Senators vow to block VA's hospital closure commission - Military Times

A bipartisan group of senators, including the chairman of the Senate Veterans' Affairs Committee, on Monday announced plans to block the veterans Asset and Infrastructure Review Commission, saying the process is flawed and unneeded.

The move all but ends more than five years of efforts to significantly cut back the Department of Veterans' Affairs footprint across America, and throws into question the long-term plans for what new facilities should be built to provide medical care to veterans.

But the opponents of the AIR Commission efforts — led by Jon Tester, D-Mont., chairman of the veterans committee and one of the chamber's most influential voices on veterans policy decisions — said the slow pace of the work thus far coupled with the controversial recommendations put out by VA leaders earlier this year have made the process unworkable.

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"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," the group said in a statement.

"That is why we are announcing that this process does not have our support and will not move forward. The commission is not necessary for our continued push to invest in VA health infrastructure."

The group includes Sens. Joe Manchin, D-W.Va.; Martin Heinrich, D-N.M.; Mike Rounds, R-S.D.; and Shelley Moore Capito, R-W.Va. Those four last month introduced legislation to completely eliminate the commission, saying the recommendations offered by VA leaders were too flawed to try and salvage.

In addition to those senators, seven more senators also signed on to the new pledge to block the commission: Maggie Hassan, D-N.H.; John Thune, R-S.D.; Sherrod Brown, D-Ohio; Patty Murray, D-Wash.; Steve Daines, R-Mont.; Rob Portman, R-Ohio; and Ben Ray Luján, D-N.M.

The AIR Commission has been compared to the Defense Department's Base Closure and Realignment Commission, designed to reduce the military's footprint across America and return public land to local communities for new use.

But the VA asset review is more complicated. Congress passed language in 2018 mandating the commission meet, review thousands of VA facilities across the country and come up with a list of changes in the future.

VA officials have said they have nearly 1,000 non-vacant but underused facilities spread across the country, creating a significant drain on department resources. Closing many of them would require an act of Congress.

When the law creating the commission was adopted, conservatives hyped the effort as a way to reduce wasteful spending on VA facilities and push more veterans services into private-sector care.

But Democratic leaders insisted the language was written broadly enough so that VA could either reduce or increase the number of VA medical sites across the country, with the goal of better aligning facilities with veterans needs.

In March, VA Secretary Denis McDonough unveiled his recommendations to the commission, which included hundreds of changes to facilities in every state.

Thirty-five Veterans Affairs Medical Centers in 21 different states would be closed or completely reconstructed under the nearly $2 trillion infrastructure overhaul. Fourteen new major VA hospitals would be built along with 140 multi-specialty community-based outpatient clinics.

The plan in total would add 80 new medical buildings to the department's existing inventory of more than 1,200 across the country.

Many lawmakers and outside advocates hated it

Conservatives said the Democratic administration's goals didn't go far enough to reduce VA's landholdings. Democratic lawmakers noted that many of the health care market assessments used in crafting the plan relied on pre-pandemic data, making them outdated.

Officials from rural areas said the recommendations cut off services for too many veterans not living close to major U.S. cities. Staff in hospitals in New York and Ohio scheduled for eventual closure held rallies to protest the decisions.

Since March, the process has been stalled over commission nominees. The first eight were announced in the spring. The ninth, Thomas Harvey, wasn't announced until Wednesday. That delayed confirmation work on the whole group by months.

The delay is particularly problematic because commission members by law only have until early 2023 to present any revisions to the secretary's plan. With less than a year left to complete site visits, new market assessments and staff interviews, the commission's workload appeared unrealistic.

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Now, with 10 key senators promising to block those confirmations, the work may be impossible. Tester would be the one to schedule and lead confirmation hearings for the nominees, and he has no intention to do so.

The group said their decision is not an attack on the nominees but instead on the process itself.

"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," the group said in a statement.

Last week, when asked whether the delay of the commission nominees would make the work on the AIR Commission thus far worthless, McDonough insisted that the framework behind the recommendations could form the basis of future planning discussions by the department.

"I define the entire project that the AIR Commission is designed around to be modernization," he said. "We are bound and determined to do right by our veterans, and that means upgrading our physical infrastructure. We will not be deterred from that."

In a statement Monday, VA officials said they will continue that work.

"President Biden has insisted that our weterans in the 21st century should not be forced to receive care in early 20th century buildings," said Melissa Bryant, acting Assistant Secretary for Public and Intergovernmental Affairs. "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.

"Whatever Congress decides to do with the AIR Commission — which was called for in the 2018 Mission Act — we will continue to fight for the funding and modernization that our veterans deserve."

The Senate opponents said they are confident those kinds of changes can still be made without the AIR Commission itself moving ahead.

The ranking members of the Senate and House Veterans' Affairs Committee condemned the announcement.

"I am astonished by the announcement today that several senators, including the Chairman of the Senate Veterans' Affairs Committee, are refusing the fulfill their responsibility under the law to confirm members of the AIR Commission," said Rep. Mike Bost, R-Ill.. "The MISSION Act was signed into law with broad support from lawmakers on both sides of the aisle and every major veterans service organization. It established an Asset and Infrastructure Review process ... [that is vital] for the future of modern, state-of-the-art VA care.

"This decision does an immense disservice to veterans and VA staff who will feel its repercussions for years to come."

Sen. Jerry Moran, R-Kansas, echoed that sentiment.

"I am disappointed that after more than a year delay, the committee will not be holding a confirmation hearing on the commissioners," he said in a statement. "This commission was designed to assess the 7,500 buildings the VA owns, leases and operates to determine how the buildings are utilized, whether facilities need updating, the funding necessary to upgrade facilities, and how efficiently health care is being delivered to our veterans. Many of the VA's facilities are empty, underutilized and severely outdated.

"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."

Leo covers Congress, Veterans Affairs and the White House for Military Times. He has covered Washington, D.C. since 2004, focusing on military personnel and veterans policies. His work has earned numerous honors, including a 2009 Polk award, a 2010 National Headliner Award, the IAVA Leadership in Journalism award and the VFW News Media award.