MORGANTOWN – Sen. Joe Manchin heard from concerned West Virginia veterans on Monday about a proposed U.S. Veterans Affairs plan that would include downsizing three of West Virginia’s VA hospitals to urgent care centers and would relocate some VA community-based outpatient clinics.
“This would be a tragedy,” one veteran said during the meeting – a combined in-person and Zoom “listening session.”
Retired National Guard Gen. James Hoyer said, “It is an absolute disservice to our veterans.”
The proposal is part of the VA’s preliminary recommendations for the Asset and Infrastructure Review (AIR) Commission to consider.
Manchin elaborated in an emailed statement that the VA MISSION Act established a new process for the development, review, approval and implementation of a list of recommendations for the modernization and realignment of VA medical facilities. The Act requires the VA Secretary to develop an initial list of recommendations, including the acquisition of new space, the modernization of existing space and the disposal of unneeded space. The Secretary was required to publish these recommendations in the Federal Register by Jan. 31.
The Act also established an AIR Commission – a panel of nine members nominated by the president and approved by the Senate, which is meant to review the recommendations submitted by the VA Secretary. The AIR Commission membership is not yet complete.
The targeted hospitals are in Clarksburg, Beckley and Huntington; only the Martinsburg hospital, which sits close to the D.C. Beltway, is kept whole under the proposal.
The veterans and Manchin staffer Olivia Chartier discussed some of the problems the downsizing would cause. Among them, it will deprive rural veterans of easy access to care, as the proposal tends to favor urban centers. It will deprive veterans of appropriate emergency room care as they will be forced to seek care at civilian hospitals.
They will also lose access to VA surgery and inpatient mental health care.
The vets noted that civilian emergency departments and medical facilities are not trained to deal with veteran-specific issues such as PTSD, and statistics show that veterans are more likely to die in civilian ER’s than in VA ER’s.
The vets and Chartier noted that the VA’s approach to the issue seems focused on bottom-line cost savings and appears to be based on flawed data and presumptions about the demand for care at the three hospitals and the ease of access to care for rural veterans in rural West Virginia where driving distance and crow-flies distance are very different things.
One veteran said the Huntington hospital parking lot is always full and he doesn’t know how already understaffed civilian hospitals could handle the extra pressure. Another said this appears to be a move to privatize much of the VA’s care, in violation of the VA’s mission.
Several said veterans prefer to receive their care at VA facilities. Talking about civilian hospitals, one said, “I don’t think people want to go there. I’m confident they don’t want to go there.”
Manchin introduced legislation to eliminate the AIR Commission in 2019. Last month he expressed concern that all those who have been nominated to serve on the AIR Commission are from heavily populated urban areas and urged the Biden administration to make certain rural perspectives are considered by the commission.
Manchin isn’t alone among West Virginia’s Congressional delegation in opposing the proposals.
Sen. Shelley Moore Capito joined Machin and a bipartisan group of 10 other senators to write to Biden earlier this month and call on him to consult with Congress and local stakeholders on a state-by-state basis on the potential impacts the AIR Commission recommendations would have.
They wrote, “The recommendations are overly focused on quantitative data that does not do enough to consider the impact the proposed changes would have on our veterans, particularly elderly veterans. We request that when you receive the final recommendations from the AIR Commission you consult our offices on a state-by-state basis for our feedback before you decide to approve or deny them.”
Rep. David McKinley shares their concerns. He said on Monday, “We are working with the delegation and the West Virginia Department of Veterans Assistance to address the drastic, sweeping changes recommended by this VA study. The proposed changes to services offered by VA Medical Centers in West Virginia would hurt our rural veterans by limiting access to essential health care services through a provider they trust.
“We need to make sure that veterans in rural communities continue to have access to quality medical care they deserve and were promised through the VA Medical Centers,” McKinley said. “Our goals continue to focus on improving the process for veterans to access their benefits, which includes enhancing the medical care provided, not cutting these essential services.”
Manchin told the veterans on Monday he and his colleagues will be staying on top of this and providing regular updates. He sits on the Senate Armed Services and Veterans Affairs committees and expects the proposals to have a tough time there.
A timeline provided by Manchin and Capito says that once the AIR Commission is stood up and receives the department’s recommendations, it will conduct its own hearings and investigations, make its own recommendations and send its final recommendations to the White House by Jan. 31, 2023.
The president is to notify the commission and Congress if he approves or disapproves the list by Feb. 15, 2023. If disapproved, the commission may revise the recommendations and submit a new list by March 15. The president then has until March 30, 2023, to approve the commission’s initial or revised recommendations in their entirety and submit them to Congress, or the modernization and realignment process terminates.
If the president approves the recommendations, Congress has 45 days from the date of approval to terminate the process by enacting a joint resolution of disapproval. If Congress does not enact a joint resolution of disapproval, the VA is required to implement the recommendations.
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