaria, diarrhea, dengue fever, and rickettsial disease and the carrying out of clinical trials in
support of vaccine development. The NMRC employed 339 military and civilian individuals as of
mid-2005.
The Armed Forces Pest Management Board (AFPMB) recommends policy, provides guidance,
and coordinates the exchange of information on all matters related to pest management
throughout DOD. The AFPMB’s mission is to ensure that environmentally sound and effective
programs are present to prevent disease vectors from adversely affecting DOD operations. The
AFPMB hosts meetings, maintains a virtual information library on relevant literature, and
encourages continuing education and training in pest and disease vector management. The
AFPMB staff is located in Building 172 of the WRAMC Forest Glen Annex.

Army Medical Command exercises command authority over the medical functions at WRAMC,
but the caretaker of the Walter Reed complex (main post, Forest Glen Annex, and Glen Haven
Housing area) is the Army’s Installation Management Command (see Figure 1).

Figure 1. Parallel Command Structure, Walter Reed Army Medical Center
^Source:^Prepa^{red by CRS bas}^{ed on information provided by DO}^D.
As noted earlier, the commanding general of Army Medical Command (MEDCOM) also serves
as the Army’s Surgeon General. MEDCOM is headquartered at Ft. Sam Houston, Texas, and
includes the North Atlantic Regional Medical Command as well as five other regional medical
commands – Europe, Great Plains, Pacific, Southeast, and Western. Major commands subordinate
to MEDCOM that are not depicted in Figure 1 include the Army Medical Department Center &
School, Army Center for Health Promotion & Preventive Medicine, Army Dental Command,
Army Medical Research & Materiel Command, and Army Veterinary Command.
The North Atlantic Regional Medical Command is headquartered at the WRAMC Main Post.
This region includes two Army medical centers (at Walter Reed and Ft. Bragg, North Carolina),
eight other clinics, community hospitals, and equivalent facilities (Ft. Belvoir, Ft. Lee, and Ft.
Eustis in Virginia, Ft. Drum and West Point in New York, Ft. Knox in Kentucky, Ft. Meade in
Maryland, and Ft. Monmouth in New Jersey), and the research installations at the Forest Glen
Annex and Ft. Detrick, Maryland.
Army Installations Management Command (IMCOM) is headquartered in Ft. Monroe, Virginia.
Just as MEDCOM is commanded by a lieutenant general who is dual-hatted as the Army’s
Surgeon General, IMCOM’s commander is a lieutenant general who is dual-hatted as the Army’s

Assistant Chief of Staff for Installation Management. As illustrated in Figure 1, both officers
report directly to the Army Chief of Staff.
IMCOM includes seven regions: Northeast, Northwest, Southeast, Southwest, Europe, Pacific,
and Korea. It was created in October of 2006 with the consolidation of the former Installation
Management Agency (IMA), Community and Family Support Center, and Army Environmental
Center. IMCOM is responsible, among other missions, for bringing efficient oversight and
business practices to the management of the Army’s installations, inheriting this from its ¹⁶
predecessor, the IMA.
Before 2002, the Army did not have a single, consolidated management agency dedicated to the
operation, modernization, and maintenance of its individual posts and other sites. Responsibility
for the physical plant at any given installation was then vested in a senior post commander whose
chain of command usually ran upward through a division, army, or other such operational unit.
Because the funds used to maintain and modernize these posts come from the same operations
and maintenance (O&M) appropriations accounts as funds for training, operations, and the direct
day-to-day support of the post’s military mission, many Army managers came to understand that,
over time, infrastructure suffered as funding tended to migrate toward operations and away from
maintenance. One of the reasons for establishing the IMA was to create an institutional advocate
for the installations themselves and for the funding necessary for their upkeep and operation.
IMA became the Army’s “landlord” and took responsibility for operating posts, forts, etc. It did so
by establishing the regions listed above, and then by creating “garrisons” at all installations
within each region. Each garrison was commanded by an officer assigned to the position, usually
a colonel, who was accountable for maintenance, construction, servicing, etc., on the site or sites
constituting the installation. Funding for the operation of each post was then no longer funneled
through the operational chains of command, but rather through the IMA and its regions to the
individual garrisons. Garrison commanders, since the creation of the IMA and its transition into
IMCOM, have supervised the installation of contract guard forces at posts on United States
territory, military construction and building demolition, provision of supplies and services,
privatization of installation utilities and military housing, and the creation of public-private ¹⁷
partnerships, such as the two enhanced use lease projects at the Walter Reed installation.
Therefore, all medical practice-related functions at the Walter Reed Army Medical Center are the
responsibility of MEDCOM’s installation commander, while all facility maintenance, operations,
and services are the responsibility of the IMCOM garrison commander.

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Under the guidance of the Department of the Army, the military departments and defense
agencies affected by BRAC Commission Recommendation #169 negotiated and agreed on a plan
of 13 distinct actions to distribute functions and establish the Walter Reed National Military ¹⁸
Medical Center in time to meet the September 15, 2011, deadline. Figure 2 depicts in graphic
form the timelines of the actions described in this section. Figure 3 illustrates the
recommendation’s geographic disposition of WRAMC functions resulting from the
Commission’s recommendation.

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Figure 2. BRAC Recommendation #169 Timeline
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1. Relocate all tertiary (sub-specialty and complex care) medical services to National Naval
Medical Center (NNMC), Bethesda, MD, establishing it as the Walter Reed National Military
Medical Center Bethesda (WRNMMC), MD.
Master planning for the creation of the WRNMMC and necessary NEPA (National Environmental
Policy Act) actions began during Fiscal Year 2006. This planning is to be completed during Fiscal
Year 2007. The current National Naval Medical Center (NNMC) at Bethesda requires additional
clinical treatment, graduate medical education, ancillary, parking, and supporting facilities in
order to absorb the functions being transferred from the WRAMC. A contract for the development
of a Request for Proposal (RFP) for design and construction is to be awarded during Fiscal Year

2007.

