VA Butler to set to break ground on outpatient center

| Tuesday, April 2, 2013, 12:11 a.m.

The Department of Veterans Affairs and Westar Development plan to break ground on Friday on a $75 million outpatient center in Butler that will have a state-of-the-art water sterilization system designed to prevent a Legionnaires' outbreak such as the ones in VA hospitals in Pittsburgh.

“We're going to use the most high-tech system that's out there right now,” said Sam Calabrese, president of Westar Development, which has a federal contract to build the three-story building. VA Butler will lease it for an average of $7.6 million a year for 20 years.

The plumbing will include a system that will zap water with ultraviolet rays, rather than the copper-silver ionization system that's used by the VA Pittsburgh and other hospitals across the country, he said.

The VA Pittsburgh outbreak sickened as many as 21 patients at the Oakland and O'Hara campuses, five of whom died. The outbreak lasted from February 2011 through November 2012, the Centers for Disease Control and Prevention found.

VA Butler discovered Legionella bacteria in its water system on Dec. 11 during routine testing, but no patients were sickened, spokeswoman Amanda Kurtz said. The sample came from Building No. 2, which is used for administration, physical therapy and other outpatient services.

Kurtz said VA guidelines don't require that that building have a Legionella prevention device attached to its water system, but staff and patients could come into contact with water from plumbing fixtures.

VA Butler used CDC-recommended water sample sizes for Legionella of one liter, rather than the 100-milliliter sample the Pittsburgh hospitals used. It responded to the Legionella discovery by flushing the building's pipes with superheated and hyperchlorinated water, and testing hasn't found the bacteria since, Kurtz said.

The Health Care Center will be built adjacent to and south of the VA campus, with its own connection to the municipal water system, Kurtz said.

The building is expected to be completed in 2015. In addition to ultraviolet disinfection, its water system will be designed to allow constant flow that eliminates plumbing “dead ends” that shelter bacteria and allow them to grow, Calabrese said.

He estimated it will cost two to three times as much as a standard plumbing system but could not provide a precise dollar figure.

“We wanted to make sure we didn't have an issue” with Legionnaires', Calabrese said. He said his company planned to use this system before the Pittsburgh outbreak became public on Nov. 16, prompting investigations and an ongoing overhaul of the VA's Legionnaires' prevention policy.

“Of course, it comes to the forefront” because of what happened in Pittsburgh, he said.

The VA Butler Healthcare system handles about 170,000 patient visits a year at the Butler facility and smaller outpatient clinics in Butler, Armstrong, Clarion, Lawrence and Mercer counties.

The Health Care Center in Butler will replace sprawling Building No. 1, built by the state as a tuberculosis clinic and completed in 1937. The building sat empty until the Army turned it into a military hospital in 1942. It became part of the VA system in 1947, said Kenneth Kalberer, health systems specialist at the VA Butler.

The building's long, wide hallways and spread-out design — common in tuberculosis clinics of the era — make it an inefficient place to provide modern medical care, he said. Concrete support columns make it nearly impossible to convert the facility into the open layout of newer VA facilities.

The asbestos-laden structure would require $40 million for remediation and renovation if the VA were to keep it, Kalberer said. The long-term future of Building No. 1 is unclear.

“If we get a roof leak, we're going to fix it. If we have a safety hazard, we're going to fix it,” Kalberer said. But other than immediate needs, the building won't be refurbished, he said.

The Health Care Center will be significantly smaller than the five-story building it replaces. The first two floors will be used for patient care, and the third will have administrative offices and a cafeteria, Kalberer said.

Its open design will allow the VA to organize care into teams of pharmacists, dieticians, social workers and doctors. The teams will work in a “bullpen,” so patients can remain in one place, he said.

The VA Butler built a $16 million, 60-bed assisted-living center that should be in full use next year, and an $8.5 million, 56-bed housing facility for veterans undergoing rehabilitation that opened in November. All of VA Butler's main facilities will be less than five years old when the Health Care Center opens, Kalberer said.

“I don't know of any other place in the country that can say that,” he said.

Mike Wereschagin is a staff writer for Trib Total Media. He can be reached at 412-320-7900 or

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