Senators Urge Action on Delayed V-A Medical Leases
Eighteen major medical leases in 12 states have been awaiting congressional action for more than one year
May 24 2016
Washington – Today U.S. Sen. Mark R. Warner (D-VA) led a bipartisan group of 15 Senators in urging the Senate Committee on Veterans’ Affairs to authorize leases for 18 major medical facilities across 12 states that have been awaiting congressional authorization for over a year. Under current law, the Department of Veterans Affairs (V-A) must receive specific legislative authorization to lease medical facilities with average annual rental payments in excess of $1 million. But since 2012, Congress has not, through a regular process, authorized any V-A major medical facility leases, hampering the ability of the V-A to provide much-needed health care and services to veterans around the country.
Among the projects stuck in limbo is a 155,000 square foot outpatient facility in Hampton Roads, Virginia, which has one of the fastest-growing veterans populations in the country. Patient visits in Hampton's service area increased by 30.5 percent from 2011 to September 2014, while the national average across the V-A system was 8.6 percent.
“This issue is personal to me. Not long ago, the V-A medical center in Hampton had one of the longest wait times in the nation for veterans attempting to access the care they have earned. I worked closely with the local leadership – including three in-site visits in 9 months – to reduce wait times and make sure that veterans are able to access medical services in a timely manner,” said Sen. Warner. “But the doctors, nurses, physician assistants, social workers, and support staff at Hampton VAMC are managing a patient workload that has grown at nearly four times the national average. The simple fact is, the wait times can and will go back up unless Congress does the right thing and authorizes a new outpatient facility for Hampton Roads, which has one of the fastest-growing veterans populations in the country.”
One reason for the delay in congressional authorization has been a recent change in the way that the Congressional Budget Office (CBO) scores these leases. Prior to 2012, the V-A classified major medical facility leases as operating leases and recorded the obligations on an annual basis in an amount equal to the lease payments due in that year, and the CBO used V-A’s classification to score the legislation.
In 2012, CBO determined that budget authority for these leases, many of which cover a 20-year period, should be recorded up front when the leases are initiated and the acquisition occurs, not when the debt is repaid. As such, scoring for legislation that authorized these leases increased significantly, even though actual spending would not increase and the leases are ultimately subject to annual appropriations.
The scoring change has stymied efforts to authorize any V-A major medical facility leases. Currently, 18 leases in 12 states from fiscal years 2015 and 2016 have been pending authorization in Congress for more than one year. The CBO scores the overall cost of these 18 leases at $904 million. In a letter to the Senate Veterans’ Affairs Committee today, Sen. Warner and his colleagues urged the Committee to allow leases to go forward on the 18 facilities from FY 2016 and FY 2017 while Congress seeks a more permanent resolution on the scoring challenges facing these leases.
Writing to Committee Chairman Johnny Isakson (R-GA) and Ranking Member Richard Blumenthal (D-CT), the Senators urged, “These lease authorizations are needed to enable the VA to deliver care and services to veterans across the United States… As such, we ask that you act swiftly to authorize these pending leases until a more permanent solution to the issue can be found. Inaction on this issue hampers the ability of veterans in our states to access timely and quality care from the VA.”
The 18 leases that are pending from FY 2015 and FY 2016 are:
- Ann Arbor, MI - Outpatient Clinic
- Birmingham, AL - Outpatient Mental Health Clinic
- Birmingham, AL - Outpatient Specialty Clinic
- Boston, MA - Research
- Charleston, SC - Research
- Daytona Beach, FL - Outpatient Clinic
- Denver, CO - Chief Business Office Purchased Care
- Gainesville, FL - Outpatient Clinic
- Hampton Roads, VA - Outpatient Clinic
- Mission Bay, CA - Research
- Missoula, MT - Outpatient Clinic
- Northern Colorado, CO - Outpatient Clinic
- Ocala, FL - Outpatient Clinic
- Oxnard, CA - Outpatient Clinic
- Pike County, GA - Outpatient Clinic
- Portland, ME - Outpatient Clinic
- Raleigh, NC - Outpatient Clinic
- Santa Rosa, CA - Outpatient Clinic
In addition, the issue is expected to affect six leases for FY 2017:
- Corpus Christi, TX – Replacement Outpatient Clinic
- Jacksonville, FL – Replacement Outpatient Clinic
- Pontiac, MI – Replacement Outpatient Clinic
- Rochester, NY – Replacement Outpatient Clinic II
- Tampa, FL – Replacement Lakeland Outpatient Clinic
- Terre Haute, IN – Replacement Outpatient Clinic
In addition to Sen. Warner, the Senators who signed today’s letter are Sens. Michael Bennet (D-CO), Richard Burr (R-NC), Susan Collins (R-ME), Steve Daines (R-MT), Kirsten Gillibrand (D-NY), Tim Kaine (D-VA), Angus King (I-ME), Ed Markey (D-MA), Bill Nelson (D-FL), Gary Peters (D-MI), Chuck Schumer (D-NY), Debbie Stabenow (D-MI), Jon Tester (D-MT), and Elizabeth Warren (D-MA).
A signed PDF of the letter is available here.
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