St. Elizabeths Hospital is located approximately 2 miles south of the Capitol building and is divided by Martin Luther King, Jr., Ave. into what are known as the west and east campuses. St. Elizabeths began operations in 1855 as the “Government Hospital for the Insane.” During the Civil War, St. Elizabeths was used to house soldiers recuperating from amputations, and the west campus includes a Civil War cemetery. In 1916, Congress formally changed its name to St. Elizabeths Hospital, which refers to the historic name of the old royal land grant of which the hospital was a part. According to an HHS official, during its peak use period in the early to mid-1960s, St. Elizabeths housed approximately 7,000 inpatients and employed nearly 4,000 people. As discussed in more detail below, a 1984 law authorized the transfer of part of St. Elizabeths to the District. Today, the District primarily uses the east campus for its mental health services program. The west campus—61 buildings containing about 1.2 million square feet of space on 182 acres—is owned by the federal government, with the exception of 5 buildings that are owned by the District. HHS is the holding agency that is responsible for the federal portion of the west campus. The District owns the east campus, which comprises some 42 buildings containing 1.75 million square feet on 118 acres. Figure 1 is a map of the St. Elizabeths hospital complex. Buildings on the west side of the map shaded in grey indicate ownership by the District of Columbia. Under a use and occupancy agreement between HHS and the District, the District was, at the time of our review, using about 15 of the west campus buildings at no charge other than accepting responsibility for maintenance. The District also provides security for the west campus. West campus buildings not being used by the District are vacant. In addition, the District plans to completely vacate the west campus in 2001. On January 17, 2001, HHS officially notified GSA of its intention to declare the federal portion of the west campus excess. Under the Federal Property and Administrative Services Act of 1949 (Property Act), as amended, GSA has responsibility for federal real property utilization and disposal of excess and surplus property. In 1984, the St. Elizabeths Hospital and District of Columbia Mental Health Services Act authorized HHS to transfer to the District all property at St. Elizabeths Hospital needed by the District to provide mental health and other services under the District’s comprehensive mental health system plan. In accordance with that provision, on September 30, 1987, the Secretary transferred to the District title to almost all of the portion of St. Elizabeths that is known as the east campus and several buildings on the west campus. The act contemplated that the remaining portion of St. Elizabeths that was not so transferred, which would include most of the west campus, would be subsequently transferred to the District after Congress approved a master plan prepared by the District for the use of such property. The act, as amended, also stated that Congress would approve and enact a law transferring the remainder of the property at St. Elizabeths within 2 years after the plan was submitted to Congress.Athough the master plan was submitted to Congress in 1993, it was never approved. The 1993 master plan recommended renovation of the west campus, after which approximately 52 percent of the west campus would continue to be used for the District’s mental health program. The remainder of the west campus would be adapted for other institutional-type uses, retail facilities, and support buildings. The plan also included estimated costs ranging from about $116 million to $128 million for implementation. A District official informed us that the District does not intend to use the west campus at St. Elizabeths for mental health programs because it currently intends for mental health services to be community-based. Because Congress did not approve the 1993 master plan and did not enact legislation transferring the west campus of St. Elizabeths from HHS to the District, and because the District no longer needs or intends to use the west campus to provide mental health services, HHS is preparing the property to be excessed to GSA under the normal process for excessing federal real property. St. Elizabeths was designated a national historic landmark (NHL) in December 1990. This is the same designation given to the White House and the U.S. Capitol Building; and, according to an Advisory Council official, is granted to a very small percentage of historic properties. Agencies that hold NHL properties are responsible for preserving their historic character; and the National Historic Preservation Act (NHPA) provides that the agency responsible for the property shall, to the maximum extent possible, undertake such planning and actions as may be necessary to minimize harm to such a landmark. The NHL designation for the west campus recognized the exceptional national significance of the property and mandated the highest level of national preservation priority. The west campus comprises the oldest portion of the St. Elizabeths complex and consists