The History of CFM, Part 3: Post-World War II Updates to VA’s Medical Facilities, 1940s – 1950s

This is Part 3 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 and Part 2 as well.

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In the early 1940s, as the United States mobilized for World War II, construction slowed at VA. When the country entered the war, building supplies grew more limited and the number of available laborers was reduced by enlistment.^[1] As soldiers returned home, public criticism of the pace of VA construction and its approach to medical care increased. The VA medical system, which developed in response to World War I, was not prepared to care for the massive increase in the Veteran population. With nearly three times the number of Veterans than World War I, the surge overwhelmed VA and highlighted the need for more hospitals.

In 1945, media pressure regarding the conditions and quality of care in many VA facilities led Congress to investigate VA, which included a probe into the activities of the Construction Service. Through the investigations, Congress found that VA’s hiring processes and salaries were hindering staffing, the Administration’s hospitals were not located close enough to patient populations, VA needed stronger connections with medical groups and schools, and the organization was too centralized, resulting in slower response times in addressing the needs of Veterans across the country.^[2] Concerns directly related to the activities of the Construction Service were largely associated with the pace of construction immediately before and during the war. The Congressional Committee on World War Veterans’ Legislation’s hearing with Louis Tripp, director of the Construction Service, highlighted areas that could be improved to quicken the pace of construction, including working with Federally-employed engineers outside of VA, hiring more staff within the department, and reducing the amount of bureaucracy required to initiate and manage construction projects.^[3]

The criticism facing VA led President Harry Truman to replace Administrator Frank Hines with General Omar Bradley in mid-1945.^[4] Before the investigations into VA began, Congress, in 1944, allotted $500 million to new hospital construction as part of the G.I. Bill.^[5] The American Legion (which helped craft the original version of the bill), President Franklin D. Roosevelt, and members of Congress recognized the need for more medical facilities to accommodate the massive growth of the post-war Veteran population.^[6] Congress also passed Public Law 79-293 shortly after the investigation, which increased funding for hospital construction and restructured VA’s medical service, creating the Department of Medicine and Surgery and expediting the hiring process for doctors. PL-79-293 also permitted VA to partner with medical schools, increasing the number of hospitals built close to colleges and universities. Though the funding from these two pieces of legislation arrived too late to alleviate the public pressure facing VA, it allowed the Construction Service to initiate a new building program. Completed between 1946 and 1958, the program modernized VA’s hospital network through the construction of new medical centers located in more populous urban areas where they could serve more Veterans.

In 1946, General Bradley restructured VA to address many of the issues that were identified during the congressional hearings the year prior, making the Administration’s services more accessible to the millions of discharged Veterans now eligible for benefits. As part of these changes, Bradley also decentralized the authority of VA’s many offices, making it easier for staff working both in Washington and across the country to manage the increased workload.^[7] During the restructuring, the Construction Service was combined with the Supply Service and the newly established Real Estate Service to form the Office of Construction, Supply, and Real Estate.^[8] Previously, the Supply Service had been responsible for activities related to real property as part of the Property and Contract Division.^[9] Francis H. Dryden was selected to lead the office, serving as the Assistant Administrator for Construction and Supplies.^[10] In his final month as director of the Construction Service, Louis Tripp noted that the new building program was the “largest hospital construction program in the history of the world.”^[11] The program was also one of the largest projects in VA’s history, resulting in the addition of over eighty facilities to the VA’s hospital network between 1946 and 1958.^[12]

Due to both the scale of the project and the desire for more modern hospital designs, VA initially outsourced the management of its new hospital construction program to the U.S. Army Corps of Engineers. Between 1946 and early 1947, the Army Corps contracted with private architects to design the new hospitals, which resulted in a wider variety of hospital designs than the Construction Service had created using their standardized plans in the preceding decades.^[13] Hospital design also shifted toward taller, more concentrated campuses since many of the new facilities were built on smaller parcels in urban environments. During this period, VA’s Real Estate Service aided in the hospital program through the acquisition of land needed for the new facilities, but the Construction Service focused solely on projects for existing facilities.^[14] By mid-1947, as scarcity increased the prices of construction materials and impacted the overall cost of the program, the Construction Service became more involved in design activities for the new hospitals.^[15] Design work for the hospital program continued to be split between the Army Corps and VA through 1950, with the Construction Service focusing on reducing non-essential spaces in facility designs and creating cost-efficient standardized plans.^[16] 

During the construction of the post-WWII hospitals, the Office of Construction, Supply, and Real Estate continued to grow and change. In the late 1940s, the office’s staff increased from approximately 200 people to nearly 1,000, with most of the new positions filled by architects and engineers.^[17] New sections were also created within the office, including the Safety and Fire Prevention program, which was established in 1947.^[18] Originally focused on protecting VA’s staff, patients, and property from fire, the office increasingly concentrated on work-related injuries and external threats to VA facilities, from natural disasters to nuclear war, through the early 1950s.^[19] A separate, short-lived Maintenance and Operations program, specifically dedicated to the care of VA’s existing facilities, was carved out of the office’s Construction program in 1951.^[20]

Through the early 1950s, VA’s construction progress was hampered by the Korean War, which caused material and labor constraints across the nation.^[21] The pace of construction quickly recovered afterwards, and by 1958, all the hospitals planned as part of the post-WWII construction program were completed.^[22]

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Part 4, Reorganization and Expansion: New Duties in the Cold War Era will be posted in September.