The construction contract is to be awarded during February 2008, and construction in itself is
expected begin in March of that same year and continue through May 2011. Initial outfitting of
the building and the first transition of personnel and activities is scheduled to begin during Fiscal
Year 2009. Tertiary (sub-specialty and complex care) is scheduled to move from WRAMC to the
WRNMMC in April 2010. The bulk of construction costs are being borne by the DOD TRICARE
Management Agency. Some community support infrastructure, including a new physical training
facility and an expansion of general administrative space, is funded by the Department of the
Army. Community support construction is scheduled to begin in February 2009 and end in May

2011.

The functional integration of the clinical departments at WRAMC and NNMC began during early ¹⁹
2007. Specialty and inpatient care at the two facilities is scheduled to be functionally integrated
in early Fiscal Year 2008. The new Bethesda WRNMMC will be a joint military facility ²⁰
administered by the Department of the Navy. Civilian DOD employees transferred to Bethesda
from WRAMC will become part of the Navy civilian workforce. WRNMMC is to officially open
in September 2011.

2. Relocate Legal Medicine to the new Walter Reed National Military Medical Center Bethesda,

MD.
The move of Legal Medicine’s staff from the current AFIP location to new offices will not entail
significant new construction. The transition is scheduled to occur in April 2010.

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^of^{this re}^por^t.

Figure 3. Geographic Disposition of WRAMC Functions
^Source:^Prepa^{red by CRS bas}^{ed on information provided by DO}^D.
3. Relocate sufficient personnel to the new Walter Reed National Military Medical Center
Bethesda, MD, to establish a Program Management Office that will coordinate pathology
results, contract administration, and quality assurance and control of DoD second opinion
consults worldwide.
This recommendation involves the translation of a portion of the pathology consultation function
currently administered by the AFIP from WRAMC to a new Program Management Office at
WRNMMC. No significant new construction is involved. The move is scheduled to take place in
April 2010.

4. Relocate all non-tertiary (primary and specialty) patient care functions to a new community
hospital at Ft. Belvoir, VA.
Because four separate BRAC recommendations will relocate functions and facilities onto Ft.
Belvoir, the responsibility for funding a $152 million general upgrade of basic installation
infrastructure (utilities, roads, etc.) has been apportioned to each recommendation. A $40 million
share has been allocated to BRAC Recommendation #169 that is divided between Fiscal Years
2007 and 2008. The current DeWitt Army Community Hospital, which this construction will
replace, was built in 1957 as a 250-bed inpatient facility that still utilizes its original heating, air
conditioning, electrical, and other support facilities. Extensive use of asbestos throughout the
building has encouraged plans to replace, rather than renovate, the facility. New construction will
include the hospital, a medical office building, ambulance shelter, parking garage, and central
energy plant, among other ancillary facilities.
Master planning for on-base construction, moves, and necessary NEPA actions began during
Fiscal Year 2006. This planning is scheduled to be completed during Fiscal Year 2007, when a
design contract for the new hospital and design initiation are to begin. As part of the first phase,
primary care functions at WRAMC and Ft. Belvoir are scheduled to integrate in early Fiscal Year

2009.

The hospital’s construction contract is to be awarded in January 2008 with construction set to
begin in February. Hospital construction is to continue throughout Fiscal Year 2009 while the
building’s initial outfitting and the transition of activities from WRAMC begins. Construction is
to be completed by May 2011. The non-tertiary patient care functions at WRAMC are scheduled
to move to the Ft. Belvoir hospital in August 2011. At the same time, the design of a new dental
clinic at Ft. Belvoir is to begin. Construction of the new dental clinic is scheduled to begin during
Fiscal Year 2010. The clinic is scheduled to be completed and the WRAMC staff is set to
transition into the new facility during Fiscal Year 2011. The Ft. Belvoir Community Hospital and
Dental Clinic will be a joint military facility administered by the Department of the Army.
Civilian DOD employees transferred from WRAMC to Ft. Belvoir will remain part of the Army
civilian workforce.
The final major building project, construction of a new headquarters for the Army’s North
Atlantic Regional Medical Command (NARMC) staff at Ft. Belvoir is scheduled to begin in
Fiscal Year 2010. The staff is currently located at WRAMC.

5. Relocate the Office of the Secretary of Defense supporting unit to Ft. Belvoir, VA.

The supporting unit is scheduled to move from WRAMC to Ft. Belvoir in August 2011.
6. Dissolve all elements of the Armed Forces Institute of Pathology (AFIP) except the National
Medical Museum (National Museum of Medicine and Health) and the Tissue Repository
(National Pathology Repository).
The National Museum of Medicine and Health will relocate from the WRAMC main post to the
new WRNMMC during the general move as space becomes available. Construction of a Medical
Artifact Storage Facility at Bethesda is scheduled to commence during Fiscal Year 2010.
7. Relocate the Armed Forces Medical Examiner, DNA Registry, and Accident Investigation to
Dover Air Force Base, DE.

Design of a new Joint Medical Examiner Facility to receive the Armed Forces Medical Examiner
staff and DNA Registry is scheduled to begin in December 2007. The Facility will support the
existing DOD Port Mortuary at Dover Air Force Base. A construction contract is planned for
award in January 2009. Construction is to be completed by September 2010.

8. AFIP capabilities not specified in this recommendation will be absorbed into other DoD,

Federal, or civilian facilities, as necessary.
There have been no public announcements regarding which of the remaining capabilities will
migrate or when this will occur.

