Funding Level for the Proposed Teaching Hospital to be Constructed on the Campus of Howard University, Washington, D.C.

Published by the Government Accountability Office on 1971-03-08.

Below is a raw (and likely hideous) rendition of the original report. (PDF)

                                   COMPTROLLER            GENERAL             OF     THE       UNITED    STATES
                                                        WASHINGTON.            DC.         20548


c\ F     Dear Mr. Shrivet!
,t             Reference ilr made to your letter   of December 30, 1970, which
         enclosed a copy of a letter   you receiyed   from Dr. Leslie E. Becker

     ’   concernfng  this project,                 you asked u6 to reevaluate our recommandatiotro
         for the Howard University                  project and to furnish you out conclusions
         af tst ruch a reevaluation,

                Enclosed ia a copy of the General Accounting           Off ice report,      refer-
         red to in Dr. Becker’r      letter,     on %urvey of Prqreea        Toward Construct-
         ing New Teaching Hoepital        on Howard University     Campusert (B-164031(1),
         April    3, 1970).  Aa indicated      in our letter   of transmittal       to the Chair
         man) Subcommittee on Departmente          of Labor and Health,      Education,    and
         Welfare and Related Agencies,         Committee on Appropriations,        United Stater
         Senate, the purpose of our report wab to provide             information     to the Sub-
         committee on the progress        being aade toward the construction          of a new
         hospital    on the Howard Univeruity       campus, authorized      under legislation
         enacted in 1961.

                 The survey on which our report         wbm bawd dfd not include an
         appraisal      of the adequacy of the
         by Howard Univerdity         and agreed
         for adminieterlng         tha Federal interest    in the projact-the     Department
         of Health,       Education,   and Wolfan    WJW, the General Sarvicar         AdaLnir-
         tration      (GSA), and the Off&m       of Management and Budget (formerly       Buorau
         of the Budget).         Our report did not contain      any recommendationa..
                 Pollowidg    are our comments on Dr. Becker’*       letter.                                                                                .

                 Dr. Becker questioned    the statements    in our report (p. 10) that
         the estimated     cost of $52.06 per pore       aqmre foot for the Howard
         holrpital   compared favorably    with the average experienced    cost of $54.32
         per prose square foot for 12 recently         completed teaching  hospital@.
         Dr. Sacker rtated      that he presumed that the source of the WA data on
         rerhicb our rmtsmmtr       wro bmed ww 8 1967 tMching borpftal         conltrue-                                                                             .
         tion survey lrsdr by the Aaoocirtim        of Amarican Medical Colla~rr      uhfeb
         reportad   titlitirtscr          oa borpitrir                built           u        fat      hmck aa   1964.




                                     ,;        50 TH ANNIVERSARY                            1921.1971
                                                                                                                                             ,/   ,,   I,   ‘,,   ,       ,L.
       The statistice    included    in our report were intended       to afford     the
Subcommittee a bneij for relating          the amount of Fedora1 funds being
sou&t      by Howard Univoreity    to costs actually     experienced    by other orga-
nizations     which had recently     completed construction      of tcsching    hoepltalr,
Our report showad that the estimatad          cost of construction      and the amount
of Federal funds required WB not cut of line with the avcrqe                   costs
recently     experienced   by other organizationa     in constructing      teaching
hospitals.      We did not intend for thcso statements,          in any wry, to be
an appraisal      of the adequucy of the ovcraA1 plans for the Howurd

       The basic for our comparison was information   compiled by GSA for
the President,    Howard University,  on 12 teaching hospitals     completed
betmen     March 1967 md December 1968. Thess taaching      hospitals     ranged
in size from about 224,000 gross aqunn feat to more than one million
gmse square feet and averaead about 504,000 gmss rquAro feet.              The
construction    costs per gross squsre foot for these hospitala       ranged
fnnn $38.63 to $71.23 and weraged      $54.32.

