U.S. Army Engineering and Support Center, Huntsville: A Part of the Solution [Building Strong® 2020-2021 Edition]

By U.S. Army Corps of Engineers - February 2, 2021

Professionals from the U.S. Army Engineering and Support Center, Huntsville, conduct a site assessment in Jacksonville, Alabama, April 8, 2020. Huntsville Center and Mobile District had joined forces to evaluate potential sites for alternate care facilities in support of the Federal Emergency Management Agency and in coordination with other federal, state, and local partners in response to the COVID-19 pandemic. (Photo by Stephen Baack, U.S. Army Engineering and Support Center, Huntsville)

BY DAVID SAN MIGUEL, U.S. Army Engineering and Support Center, Huntsville

Working hand in hand with the U.S. Army Corps of Engineers’ (USACE) geographic districts and divisions, the Federal Emergency Management Agency (FEMA), and the Department of Health and Human Services (HHS), the U.S. Army Engineering and Support Center, Huntsville, is focusing its skill and expertise on supporting the nation’s efforts to combat the coronavirus pandemic.

Established in 1967 as the Huntsville Division, the organization was redesignated in 1995 to its present configuration because of an expanding mission to provide innovative engineering solutions to the Corps of Engineers’ and the nation’s toughest challenges.

Huntsville Center today boasts a 1,100-plus workforce of professional, highly skilled technical experts to execute and manage 40-plus programs and 4,500 to 5,000 ongoing projects globally.

Its programs and projects touch the lives of almost every American, and in fiscal year 2019, the Huntsville Center awarded more than 4,800 contract actions, totaling more than $2.2 billion in obligations for its stakeholders. More than 43% of the $2 billion obligations were small business awards. That number pushed the Center over the $6 billion mark in obligations awarded to U.S. small businesses over the last decade.

According to Albert “Chip” Marin III, Huntsville Center’s programs director, these programs and projects incorporate a broad spectrum of the global enterprise covering five main lines of effort: energy, operational technology, environmental, medical, and base operations and facilities.

Jelani Ingram, acting Architecture Branch chief with the U.S. Army Engineering and Support Center, Huntsville, takes notes during a site assessment in Tuscaloosa, Alabama, April 6, 2020, with a group including hospital staff and administrators, as well as his colleagues from Huntsville Center and an engineer with the Mobile District. (Photo by Stephen Baack, U.S. Army Engineering and Support Center, Huntsville)

“Through partnership with Department of Defense agencies, private industry, and global stakeholders, we deliver leading-edge engineering solutions in support of national interests around the globe,” he said.

Included within these lines of effort are nine mandatory centers of expertise, five technical centers of expertise, and 17 centers of standardization.

“In light of the pandemic,” Marin added, “it’s particularly noteworthy that the Huntsville Center is a medical support team that includes USACE’s Medical Facilities Mandatory Center of Expertise and Standardization (MX), and owns the technical experts who determine whether or not new construction designs meet code requirements for medical facilities.”

It’s an expertise that drew the attention of federal, state, and local officials who anticipated the rapid spread of COVID-19 and expected a massive shortage of hospital bed space to treat those affected by the virus.

According to Lt. Gen. Todd T. Semonite, former chief of engineers and commanding general of USACE, the urgency of this response was largely driven by the rapid spread of COVID-19.

The race against the virus is “an unbelievably complicated problem” that needs a simple solution, Semonite said.

Mobilized under the National Response Framework and Stafford Act, USACE was given mission assignments from FEMA to execute planning for expanding hospital capacity, first in New York and then elsewhere if called upon.

Semonite had already acknowledged that “you can’t build hospitals in a couple of weeks,” and reached out to Huntsville Center to look into adapting existing facilities to address that challenge.

“We received a request from the chief directly because we had the Medical Center of Expertise, and we leveraged the whole enterprise and pulled in the medical support teams from the Corps’ Little Rock and Mobile districts,” said Wade Doss, Huntsville Center engineering director.

Doss said experts from the U.S. Army Engineer Research and Development Center were a growing part of the team, too.

As USACE’s “go-to” enterprise for innovative solutions, the Huntsville Center brought in its subject-matter experts and technical engineering professionals to quickly develop strategies and concepts to help USACE’s geographic districts and divisions rapidly convert hotels, dorms, convention centers, and large, arena-type facilities into ICU-capable, or, as they’ve come to be known, alternate care facilities (ACFs).