9. Relocate enlisted histology technician training to Ft. Sam Houston, TX.

The Department of the Air Force is responsible for implementing the non-clinical portions of
BRAC Commission Recommendation #172, the creation of the San Antonio Regional Medical
Center at what is now the Brooke Army Medical Center, Ft. Sam Houston, Texas. One of those
non-clinical actions is the construction of a Medical Enlisted Training Center (METC) to
consolidate enlisted medical technician instruction now conducted at several installations.
Construction of the METC is scheduled to be completed in September 2010. The training
function is scheduled to move to Ft. Sam Houston not later than August 2011.
10. Relocate the Combat Casualty Care Research sub-function (with the exception of those
organizational elements performing neuroprotection research) of the Walter Reed Army
Institute of Research (Forest Glen Annex) and the Combat Casualty Care Research sub-
function of the Naval Medical Research Center (Forest Glen Annex) to the Army Institute of
Surgical Research, Ft. Sam Houston, TX.
The Combat Casualty Care Research subfunction of the NMRC will join dental and biomedical
research functions currently being carried out at Great Lakes Naval Station, Illinois, and Brooks
City Base (San Antonio), Texas, in a Joint Center of Excellence for Battlefield Health and Trauma
that is being established at Ft. Sam Houston, Texas (BRAC Commission Recommendation #174).
Construction of this new facility is scheduled to be completed by June 2009. Movement of the
Combat Casualty Care Research subfunction from the current Forest Glen Annex facility to Ft.
Sam Houston is scheduled for January 2010.
11. Relocate Medical Biological Defense Research of the Walter Reed Army Institute of Research
(Forest Glen Annex) and Naval Medical Research Center (Forest Glen Annex) to Ft. Detrick,
MD, and consolidate it with U.S. Army Medical Research Institute of Infectious Diseases.
The Medical Biological Defense Research function is scheduled to move into facilities at Ft.
Detrick, Maryland, in May 2010. This is associated with the consolidation of DOD biomedical
research and management functions into a single Joint Biomedical Research, Development, and
Acquisition Management Center at Ft. Detrick (BRAC Commission Recommendation #174).
12. Relocate Medical Chemical Defense Research of the Walter Reed Army Institute of Research
(Forest Glen Annex) to Aberdeen Proving Ground, MD, and consolidate it with the U.S.
Army Medical Research Institute of Chemical Defense.
The movement of the chemical defense research function will require building a new Chemical
and Biological Defense Medical Research Laboratory at Aberdeen Proving Ground, Maryland.
The construction contract is scheduled to be awarded in January 2008 with construction itself

beginning two months later. The new facility is to be completed during March 2010. The research
function is to move from its Forest Glen Annex facility in May 2010.
Movement of an associated function, the Joint Program Executive Office for Chemical,
Biological Defense, from leased facilities in Falls Church, Virginia, and Ft. Belvoir, Virginia, to
Aberdeen Proving Ground is scheduled to occur in April 2009.

13. Close the main post.

Closure will take place subsequent to the last relocation of official functions, currently scheduled
for August 2011. The Department of State and the General Services Administration have
requested that title to the property be transferred to them in roughly equal portions.

Some legislation that could affect the implementation of BRAC Commission Recommendation ^th
#169 has already been proposed in the 110 Congress. Appendix C lists these bills, quotes the
relevant sections of each, and indicates their status. The bills that are most advanced include the
proposed National Defense Authorization Act for Fiscal Year 2008 (H.R. 1585), which would
establish a funding floor for WRAMC operations, and the Dignified Treatment of Wounded
Warriors Act (S. 1606), which would require the Secretary of Defense to assess the feasibility of
accelerating the construction of new medical facilities. Both bills are on the Senate’s Legislative
Calendar.
Potential options for Congress regarding the creation of the Walter Reed National Military
Medical Center – some of which might have the effect of legislatively altering the statutory
deadline for completing BRAC Commission actions – include but are not limited to the
following:
• Further modify, delay, or negate the BRAC Commission Recommendation #169.
• Require DOD to report one time or on a set schedule the progress of
implementation of BRAC Commission Recommendation #169.
• Adjust or expand the proposed acceleration in implementation of BRAC
Commission Recommendation #169.
• Create a dedicated funding stream to ensure the timely implementation of BRAC
Commission Recommendation #169.
• Obligate the Department of the Army to track and report on the reforms
suggested by the Independent Review Group on Rehabilitative Care and
Administrative Processes and Walter Reed Army Medical Center and National
Naval Medical Center in their report “Rebuilding the Trust,” of April 2007.
• Commission a blue ribbon panel to monitor Department of Defense and
Department of the Army implementation of Independent Review Group
recommendations and BRAC Commission Recommendation #169.
• Require DOD or the Department of the Army to report on the organization of the
newly created Installation Management Command (IMCOM) and its subordinate

Installation Management Agency (IMA) and assess their performance in
managing Army installations since IMA creation in 2002.

