Sunday, May 1, 2005
If a year with no mission change at Walla Walla's veterans hospital has given anyone a feeling of security about the facility, it has had the exact opposite effect on Ron Fry.
If anything, the past state commander of the Veterans of Foreign Wars has more concerns about the future of the Jonathan M. Wainwright Memorial Veterans Affairs Medical Center than he did a year ago when the 88-acre campus was staring in the face of sweeping changes.
But he _ and many others _ will have an opportunity to make his fears known. The federal group chosen to study options at Walla Walla's VA hospital will have its first public meeting this week _ one year after a ruling was made to create the group.
``We're getting ready to start bringing in some people and trying to make sure everyone knows,'' Fry said.
``It's not something that's been widely broadcast.''Among those reportedly planning to testify to the 11-member Local Advisory Panel is Sen. Patty Murray, D-Wash., who played a major role in convincing the federal VA to further study Walla Walla's hospital and also securing $250,000 for an economic development study of the historic facilities.
Oral and written testimony will be accepted. Roxeanne Sisemore, facility planner and public affairs officer at the Walla Walla VA medical center, said it's likely not everyone will have a chance to speak. As a result, the VA plans to have a computer site so people can testify online.
The Local Advisory Panel will be in town two days. The first of the meetings will take place on Tuesday and be closed to the public, Sisemore said. During that session, the group will discuss how to organize Wednesday's meeting, including possible time limits on speakers.
On Wednesday, the panel will host a meeting from 8 a.m. to 5 p.m. in the VA theater.
Although the entire meeting will be open to the public, only a portion of the time will be allotted for public comment, Sisemore said. The public comment period will likely begin after the lunch hour, she said.
The meeting will be the first of four on Walla Walla's VA hospital between now and the end of the year, according to a project timeline.
The Local Advisory Panel is expected to use the information to provide advice to the secretary of Veterans Affairs on a plan for the site and services. The panel will work with PricewaterhouseCoopers, the federal contractor working on this and 17 other facilities nationwide.
Last year the independent Capital Asset Realignment for Enhanced Services Commission recommended contracting out, where appropriate, for inpatient, psychiatry and nursing home care and moving outpatient care off the historic campus at 77 Wainwright Drive.
The recommendation was part of a comprehensive overhaul of the VA's federal health-care system. Efforts were intended to align the VA's services with moving populations of veterans and help save the VA some of the money it was spending on inefficient and unnecessary facilities.
Although many advocates of Walla Walla's VA hospital agree the 28 buildings at the sprawling campus have become a financial obstacle _ many of the buildings are laden with lead paint or asbestos problems and don't meet seismic code _ the recommendation to change the services would pose several more challenges, say city and medical officials.
The first is simply what to do with the 28 buildings, which date between 1858 and 1947. Another is the potential loss of Walla Walla County's 12th largest employer, which has 365 workers and a 2005 budget of $46.5 million, Sisemore said.
But arguably the biggest concern is care in an area that has no other capacity for psychiatric or long-term rehabilitation services, according to the two other local hospitals.
Walla Walla City Manager Duane Cole, a member of the Local Advisory Panel, said problems with the facility are partly the fault of the federal VA.
``They haven't allocated their resources to rural America,'' he said.
He believes the goal of CARES was honorable as the VA attempted to make better use of its budget. But he said local studies and figures show there are no other options for veterans needing care here.
``The notion that (the VA) would pull out of here and leave us without adequate facilities is crazy,'' he said.
The facility serves more than 15 counties in Southeastern Washington, Northeastern Oregon and Central Idaho. According to Bruce Stewart, director of Walla Walla's VA, the number of veterans served there has increased by over 75 percent in the last seven years _ from 8,172 in 1997 to a projected 14,253 this year.
Fry said he hopes statistics like that will help save the VA for good _ not just delay an eventual closure. But he worries the numbers won't be enough.
He said the veterans he talks to at the VFW have concerns over what he describes as the closed-door nature of the federal VA, an administration they worry is not realistic about veterans' needs and a growing number of vets who have difficulty getting care.
``There's exhaustion, frustration,'' Fry said. ``I'm losing confidence in the people who are supposed to be looking out for the veterans.
HOW TO PARTICIPATE
Occupancy in the Walla Walla VA medical center theater is limited to 200. Audio of Wednesday's public meeting will be available in the chapel at the VA.
Those who don't get an opportunity to publicly testify may do so by visiting: http://www.va.gov/CARES.
