(WASHINGTON) – The American Federation of Government Employees (AFGE) testified on June 10 before the Senate Committee on Veterans Affairs to voice concerns about the VA’s Health Care Center Facility Leasing Program. AFGE, which represents 160,000 employees of the VA workforce, more than two-thirds of whom are on the front-lines of caring for veterans at VA hospitals and long-term care facilities, has been critical of the program since it was introduced in March 2008.
“The VA has been the crown jewel of the American health care system, chipping away at the system through a permanent shift toward contract care and leasing arrangements undermines its quality and threatens the agency at a time when our veterans facing post-traumatic stress disorder and traumatic brain injury are in need of the specialized care of the VA,” said J. David Cox, AFGE national secretary-treasurer.
In March 2008, the VA quietly issued a radical new approach to providing outpatient and inpatient care through the Health Care Center Facility Leasing Program. The leasing program relies on long term leasing arrangements with private hospitals for inpatient and emergency room services instead of constructing new or replacement VA medical centers. Health Care Centers, large outpatient clinics that comprise the other core component of this program, also threaten to siphon off core resources from the VA. The policy was introduced by former VA Secretary James Peake but a number of Health Care Centers are already in place and more are in the pipeline including three in North Carolina, which Cox cautioned the Committee will lead to the closing of the Salisbury (Hefner) VA Medical Center.
In his testimony, Cox relayed the following to the committee: “The VA has evolved into a national healthcare leader because it relies on a single, integrated system that concentrates its resources and expertise to provide comprehensive, high quality, cost effective specialized care in tandem with invaluable academic affiliations and specialized research. The VA’s teaching mission produces significant benefits for patient care because it is uniquely positioned to move scientific discovery from investigators’ laboratories to patient care.”
North Carolina Senator Richard Burr (R-N.C.), who has been an outspoken supporter of the leasing plan, was involved in a rather heated exchange with Cox, where he attempted to justify the use of private health care providers via the leasing program, despite heavy criticism from the veterans’ service community and VA employees in his home state.
Cox also said, “We are deeply concerned about the overall impact of this new model on the future of VA’s system of care, including the potential unintended consequences on continuity of high-quality care, delivery of comprehensive services and particularly VA’s renowned system electronic health records, recognized biomedical research and development programs.
In contrast, the leasing program utilizes an entirely different and untested delivery model. Because the VA is a fully integrated health system, medical centers are able to operate as “hubs” that support small, community based outpatient clinics (CBOCs), telehealth facilities, limited fee basis care and other “spokes”. The only “hubs” available to support the outpatient services provided by Health Care Centers are non-VA hospitals that often struggle financially to serve the general population, including large numbers of the uninsured and underinsured.
“This Leasing program has not really been about leases. It’s been about permanently diverting major construction and patient care funds away from standalone VA hospitals and shifting them to private hospitals – and doing it without Congressional authority,” concluded Cox.
AFGE’s objections to the VA’s leasing program have been echoed by the veterans’ service community. In testimony before the committee, Disabled American Veterans, chastised the VA for failing to communicate effectively with veterans, VA employees, and the communities affected by dramatic changes in the health care provided by the VA.