WALTER REED NATIONAL MILITARY MEDICAL CENTER, BETHESDA, MD
RECOMMENDATION # 169 (MED 4)
ONE-TIME COST: $988.8M
ANNUAL RECURRING COSTS/(SAVINGS): ($145.3M)

20-YEAR NET PRESENT VALUE: ($830.6M)

PAYBACK PERIOD: 6 YEARS
SECRETARY OF DEFENSE RECOMMENDATION
Realign Walter Reed Army Medical Center, Washington, DC, as follows: relocate all tertiary
(sub-specialty and complex care) medical services to National Naval Medical Center, Bethesda,
MD, establishing it as the Walter Reed National Military Medical Center Bethesda, MD; relocate
Legal Medicine to the new Walter Reed National Military Medical Center Bethesda, MD; relocate
sufficient personnel to the new Walter Reed National Military Medical Center Bethesda, MD, to
establish a Program Management Office that will coordinate pathology results, contract
administration, and quality assurance and control of DoD second opinion consults worldwide;
relocate all non-tertiary (primary and specialty) patient care functions to a new community
hospital at Ft. Belvoir, VA; relocate the Office of the Secretary of Defense supporting unit to Ft.
Belvoir, VA; disestablish all elements of the Armed Forces Institute of Pathology except the
National Medical Museum and the Tissue Repository; relocate the Armed Forces Medical
Examiner, DNA Registry, and Accident Investigation to Dover Air Force Base, DE; relocate
enlisted histology technician training to Ft. Sam Houston, TX; relocate the Combat Casualty Care
Research sub-function (with the exception of those organizational elements performing
neuroprotection research) of the Walter Reed Army Institute of Research (Forest Glen Annex) and
the Combat Casualty Care Research sub-function of the Naval Medical Research Center (Forest
Glen Annex) to the Army Institute of Surgical Research, Ft. Sam Houston, TX; relocate Medical
Biological Defense Research of the Walter Reed Army Institute of Research (Forest Glen Annex)
and Naval Medical Research Center (Forest Glen Annex) to Ft. Detrick, MD, and consolidate it
with US Army Medical Research Institute of Infectious Diseases; relocate Medical Chemical
Defense Research of the Walter Reed Army Institute of Research (Forest Glen Annex) to
Aberdeen Proving Ground, MD, and consolidate it with the US Army Medical Research Institute
of Chemical Defense; and close the main post.
SECRETARY OF DEFENSE JUSTIFICATION
This recommendation will transform legacy medical infrastructure into a premier, modernized
joint operational medicine platform. This recommendation reduces excess capacity within the
National Capital Region (NCR) Multi-Service Market (MSM: two or more facilities collocated
geographically with “shared” beneficiary population) while maintaining the same level of care for
the beneficiaries. Walter Reed Army Medical Center (AMC) has a military value of 54.46 in
contrast to the higher military values of National Naval Medical Center (NNMC) Bethesda
(63.19) and DeWitt Hospital (58). This action relocates medical care into facilities of higher
military value and capacity. By making use of the design capacity inherent in NNMC Bethesda

(18K RWPs) and an expansion of the inpatient care at DeWitt Hospital (13K RWPs), the entire
inpatient care produced at Walter Reed AMC (17K RWPs) can be relocated into these facilities ²¹
along with their current workload (11K RWPs and 1.9K RWPs, respectively). This strategically
relocates healthcare in better proximity to the beneficiary base, which census data indicates is
concentrating in the southern area of the region. As a part of this action, approximately 2,069
authorizations (military and civilian) will be realigned to DeWitt Hospital and 797 authorizations
will be realigned to NNMC Bethesda in order to maintain the current level of effort in providing
care to the NCR beneficiary population. DeWitt Hospital will assume all patient care missions
with the exception of the specific tertiary care missions that will go to the newly established
Walter Reed National Military Medical Center at Bethesda. Specialty units, such as the Amputee
Center at WRAMC, will be relocated within the National Capitol Region. Casualty care is not
impacted. Development of a premier National Military Medical Center will provide enhanced
visibility, as well as recruiting and retention advantages to the Military Health System. The
remaining civilian authorizations and contractors at Walter Reed AMC that represent unnecessary
overhead will be eliminated. Military personnel filling similar “overhead positions” are available
to be redistributed by the Service to replace civilian and contract medical personnel elsewhere in
Military Healthcare System activities of higher military value.
Co-location of combat casualty care research activities with related military clinical activities of
the trauma center currently located at Brooke Army Medical Center, Ft. Sam Houston, TX,
promotes translational research that fosters rapid application of research findings to health care
delivery, and provides synergistic opportunities to bring clinical insight into bench research
through sharing of staff across the research and health care delivery functions.
This action will co-locate Army, Navy, Air Force and Defense Agency program management
expertise for non-medical chemical and biological defense research, development and acquisition
(each at Aberdeen Proving Ground, MD) and two separate aspects of medical chemical and
biological research: medical biological defense research (at Ft. Detrick, MD) and medical
chemical defense research (at Aberdeen Proving Ground, MD). It will promote beneficial
technical interaction in planning and headquarters-level oversight of all defense biomedical R&D,
fostering a joint perspective and sharing of expertise and work in areas of joint interest; create
opportunities for synergies and efficiencies by facilitating integrated program planning to build
joint economies and eliminate undesired redundancy, and by optimizing use of a limited pool of
critical professional personnel with expertise in medical product development and acquisition;
foster the development of common practices for DoD regulatory interactions with the US Food
and Drug Administration; and facilitate coordinated medical systems lifecycle management with
the medical logistics organizations of the Military Departments, already co-located at Ft. Detrick.
The Armed Forces Institute of Pathology (AFIP) was originally established as the Army Medical
Museum in 1862 as a public and professional repository for injuries and disease specimens of
Civil War soldiers. In 1888, educational facilities of the Museum were made available to civilian
medical professions on a cooperative basis. In 1976, Congress established AFIP as a joint entity
of the Military Departments subject to the authority, control, and direction of the Secretary of
Defense. As a result of this recommendation, in the future the Department will rely on the civilian