FACTORS TO BE CONSIDERED
Options for the VA facility and health-care services in Walla Walla will be determined by PricewaterhouseCoopers on these factors:
The VA forecast of demand for health care.
Condition of existing facilities and future modernization needs.
Stakeholder opinions and preferences.
Potential re-use/redevelopment of excess land or buildings.
Whether the VA should own or lease the delivery site.
Whether the VA should deliver the care or use community health-care providers.
Each acceptable business plan option should:
Maintain or improve overall health-care quality.
Maintain or improve veterans' access to care.
Result in a cost effective configuration of VA physical and operational resources.
Result in a modernized, safe, health-care delivery environment.
Maximize the re-use/redevelopment potential of VA-owned sites.
Information provided from a congressional briefing on the VA study process.
FACILITIES UNDER SCRUTINY
Walla Walla's VA medical center is one of at least 18 facilities where services are under scrutiny. Between now and June 7, Local Advisory Panels in each community will hold similar hearings as they take the first step in the study process.
Other hospitals and services are being examined in:
Perry Point, Md.
St. Albans, N.Y.
West Los Angeles, Calif.
White City, Ore.
Montrose/Castle Point, N.Y.
Big Spring, Texas.
Poplar Bluff, Mo.
TIMELINE OF THE VA PROCESS
The U.S. Department of Veterans Affairs began the Capital Asset Realignment for Enhanced Services study of its facilities and health-care service.
CARES recommends contracting, where appropriate, inpatient and psychiatric care and moving outpatient services to an unspecified location.
Sen. Patty Murray, D-Wash., secures a field hearing of the Senate Veterans Affairs Committee in Walla Walla to take testimony on proposed changes.
The city of Walla Walla asks the VA to reconsider the CARES recommendation.
Veterans and advocates of Walla Walla's VA medical center rally against the closure, marching through downtown and assembling at the First Congregational Church to hear speakers call for action.
Jonathan Perlin, the acting undersecretary for the VA's health administration, meets with veterans and supporters of the VA to hear concerns. The visit was arranged by U.S. Rep. George Nethercutt, R-Wash.
The Union-Bulletin runs a five-day series examining the proposal and potential effects on veterans, health-care delivery, employment and the economy.
Walla Walla hosts a sometimes contentious field hearing of the Senate Veterans Affairs Committee. An interrogation by Murray reveals the VA has no plans to build long-term or mental health care facilities to replace those that would potentially close. She vows to take the battle back to Washington, D.C.
The city, county and Port of Walla Walla send a letter to VA Secretary Anthony Principi, asking him to delay a decision and work with the community on plans for the medical facility.
The Bush administration withdraws the recommendation for Walla Walla's VA and orders further study on the facility and services, along with 17 other facilities. The studies are to be completed by the end of 2004 with input from appointed advisory panels and a hired consultant. Federal VA officials vow the facility will remain open through the process.
Murray proposes an amendment to a Senate bill, calling for the consent of Congress before mission changes are accepted at any veterans hospital.
Nethercutt authors an amendment guaranteeing the community a voice in any mission change.
A group of local people _ including government, education and business officials, along with veterans and representatives of veterans service groups _ organize a 20-member Community Task Force. The task force aims to conduct its own research.
The federal study process is delayed so VA officials can determine the composition of the federal advisory panels that will report to the yet-to-be-named consultant.
The Department of Veterans Affairs names the advisory panel. Five of the 10 members represent Walla Walla government, businesses, education and veterans.
Congress appropriates $250,000 in an omnibus bill for an economic development study of Walla Walla's VA facility.
The Community Task Force releases its 250-page draft findings of services and facilities.
The report shows that, despite the CARES Commission's recommendation to contract out for many services, there are no local agencies that can absorb the patient load.
Members of the Community Task Force call for more local representation on the 10-member advisory panel that will work with the contractor. They want additional members to represent elected officials, the VA's union employees and the Confederated Tribes of the Umatilla Indian Reservation.
The U.S. Department of Veterans Affairs rejects the request for more representation on the advisory panel.
PricewaterhouseCoopers receives the VA's $9.6 million contract to consult on studies of Walla Walla's and 17 other VA facilities. The studies are expected to be complete by February 2006.
Jim Nicholson is confirmed as secretary of the U.S. Department of Veterans Affairs. He succeeds Principi, who resigned.
The initial meeting of the Local Advisory Panel, expected in March, is postponed.
The VA adds Leo Stewart to the Advisory Panel to represent the Tribes.