“Our mission was to come up with some conceptual site-adaptable designs, engineering and construction deliverables and artifacts that would help our districts and divisions execute faster when they get to these facilities,” Doss said. “The idea is to help FEMA and the state and local governments get ahead of the hospital bed shortage.”

He added that his team of about 30-40 engineers and architects worked around the clock putting these concepts, sketches, and designs together, and drafting equipment lists, schedules, and performance work statements – all the things that engineers and constructors need to hit the ground running. “Time is of the essence,” he said. The Medical Facilities MX has the capability and experience in medical facilities design and outfitting needed to support USACE in its efforts to establish ACFs, and works closely with its stakeholders and partners to ensure that projects executed meet mission requirements.

“Most of what we do is cutting-edge technology,” Marin said. “We are creating solutions for challenges that may not have existed before.”

To develop these deliverables, Doss put together a team of construction experts and medical design, architect, and code-criteria experts and fleshed out the concepts, including sketches, functional layouts, performance work statements, equipment lists, etc.

“We worked closely with FEMA, HHS, the NFPA [National Fire Protection Association] as well as the Corps’ geographic districts and divisions to support ACF projects across the country,” he said. And like the rest of the USACE enterprise, most of the work was done virtually through Skype, teleconferences, WebEx, and everything else.

Doss said this entailed working every day, seven days a week, until all the districts and divisions got the deliverables they needed to turn concepts into reality.

“Our goal was to get ahead of it and try to get these concepts laid out for hotels, dorms, and arenas – facilities we thought could be good fits and that would already have a lot of the infrastructure,” he said. “But our main goal was to help the districts’ assessment teams.”

Doss immediately put a core team together, and contacted Tony Travia, chief of the Medical Facilities MX, tasking him to join Semonite and meet with New York Gov. Andrew Cuomo to discuss these concepts to address the hospital bed shortage.

“I had just gotten off self-isolation from a temporary duty assignment in Germany,” Travia said, “but I had already formulated what information we might need to deliver, reaching out and engaging partners outside the Corps, tapping into the command surgeon’s expertise and HHS to gather what information it already had about alternate care facilities.

“By the time I boarded the plane, we probably had the 80% solution of what became the first hotel-to-health care concept, and started working the arena,” he said.

By mid-March, the MX was fully engaged and actively developing concepts to convert arenas and hotels into ACFs. Travia explained the challenges the team had to overcome. “Our standard mission is to perform group design review and construction support for medical treatment facilities,” he said. “This is typically for new construction, though sometimes that may consist of additions or alterations.”

He explained that these particular FEMA mission assignments entailed converting facilities not normally configured for the treatment of hospital patients.

“Every district has those core competencies – engineering, architecture, and environmental – permitting disciplines,” Travia said. “But districts may only execute a medical project once in a decade and may not have the time to build that experience from scratch. That’s why we help assess the medically unique aspects of the project – what is required to convert sites into facilities capable of delivering health care – so the districts can focus on what they do best.”

Specifically, site assessments help determine whether health care requirements can be met based on the number of patients it would support, the proximity to nearby hospitals, utility requirements, air filtration and handling capacities, safety features for emergency response and egress, staging of ambulances, and parking availability.

Another consideration is the time it would take to convert the facility for health care use. Normally, such conversions take between five days and two weeks, varying from site to site based on the level of patient care, number of patient beds, and the extent of work required.

Doss explained how the Huntsville team developed facility assessment checklists that field engineers could take with them to determine whether those facilities identified by FEMA and state and local government could be converted into viable alternate care facilities.

“We try to draft our deliverables around several scenarios,” he said, “COVID-19 and non-COVID patients. We’re working with local health officials to make it site adaptable. It all depends on the local officials: the mayor, the governor, local health officials, wherever you’re at in the country to see what they need.”

Jelani A. Ingram, Huntsville Center’s acting branch chief of architecture, said the MX initially developed a checklist of items that a building/site needed to have in order for it to be considered a viable site for an ACF.

“The checklist focused on all building conditions including architectural, site, MEP [mechanical, electrical, and plumbing] systems, fire protection, ADA [Americans with Disabilities Act] accessibility, all building infrastructure, and that it met minimum code requirements,” he explained. “There were certain conditions that a building had to meet before a full-on assessment would be done.”