²¹^Aⁿ^RW^P^{is a DOD w}^o^rklo^ad^m^e^asu^r^e^m^en^{t rep}^r^esen^tin^{g th}^{e re}^sou^r^{ce co}ⁿ^s^u^m^p^tioⁿ^(m^aterials,^p^e^rsonⁿ^e^l,^etc.⁾^o^f^oⁿ^e
^pa^tie^nt’^s^h^o^s^pⁱ^t^a^liz^a^tion^a^s^c^o^m^p^ar^e^d^to^tha^t^of^othe^rⁱ^npa^tieⁿ^t^s^.^R^W^P^s^a^r^e^c^o^m^pute^d^f^r^om^da^ta^ta^k^e^{n f}^r^om^C^o^m^pos^ite
^H^e^a^{lth Ca}^re^Sy^s^t^e^m^(CH^C^{S) Sta}^nda^rd^In^p^a^tien^t^{Data Reco}^rd^{s (SID}^Rs).

market for second opinion pathology consults and initial diagnosis when the local pathology labs
capabilities are exceeded.
COMMUNITY CONCERNS
The Washington, DC community argued that moving Walter Reed Army Medical Center to the
National Naval Medical Center in Bethesda, MD would disrupt the mission of the premier
military medical facility, and have a negative effect on the economy of the District of Columbia
and homeland security in the nation’s capital. Concerns were also expressed about whether there
would be sufficient housing for family members visiting service members recovering from
serious conditions or injuries. They claimed DoD substantially deviated from the BRAC criteria
by incorrectly calculating Walter Reed’s military value, underestimating the costs for closure and
realignment, and ignoring environmental cleanup costs. They suggested Walter Reed remain
open, and the mission of the National Naval Medical Center be aligned with Walter Reed to
ensure there are no disruptions during a time of war. They also expressed concerns about the
disestablishment of the Armed Force Institute of Pathology (AFIP), which is a part of the larger
Walter Reed Recommendation. The community argued that AFIP is an irreplaceable resource for
disease research and education, and disestablishing elements like the tissue repository would have
far-reaching implications for military and civilian medicine.
COMMISSION FINDINGS
The Commission acknowledged Walter Reed Army Medical Center’s rich heritage and earned
reputation as a world-class medical center. However, the Commission found that service members ^st
deserve a state-of-the-art 21 century medical center and that the Secretary’s proposal would
increase military value. The Commission considered the community’s concerns that realigning
medical services will disrupt Walter Reed’s mission, but the Commission found that the Walter
Reed legacy will be preserved in the plan for the new facility and that service members would
continue to receive needed medical services during the implementation period. The Commission
concurred with the Department’s objective to transform medical infrastructure within the National
Capital Region. However, the Commission agrees with the communities’ concern about whether
sufficient housing will be available for family members at the Bethesda Campus and urges the
DoD to address this issue. The professional community regards AFIP and its services as integral
to the military and civilian medical and research community, and relies on AFIP for pathology
consultations and the training of radiology residents. The Commission found that DoD failed to
sufficiently address several AFIP functions, such as the Radiologic Pathology program, with the
associated tissue repository, veterinary pathology and continuing medical education.
COMMISSION RECOMMENDATIONS
The Commission found that the Secretary of Defense deviated substantially from final selection
criteria 1, as well as from the Force Structure Plan. Therefore, the Commission recommends the
following: Realign Walter Reed Army Medical Center, Washington, DC, as follows: relocate all
tertiary (sub-specialty and complex care) medical services to National Naval Medical Center,
Bethesda, MD, establishing it as the Walter Reed National Military Medical Center Bethesda,
MD; relocate Legal Medicine to the new Walter Reed National Military Medical Center
Bethesda, MD; relocate sufficient personnel to the new Walter Reed National Military Medical
Center Bethesda, MD, to establish a Program Management Office that will coordinate pathology
results, contract administration, and quality assurance and control of DoD second opinion
consults worldwide; relocate all non-tertiary (primary and specialty) patient care functions to a

new community hospital at Ft Belvoir, VA; relocate the Office of the Secretary of Defense
supporting unit to Ft. Belvoir, VA; disestablish all elements of the Armed Forces Institute of
Pathology except the National Medical Museum and the Tissue Repository; relocate the Armed
Forces Medical Examiner, DNA Registry, and Accident Investigation to Dover Air Force Base,
DE; AFIP capabilities not specified in this recommendation will be absorbed into other DoD,
Federal, or civilian facilities, as necessary; relocate enlisted histology technician training to Ft.
Sam Houston, TX; relocate the Combat Casualty Care Research sub-function (with the exception
of those organizational elements performing neuroprotection research) of the Walter Reed Army
Institute of Research (Forest Glen Annex) and the Combat Casualty Care Research sub-function
of the Naval Medical Research Center (Forest Glen Annex) to the Army Institute of Surgical
Research, Ft. Sam Houston, TX; relocate Medical Biological Defense Research of the Walter
Reed Army Institute of Research (Forest Glen Annex) and Naval Medical Research Center
(Forest Glen Annex) to Ft. Detrick, MD, and consolidate it with U.S. Army Medical Research
Institute of Infectious Diseases; relocate Medical Chemical Defense Research of the Walter Reed
Army Institute of Research (Forest Glen Annex) to Aberdeen Proving Ground, MD, and
consolidate it with the U.S. Army Medical Research Institute of Chemical Defense; and close the
main post.