       Dr. Becker commented that our report did not note that,            on the
advice of Dr. Russell A. IVelssn, Ho&d          University    roconrmended to HIM
and to the Bureau of the Budget that the new hospitil             have 683,466 grorrr
aquar0 feat.     The records WQ exam ed at flowmd University           ehowmd that
a committee chaired     by Dr. Robert,S.7   Jason, the Dean of the College of
Hedfcine,   Eoward University,     had recommended in the constmction          program
submitted   to the President     of Hcwrd University       on Juna 22~ 1962, that
the proposed hospital     contnin   683,466 ~rosrr squars feet,

      ln presenting the recommendation          to the Preridant     of Howntd Uni-
wmity,    Dr. Jason said, in pertr

     . nThts Program is the product of runny minds, within             and
       outside  of the University       * * *,    lt ban a broad base
       aria ing f ram the o tatemcnts      of needs, recommendationa
       and suggestions    filed    by the head of evety profess tonal
       deprtamt     and the chief of every regtncnt of the Staff
       bf tha Roepit;sl.      It is the cerult      of the many.delibetY
      l tiona and the final      deeisfonr    of a gmup conrirtti8       of
      a Corn ColPrittee     compared of1       * * *.”

                                                                                             (   ; ,*’   I r,

       The list of committee members included      Wr. Russell A. Neleon,
Director,    Johns Hopkins Ifospital and Authority    on hospital plnnning,
opetations,    and mmngemcnt .n Although our report did not identify
Dr. Neloon by name, he me the hospital       planning consultant   mentioned
on page 7 of our report.

      The Howard University        tecorda ahowed slao that,       on July 27, 1964,
the Core Committee submitted          a revised construction     progrm    to the
President     of Howard University,       followLng a oerierl of conferf3ncea with
reyreeentatives     of the Buroau of the Budget.          The rerisad    pYmgrm pm-
vided for SSO,SSO gross square feet.

        In comanting      on the authorization     by the Bureau of the Budget in
1967 to increase       the srea of the hospital      ftom 550,550 groae equam
feet to 587,625 gross square feet (see page 8 of our report),             Dr. Ikcket
stated that the proposed hospital            still would be only 86 percent CLIJ
large,     in terms of gross sqwwa footage,         aa the Surgeon Cenerel@r 1964
architectural      guide indicated    it should be.

       During our survey, Dr. Jason referred        ud to the 1964 Public Health
Service publication      mentioned by Dr. Becker, which suptirsedad Wcdical
S&oat Facilities      I Planning Considerations     ,* and Wedical   School Facik
itiest     Planning Considerations   and Architectural     Guide,” both published
in 1961 by the Public Health SBwice.          It wae our understanding     that
Dr. Jasongo committee brad utilized      these,,1961 publications    in the ori-
ginal planning     for the Howard hospital.                 Y

      We note that Table 50 of the Public Realth Sbrvicc*s             1964 publicn-
tion showa 602,000 grortr square feet bs the atea,‘ncomended               for a
hypothetical    teaching    hospital    of 500 beda,  Thus, the 587,625 gmer
rqwte     feet authorized    by the Bureau of the Budgpt in 1967 for the pro-
posed hospital     represented     about 98 percent  of thti total    8paca indicated
as needed in the Public Health Service publication.             We noted, howems,
that  587,625 gmse square feet ia about 86 perccn‘t of the area that wu
recommended in 1962 by the Houmd Univcsmity           Core bmrnittee,

      Dr.   &ek&m       latter   ruted   that,    in 196Y, the Burem of ttm lkrdget
had l llorrrd  a tort     at $20,415,000    for   a 587,625 $mrr   rqwtr foot teach-

hospital containing      500 beds and that,    am a result  of qucstiona  raieed
by the Nattonal   Medical Aeeociation       in 196g9 Uowatd UnivQrsfty   had
sought additional     consttuction    funds of $7.7 million   end thnt GSA had
allowed an additional       45,082 grass squ~e feet of space,

       Ae pointed out on page 11 of our report,               through January 31, 1970,
of the $1,230,000 which had been appropriated                 for planning     the Howard
Univereity    hospital,      $260,300 remained unobligated.             Public Law 91-204,
approved March 5, 1970, provided             nn appropriation      of $22.2 million     for
constructing     the hoepital.        This amount wae baaed on 1966 coet estimater.
A rupplemantal      appropriation      of $7.7 million       WEIIYprovided    by Public Inw
91-305, approved July 6, 1970, because of incteaaea                   in the estimated
conrtruction     cortr   attributable      in part to increases         in the equara foot-
raa provided     for in the plane.