Paul McCarty, second from left, a mechanical engineer with the U.S. Army Engineering and Support Center, Huntsville, talks with Jelani Ingram, acting Architecture Branch chief, also with Huntsville Center, second from right, during a site assessment in Tuscaloosa, Alabama, April 6, 2020. (Photo by Stephen Baack, U.S. Army Engineering and Support Center, Huntsville)

Based on this checklist, these buildings could quickly be eliminated based on a “Go/No Go” evaluation.

“If a structure did not have a fire suppression system it would automatically be considered a No Go and eliminated,” he said.

Ingram admits, however, that in the case of an arena, such restrictions could be relaxed because they often encompass large open spaces and normally do not have sprinkler systems.

“In such cases, other means to sprinkler the space would need to be explored,” he said.

“Other factors that could quickly eliminate a building/site were no ADA accessibility routes for handicap and patient gurneys, elevators too small to fit a gurney, exposed asbestos, and if utilities were in need of extensive repair or replacement, that required long lead times on replacement parts,” Ingram said.

The hospital and city members are responsible for providing USACE with potential buildings/sites for ACF conversion. They would decide if they wanted the ACF to accommodate COVID or non-COVID patients (most chose non-COVID, because it would be less taxing on their resources).

“Our team would look at each site identifying first the No Go markers,” Ingram added. “Then, when those were eliminated, we would look at proximity to local hospitals because being able to staff these ACFs with health care providers was going to stretch hospital resources. So, it was determined that ACF sites needed to be within at least a 10-mile radius of the hospital.”

We would design and lay out the space showing patient beds/cots, nurses’ station, administrative support, storage, portable bathroom and shower facilities, and medical support areas. This information was packaged and handed over to our partner and then briefed to the governor.
Since Huntsville Center is not bound by regional location and provides technical and engineering support to all USACE geographic districts, the Mobile District asked for support in its efforts with statewide assessments.

“They looked to us to cover the northern part of Alabama,” he said. “We conducted our assessment in Huntsville, Tuscaloosa, and Calhoun counties [Anniston, Oxford]. Once a site was chosen, the team would go in and photograph the site, taking notice of open floor space, access points for patients, staff, and equipment. The team would assess the HVAC [heating, ventilation, and air conditioning] system, power requirements, and if there was back-up power to help run potential medical equipment.”

That assessment included looking at the number of restrooms to accommodate staff and patients, and whether the facilities had a full kitchen and laundry room that could be utilized.

“We found that abandoned or repurposed hospital spaces were the best locations, because the medical infrastructure was already in place,” Ingram said. “There would be nurse call, back-up power, critical power outlets, clean and dirty zones, private bathroom and showers, full kitchens, laundry, proper nurse stations, pharmacy, sterile storage, elevators for gurneys, ADA access, hazardous waste disposal, and security checkpoints. These facilities could be quickly recommissioned and brought back online.”

The team assessed arenas, abandoned and repurposed hospital spaces, hotels, city meeting centers, and convention centers, trying to accommodate a wide range of options for the areas.

“We had 48 hours: a day to assess two or three sites and a day to package the report that covered all major disciplines ranging from architectural/site, mechanical, electrical, and fire protection, and get it back to the Mobile District,” Ingram said. “We would design and lay out the space showing patient beds/cots, nurses’ station, administrative support, storage, portable bathroom and shower facilities, and medical support areas. This information was packaged and handed over to our partner and then briefed to the governor.

“The process was pretty seamless. Once a site was chosen, the Corps was given 30 days to design, construct, and hand over an ACF to FEMA and local officials,” he said. “The Huntsville Center was critical to getting out early facility checklists, performance work statements, business rules, points of contacts, and early design studies that the district could use and adapt on the ground.”

Ingram explained that throughout the process, safety was paramount.

“When we first started the assessments, we tried to keep 6 feet apart, based on CDC [Centers for Disease Control and Prevention] recommendations and guidelines from our safety department,” he said. “As things got worse, we moved to all personnel wearing masks because trying to maintain 6 feet [apart] in large groups was proving difficult, especially when trying to communicate to everyone or moving through small spaces.”

Through it all, Ingram says it was a very humbling and awesome experience to be on calls with Semonite and to hear him discuss the impact of the work that had been done for the COVID response.

