VA Halts Further Clinic Leases: Future Care to be Denied

OFF THE WIRE

Federal law requires the Department of Veterans Affairs (VA) to obtain Congressional approval for a commercial lease of a future VA medical facility if the estimated first-year lease cost exceeds $1 million.  This policy has been in place for more than a decade.  Dozens of leases for VA-operated community-based outpatient clinics have been approved under this procedure.  Using a leasing authority rather than constructing VA-owned facilities allows VA to quickly establish convenient primary care facilities for veterans in communities where they live.  Veterans who use these community clinics report high satisfaction with their care and the convenience they offer.
 In 2012, in evaluating 15 proposed VA leases that each exceed the $1 million threshold, the Congressional Budget Office (CBO) concluded that Congressional rules require that funds to offset the entire 20-year prospective lease cost would need to be included either in the VA budget, or would be taken from funding of ongoing veterans programs—all in the first year of each lease.  CBO indicated this policy also would apply to renewals of existing VA leases. This CBO decision multiplied VA’s costs for these proposed 15 leases by 20-fold, for a total need of $1.2-$1.5 billion in Fiscal Year (FY) 2013.  Since funds of this magnitude could not be diverted from other VA accounts for this surprising new requirement and aren’t covered in the budget request that had been submitted to Congress, these 15 leases were dropped from further Congressional consideration last year.
 In VA's current planning, including 15 new community-based outpatient clinics located in California, Connecticut, Florida, Georgia, Hawaii, Kansas, Louisiana (2 sites), Massachusetts, New Jersey, New Mexico, Puerto Rico, Texas (2 sites), and South Carolina, VA also projects a need to lease or renew existing leases for 23 more community-based health care facilities through FY 2017 to provide care for more than 340,000 veterans across 22 states and US territories.
 Unless CBO changes its policy or Congress acts to overturn this CBO decision with legislation or makes a change in House Rules in current funding policy, most if not all these leases are in jeopardy.  Veterans consequently will be denied access to VA health care in these locations.
Please use the prepared electronic letter provided in this alert, or write your own letter, to express to your Senators and Representatives your concerns about this unfair policy that will negatively impact availability of services to wounded, injured and ill veterans.  Unless a change is made, VA will be forced to buy land and construct government-owned clinics, or more likely will require veterans who need VA care to travel longer distances to receive it.  VA-built clinics would be more expensive, would take much longer to approve and activate, and would reduce VA’s flexibility to place and move facilities based on the changing needs of the veteran population.  Forcing veterans to unnecessarily travel for care would increase inconvenience and add additional costs.
 As always, DAV appreciates your grassroots advocacy in the DAV Commander’s Action Network (DAV CAN) and your support for wounded, injured and ill veterans who need VA care.