Mission Ready

From housing to healthcare, federal and state agencies have been reinventing the way they serve Veterans for more than 15 years, systematically breaking down institutional models in favor of individually centered patient care, affordable housing, and senior living. And almost from the beginning of this turnaround, Perkins Eastman has been an active partner in that mission.

Principal Jerry Walleck remembers seeing a Request for Qualifications from the U.S. Department of Veterans Affairs in 2009, seeking design for nursing homes under a new initiative then known as the Community Living Centers Design Guide. The VA describes it as “a commitment to cultural transformation … away from the medical/institutional model of care that serves the needs of the institution and changes the focus to the needs and preferences of the resident.” No longer would nursing homes resemble hospital wards with shared bedrooms and communal bathrooms. The new approach called for a residential setting with a comfortable living area, den, kitchen, and private ensuite bedrooms for its 10 to15 residents. The necessary medical services and equipment would be carefully camouflaged or hidden away. “With our senior living knowledge, we had the background in working in these Small House models [as they’re now known]. It was a great fit,” Walleck says. Perkins Eastman would design six of the VA’s first Community Living Centers—the beginning of a successful relationship whose ongoing work was recently featured on public television.

Above: The North Little Rock Veterans’ Home in Arkansas enjoys a residential setting with welcoming porches and an open kitchen-dining-living area. Photographs copyright Sarah Mechling/ Courtesy Perkins Eastman

The Veterans Health Administration made a similar pivot toward patient-centered care in 2010, rolling out a plan to extend “medical homes” across the country where Patient Aligned Care Teams of doctors, nurses, therapists, and administrative staff would provide a one-stop shop to address the spectrum of Veterans’ health needs under the same roof. The VA’s big picture, Perkins Eastman Principal Bruce Moore says, was “how do we reinvent ourselves to be closer to our patients, give them the care that they need, and give them the dignity and respect they deserve?” Moore and the Perkins Eastman healthcare practice have since worked on more than twenty clinics and healthcare centers across the sprawling Veterans Integrated Services Network.

The lobby at the VA Community Based Outpatient Clinic in Tulsa, OK, is full of windows and natural light, opening up views of the lush surroundings. Glass panels over the reception desk resemble a waterfall. All of these details help instill a sense of calm and wellbeing. Photograph copyright Andrew Rugge/ Courtesy Perkins Eastman

In each case, the architects and designers are incorporating the VA’s “kit of parts”—a set of systems requirements and design guidelines for every healthcare and housing project type—into a destination that’s uniquely suited to its location and culture. “We try to do our best work so it becomes a model,” Walleck says.

On this Veterans Day, take a look at some of the brightest examples in that portfolio.

Senior Living

Minnesota Sen. Amy Klobuchar attended the Aug. 23 groundbreaking of one of three new Veterans’ homes being constructed across the state. “When our Veterans signed up to serve, there wasn’t a waiting line,” she said in a video filmed for the local public-television station in Montevideo. “When they need healthcare, or a place to live, a bed to sleep on, there shouldn’t be a waiting line,” Klobuchar said. Walleck and Associate Principal Greg Gauthreaux share that sentiment. They led the design teams at Montevideo, in Western Minnesota, and also in Preston to the Southeast and Bemidji in the far North. After spending months traveling to each town and meeting with Veterans’ groups at their local diners and meeting halls, Gauthreaux understands why Veterans need to be with each other, rather than dispersed among nursing homes that serve the general population.

Gallery space in the community center at the future Veterans’ Home in Preston, MN, makes room for displays that speak to its residents’ military backgrounds.

“It’s a pretty big deal when they talk about it. You can tell there’s a connection they really need,” Gauthreaux says, noting they’ve often spent most of their lives together post-service, socializing, going on hunting trips, blending families. The home had to fit their lives, and not the other way around, he says. “To generate a space for them so they can continue doing what they’ve always been doing is really important.” What’s more is that the architecture also celebrates their military legacy with features such as built-in display spaces for plaques, medals, flags, and sculpture.

Each of the three homes had to follow a generally identical layout to meet VA design guidelines—the residential wings feature a large kitchen-dining hub, living-room and den areas, and a central “community center” with amenities such as a coffee shop, barber, theater, and club room. From there, designers took advantage of the many opportunities to integrate the local aesthetic and culture within each property.

The team nicknamed each site to define its personality. Montevideo was the “House on the Prairie,” located centrally near schools, churches, and the Veterans of Foreign Wars post.

A stand-alone community center open to the public will be located at the Veterans’ Home in Montevideo, thanks to a $3 million bequest from local veteran Steve Williams.

Preston, overlooking a farming community that’s also known as the Trout Capital of Minnesota, became “The House on the Hill.”

The architecture and landscape befits the Preston Home’s broad promontory overlooking the town.

And Bemidji earned the moniker “The House in the Woods,” two blocks from the Paul Bunyan State Trail, in a region where people are fiercely independent and move there to get away from large populations.

The material selections for the Bemidji site channel a cabin in the woods. Common spaces vary in scale from a large multipurpose room like the one above to small alcoves for more privacy.

Accordingly for each site, “We always try to carry the local context on the interior,” interior designer Jen McDermott says, such as buffalo plaid and rough-grained wood finishes in Bemidji; Prairie-style interior architecture in Montevideo; and fishing-inspired accessories and locally quarried stone in Preston. “The residents get to touch and feel what’s in this final phase, so it’s really important that we get it right,” says McDermott. She’ll be working on the interiors next year as the construction continues, seeking out local artists and photographers and visiting antique shops in each area to inject unique flavor.