On May 1, 1909, the staff and patients of the Army’s General Hospital at the District of ²²
Columbia’s Washington Barracks relocated to a new facility on the city’s northwest periphery.
After World War I, the General Hospital (now Building 1 at the Georgia Avenue campus of the
Walter Reed Army Medical Center) was joined by the Army Medical School (Building 40), the
combined facility being designated the Walter Reed Army Medical Center in 1951. The former
Medical School was redesignated the Walter Reed Army Institute of Research in 1955.
During the mid-1970s, the Army constructed Building 2, an additional 200-bed hospital, at the
Army Medical Center, raising the inpatient capacity on the site to the current 261. The Institute of
Research vacated Building 40 and moved to a new facility at the Center’s Forest Glen Annex in
nearby Maryland in 1999. Building 40 was then leased to a private concern by the Department of ²³
Defense under a so-called Enhanced-Use Lease.
In October 1906, a Naval Hospital was opened at 23^rd and E St., NW, replacing a 50-bed post-
Civil War facility located near the Washington Navy Yard. By 1935, a Navy Medical School had
been added and the combined facility was renamed the Naval Medical Center.
A new Naval Medical Center, consisting of a 1,200-bed hospital, the Naval Medical School (now
the Uniformed Services University of the Health Sciences), the Naval Dental School (now the
National Naval Dental Center), and the Naval Medical Research Institute (now the Naval Medical
Research Center), opened at the current 243-acre location in Bethesda, Maryland, in February
1942. Temporary World War II, Korean War, and Vietnam War inpatient facilities were gradually
replaced by permanent structures, and the entire facility was reconstructed in the late 1970s.
There are 257 inpatient beds available in the current facility, known since 1989 as the National ²⁴
Naval Medical Center. In 1999, the Naval Medical Research Center relocated to the Walter
Reed Army Medical Center Forest Glen Annex, joining the Walter Reed Army Institute of
Research in the Daniel J. Inouye Building.

²²^Wⁱ^t^h^t^h^{e t}^r^aⁿ^sf^er,^t^h^{e f}^o^r^m^er^G^eⁿ^e^ral^Ho^spⁱ^t^a^l^b^ecam^{e t}^h^{e p}^o^s^t^’^{s ho}^spⁱ^t^a^l^.^A^po^rtⁱ^oⁿ^o^f^t^h^{e ho}^spⁱ^t^a^l^b^uⁱ^l^dⁱⁿ^{g i}^s
^toda^y^’^s^m^e^dic^a^l^tre^a^t^m^e^{nt f}^a^c^ilit^y^a^t^the^re^na^m^e^{d Ft. L}^e^slie^{J. Mc}^Na^ir.
²³^{38 U}^S^{C 8}¹⁶¹^de^fⁱ^ne^s^aⁿ^e^nha^nc^e^d^-us^e^le^a^s^e^a^s^“^a^w^r^itte^{n le}^a^s^e^eⁿ^te^re^{d int}^o^by^the^Se^c^r^e^t^a^r^y^unde^{r t}^h^is^s^u^bc^ha^pte^r
⁽³⁸^US^C⁸¹⁶¹^et^seq^.^).^{” I}ⁿ^gen^e^ral^,^st^at^u^t^{es p}^e^rmⁱ^t^t^h^{e S}^ecret^ary^o^f^an^y^e^x^ecu^tⁱ^v^{e d}^e^p^a^rt^m^eⁿ^t^t^o^en^t^e^rⁱⁿ^t^o^su^{ch l}^{ease o}^f
^r^e^a^l^pr^ope^r^t^y^unde^r^his^j^u^rⁱ^s^d^ic^tⁱ^oⁿ^or^c^ontr^o^l.³⁸^U^S^C⁸¹^{64 s}^t^a^t^e^s^t^h^a^t^“^I^f^,^durⁱⁿ^g^the^te^r^m^of^aⁿ^eⁿ^h^a^nc^e^d^-^u^s^e^le^a^s^e^or
^wⁱ^t^hⁱⁿ³⁰^d^a^y^s^a^f^t^e^{r t}^h^{e en}^d^o^f^t^h^{e t}^e^rm^o^f^t^h^{e l}^ease,^t^h^{e S}^ecret^ar^y^d^e^t^e^rmⁱⁿ^{es t}^h^at^t^h^{e l}^eased^p^r^op^ert^yⁱ^sⁿ^o^l^oⁿ^g^er
^ne^e^d^e^d^by^the^De^pa^rtm^e^{nt, the}^Se^c^r^e^t^a^r^y^m^a^y^initia^te^a^c^{tion f}^o^r^t^h^e^traⁿ^sf^e^r^{to the}^le^sse^e^of^a^{ll rig}^h^{t, t}^itle^{, a}ⁿ^d^inte^re^st
^o^f^t^h^{e Un}ⁱ^t^e^d^S^t^at^{es i}ⁿ^t^h^e^p^r^op^ert^y^.^”
²⁴^Ov^{er th}^{e co}^u^r^{se o}^f^th^e^p^a^{st six}^d^ecad^{es, m}^ilitar^y^medⁱ^cal^p^r^{actice h}^a^{s e}^m^p^h^a^sized^o^u^t^p^a^tien^t^treatm^eⁿ^t^{, red}^u^cin^g^t^h^e
^num^be^r^of^be^ds^ne^e^d^e^d^f^o^r^a^gⁱ^v^e^{n le}^v^e^{l of}^m^e^dic^a^l^c^a^r^e^.

The Army is scheduled to move all tertiary medical services, Legal Medicine, and some of the
functions currently performed by the Armed Forces Institute of Pathology currently located at the
Walter Reed Army Medical Center to the Bethesda Navy site during 2010 to create the Walter ²⁵
Reed National Military Medical Center.

²⁵^P^r^im^a^r^y^a^{nd s}^e^c^onda^ry^m^e^dic^a^l^s^e^rv^ic^e^s^w^{ill re}^loc^a^t^e^{to a}^ne^w^$10^{0 m}^{illion c}^o^m^m^unity^hos^pita^{l be}ⁱⁿ^g^c^ons^truc^te^{d a}^t
^{Ft. Be}^lv^oir,^Vⁱ^rgⁱⁿ^ia^{. Co}^nstruc^ti^oⁿ^of^{this f}^a^c^ility^w^a^{s a}^u^t^horiz^e^d^a^{nd f}^uⁿ^d^{s w}^e^re^a^ppropria^te^dⁱⁿ^the^sta^nda^{rd m}^ilita^ry
^c^ons^tr^uc^ti^on^pr^oc^e^s^s^f^o^r^Fis^c^a^l^Y^e^a^r^s²⁰⁰⁵^aⁿ^d²⁰⁰⁶^.