of the buildings with the most historic importance. In addition to the buildings on the west campus, the NHL designation covers the landscaping and grounds, the vistas of the rivers and city, and a Civil War cemetery that is located on the property. Figure 2 shows the Center Building, which opened in 1855 and served as the main hospital building on the west campus; the Civil War cemetery, which houses the remains of about 300 Confederate and Union dead; and the vistas. Prior to the NHL designation, St. Elizabeths was listed on the National Register of Historic Places. In 1989, HHS, the District, and the Advisory Council entered into a Memorandum of Agreement (MOA) on St. Elizabeths. The MOA detailed specific measures for preserving the historic character of St. Elizabeths in accordance with the Department of the Interior’s standards for maintaining historic properties. Despite the NHL designation and the MOA, officials from HHS, the District, and GSA said that lack of funding and the absence of a clear direction for the future of the west campus over the years have left it in a badly deteriorated condition. Figure 3 shows examples of the deterioration that has occurred on the west campus. During fiscal year 2001 congressional budget deliberations, GSA and HHS jointly developed a cost estimate of $8.5 million for stabilizing and mothballing the federal portion of the west campus and performing various studies to start preparing it to be excessed and eventually disposed of by GSA. Table 1 shows the cost estimates that were developed and identifies who would normally be responsible for funding each item under existing laws and implementing regulations. According to GSA officials, the $5.3 million for stabilization and mothballing would have been used to prevent further deterioration of the buildings and prepare them for approximately 5 years of nonuse while the process of preparing the property to be excessed and disposed of takes place and a plan for reuse is developed. As the holding agency for the property, HHS is responsible for funding this item. The regulations implementing the Property Act require the holding agency to be responsible for the protection and maintenance of property pending its transfer to another federal agency or its disposal. NHPA adds an additional requirement in that the heads of all federal agencies are responsible for the preservation of historic properties that are owned or controlled by the agency. Prior to the approval of any federal undertaking that may affect any NHL, the head of the responsible federal agency shall, to the maximum extent possible, undertake planning and action to minimize harm to the landmark. Mothballing and stabilization of the property are actions HHS intends to take that will prevent further deterioration and minimize harm to the historic St. Elizabeths property. According to GSA and HHS officials, they developed this estimate by using a previous estimate HHS had developed for stabilizing and mothballing the west campus. The previous estimate was based on a detailed study of five west campus buildings that was prepared by a team of experts HHS contracted with in 1998. GSA and HHS applied the cost per square foot to stabilize and mothball these five buildings to the entire square footage of the west campus to come up with a total cost. A GSA official said they used the total square footage for the west campus, including the District- owned buildings, to add some flexibility to the estimate to compensate for inflation and additional deterioration that would have occurred since 1998. However, the official said that the $5.3 million would have been used to mothball and stabilize only the federal portion of the west campus. According to GSA officials, there were other attempts to develop a stabilization and mothballing estimate. In March 2000, GSA estimated the cost at about $11 million. However, this estimate was not based on an analysis of actual conditions, and GSA and HHS decided to contract for an estimate in the summer of 2000. The contractor estimated a cost of $2.6 million, but GSA and HHS officials were not satisfied with the estimate because of their knowledge of the conditions of the buildings and past experience. GSA and HHS then decided to rely on the $5.3 million estimate that was derived from the 1998 HHS estimate discussed above because there was pressure to provide the estimate for the fiscal year 2001 budget deliberations. GSA officials acknowledged that the $5.3 million estimate was not as refined as it could have been because of the time constraints but said they believed it was reasonable given the circumstances under which it was prepared. GSA officials recognized that a better estimate would be based on a more thorough assessment of the conditions in all the buildings. They also said that because the $5.3 million was not funded for fiscal year 2001, the estimate might have to be adjusted to reflect additional deterioration that likely has occurred and inflation. The Phase II environmental and archeological studies are required prior to disposal. During fiscal year 2000, GSA contracted for a Phase I environmental study of the west campus that was paid for with HHS funds.