TThe Virginia State Commissioner of Health has approved establishment of a new outpatient medical center in Springfield which is expected to open this summer.

The commissioner also is expected to decide late June whether to approve or disapprove the expansion of National Prthopaedic and Rehabilitation Hospital in Arlington.

The two health care projects were reviewed recently by a local health planning group, the Health Systems Agency of Northern Virginia. The agency, one of five similar health planning groups in Virginia, is a federally mandated organization responsible for evaluating local health care. It advises the state health commissoner on Northern Virginia's needs for health facilities, but the commissioner is not bound by the agency's recommendations.

The health systems agency last month recommended that the commissioner approve establishing the Springfield outpatient medical center proposed by the Georgetown University Community Health Plan, Inc. At the same time, the agency rejected a proposal from National Orthopaedic and Rehabilitation Hospital to build a two-story expansion to the hospital at 2838 Army-Navy in South Arlington.

The Georgetwon University Community Health Plan is a medical pre-paid group practice that offers a wide variety of health services. The plan operates three medical centers in the metropolitan area in Reston, Kensington, Md., and Northeast Washington.

If approved by the health commissioner, the new center would open in July or August in a newly built office building directly across the street from Springfield Mail.

The center, which would occupy about one and a half floors of the office building, would serve about 18,000 Northern Virginia residents enrolled in the Georgetwon University Health Plan. The facility, expected to cost more then $500,000, would include 32 examination rooms, waiting areas, a small administrative area, laboratory and radiology services and a medical records area.

The health systems agency, in its recommedation last month that the Georgetown health plan's medical center be established, noted that the demand for prepaid medical services in Northern Virginia will exceed what is available in the near future.

At the same time, however, the agency rejected a proposal by the National Orthopaedic and Rehabilitation Hospital to build a $2.4 million addition to the hospital.

The addition, which still may be approved by the health commissioner, would allow the hospital to move what hospital officials call inadequate surgical facilities on teh fourth floor to the more convenient second floor of the proposed addition.

The health systems agency staff reported that there does not appear to be sufficient need for more surgical facilities, and said that the projections of need presented by the hospital were unreliable.

The staff also suggested that expansion may not be financially feasible for the hospital since utilization of the hospital may not increase.

The agency agreed with hospital representatives that some of the present surgical facilities require improvement, but said that much improvement could be made without building an expensive addition.

The Northern Virginia Health Systems Agency recommended that the hospital withdrew its application to build the addition until the agency and its statewide counterpart, the State Health Planning and Development Agency, complete reviews of Northern Virginia health institutions. The reviews must be completed within four years, according to federal regulations governing health planning agencies.

The agency also recommended that the state health commissioner not approve construction of the addition if the hospital does not withdraw its application.