Various bills have been introduced during the 110^th Congress that would affect in some way the
implementation of BRAC Commission Recommendation #169. As of the date of this report, the
relevant bill sections and bill status are listed below:
Status: Referred to the House Committee on Armed Services Subcommittee on Readiness on
April 3, 2007.
SECTION 1. PROHIBITION ON CLOSURE OF WALTER REED ARMY MEDICAL CENTER.
Notwithstanding section 2904(a)(5) of the Defense Base Closure and Realignment Act of 1990
(part A of title XXIX of P.L. 101-510; 10 U.S.C. 2687 note) and the recommendations of the
Defense Base Closure and Realignment Commission contained in the report transmitted to
Congress on September 15, 2005, under section 2903(e) of such Act, the Secretary of Defense
shall not close Walter Reed Army Medical Center.
Status: Laid before the Senate by motion on June 28, 2007.
SEC. 712. GUARANTEED FUNDING FOR WALTER REED ARMY MEDICAL CENTER.
The amount of funds available for the commander of Walter Reed Army Medical Center for a
fiscal year shall be not less than the amount expended by the commander of Walter Reed Army
Medical Center in fiscal year 2006 until the first fiscal year beginning after the date on which the
Secretary of Defense certifies to the Committee on Armed Services of the Senate and the
Committee on Armed Services of the House of Representatives that the expanded facilities at the
National Naval Medical Center, Bethesda, Maryland, and DeWitt Army Community Hospital, Ft.
Belvoir, Virginia, as described in section 304(a), are completed, equipped, and staffed with
sufficient capacity to accept and provide at least the same level of care as patients received at
Walter Reed Army Medical Center during fiscal year 2006.

Status: Became P.L. 110-28 on May 25, 2007.
SEC. 3701. Notwithstanding any other provision of law, none of the funds in this or any other Act
may be used to close Walter Reed Army Medical Center until equivalent medical facilities at the
Walter Reed National Military Medical Center at Naval Medical Center, Bethesda, Maryland,
and/or the Ft. Belvoir, Virginia, Community Hospital have been constructed and equipped:
Provided, That to ensure that the quality of care provided by the Military Health System is not
diminished during this transition, the Walter Reed Army Medical Center shall be adequately
funded, to include necessary renovation and maintenance of existing facilities, to maintain the
maximum level of inpatient and outpatient services.
Sec. 3702. Notwithstanding any other provision of law, none of the funds in this or any other Act
shall be used to reorganize or relocate the functions of the Armed Forces Institute of Pathology
(AFIP) until the Secretary of Defense has submitted, not later than December 31, 2007, a detailed
plan and timetable for the proposed reorganization and relocation to the Committees on
Appropriations and Armed Services of the Senate and House of Representatives. The plan shall
take into consideration the recommendations of a study being prepared by the Government
Accountability Office (GAO), provided that such study is available not later than 45 days before
the date specified in this section, on the impact of dispersing selected functions of AFIP among
several locations, and the possibility of consolidating those functions at one location. The plan
shall include an analysis of the options for the location and operation of the Program
Management Office for second opinion consults that are consistent with the recommendations of
the Base Realignment and Closure Commission, together with the rationale for the option
selected by the Secretary.
Status: Read twice and referred to the Senate Committee on Armed Services on March 29, 2007.
SEC. 4. LIMITATION ON IMPLEMENTATION OF RECOMMENDATION TO CLOSE
WALTER REED ARMY MEDICAL CENTER.
(a) Findings- Congress finds the following:
(1) The final recommendations of the Defense Base Closure and Realignment Commission under
the 2005 round of defense base closure and realignment include recommendations to close Walter
Reed Army Medical Center and to build new, modern facilities at the National Naval Medical
Center at Bethesda and at Ft. Belvoir to improve the overall quality of and access to health care
for members of the Armed Forces.
(2) These recommendations include the transfer of medical services from the Walter Reed Army
Medical Center to the National Naval Medical Center at Bethesda and at Ft. Belvoir, but they do

not adequately provide for housing for the families of wounded members of the Armed Forces
who will receive treatment at such new facilities.
(3) The recommended closure of the Walter Reed Army Medical Center has impaired the ability
of the Secretary of Defense to attract the personnel required to provide proper medical services at
such medical center.
(b) Limitation on Implementation of Recommendations- The Secretary of Defense shall not take
any action to implement the recommendations of the Defense Base Closure and Realignment
Commission under the 2005 round of defense base closure and realignment relating to the transfer
of medical services from Walter Reed Army Medical Center to the National Naval Medical
Center at Bethesda and at Ft. Belvoir during the period beginning on the date of the enactment of
this Act and ending on the date that is 60 days after the date on which Congress receives the plan
required under subsection (c).
(c) Plan Required- Not later than one year after the date of the enactment of this Act, the
Secretary of Defense shall submit to Congress a plan that includes an assessment of the
following:
(1) The feasibility and advisability of providing current or prospective employees at Walter Reed
Army Medical Center a guarantee that their employment will continue in the Washington, DC,
metropolitan area for more than two years after the date on which Walter Reed Army Medical
Center is closed.
(2) Detailed construction plans for new medical facilities and family housing at the National
Naval Medical Center at Bethesda and at Ft. Belvoir to accommodate the transfer of medical
services from Walter Reed Army Medical Center to the National Naval Medical Center at
Bethesda and at Ft. Belvoir.
(3) The costs, feasibility, and advisability of completing all of the construction planned for the
transfer of medical services from Walter Reed Army Medical Center to the National Naval
Medical Center at Bethesda and at Ft. Belvoir before any patients are transferred to such new
facilities from Walter Reed Army Medical Center as a result of the recommendations of the
Defense Base Closure and Realignment Commission under the 2005 round of defense base
closure and realignment.
Status: Placed on Senate Legislative Calendar under General Orders (Calendar No. 203) on June

18, 2007.

