VA hospitals could close with shift of focus to outpatients

Veterans hospitals in cities across the country could be closed as the Department of Veterans Affairs shifts its focus to outpatient care and works to bring services closer to people who need them.

The massive restructuring, being announced today, would touch every community where the VA operates, though decisions about specific cities and hospitals won't be made for more than a year. In some cities, hospitals are likely to be closed or operations scaled back; in others, new services will be added.

"This is not about the closure of facilities. It's about continuing the change in VA health care and changing it for the better," Deputy Secretary of Veterans Affairs Dr. Leo S. Mackay Jr. said in an interview.

Decisions about where to cut and where to add will be made after analyses of demographics and services available at 163 hospitals and more than 1,000 clinics, nursing homes and other health care facilities.

How the John J. Pershing Veterans Administration Medical Center in Poplar Bluff could be affected won't be known for at least a year.

"The initial round of recommendations will be at the central office about this time next year," said Elaine Buehler, deputy director of Public Affairs for the Veterans Administration regional office in Denver.

She said the assessment is occurring in light of massive changes that have occurred in the health-care delivery systems from inpatient to outpatient care.

"We are looking at how we do business," she said.

No veteran should fear that whatever changes are made will mean they could be deprived of benefits, Buehler said.

"Our job is to provide those health-care services."

Genise Denton, public affairs assistant at the Poplar Bluff hospital, said nothing is known locally about how the evaluation might affect the hospital.

"That's more of a regional issue," she said.

An independent, nine-member commission is to make recommendations to the VA secretary in August 2003. As with recommendations on military base closings, the secretary must accept or reject the plan as a whole -- an attempt to minimize the politics surrounding the closure of sometimes cherished institutions.

Some veterans are concerned that the VA may be dismantling an infrastructure that is part of the national homeland security plan. And they worry that some vets will lose access to care.

"While they keep saying they're improving services, they are drastically cutting services," said Bruce Parry, 55, of Veterans for Unification, a Chicago advocacy group. "The result will be the VA serves fewer veterans, and as people find it less attractive, they will have further excuses for shutting more down in the future."

The national overhaul, recommended by government auditors in 1999, is aimed at shifting dollars away from aging, inefficient facilities in communities where the number of veterans is shrinking in order to provide modern medicine closer to where vets of the future will live.

Staff writer Sam Blackwell contributed to this report.