With changes swirling in veterans health care, senators press for action on stalled projects

By HUGH LESSIG | The Daily Press | Published: December 2, 2016

With President-elect Donald Trump eying an overhaul in veterans health care, 18 senators are urging quick action from the lame duck Congress on two dozen stalled VA projects, including a major one in Hampton Roads, Va.

Virginia Sens. Mark R. Warner and Tim Kaine joined 16 of their colleagues Thursday in calling for Congress to set aside funding for a list of health care centers, outpatient clinics and research facilities proposed throughout the Veterans Affairs system.

It asks Senate leaders to authorize the money “in the December funding bill, or another appropriate vehicle, to be signed into law this year.”

If Congress doesn’t act, it is unclear how these proposed projects would fare under a President Trump and a new Congress come January. Trump has talked about improving veterans health care, but in the context of providing more private-sector choices, not building more VA facilities.

The list of 24 projects includes a proposed 155,000 square-foot care center planned for South Hampton Roads, a project considered the top priority for the fast-growing Hampton VA Medical Center.

Congress has delayed approving these projects because the Congressional Budget Office has changed how it rates the financial impact.

Before 2012, CBO scored these projects -- which result in signed leases, even the project results in new construction -- as equal to the annual lease payment. But then it switched, saying Congress should consider the full cost up front. Because many of these leases run for 20 years, it made it more difficult for these projects to move forward.

Sen. Mark R. Warner is the leading co-sponsor on legislation that aims to make the regional center a reality. It is considered...

The proposed South Hampton Roads center would offer primary and specialty care, day surgery, an eye clinic, a pharmacy and a radiology services. A location has not been specified, but putting it in South Hampton Roads would relieve pressure on the Hampton VA, where patient visits grew more than three times the national average between 2011 and 2014.

Medical center officials have worked to create more space on the Hampton campus, converting administrative areas into exam rooms and adding floors. But that will not solve the problem, said Michael Dunfee, the center’s director.

“A lot of the changes we've made space-wise are short-term solutions for what is becoming a long-term problem," Dunfee recently told the Daily Press. "At some point, we're going to reach the end of our limit to be creative."

Warner has openly expressed frustration at the lack of progress on the proposed center. He has attempted different strategies this year, only to be stymied at every turn.

In September, the senator co-sponsored legislation to authorize funding. It has been referred to the Veterans Affairs Committee.

In June, he tried to amend the National Defense Authorization Act to include the project, but that fizzled. That same month, a House bill to fund the centers died without a vote because it drew money from veterans benefits.

Thursday’s plea comes as Trump is contemplating who will head the Department of Veterans Affairs.

Supporters say a plan that leans more on private hospitals would give veterans additional choices. Critics fear it marks the first step toward privatization of veterans health care and abandonment of long-held promises for retired service members.

Trump met Tuesday with Pete Hegseth, a Fox News commentator and former president of Concerned Veterans for America, a conservative advocacy group, according to Military Times.

Hegseth is considered a candidate to lead the VA along with Sarah Palin, the former Alaska governor and Republican vice presidential candidate.

CVA’s report, “Fixing Veterans Health Care,” is a 102-page document that describes a dramatic shift in veterans health care. Under the plan, the Veterans Health Administration would be split in two -- one entity responsible for medical centers and another handing health insurance oversight. Essentially, it’s a division between provider and payer, which supporters say would offer veterans more options to seek private care.
VA hospitals could concentrate on military-specific areas for which it has expertise, such as traumatic brain injuries, spinal cord injuries, and post-traumatic stress disorder.

Supporters say this would not lead to a dismantling of the VA health system. The federal government would still bear responsibility for veterans health care.

Not all agree. Sherman Gillums Jr., executive director of the Paralyzed Veterans of America, told Military Times: “A fragmented and less coordinated care environment is not optimal for veterans whose health issues are often too complex and hard to treat for providers who do not specialize in them.”

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