SEC. 402. REPORTS ON ARMY ACTION PLAN IN RESPONSE TO DEFICIENCIES
IDENTIFIED AT WALTER REED ARMY MEDICAL CENTER.
(a) Reports Required- Not later than 30 days after the date of the enactment of this Act, and every
120 days thereafter until March 1, 2009, the Secretary of Defense shall submit to the
congressional defense committees a report on the implementation of the action plan of the Army
to correct deficiencies identified in the condition of facilities, and in the administration of

outpatients in medical hold or medical holdover status, at Walter Reed Army Medical Center
(WRAMC) and at other applicable Army installations at which covered members of the Armed
Forces are assigned.
(b) Elements of Report - Each report under subsection (a) shall include current information on the
following:
(1) The number of inpatients at Walter Reed Army Medical Center, and the number of outpatients
on medical hold or in a medical holdover status at Walter Reed Army Medical Center, as a result
of serious injuries or illnesses.
(2) A description of the lodging facilities and other forms of housing at Walter Reed Army
Medical Center, and at each other Army facility, to which are assigned personnel in medical hold
or medical holdover status as a result of serious injuries or illnesses, including—
(A) an assessment of the conditions of such facilities and housing; and
(B) a description of any plans to correct inadequacies in such conditions.
(3) The status, estimated completion date, and estimated cost of any proposed or ongoing actions
to correct any inadequacies in conditions as described under paragraph (2).
(4) The number of case managers, platoon sergeants, patient advocates, and physical evaluation
board liaison officers stationed at Walter Reed Army Medical Center, and at each other Army
facility, to which are assigned personnel in medical hold or medical holdover status as a result of
serious injuries or illnesses, and the ratio of case workers and platoon sergeants to outpatients for
whom they are responsible at each such facility.
(5) The number of telephone calls received during the preceding 60 days on the Wounded Soldier
and Family hotline (as established on March 19, 2007), a summary of the complaints or
communications received through such calls, and a description of the actions taken in response to
such calls.
(6) A summary of the activities, findings, and recommendations of the Army tiger team of
medical and installation professionals who visited the major medical treatment facilities and
community-based health care organizations of the Army pursuant to March 2007 orders, and a
description of the status of corrective actions being taken with to address deficiencies noted by
that team.
(7) The status of the ombudsman programs at Walter Reed Army Medical Center and at other
major Army installations to which are assigned personnel in medical hold or medical holdover
status as a result of serious injuries or illnesses.
(c) Posting on Internet- Not later than 24 hours after submitting a report under subsection (a), the
Secretary shall post such report on the Internet website of the Department of Defense that is
available to the public.

SEC. 403. CONSTRUCTION OF FACILITIES REQUIRED FOR THE CLOSURE OF
WALTER REED ARMY MEDICAL CENTER, DISTRICT OF COLUMBIA.
(a) Assessment of Acceleration of Construction of Facilities- The Secretary of Defense shall carry
out an assessment of the feasibility (including the cost-effectiveness) of accelerating the
construction and completion of any new facilities required to facilitate the closure of Walter Reed
Army Medical Center, District of Columbia, as required as a result of the 2005 round of defense
base closure and realignment under the Defense Base Closure and Realignment Act of 1990 (part
A of title XXIX of P.L. 101-510; U.S.C. 2687 note).
(b) Development and Implementation of Plan for Construction of Facilities-
(1) IN GENERAL - The Secretary shall develop and carry out a plan for the construction and
completion of any new facilities required to facilitate the closure of Walter Reed Army Medical
Center as required as described in subsection (a). If the Secretary determines as a result of the
assessment under subsection (a) that accelerating the construction and completion of such
facilities is feasible, the plan shall provide for the accelerated construction and completion of
such facilities in a manner consistent with that determination.
(2) SUBMITTAL OF PLAN - The Secretary shall submit to the congressional defense
committees the plan required by paragraph (1) not later than September 30, 2007.
(c) Certifications- Not later than September 30, 2007, the Secretary shall submit to the
congressional defense committees a certification of each of the following:
(1) That a transition plan has been developed, and resources have been committed, to ensure that
patient care services, medical operations, and facilities are sustained at the highest possible level
at Walter Reed Army Medical Center until facilities to replace Walter Reed Army Medical Center
are staffed and ready to assume at least the same level of care previously provided at Walter Reed
Army Medical Center.
(2) That the closure of Walter Reed Army Medical Center will not result in a net loss of capacity
in the major military medical centers in the National Capitol Region in terms of total bed capacity
or staffed bed capacity.
(3) That the capacity and types of medical hold and out-patient lodging facilities currently
operating at Walter Reed Army Medical Center will be available at the facilities to replace Walter
Reed Army Medical Center by the date of the closure of Walter Reed Army Medical Center.
(4) That adequate funds have been provided to complete fully all facilities identified in the Base
Realignment and Closure Business Plan for Walter Reed Army Medical Center submitted to the
congressional defense committees as part of the budget justification materials submitted to
Congress together with the budget of the President for fiscal year 2008 as contemplated in that
business plan.
(d) Environmental Laws- Nothing in this section shall require the Secretary or any designated
representative to waive or ignore responsibilities and actions required by the National
Environmental Policy Act of 1969 (42 U.S.C. 4321 et seq.) or the regulations implementing such
Act.

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