The History of CFM, Part 6: VA’s Construction and Facilities Management at the Turn of the Twenty-First Century, 1990s – 2000s

This is Part 6 of a 6-part short history of the Office of Construction and Facilities Management. This short history is also the first in a series of histories covering VA Central Office directorates. Make sure to check out Part 1, Part 2, Part 3, Part 4, and Part 5 as well.

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As the new millennium approached, VA again faced scrutiny from Veterans, the public, the media, and other Federal agencies about its approach to healthcare and the age and condition of its facilities. Through the second half of the twentieth century, advances in medical care altered the way people accessed and received healthcare in the United States, leading to more outpatient care than overnight or extended stays in hospitals. While other healthcare systems in the country updated their facilities to address this change, VA continued to maintain its hospital-oriented network through the 1990s.^[1] Compounding VA’s out-of-date facilities issue, a large segment of the Veteran population began relocating to states in the southern parts of the country during this period. With Veterans moving further from the established medical centers built to serve them, more strain was placed on hospitals designed for fewer patients, while funding continued to go towards maintaining large, underutilized facilities in other parts of the country.^[2]

In 1999, the General Accounting Office completed a study highlighting these issues and recommending VA find a way to address them. In response, VA developed an assessment process known as Capital Asset Realignment for Enhanced Services (CARES).^[3]  As the entity responsible for building and maintaining many of VA’s largest capital assets, the Office of Facilities Management played a major role in this medical infrastructure planning project, and CARES influenced most of the office’s work at the turn of the twenty-first century.

The CARES plans and study were completed between 2002 and 2004. These documents outlined a new process for analyzing the changing medical needs of the Veteran population and predicting the facilities required to meet those needs in the future.^[4] During this planning period, Congress cut the funding for the Office of Facilities, as lawmakers were not willing to support more construction before the completion of the CARES study.^[5] However, reduced funding did not prevent the office from participating in the VA-wide preparation for CARES. In 2001, VA created the Capital Asset Management and Planning Service in the Office of Facilities Management. This new service coordinated with VA’s central capital asset management office, the Office of Asset Enterprise Management, in overseeing the planning and management of the Veteran Health Administration’s properties.^[6] In 2004, VA Secretary Anthony Principi released the CARES decisions, which outlined VA’s plan to consolidate duplicate services, close excess facilities, and construct new hospitals and outpatient clinics in underserved and/or strained areas.^[7] The CARES decisions guided the Office of Facilities’ work through the first decade of the twenty-first century, with a focus on construction that brought healthcare closer to where Veterans were then living.

While completing the CARES-related construction projects, the Office of Facilities Management experienced organizational changes that helped bring it closer to the office it is today. On December 22, 2006, Congress passed the Veterans Benefits, Health Care, and Information Technology Act of 2006. The law included a section establishing the position of Director of Office of Construction and Facilities Management.^[8] VA created the Office of Construction and Facilities Management (CFM) in February 2007, combining the Office of Facilities Management with the Office of Construction Management, the latter of which was formed around 2000 in the National Cemetery Administration to oversee cemetery construction.^[9] The new office was relocated to the Office of the Secretary, returning construction duties to the VA Central Office for the first time since the early 1990s. Though the name changed, CFM continued to focus on medical centers while also helping with cemetery and office projects, as it had been doing since the mid-1990s.

In 2008, VA established the Office of Acquisition, Logistics, and Construction (OALC) to oversee both CFM and the Office of Acquisition and Logistics (OAL).^[10] OAL provides oversight and planning for the procurement and management of supplies and services for VA. The connection of these two offices mirrored the early organizational structure of VA, where the supply and construction services were closely associated due to their acquisition-related roles.

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As of 2024, the office is still known as the Office of Construction and Facilities Management and remains within OALC. Though CFM has experienced multiple name changes, role expansions, and relocations within the structure of VA, its goal has remained the same since the Construction Division was formed in 1923: to provide both high-quality and cost-efficient spaces for Veterans to receive care and other services from the nation that they served. Check out CFM and learn more about their current activities here.

^[1] U.S. Department of Veterans Affairs, Office of the Secretary, Department of Veterans Affairs: Capital Asset Realignment for Enhanced Services (CARES), Secretary of Veterans Affairs CARES Decision (Washington, D.C.: United States Department of Veterans Affairs), 2004.

^[2] Ibid.; Michelle Pellemans, “Veterans Health Care in Florida Shortchanged,” The Tampa Tribune (Tampa, Florida), December 27, 1999.

^[3] U.S. General Accounting Office, Performance and Accountability Series: Major Management Challenges and Program Risks: Department of Veterans Affairs, GAO/OCG-99-15 (Washington, D.C.: United States General Accounting Office), January 1999; U.S. General Accounting Office, Report to the Secretary of Veterans Affairs: VA Health Care – Improvements Needed in Capital Asset Planning and Budgeting, GAO/HEHS-99-145 (Washington, D.C.: United States General Accounting Office), August 1999; U.S. Department of Veterans Affairs, Office of the Secretary, Department of Veterans Affairs: Capital Asset Realignment for Enhanced Services (CARES), Secretary of Veterans Affairs CARES Decision.

^[4] Draft National CARES Plan, (Washington, D.C.: United States Department of Veterans Affairs), August 2003, 4; U.S. Department of Veterans Affairs, Office of the Secretary, Department of Veterans Affairs: Capital Asset Realignment for Enhanced Services (CARES), Secretary of Veterans Affairs CARES Decision.

^[5] U.S. Department of Veterans Affairs, Office of the Secretary, Department of Veterans Affairs: Capital Asset Realignment for Enhanced Services (CARES), Secretary of Veterans Affairs CARES Decision, 1-2 – 1-3.

^[6] U.S. Department of Veterans Affairs, 5-Year Capital Plan 2004-2009 (Washington, D.C.: United States Department of Veterans Affairs), 2004: 17-18.

^[7] U.S. Department of Veterans Affairs, Office of the Secretary, Department of Veterans Affairs: Capital Asset Realignment for Enhanced Services (CARES), Secretary of Veterans Affairs CARES Decision.

^[8] Veterans Benefits, Health Care, and Information Act of 2006, S. 3421, 109^th Cong. (2006).

^[9] “Subpart 836.6 – Architect-Engineer Services: 836.603 Collecting Data on and Appraising Firms’ Qualifications,” Code of Federal Regulations, Chapter 8 (2003): 212; “Office of Facilities Management,” United States Department of Veterans Affairs, U.S. Department of Veterans Affairs, February 16, 2007.

^[10] “About CFM,” Office of Construction & Facilities Management, U.S. Department of Veterans Affairs, March 2011.