U.S. Senators Susan Collins and Angus King and U.S. Representatives Chellie Pingree and Bruce Poliquin today sent a letter to the Office of Management and Budget and the U.S. Department of Veterans Affairs (VA) requesting that they include funding for 24 VA medical facility leases in the President’s FY 2018 budget request. The letter also urges the administration to assume authorization of the leases and partner with members of Congress to raise awareness about the need for a permanent solution to the delays in authorizing VA major medical facility leases.
Under law, the VA must receive specific legislative authorization to lease medical facilities with average annual rental payments in excess of $1 million. However, since 2012, Congress has not, through a regular process, authorized any major VA medical facility leases, hampering the ability of the department to provide much-needed health care and services to veterans around the country. The majority of these medical facilities – located in 15 states and serving an estimated 11 million veterans – have been awaiting Congressional approval for more than a year.
“Many of these leases will serve urgent needs in the veteran population for accessible, high-quality medical services,” the Members of Congress wrote. “In numerous cases, the leases will greatly reduce veterans’ commuting times for care or replace cramped and antiquated facilities with modern facilities that offer increased services, including expanded critical health care services. Some of the leases will consolidate multiple existing facilities, thereby reducing inefficiencies and simplifying veteran care. Finally, the facilities will address projected future growth in veteran demand for services.”
One reason for the delay in congressional authorization has been a recent change in the way that the Congressional Budget Office (CBO) scores the cost of VA’s leases. Prior to 2012, the major medical facility leases only required an annual budgetary offset to fund each year of rent under the lease, but that year, CBO determined that the total cost of these leases, many of which cover a 20-year period, should be recorded entirely up front when the leases are initiated and the acquisition occurs. As such, any legislation authorizing these VA medical facilities leases requires full budgetary offsets covering the entire life of the lease, even though actual spending would not increase and the leases are ultimately subject to annual appropriations.
The proposed VA Community Based Outpatient Clinic (CBOC) in Portland would consolidate the existing Saco and Portland CBOCs and enhance VA outpatient services. The lease would increase veterans’ access to a core set of services and additional specialty care in a state-of-the-art, energy efficient health care facility in the Portland-area. The planned full deployment of tele-medicine technologies in the new clinic would further improve veterans’ access to care in rural locations throughout Maine. Congresswoman Pingree and Congressman Poliquin have also cosponsored a companion bill in the House.
In January, Senators Collins and King reintroduced the bipartisan Providing Veterans Overdue Care Act, to authorize the pending leases for the 24 VA medical facilities in Congress. Congresswoman Pingree and Congressman Poliquin have also cosponsored a companion bill in the House.
The complete text of the letter can be read below:
May 19, 2017
The Honorable Mick Mulvaney
Office of Management and Budget
The Honorable David Shulkin
U.S. Department of Veterans Affairs
Dear Director Mulvaney and Secretary Shulkin:
As you finalize the President’s fiscal year (FY) 2018 budget request, we ask that the Administration commit to ensuring that our nation’s veterans are able to access critical medical services in a timely manner. To that end, we have introduced bipartisan legislation in both houses of Congress to authorize 24 Department of Veterans Affairs (VA) major medical facility leases in 15 states across the United States that have a combined population of more than 11 million veterans. These leases were evaluated and requested by the VA in the agency’s FY 2016 and FY 2017 budgets, and funding has been included in previous appropriations legislation. A scorekeeping issue however, has prevented the Congressional authorizing committees from moving forward with these much-needed leases. We are writing to ask for your help in moving authorizing legislation to enactment. At stake is the health and quality of life for thousands of our nation’s veterans.
The 24 leases will support facilities around the country, in the following cities: Ann Arbor, Michigan; Birmingham, Alabama; Boston, Massachusetts; Charleston, South Carolina; Daytona Beach, Florida; Denver, Colorado; Gainesville, Florida; Hampton Roads, Virginia; Mission Bay, California; Missoula, Montana;Northern Colorado, Colorado; Ocala, Florida; Oxnard, California; Pike County, Georgia; Portland, Maine; Raleigh, North Carolina; Santa Rosa, California; Corpus Christi, Texas; Jacksonville, Florida; Pontiac, Michigan; Rochester, New York; Tampa, Florida; Terre Haute, Indiana.
Many of these leases will serve urgent needs in the veteran population for accessible, high-quality medical services. In numerous cases, the leases will greatly reduce veterans’ commuting times for care or replace cramped and antiquated facilities with modern facilities that offer increased services, including expanded critical health care services. Some of the leases will consolidate multiple existing facilities, thereby reducing inefficiencies and simplifying veteran care. Finally, the facilities will address projected future growth in veteran demand for services.
The President’s FY 2018 Budget Blueprint (“Blueprint”) proposes to increase the VA’s discretionary funding levels by six percent. The Blueprint states that this funding will be used “to improve patient access and timeliness of medical care services” and to “enable the Department to provide a broad range of primary care, specialized care, and related medical and social support services to enrolled veterans, including services that are uniquely related to veterans’ health and special needs.” The 24 leases authorized by our legislation would go a long way to achieving both of those goals.
We therefore ask for your assistance in moving toward completing projects that are critical to providing access to health care for veterans, often in rural communities. Specifically, we ask that the President’s FY 2018 budget request assume authorization of, and fund, the 24 leases, and that the Administration send language to Congress that, if enacted, will authorize and fund the leases. We are confident that these actions will demonstrate the Administration’s support for the leases, and the veteran populations they are meant to serve, and will help advance authorization of the leases in Congress.
We also ask that you partner with us in raising awareness about the need to bring about a permanent solution to the delays in authorizing VA major medical facility leases. Specifically, we would ask that you reach out to each of the Congressional offices that has a currently pending lease to ensure they are aware of the issue affecting veterans in their states and encourage them to work with us and Senate and House VA Committees to seek a permanent solution to the problem.
We appreciate your consideration of this request and look forward to working with you to ensure that veterans have access to the timely, high-quality health care they have earned through their service to this country.