Move-in, expected in the spring of 2023, will add to Perkins Eastman’s growing portfolio of Small Houses within the VA. These three new homes will contrast dramatically with the institutional settings of old, where residents were treated more like wards than real people with friends, family, and routines they’re used to, such as gardening in the back yard or cooking a favorite meal in the kitchen. “These settings are much more residential—and human,” Walleck says. “I love the idea that we can make a difference with this new paradigm.”

Affordable Housing

Perkins Eastman had already designed two Green House homes (a branded version of the Small House) on the VA’s Illiana Health Care campus in Danville, IL, when Mercy Housing, a Chicago-based developer, approached the firm about building affordable, intergenerational housing there that would be available to homeless and at-risk Veterans. “I was shocked that there are so many homeless Veterans out there,” Associate Principal JinHwa Paradowicz says. “They just need a place to go, they need a little help to get back on their feet.” The setting, known as Cannon Place, was ideal for Veterans at every stage of life, because the campus includes healthcare and the aforementioned Green Houses, an adjacent community college for those who seek education and job training, and nearby schools for the children.

Cannon Place bucks the dark, institutional stereotype of “affordable housing.” Photograph copyright Sarah Mechling/ Courtesy Perkins Eastman

The resulting project features a series of connected three-story structures tiered down into the sloping property, where each corridor of one-, two-, and three-bedroom units ends in a lounge surrounded by floor-to-ceiling windows that offer broad views and send light deep into the building. A front lobby and community center, meanwhile, provides residents and the public with space to meet and host events, but it’s located away from the more secure residential sections so they can remain private and safe—a big concern among this population, Paradowicz says.

Above: The sunny lounges on each floor, left, extend out from the buildings so light can penetrate from three sides.
At right, residents relax in the development’s wide lobby.
Photographs copyright Sarah Mechling/ Courtesy Perkins Eastman

In a video filmed for the Local Initiatives Support Corporation, veteran Gerald Eugene Hurt recounted a history of sleeping under bridges, in tents, and in abandoned homes. “It has been a very long time since I lived in a place that is this nice,” he said of the newly completed Cannon Place. “I feel a lot better about myself living here. I feel like I amount to something.” For its work designing this new community for 65 residents and their families, Mercy Housing awarded Perkins Eastman a Partner in Innovation award in 2014. “It was a really humbling experience every step of the way,” Paradowicz says. “We were really reminded who we were designing for. We were creating a new life, a new beginning for them—their home.”

Healthcare

Following years of criticism for perennially backlogged services at centers that were spread too far apart, the VA developed a new program to expand care through Community Based Outpatient Clinics and larger Health Care Centers. Perkins Eastman has partnered with the VA in designing for both project types, which are all centered on the medical-home model that supports Patient Aligned Care Teams. “It’s the mission of getting these clinics to population centers where Veterans tend to reside, and it’s continuing all over the country,” Bruce Moore says.

A recent completion in Tulsa, OK, for example, “was the fastest activation of a large community-based outpatient clinic in the VA’s history,” Moore says. The 180,000 sf project took just 18 months from start to finish, despite the onset of the pandemic. Part of the reason for this swift timeline is the VA’s already established design guidelines that can be repeated at each property. They enable Veterans to schedule a day of appointments that could cover primary care, dental and vision treatment, women’s healthcare, or specialty exams. It’s more of a “healing zone” than a single exam room, Moore explains, and to the extent a patient has to move from one place to another, “that’s maybe a minute’s walk and not an hour’s drive.”

Biophilia is an important element at every VA site such as the Community Based Outpatient Clinic in Tulsa, OK. Walls of windows from the double-height reception area, above right, all the way down to the cafeteria, at the center of the picture, provide patients and families with an infusion of nature and light. Photograph copyright Andrew Rugge/ Courtesy Perkins Eastman

Perkins Eastman designed the exterior of the building to reflect the surrounding landscape and palette. Architecturally, it channels Tulsa’s Art Deco roots, but in a more contemporary style. “They wanted this campus to be very pedestrian oriented, and they wanted the building to be very connected to the natural elements on the site,” says Moore, who explains how each Veterans’ healthcare project is firmly rooted in its community despite the standardized requirements within.

While he was at Perkins Eastman, former Principal Sanjay Parmer oversaw a much bigger, 400,000 sf Health Care Center in Kernersville, NC, that opened in 2016, which accommodates surgeries and more invasive health procedures, though the team-based, patient-centered mission is the same. Veterans come from a hundred-plus-mile radius, and some arrive in RVs to stay over, while the VA pays for travel and mileage. “That’s something the VA does in a very unique fashion,” Parmer says. As a result, this facility caters not only to Veterans but also family members who accompany them. And when certain expertise isn’t available, a robust telehealth department can connect local physicians with remote specialists who can guide them through a patient’s care.

Above: “The whole experience starts in the parking lot,” Perkins Eastman Principal Bruce Moore says, where a flat, easy approach with clear wayfinding such as the one at the VA Health Care Center in Kernersville, NC, can immediately set patients at ease. Likewise, Moore says, public areas like the lobby, left, and the cafeteria, right, are designed to be “very light filled, very welcoming, and a place for the Veterans and their families to become oriented.” Photographs copyright Sarah Mechling/ Courtesy Perkins Eastman

This type of “comprehensive and holistic care,” Parmer says, “is not so common in the civilian population.” And that’s the point. From a broader perspective, Jerry Walleck says, for the architects and designers who work with the VA to serve Veterans across different aspects of their lives, “it’s about us being able to bring our expertise to a group of people to further that mission.”