^[1] Investigation of the Veterans’ Administration with a Particular View to Determining the Efficiency of the Administration and Operation of Veterans’ Administration Facilities: Hearings Before the H. Committee on World War Veterans’ Legislation, 79th Cong. (1945) (testimony of Louis H. Tripp, Director of Construction Service, Veterans’ Administration), 2239-2257; Investigation of the Veterans’ Administration with a Particular View to Determining the Efficiency of the Administration and Operation of Veterans’ Administration Facilities: Hearings Before the Committee on World War Veterans’ Legislation, 79th Cong. (1945) (statement of Col. George E. Ijams, Assistant Administrator, Veterans’ Administration), 2269-2292.

^[2] Lindsay Hannah, “United States Third Generation Veterans Hospitals,” National Register of Historic Places Multiple Property Documentation Form (Washington, D.C.: U.S. Department of the Interior, National Park Service, 2018), E-22 – E-25.

^[3] Investigation of the Veterans’ Administration with a Particular View to Determining the Efficiency of the Administration and Operation of Veterans’ Administration Facilities: Hearings Before the H. Committee on World War Veterans’ Legislation, 79th Cong. (1945) (testimony of Louis H. Tripp, Director of Construction Service, Veterans’ Administration), 2239-2257.

^[4] Lindsay Hannah, “United States Third Generation Veterans Hospitals,” E-22 – E-25.

^[5] Servicemen’s Readjustment Act of 1944 [G.I. Bill], S. 1767m 78th Cong. § 2 (1944).

^[6] Veterans’ Omnibus Bill: Hearings Before a Subcommittee of the Committee on Finance on S. 1617, A Bill to Provide Federal Government Aid for the Readjustment in Civilian Life of Returning World War II Veterans, 78^th Cong. (1944) (Washington, D.C.: United States Government Printing Office, 1944) (statement of Warren H. Atherton, National Commander, The American Legion), 8-9.

^[7] U.S. Veterans’ Administration, Annual Report for the Fiscal Year Ending June 30, 1946 (Washington, D.C.: United States Government Printing Office, 1946), 1-2.

^[8] Ibid., 46; Bureau of the Budget, Division of Public Inquiries, Government Information Service, United States Government Manual (Washington, D.C.: U.S. Government Printing Office, 1947), 537-538.

^[9] U.S. Veterans Administration, The Medical Bulletin of the Veterans Administration, vol. 7, ed. Martin Cooley (Washington, D.C.: U.S. Government Printing Office, 1931), 1003.

^[10] U.S. Congress, Office of Congressional Directory, Official Congressional Directory (Washington, D.C.: United States Government Printing Office, 1946), 447.

^[11] “Hospital Expansion Creates Jobs,” Employment Service Review 13, no. 5 (May 1946): 23; Eric Gradoia, “Louis and Eleanor Tripp, 1936-2003.”

^[12] “History of CFM,” Office of Construction and Facilities Management.

^[13] Lindsay Hannah, “United States Third Generation Veterans Hospitals,” E50, E53 – E55.

^[14] U.S. Veterans’ Administration, Annual Report for the Fiscal Year Ending June 30, 1947 (Washington, D.C.: United States Government Printing Office, 1948), 62-64.

^[15] Lindsay Hannah, “United States Third Generation Veterans Hospitals,” E62 – E64; “Progress Report: The Veterans Hospital Program,” Progressive Architecture 28, no. 8 (August 1947), 20.

^[16] Lindsay Hannah, “United States Third Generation Veterans Hospitals,” E-64 – E65; U.S. Veterans’ Administration, Annual Report for the Fiscal Year Ending June 30, 1950, (Washington, D.C.: U.S. Government Printing Office, 1951), 100.

^[17] Lindsay Hannah, “United States Third Generation Veterans Hospitals,” E-64.

^[18] U.S. Veterans’ Administration, Annual Report for the Fiscal Year Ending June 30, 1947, 64.

^[19] Ibid.; U.S. Veterans’ Administration, Annual Report for the Fiscal Year Ending June 30, 1951 (Washington, D.C.: U.S. Government Printing Office, 1952), 118; U.S. Veterans’ Administration, Annual Report for the Fiscal Year Ending June 30, 1955 (Washington, D.C.: U.S. Government Printing Office, 1956), 149, 152.

^[20] U.S. Veterans’ Administration, Annual Report for the Fiscal Year Ending June 30, 1951, 115.

^[21] U.S. Veterans’ Administration, Annual Report for the Fiscal Year Ending June 30, 1951, 114; U.S. Veterans’ Administration, Annual Report for the Fiscal Year Ended June 30, 1952, (Washington, D.C.: U.S. Government Printing Office, 1953), 107.

^[22] Lindsay Hannah, “United States Third Generation Veterans Hospitals,” E-48.