The VA’s difficulties in both opening new facilities and closing outdated ones to better match its structure to the needs of veterans has leaders of the House Veterans Affairs Committee considering a bill to trigger a process much like the DoD base realignment and closure, or BRAC, authority.
The department and outside entities such as GAO have repeatedly cited issues with a mismatch between the VA’s physical structure and the demand for services. At a recent House hearing, GAO repeated that concern.
“Geographic shifts in the veterans’ population, changes in health care delivery, aging infrastructure, and limited stakeholder involvement affect the Department of Veterans Affairs’ efforts to align its services and real property portfolio to meet the needs of veterans. For example, a shift over time from inpatient to outpatient care will likely result in underutilized space once used for inpatient care. Further, the historic status of some VA facilities adds to the complexity of converting or disposing of them. In such instances, it is often difficult and costly for VA to modernize, renovate, and retrofit these older facilities,” GAO said in a summary of its findings.
A proposal under consideration before the committee would require the VA to assess its medical facilities, taking into account factors such as access to care, the capacity of the local healthcare market, input from local veterans and stakeholders, and potential costs and savings. Based on those criteria the VA would make recommendations to be reviewed by an 11-member commission which could make changes. Its report in turn would go to the President and on approval would go to Congress, which could stop the plan only by disapproving it within 45 days.
GAO added that its review of prior BRAC rounds revealed that to succeed, such a process at the VA would need “sustained senior leadership’s attention and a high level of coordination among many stakeholders” because such efforts involve a “large number of actions that depend on each other for successful implementation.”