       The increaeed       equate   footage   wea explained       in our   report    (LO followrt

       1.   An incteaee    of 37,075 gross square feat--from   550,550
            to 587,62f--was     authorized by the Bureau of the Budget
            in January 1967 in response to the Univetaity’s      request
            to increase    the gross area to bring the proposed Howard
            borpital    in line with other teaching hospitala.     (Sea
            page 8 of our report.)

       2.   An increase     of 45,082 grose equate feat--from       507,625
            to 632,707.-war     subsequently  conridered     neceesary by
            Gti to accommodate required      machanical    equipment and
            meet circulation     and storage needa.      (See page 11 of
            our report,)

        In November 1969 GSA estimated              that,    &II of October 1970, the con-
etructfon       cortu of the propoeed hoepftat             would be $32,940,000.          There-
fore,     in out April      1970 report,      we pointed out (p. 11) that the amount@
appropriated       , together     with additional        amount8 requested     (totaling      $31.1
million),       would be about $2 million           lam than GSA’6 e&imats.              The con-
tract     price for constructing          the new Howard horpital         will not be known
until     after    the conrtruction      bide for the project         have been opened, which
lo tentatively         scheduled for April        1971.
        Becaura we did not evaluh              the planr for tha Hoard hospital,               we
do not havr my cammente to offer                 concerning      the $I%$80 coat per atore
rquaru foot projected           by ths,Amociation          of hmrican     Medical Coll~gor
aa thu cart of l taachim              hobpic&                                                         (


        After    reieipt   of your letter , we intewiewd     officials  of the
Facilities       Engineering   and Construction   Agency of 11615to ascerl;ain
the current       etatua of the construction     program for the Iloward hoepital.

     These officials        furnished   ua 6 copy of 6 project   schedule which
GSA had oent ta Dr.        Jameo B. Cheek, Preeidcnt    of Howard Universfty,on
December 15, 1970.         The schedules ehowed the following    t$.membla planned
for the uonstruction        program

                Invitation    for bida                  January     197lU
                Bid opening                             March       1971f/
                Construction     contract marci         April       1971
                Cons true Lion completion               November    1973

         UOn January 27, 1971, we wet2 advised by HRW official6   that
           the tentative   date for &swing Lnvitatiom to bZd had been
           changed to February 26, 1971, and the bid opening date
           changed to April    15, 1971.

       Accompanying this echedule was a revised co8 t eetimnte,     dated
December 7, 1970, that had been prepared by GSA. The revised esttite
was ‘$33.9 million-an     increase of $1 million  over G!SA~s prior  cost
estimate   for a hoepital    havini 632,707 gross eqwre feet.

       The HI34 officiala’      informed UB also that, as a result              of HEW@@
recent     review of the plans for the now hospital,                the outpatient       facil-
itier   till    be redesigned      to provide more flexibility           for possibls
future    Cixpansionr      Those off iciala       etated that mchitect-engineer             fee@   .
for the radaign        had not been determined             end estimated    construction
coata had not been revLed              therefore,       these additionaL     coats had not
been included      in G9Aas December eetfmati,

        We betlrsve our commcn~ till    help clarity   the questions    which
have arisen regarding     our survey report on the prqgteaa       toward con-
atructln8     the Eoward Univtmlty   teaching hospitale

                                        Comptroll+r  General
                                        of the United Statcar

The Eonorabla CWner lc, S’hrimr
fiousrr of Reprerentativer