Wednesday, March 06, 2019

VA Facility Closures: Coming Soon(er)? VeteransPolicy.org

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VA facility closures could begin sooner than expected

It was a big moment during last week’s “VA 2030” House Committee on Veterans Affairs hearing. Read more from Leo Shane III at Military Times:

Veterans Affairs’ version of a base closing round could start years ahead of schedule, department officials told Congress on Wednesday.

Under the VA Mission Act signed into law last year, the president is authorized to appoint an Asset and Infrastructure Review Commission for the department in 2022. To inform the group’s work, VA officials were given three years to perform regional market assessments across the country to determine areas where there were medical facility shortages, gluts and other challenges.

On Wednesday, VA Secretary Robert Wilkie said those assessments were delayed slightly late last year but could still be finished in the next 12 months. If so, that could create a problematic gap between collecting that information and starting evaluations in 2022.

“We’ll come back to you this summer and give you an assessment of where things are,” he said. “If we can, to meet the expectations of this committee and the changing need of veterans, we’re going to come to Congress and ask to move that timeline up.”
 

How is the MISSION Act related to facility closings?

Read more on the Asset and Infrastructure Review (AIR) Commission, the body tasked with identifying and closing VA facilities as part of the MISSION Act. From VHPI:

The VA MISSION Act of 2018 establishes an external Asset and Infrastructure Review (AIR) Commission to evaluate all Veterans Health Administration (VHA) facilities with respect to under and over-utilization. In 2023, the AIR Commission will recommend which facilities to close, condense or expand. Congressional members will have limited authority to alter final recommendations.

The MISSION Act also creates new prerogatives — e.g. access to private sector walk-in care and freedom to select Veterans Community Care Program (VCCP) providers — that are explicitly intended to shift the provision of services from VHA facilities to the private sector. The more care that is delivered in the private sector over the next four years, the more likely that VHA facilities will become underutilized and potentially included on the AIR Commission’s closure list.



The AIR Commission differs from the Department of Defense’s Base Realignment and Closure (BRAC) process after which it is modeled. Unlike BRAC consolidations, veterans receiving care at a closed facility would not transfer to another VHA. In nearly all instances, other facilities are too far away. In the few areas where another VHA is within a short distance, there is little capacity to absorb redistributed veterans. All veterans at the closed facility would be offered vouchers for VCCP services.

Overall costs associated with closing a VHA facility will be significantly higher than keeping it open because the number of veterans whose care the VHA finances will automatically increase.
 

Coming up on Capitol Hill:

Joint Hearings of the House and Senate Committees on Veterans Affairs

Reminder: VA Community Care Deadline

March 25 is the deadline for comments on the VA Community Care Program. Read the rules here. Submit your comment here. So far, 358 comments have been received.
 

VA works to improve health care for women veterans

From Ben Kesling at The Wall Street Journal:

The number of women using the U.S. veterans health system has tripled since the beginning of the wars in Iraq and Afghanistan, creating pressure to improve services for a population that has often been overlooked, officials said Thursday.

Top VA women’s health officials said at a House Appropriations Committee hearing Thursday that the Department of Veterans Affairs has worked to improve women’s health services in areas ranging from basic gynecological care to advanced care like mental-health treatment associated with military sexual trauma.

“We’ve continued to experience what I call a tsunami wave of women veterans over the last 10 years,” said Dr. Patricia Hayes, the chief consultant for women’s health services at the VA, talking about large increases in demand from women veterans.

But some lawmakers and advocates said fundamental improvements still are needed both for basic medical care and for larger problems of sexual harassment and abuse.

Women now make up more than 16% of the active-duty military, according to the VA, compared to 11% during the Gulf War era, and as their numbers increase—and as opportunities for women to serve in direct combat rise—so does the proportion of women among American veterans.
 

Quick Clicks:

  • Military Times: A formal investigation has been launched into whether or not exposure to toxic chemicals at DoD facilities has caused cancer
  • PBS: Indirect costs mean that Americans pay far more than they realize for healthcare
  • Napa Valley Register: A year after the Pathway Home shooting, a community continues to heal
  • Stars And Stripes: Study on marijuana’s effect on PTSD concludes
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