Congress is once again attempting what has since been an impossible task — a full and actionable review of the Veterans Affairs Department’s more than 6,000 owned buildings and 1,500 leased facilities that many say are underutilized, outdated and insufficient to meet the modern medical needs of an evolving veteran population.
Without a complete, transparent and apolitical review of the department’s capital assets that span more than 170 million square feet, Congress, the Government Accountability Office, veterans service organizations and the independent Commission on Care fear VA will turn from a caretaker of veterans to a “caretaker of an extensive portfolio of vacant buildings.”
Acknowledging the task as a “complex and emotional issue,” House Veterans Affairs Committee Chairman Phil Roe (R-Tenn.) called for a top-to-bottom review of the Veterans Health Administration’s capital assets.
“A capital asset review and realignment free of political influence is critical to ensuring that the VA health care system remains strong and sustainable for veterans today and tomorrow,” he said during a July 12 hearing.
His colleagues on the committee, both Republican and Democrat, seemed to agree and recognized the urgency of the situation.
After all, VA medical facilities are, on average, 60 years old — five times older than most non-profit hospital buildings. They were designed to handle the influx of injured World War II and Korean War veterans in the 1940s and 1950s.
In addition, the department then concentrated construction in the northeast and midwest areas of the United States, but VA predicts more veterans are expected to move to the south and southwest. The department also projects a 14 percent decrease in the veteran population by 2024.
But as former VA Secretary Anthony Principi told the committee, the department has had these conversations with Congress before.
Principi launched the Capital Asset Realignment for Enhanced Services (CARES) Commission in 2003 to conduct a similar review of VA facilities. But Congress didn’t fully implement the commission’s recommendations and instead looked at individual facilities.
Recommendations that suggested the construction of a new facility generally received congressional support, Principi said. But lawmakers quietly dispensed with those that called for a consolidation or closure, he added.
“When you don’t have some teeth behind it, it will fail,” Principi said of the committee’s goal of reviewing all VA capital assets. “The pluses were good, but those that wanted to realign or close a facility became difficult because of the political process. It becomes very, very difficult.”
Principi said VA should create a commission, have the secretary present a final plan to Congress and then let lawmakers vote on the complete package of recommendations as a whole.
“What you’re saying … is that you need politicians like us to be courageous enough to make the case for why certain facilities have to be closed for whatever reason and not make it about abandoning veterans in their time of need,” Rep. Kathleen Rice (D-N.Y.) said. “That’s always been the hot potato that no one ever wants to touch. It’s not enough for us to just sit here and ask you what can we do to help you? We know what we can do to help this realignment that has to happen.”
“If we don’t do that … the VA will fail and will fail the needs of veterans,” Principi said. “I don’t think this can be sustained 10 or 15 years.”
The department estimated it needs about $50 billion to upgrade or replace existing facilities and meet modern medical needs.
VA Secretary David Shulkin said the department wants to dispose, consolidate or sell more than 1,100 outdated, underutilized and vacant facilities within the next two years.
It’s already begun the process of disposing or reselling 142 of those buildings now. The department has about 430 vacant or nearly empty buildings that are more than 60 years old, which cost VA about $7 million a year to maintain.
Facility consolidation was one of 13 areas of focus for Shulkin when he described the “state of VA” in May.
The department said it’s not for a lack of trying. It disposed or repurposed more than 1,000 buildings — a total of 8 million square feet — since 2004.
VA currently has 28 leases pending authorization from Congress, which represent about 2.2 million annual visits of care, said James Sullivan, director of the department’s Office of Asset Enterprise Management.
In addition, VA doesn’t have one set method to dispose of a building, Sullivan said. Environmental and regulatory factors can slow down the process of elimination, and many VA facilities have historical designations.
In other cases, VA returns buildings to the General Services Administration.
“If we’re going to GSA to sell it, it’s going to be based upon the market, what GSA can get for those buildings and how hard they find [it] is to do it,” Sullivan said. “If we find a partner to reuse it, it could move pretty quickly. If it’s a simple demolition depending upon historic and environmental issues at the site, it could be anywhere from six months to 18 months.”
As the department ramps up efforts to sell, dispose or demolish vacant and underutilized buildings, it’s beginning to work more closely with GSA.
“We did not use GSA, quite honestly, until the last year or two, because prior experiences with GSA were not very receptive to moving properties,” Sullivan said. “But I think they have retooled and refocused, so it’s a good opportunity.”
“How can VA determine a building is necessary to meet a veteran’s need when VA at this time can’t determine how much need is being met using the existing building?” committee Ranking Member Tim Walz (D-Minn.) said. “Complex problems mend complex solutions. The failure of the CARES Commission to execute its recommendation proves that a commission is not enough.”