“I was personally awestruck when our commander informed us that our work had made it all the way to brief the president and his COVID response team,” Ingram said. “Most of all, I was proud of my team of architects and engineers that worked tirelessly to get this information out to our people on the ground. This would not have been possible without their hard work and dedication to the mission and our country.”

As the COVID-19 response efforts continued nationwide, Huntsville Center did more than innovate the assessment of ACF sites.

As the chief of Huntsville Center’s Systems-Cost Division, Amanda Pommerenck led her team to help develop a site assessment checklist that geographic districts and divisions could use in searching for suitable sites.

“This was like a planning mission assignment where we put together a basic ‘how is this mission going to work and what are the site assessments going to look like,’” she said.

“We came up with this process called ‘the binder’ – not a physical binder, but like an email detailing what health care facility and what various scenarios that we might be looking at,” Pommerenck said. “It was like building in the lessons learned as we went through the process.

“Travia and one or two other folks were on the ground in New York,” she added. “But by the end of March, nobody was going anywhere. It was all virtual.”

Pommerenck explained that each district has engineers, but what they don’t have is the medical expertise to build or change a non-medical facility to be used as an alternate care facility.

“So, they don’t need us to tell them how to build or convert the facility,” she said. “We simply provided them with all the things they needed to think about when they were conducting a site assessment.”

A lot of the site assessment team’s questions centered on some sort of medical unique aspect.

“We would take that question, deliberate, and write out our response,” Pommerenck said. “We would try to work that response into our planning document and provide them with more information so that we could better inform the next team doing a site assessment.

“I get having plans for a conventional hospital or medical facility, but there are no real plans for an arena,” she explained. “You had to be adaptive – I mean it’s a hospital – treating COVID, non-COVID patients – what kind of facility does the community need to address?”

Pommerenck added that these considerations had to be taken into account and worked through authorities on the ground (i.e., the fire department of Miami had different rules and regulations than the fire department in Chicago).

“You’re dealing with different codes at different facilities, different populations of patients,” she said. “It’s a lot of work for the district, so what we were trying to do was get them off to a good start and provide them with guidelines for a solid foundation.

“Travia and his team from the Medical Center of Expertise conducted the site assessments and could reach out to us to answer any construction and/or contract administration questions.

“So about 40 people, between the MX, our construction and contract administration division, and a few from the Architecture Branch comprised the response team,” Pommerenck said. “It was a big group, and we did a good job of delineating everyone’s role.

“As of now, we’ve conducted over 1,155 site assessments and have helped Corps districts construct 38 alternate care facilities,” she said.

Pommerenck added that though things are tapering down, the team is prepared for any kind of resurgence of the virus.

“We made a final update to the binder where we took all the requests for information, the lessons learned – what we’re calling a playbook – that will be posted onto the Corps’ website,” she said. “So, if we should have a resurgence in the fall, it’s not necessarily going to be the same folks in leadership; so we wanted to have a short-and-sweet document that says this is how or what we consider an alternate care facility. Here are the other agencies involved – [the Department of] Health and Human Services, FEMA, health facilities, planning agencies, etc.

“This is the down-and-dirty playbook where all the documents can be found, points of contact, and lessons learned,” she added.

Mission aside, Pommerenck admits that throughout the whole ordeal, there were times she felt overwhelmed.

“It was such a negative event – the sickness. I have a doctor friend in Chicago, who, in the midst of all this, would share some of the horrible things that were happening to her patients,” she said. “And I found myself getting emotional about how important this mission was, how proud I was of the team, and how at a minute’s notice, we all just helped each other. I felt proud to be part of the solution – all the lives that we affected and perhaps saved.”

BY THE NUMBERS

Through partnership with Defense Department agencies, private industry, and global stakeholders, Huntsville Center delivers leading-edge engineering solutions in support of national interests around the globe.

$3.78 billion in FY 18 annual obligations

PROGRAMS AND PROJECTS

5 lines of effort
43 programs
4,500-5,000 ongoing projects
8 Mandatory Centers of Expertise
6 Technical Centers of Expertise

Huntsville Center’s workforce of professional, highly skilled technical experts is committed to providing innovative engineering solutions to unique, complex, global missions to meet the needs of stakeholders and the nation.

1,113 employees in three locations: Huntsville, Alabama; Omaha, Nebraska; and Alexandria, Virginia