When I first went to work for the Kaiser-Permanente medical care program in 1982, I performed outpatient procedures – at the Kaiser facility in Vallejo CA – in a cantonment-style hospital built during World War II. Naturally, there’s a story here.(1)
Vallejo was the home of what was then the largest west coast Navy Yard at Mare Island, just across the quarter-mile wide Napa River from the city. With a pre-war population of around 20,000, a huge influx of war-effort laborers (2) and their families had seen the city grow to 76,000 according to post office estimates (Director of the Office of Civil Defense to Navy Surgeon General June 20, 1942). The City Council estimated an “area census of 80,000 persons” (Telegram from City Council to Honorable Sheridan Downey, U S Senate, dtd May 25 1942).
Meanwhile, the only hospital serving the city was a private facility of 68 beds, one small operating room, one delivery room, an “antiquated” x-ray facility and “meager” laboratory (Director of Civil Defense, cited above). Added to this the 36 bed hospital in nearby Napa, 60 beds in the County Hospital in 18-mile distant Fairfield and a smattering of beds in tiny private hospitals in surrounding cities, this allowed for one bed per 430 residents. The area acceptable “minimum”, based on the city of San Francisco, was one bed for 250 persons. (See (2), below.) The need for more beds was clearly urgent.
The government had quickly constructed public housing for yard workers, but this housing was exempt from local tax. And because the County supervisors of Solano County – of which Vallejo lay at the western-most edge – were “engaged in agricultural occupations, [they were] not inclined to make adequate provision for the industrial area” of Vallejo. (Director of Civil Defense, cited above). Short on revenue but great with need, early in 1942 – my information doesn’t give me the date – the City applied to the Federal Works Agency for construction of a 250 bed hospital, under the 1940 Lanham Act.
Despite the urgency of the need, inevitable bureaucratic delays ensued. Prompted by California Senator Sheridan Downey (Downey to McIntire May 29, 1942), the Surgeon General weighed in on the matter with a memorandum to the Chairman of the Red Cross suggesting that a 50 to 75-bed temporary hospital built by the Red Cross “to relieve the acute shortage, until such time as the F.W.A. [Federal Works Agency] provides the authorized beds.” He added, “Should the Red Cross do this I am sure it would have a stimulating effect on the F.W.A., and I believe it would create a favorable impression throughout the county…” (McIntire to Chairman Norman H. Davis, American Red Cross, November 26, 1942).
In January 1943, almost a year into the process, McIntire apparently phoned Major General Phillip B. Fleming, the F.W.A. Administrator, to push a bit, because Fleming wrote in reply on January 14 that he had “investigated progress and [found] the excavation [was] now under way, the architect’s plans are finished, the material list for submission to the War Production Board will be in this week and the contract should be let for the superstructure by the end of next week.” A memo from Red Cross Director of Medical and Health Services – Pacific Area, highlights the bureaucratic tangle slowing progress of the project: “The Vallejo Hospital Project has reached the last in a long series of approvals required for a Lanham Act grant. The Regional Office of the U. S. Public health Service had to recognize the community need for the hospital, and approve, from a medical point of view, the original plans for its construction. The application for the Lanham Act grant and the plans were then sent for approval to the Public Buildings Administration, and the office of the Federal Works Agency. Pressure from the Red Cross and the navy brought the project to the attention of General Fleming who saw that it was rushed through the necessary channels and sent on to the War Production board.” (Milton Rose, MD, to M. E. Lapham, M. D., Executive Officer, Procurement and Assignment Service, January 27, 1943). Finally, General Fleming could write McIntire to indicate that construction was expected to be under way by 1 April 1943 (Fleming to McIntire, March 10, 1943).
The records at hand are silent on when the hospital, subsequently called “Vallejo Community Hospital”, opened for business.
By 1947, the facility had been declared “in surplus” by the Public Health Service and the Kaiser-Permanente health care program, responding to requests from plan members working at the shipyard and the nearby Benicia Army Arsenal, leased the hospital and began operating it on 1 April. In 1948, Kaiser moved its Kabat-Kaiser Institute – a pioneering rehabilitation facility – to the Vallejo facility. The Kaiser Rehabilitation Center in Vallejo maintains a world-wide reputation in physical and rehabilitation medicine.(3)
Kaiser-Permanente continued use of the cantonment style pavilions as clinic buildings until the mid 1980s when a modern two-story clinic building opened. In 2010, the organization replaced a 1960s-era hospital tower with a modern, state-of-the-art “green” hospital.
Downey’s(1) Navy Bureau of Medicine and Surgery correspondence on this matter is located at National Archives II in College Park MD, Record Group 52, Entry 15B, Box 105, File NH22/EG-2 to NH22/EG19. I cite dates of individual items in this file in this article.
(2) The Navy Yard workforce had increased from a pre-war 6,512 to 34,704 according to a letter from the Mare Island hospital commander to the Navy Surgeon General, dated June 1, 1942. The hospital CO stated a city population estimate of 75,000.
(3) Smillie, MD, John G., Can Physicians Manage the Quality and Costs of Health Care? The Story of the Permanente Medical Group, The Permanente Federation, LLC, 2000.
©2012 Thomas L Snyder