WASHINGTON – Creation of six new outpatient clinics, shifting inpatient services from Knoxville to Des Moines and planned improvements to the Des Moines and Iowa City facilities are part of a comprehensive plan by the Department of Veterans Affairs (VA) to modernize its nationwide system of health care facilities.
"These changes will provide greater access to care for veterans," said Secretary of Veterans Affairs Anthony J. Principi. "By strengthening our network of outpatient clinics, we will bring a greater quality of care closer to where most of Iowa’s veterans live."
Nearly 72,000 of Iowa's 281,000 veterans were treated last year in VA's health care facilities, up from 46,000 in 2000. In 2003, VA spent $551 million in Iowa, an increase from $439 million three years before.
Secretary Principi noted that about 80 percent of the health care provided by VA is outpatient care. He said the plan would allow the department to provide more of the outpatient care veterans want and use, while building upon VA's expertise in providing highly specialized inpatient care.
The changes are part of a comprehensive plan called CARES, short for "Capital Asset Realignment for Enhanced Services." The secretary's announcement on CARES can be viewed in its entirety on VA's Web site at http://www.va.gov/CARES.
Briefly the secretary’s CARES announcement includes the following for Iowa:
Develop six new Community Based Outpatient Clinics (CBOCs) in Carroll, Marshalltown, Cedar Rapids, Ottumwa, Shenandoah and SpiritLake by 2012;
Modernize and optimize space at the Des Moines and Iowa City facilities; and
Improve resource use, coordination of care, and the environment of care by relocating all inpatient, intermediate medicine and rehabilitation beds, nursing home care and domiciliary care at Knoxville to Des Moines.
CARES is a plan to modernize and improve VA's health care system and the Secretary’s CARES Decision is the blueprint for improvements to the VA healthcare system for the next 20 years. Among the elements of the secretary’s CARES report are more than 150 new community based outpatient clinics, potential creation of four new - and expansion of five existing - spinal cord injury centers, two new blind rehabilitation centers, and expansions throughout VA’s health care system that will enhance veterans’ access to VA care.
In July 1999, a General Accounting Office study found that VA was diverting a million dollars a day – or $3.6 billion during a decade – from veterans' health care to maintenance on unneeded or unused facilities. The average age of VA's more than 4,900 buildings is more than 50 years, and the need to reduce vacant space and unneeded buildings has been the focus of several reports by the General Accounting Office.
In Knoxville, there are nearly 177,000 square feet of unused space out of a total of 438,000. By realigning services from Knoxville to Des Moines, VA will improve resource use while also enhancing the environment of care and care coordination for Iowa veterans.
CARES was developed to identify the infrastructure VA will need to care for veterans in the 21st century, redirecting resources from unneeded buildings to veterans' care. Savings from CARES will be retained locally and used locally to strengthen health care services for local veterans.
"CARES modernizes VA’s 74-year old health care system," said Principi. "I want to emphasize that no veteran will lose health care as a result of CARES, nor will there be any gaps in their health care services."
The CARES plan was reviewed by an independent commission, which received more than 212,000 comments and held 81 site visits to VA and Department of Defense medical facilities, and State Veterans Homes, 38 public hearings and 10 formal meetings. The commission submitted its recommendations to Secretary Principi in mid-February.
