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Sen. Warner honors local veterans in Keswick, Virginia Nov. 11, 2015

Sens. Mark R. Warner and Tim Kaine are among a group of senators pushing for action on a list of stalled health care projects at the Department of Veterans Affairs that includes an outpatient center planned for South Hampton Roads.

Fifteen senators sent a letter Monday to the leaders of the Senate Veterans Affairs Committee urging authorization of leases for the projects. The list includes three each in California and Florida, research facilities in Boston and Charleston, S.C., and a business office in Denver.

In all, 18 projects can't get off the ground.

In South Hampton Roads, the proposed 155,200-square-foot facility is aimed at easing the workload at the Hampton VA Medical Center, where demand has skyrocketed. Patient visits in Hampton's service area increased by 30.5 percent from 2011 to September 2014. The national average across the VA system was 8.6 percent during that time.

The center would be the first of its kind in Virginia, officials have said. It would offer primary and specialty care, day surgery, an eye clinic, pharmacy and radiology services. Two similar centers are operating in North Carolina, another high-growth area for veterans care. Three more are under construction.

The holdup is tied to a change in how these projects are scored by the Congressional Budget Office. The projects are submitted as leases — even if it results in new construction, the VA would lease the site to a third party.

Prior to 2012, CBO calculated the annual cost of the lease in determining budget impact. But starting in 2012, CBO decided it should include the total cost up front, when the site is acquired and the leases are signed. In some cases, the term runs for 20 years.

That has made it more challenging to find room in the budget. The law requires the VA to receive specific authorization to lease medical facilities with average annual rental payments that exceed $1 million. Of the 18 on the list, Hampton's is third-largest at $18.1 million.

"Authorization of these leases has been hampered by a score-keeping issue," the senators' letter states, referring to the CBO change. It later adds: "This scoring change has stymied efforts to authorize any major medical leases."

The letter was sent to Sen. Johnny Isakson, chairman of the Senate veterans affairs panel, and the ranking Democrat, Sen. Richard Blumenthal.

The South Hampton Roads center is considered a top priority for the Hampton VA Medical Center. Its service area stretches from the Eastern Shore to parts of North Carolina. Although centered in Hampton, much of its patient growth is south of the water, in Norfolk and Virginia Beach.

During a visit in July 2015, Deputy VA Secretary Sloan Gibson predicted the new health care center would be popular — and it still wouldn't be enough to meet the growing need.

He said he sensed "a substantial amount of unmet demand" for veterans health care in the region.

The project also ranks high on the radar of Sen. Warner, who has expressed frustration at the delay.

"This issue is personal to me," he said in a statement emailed to the Daily Press. "Not long ago, the VA 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.

"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.'

Sen. Kaine said he was "proud to join Senator Warner in this commonsense effort because authorizing a new outpatient facility in Hampton Roads will significantly help fulfill the promise of timely, quality health care for those who have sacrificed so much in service to our country."