Less than two years from now, Central Iowa military veterans will have access to a new state-of-the-art outpatient clinic on Des Moines’ south side that will offer a full suite of primary care services, as well as a new delivery point for telehealth services. 

By February 2022, the VA Central Iowa Health Care System plans to open the 49,000-square-foot outpatient Primary Care Annex at 1111 E. Army Post Road. 
The completely renovated facility will be located in the former Toys R Us retail store near Southridge Mall. The $35 million outpatient clinic project will provide a full range of services, including primary care and physical medicine, mental health, radiology and pathology laboratory services, and a prosthetics lab. 

“It’s been in the works for several years to move primary care and some other supportive services into the community in what are known as primary care annexes,” said Gail Graham,  who has been director of the VA Central Iowa Health Care System (VACIHS) for the past four years. 

With the new clinic, a majority of the primary care staff — about 200 personnel including physicians, nurses, therapists, lab and radiology technicians, physical therapists and support staff — will shift from the VA Des Moines Medical Center at 3600 30th St. The new facility will also have a few additional building management personnel. 

The health system currently has about 40,000 veterans enrolled, a number that could grow with the added facility. The VACIHS serves 42 counties in the central portion of the state. 

“We certainly hope that this [clinic] expands our enrollment capabilities and attracts additional veterans,” Graham said. A stretch goal would be to increase the enrollment by 10% annually. 

“We will certainly make sure that it’s known and as we actively try to recruit additional veterans. We do anticipate that this will expand our capabilities in primary care for the veterans in our catchment area — and also for providing those additional services. We’ve had a lot of success with putting physical therapy in the outpatient clinics, and this has been very beneficial for our veterans.”  

The clinic’s size will allow the VA primary care providers to have multiple exam rooms, which will increase efficiency in seeing patients, Graham said. The need for extra exam rooms has been exacerbated recently by the need for COVID-19 distancing. 

“Right now they have a single exam room, so the veteran is actually being moved from room to room as they’re interviewed by the nurse and then by the physician,” she said. “So it will really allow us to be more like the private-sector clinics where the providers have multiple exam rooms.” 

The new clinic will also have telehealth services available to connect with providers at the medical center and possibly other locations. “Even in our community-based outpatient clinics, there are many things that we can do with specialty care by using telehealth [to connect with] a specialist at the main facility without asking the veteran to travel,” Graham said. “For example, we can use telehealth to connect with an audiologist to do hearing examinations from the main facility, or from anywhere, for that matter.” 

The VA currently provides medical resident training for physicians, pharmacists, nursing and physical therapy students at its facilities, and that will continue at the new Primary Care Annex. 

Parking, which has been an issue at the main facility, should be alleviated with 200 spaces that will come with the new clinic, Graham said. 

“And we believe that it will be easier for many veterans to get there logistically; they won’t have to drive through the city per se. They will have the parking available and they will have the services there. We will have a shuttle running between the main campus and the clinic for things like MRIs or CAT scans, but all the flat-film X-rays and all the lab draws will be done at the clinic, and we’re going to try to keep the back and forth between facilities to a minimum.”  

With all new equipment and furnishings as part of the project, the new facility can really be described as “state of the art,” she said.
 
“We determined a number of years ago that because of the age of our building that we couldn’t remodel the existing space here to meet these patient-aligned care models, the way the workflows and the way patients are seen in that environment,” Graham said.  

Each of the five existing community-based outpatient clinics (CBOCs) will remain open, she said. The new clinic will be about four times the size of those clinics, which are located in Mason City, Fort Dodge, Knoxville, Marshalltown and Carroll. Construction is currently underway to replace the Mason City CBOC with a new facility. 

The Primary Care Annex project in Des Moines could have been contracted as a build-to-suit structure like the one being built in Mason City, but the VA chose to remodel an existing building instead. 

Johnson Healthcare Real Estate was selected through a competitive bid process by the VA for the Des Moines renovation project, which will also extend the length of the structure by about 30 feet. It’s the 12th such primary care annex that will be built nationally by the Birmingham, Ala.-based firm, which will own and manage the property upon its completion. 

“The adaptive reuse of the previous building provides a significant opportunity to not only reduce costs, but also minimize the environmental impact of additional development,” said Derek Weaver, senior vice president of federal development for Johnson.

The space created in the medical center by the relocated primary care clinic will be used to better accommodate specialty services, among them an expansion of the oncology clinic to provide more room for an infusion center, as well as to move physical therapy facilities to a larger space. “I have more people vying for this space than I have space,” Graham said.