Published by STEVEN ALLEN ADAMS
CHARLESTON – Citing decreasing need for services as West Virginia’s aging veterans pass away, the U.S. Department of Veterans Affairs is considering reducing services at the state’s three VA hospitals and limiting access to other services.
State and federal officials are working to make sure those recommendations never happen.
In the middle of March, the VA released its Asset and Infrastructure Review (AIR) report. It is required by the VA MISSION Act passed by Congress in 2018. Among the bill’s provision, the VA MISSION Act required the VA to submit recommendations for modernization and streamlining healthcare services offered to veterans.
The VA recommended the approximately $2 trillion AIR proposal on March 14. According to Military.com, the VA proposal involves closing as many as three medical centers and 174 outpatient clinics while also creating 255 new healthcare facilities focused on rehabilitation, long-term care, and other services aimed at older veterans.
“VA came to these recommendations by asking ourselves one question above all else: what’s best for the Veterans we serve? Because that is our number one goal, today and every day,” said VA Secretary Denis McDonough in a statement. “We’ve spent the last several weeks and months communicating about this with VA employees, union partners, state partners, Veteran service organizations, Congress, and more. I’m continuing to consult with our unions, and will do so moving forward, because I so appreciate the strong partnership, we have with them.”
As part of the AIR recommendations, services for veterans in West Virginia would be severely impacted, effecting all three VA medical centers in the state: Huntington, Beckley, and Clarksburg. Edward “Ted” Diaz, secretary of the state Department of Veterans Assistance, said during an interview Thursday in his office on the grounds of the State Capitol Complex that he was in shock when he saw the AIR report.
“To say I was surprised would be an understatement,” Diaz said. “My jaw hit the floor; my face went ashen white. I couldn’t believe what I was reading. My first thought as soon as I read off all of the assessments for West Virginia was they were, for lack of better term, gutting the services that the VA provides in West Virginia.”
The AIR report recommends that the Huntington and Clarksburg VA medical centers stop offering inpatient medical and surgical services, instead partnering with local hospitals and healthcare facilities. The Huntington and Clarksburg VAMC’s emergency departments would convert to urgent care centers.
“With the proposed inpatient medical and surgical services strategic collaboration, there is no longer a need to provide emergency department services at the (Clarksburg and Huntington) VAMC,” the report stated. “Replacing the emergency department with an urgent care center will allow the VAMC to serve low complexity patients during the hours when most Veterans seek care. Emergency department services will continue to remain available at community providers proximate to the (Clarksburg and Huntington) VAMC.”
The report also made other recommendations, including establishing new community living centers at the Huntington and Clarksburg VAMC, establishing a new residential rehabilitation and treatment in Charleston, moving the Lenore-Williamson other outpatient services (OOS) facility to Chattaroy, relocating the Charleston multi-specialty community based outpatient clinic (MS CBOC) to a new location in Charleston and establishing a new MS CBOC near Buckhannon, relocating the Westover community based outpatient clinic to a new location, and closing the Parsons OOS facility.
The cost of the VA proposal for the Huntington VAMC is $7.2 million, down from the current cost of $7.5 million. The VA proposal for the Clarksburg VAMC would cost nearly $5 million, up from $4.8 million if no changes are made.
The VA recommends constructing a new VA Medical Center to replace the Beckley VAMC, but the new facility would not offer the same inpatient medical and surgical services. Instead, the new Beckley VAMC would have a new community living center, adult day care, and offer non-surgical outpatient services.
“The main hospital building was built in 1950. The aging infrastructure of the VAMC suggests the need for modernization to support ongoing Veteran care and clinical services,” the report stated. “The new, modernized Beckley VAMC will provide the non-surgical outpatient services most needed in the market. Inpatient medical and surgical services and outpatient surgical services will be provided through strategic collaboration with a community provider.”
Again, the VA would seek partnerships with private and for-profit hospitals and healthcare facilities to replace inpatient medical and surgical services, including discontinuing emergency department services. It would also build a new facility for other outpatient services near Summersville, increase access to home-based private care and explore broadband expansion to offer telehealth services.
The AIR recommendations are based, in part, on projections on future demand for services. According to the VA, the Huntington VA Medical Center serves a 23-county market in West Virginia, Kentucky, and Ohio, with 31,748 enrolled veterans as of fiscal year 2018. Nearly half of all enrollees come from rural areas, and 57.4 percent of enrollees live within 30 minutes of a VA primary care site.
The AIR report projects that the Huntington market will see a 15.3 percent decrease in enrollees by fiscal year 2029, with demand for inpatient medical and surgical services decreasing by 13.6 percent during the same period. On the other hand, the report projects that demand for long-term care will increase by 8.5 percent.
More than 70 percent of the 14,964 veteran enrollees in the 10-county Beckley market that serves parts of Southern West Virginia and Western Virginia are rural, with Beckley VAMC primarily serving Raleigh, Mercer, and Fayette counties. Nearly 45 percent of enrollees live within a 30-minute drive of the facility. The AIR report projects a 13.9 percent decrease in demand for inpatient medical and surgical services and a 21.3 percent decrease in demand for long-term care.
The Clarksburg market serves 22,189 veteran enrollees with 80.4 percent residing in rural areas and 58 percent living within a 30-minute drive of the VA hospital. Demand for inpatient medical and surgical care is projected to decrease by 22.5 percent, while demand for long-term care is projected to increase by 3.7 percent by the end of the decade....
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