PALO ALTO -- The last steel beam lifted high into the air by a crane is lowered into place, where workers bolt it down to the applause of onlookers. It is a small, but symbolic, piece of the extreme makeover occurring on the VA Palo Alto Heath Care System's main campus.

It feels like you need a hard hat just to walk around the Department of Veterans Affairs hospital these days. There are seven projects going up and others in the planning stages as part of a $1 billion boom that is putting Palo Alto at the forefront of the VA's effort to meet the growing demand from a new generation of veterans who served in Iraq and Afghanistan.

A centerpiece is the 174,000-square-foot Rehabilitation Center, which now is just a steel skeleton. But when finished in 2015, it will be a one-of-a-kind facility that will include the new home for the hospital's polytrauma unit that has been treating some of the most grievously wounded from the two wars -- particularly traumatic brain injuries that have multiple physical consequences.

"We're reconstructing the entire campus," said Dr. Jeffrey Teraoka, the medical director of polytrauma rehabilitation. "I've been with the VA more than 20 years, and I've never seen anything like this."


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Palo Alto, with its affiliation with the Stanford University School of Medicine and ranking as the VA's second-largest research facility, long has been a main hub in the national system. But the roll call of new facilities -- from a Mental Health Center that opened in September to expanded research buildings -- makes it clear that Palo Alto is being positioned not only as a premier venue for treating Bay Area vets, but perhaps as a model for the rest of the country.

Younger vets, including more women than ever, have come home needing long-term help for post-traumatic stress disorder and blast-related injuries in unprecedented numbers. Paul Rieckhoff, executive director of Iraq and Afghanistan Veterans of America, is hoping Palo Alto can be the trendsetter in providing more efficient care for them.

"The reason Palo Alto can be different for the VA is the same reason why Silicon Valley is different for Google, Facebook and Apple," Rieckhoff said. "It's great to see the VA putting the flag down in a place based on innovation. Palo Alto has the chance to be the epicenter of change for veterans throughout the country, and we desperately need that."

Change is everywhere on the 92-acre Palo Alto campus, where 17 new structures and renovations are to be finished by 2020. And throughout the entire Palo Alto system -- which has three inpatient facilities and seven clinics across Northern California and into the Central Valley -- $2.1 billion is being invested in construction that brings health care closer to where vets live.

"We're creating healing spaces for veterans in state-of-the-art buildings that improve efficiency and flow," said Lisa Freeman, the Palo Alto VA's executive director.

Upgrading seismically deficient facilities is a big reason for the massive remodel. But there's also a pressing reason: need. While the overall vet population continues to decrease as World War II-era service members pass away, the Palo Alto system is seeing between a 2- and 5-percent increase in patients annually -- a total of 58,000 last year on the main campus alone.

The 90,000-square-foot Mental Health Center reflects the VA's effort to meet the record number of vets seeking help for problems like PTSD.

The Rehabilitation Center will be the treatment site for those recovering from brain injuries, lost limbs and other serious ailments. The $100-million center was approved by Congress at the height of the Iraq War. This will be the only facility in the VA system that combines polytrauma, blind rehabilitation and occupational/physical therapy services.

"Blast injuries can be so devastating, and it makes sense to have these (centers) housed in the same place," Freeman said. "We sent teams all across the nation to look at rehab facilitates and take the best ideas of those."

Taking them from the drawing board to completion has been the job of Jason Nietupski, Palo Alto's director of planning and development.

Buildings are designed to be airy and bright -- without the institutional look of government buildings. An aquatics therapy building, that will open next month, has the feel of a health club.

"If you have an old facility, it leads to perceptions about the quality of care that you'll be getting," said Nietupski, 40, who was an Army medical services officer.

The Center for Investigative Reporting recently found that vets are waiting an average of 273 days to have their claims for benefits processed. While Rieckhoff criticizes the VA for "failing miserably" in helping people access services, he said vets in his organization largely are pleased with health care once they receive it.

He wants Palo Alto to make it better.

"You're not really going to see more 85-year-old guys coming in for prescription eye glasses," he said. "But you are now seeing 19-year-old women come in for PTSD treatment. That's what's facing the VA, and that's why Palo Alto is well-situated to figure out not just bigger solutions, but smarter solutions."

Contact Mark Emmons at 408-920-5745.