Twelve senators reject VA’s plans to reshape health care real estate under AIR Commission

A bipartisan group of dozen senators is rejecting the Department of Veterans Affairs' plan to close or overhaul hospitals and medical facilities that no longer ...

A bipartisan group of a dozen senators is rejecting the Department of Veterans Affairs’ plan to close or overhaul hospitals and medical facilities that no longer meet the health care needs of veterans.

The senators, half of which serve on the Senate VA Committee, said in a statement Monday that they would not proceed with nominees to serve on the Asset and Infrastructure Review (AIR) Commission.

The commission, under the 2018 MISSION Act, is supposed to review the VA’s recommendations released in March on how it expects to right-size its real-estate portfolio of medical facilities across the country.

“As senators, we share a commitment to expanding and strengthening modern VA infrastructure in a way that upholds our obligations to America’s veterans. We believe the recommendations put forth to the AIR Commission are not reflective of that goal, and would put veterans in both rural and urban areas at a disadvantage, which is why we are announcing that this process does not have our support and will not move forward,” the senators said.

President Joe Biden submitted nine nominees to serve on the AIR Commission, but the Senate has yet to act on any of those nominees. If confirmed, commissioners would review VA’s plans and issue their own recommendations to the White House.

Biden has until Feb. 15, 2023, to approve the AIR Commission’s final recommendations.

If he doesn’t submit his approval to Congress before March 30, 2023, the process for modernizing and realigning VA’s facilities under the MISSION Act ends.

Without the Senate’s confirmation of the nominees, the commission will not be established, and the process to right-size VA real estate under the VA MISSION Act will not move forward.

Melissa Bryant, VA’s acting assistant secretary for public and intergovernmental affairs, said that whatever Congress decides to do with the AIR Commission, “we will continue to fight for the funding and modernization that our veterans deserve.”

“President Biden has insisted that our Veterans in the 21st century should not be forced to receive care in early 20th century buildings.  The median age of VA’s hospitals is nearly 60 years old, and that’s why the President requested nearly $20 billion in new VA infrastructure spending last year and it is why he has requested the largest ever investment in VA infrastructure in his FY23  budget,” Bryant said.

The VA’s recommendations to the AIR Commission are based on market research that started in 2019, and doesn’t account for shifts in the demand for health care since the start of the COVID-19 pandemic.

The AIR Commission process received criticism before the VA even issued its recommendations.

The American Federation of Government Employees has held several rallies protesting the planned closure of VA medical facilities across the country.

AFGE National President Everett Kelley, an Army veteran, said senators’ rejection of the AIR Commission plan “is a major victory for veterans, military families, the American health care system, VA employees, and all those who rely on the VA,”

“This closure commission was a bad idea from the start. Automatic, mass closures of VA facilities would deny veterans the comprehensive, quality care that our nation owes to those who have defended our country – an obligation first recognized by President Abraham Lincoln,” Kelley said in a statement.

Senate Majority Leader Chuck Schumer (D-N.Y.) opposes the closure of two VA medical centers in Manhattan and Brooklyn. House Oversight and Reform Committee Chairwoman Carolyn Maloney (D-N.Y.) also opposes plans to close the VAMC in Manhattan.

The 12 senators, in their statement, said the AIR Commission “is not necessary for our continued push to invest in VA health infrastructure.”

“Together we remain dedicated to providing the Department with the resources and tools it needs to continue delivering quality care and earned services to veterans in 21st-century facilities — now and into the future,” they added.

The VA, under its plan, is looking to close approximately three dozen VA medical centers (VAMCs) but would replace about half of them with new construction. The VA would permanently close the other half, and would shift veteran care to local VA inpatient and outpatient facilities.

Meanwhile, the VA proposes building VAMCs in new areas. The plan calls for a net reduction of three VAMCs, bringing the total from 171 to 168.

While the total number of outpatient points of care would also decrease under this plan, the VA states the relocation and expansion of facilities and services will increase veterans’ overall access to VA care.

VA Secretary Denis McDonough told reporters last week that its recommendations are focused on providing veterans with modern facilities that would improve the quality of care they receive.

“I define the entire project that the commission is designed around to be modernization. We are bound and determined to do right by our veterans, and that means upgrading our physical infrastructure. And so we will not be deterred from that,” McDonough said.

But if the AIR Commission process doesn’t move forward, the MISSION Act still requires the VA to conduct four-year reviews of its real-estate needs in each of its regional health care markets.

McDonough said the VA would be on the verge of starting the next quadrennial review soon.

The following senators joined the statement  rejecting the AIR Commission process:

  1.  Jon Tester (D-Mont.),
  2. Joe Manchin (D-W.V.),
  3. Mike Rounds (R-S.D.),
  4. Martin Heinrich (D-N.M.),
  5. Shelley Moore Capito (R-W.V.),
  6. Maggie Hassan (D-N.H.),
  7. John Thune (R-S.D.),
  8. Sherrod Brown (D-Ohio),
  9. Patty Murray (D-Wash.),
  10. Steve Daines (R-Mont.),
  11. Ben Ray Luján (D-N.M.),
  12. Rob Portman (R-Ohio)

The top Republicans on the House and Senate VA committees, however, expressed continued support for the AIR Commission process.

Senate VA Committee Ranking Member Jerry Moran (R-Kan.) said many VA’s are “empty, underutilized and severely outdated,” and said the AIR Commission process would have addressed this issue.

“We passed the VA MISSION Act to address these issues but by refusing to confirm commissioners, we are essentially shutting down the work of the AIR Commission and possibly our only opportunity to fix this long-standing issue,” Moran said.

House VA Committee Ranking Member Mike Bost (R-Ill.) said the AIR Commission remains critical to updating “VA’s failing medical care infrastructure.”

“This process is vital for the future of modern, state-of-the-art VA care. It is wrong for these senators to outright refuse to even consider the nominees put forth by the Biden Administration. This decision does an immense disservice to veterans and VA staff who will feel its repercussions for years to come,” Bost said.

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