VA may lose some programs

The US Department of Veterans Affairs is considering closing parts of the Edith Nourse Rogers Memorial Veterans Hospital in Bedford, and leasing portions of the campus to private developers of housing for seniors.

The 180-acre campus on Springs Road has taken center stage in the VA's latest efforts to reorganize the VA Boston Healthcare System and streamline the region's four medical centers. VA officials have been considering ceasing operations at the Bedford campus completely, and relocating its services and programs to the Brockton VA.

The new proposal, recommended by outgoing VA Secretary Jim Nicholson and unveiled last week, would keep part of the Edith Nourse Rogers Memorial Veterans Hospital open, and relocate some of its programs to Brockton.

Both moves would allow the VA to lease out and redevelop portions of the campus.

No final decisions have been made. The public has until Oct. 1 to weigh in with opinions before a final report is given to the Veterans Affairs secretary, who will decide the fate of the region's VA facilities.

"We hope to have a decision by the end of October," said Jay Halpern, special assistant to Nicholson.

Under the latest proposal, Bedford would keep its Alzheimer's and geriatric research centers, nursing home, and outpatient services and get new state-of-the-art facilities, and its psychiatric and mental health services would relocate to the 442-bed Brockton VA. Parts of the Bedford campus would be leased to developers who would build retirement homes and assisted-living communities.

"The secretary realizes the emotions that are tied into this, and perhaps it would be best to rebuild a beautiful, new modern Alzheimer's unit [on the Bedford campus], and also keep the current outpatient services there as well," said Halpern.

Three options proposed by the consulting firm PricewaterhouseCoopers involve closing Bedford and moving all services to Brockton. (Under these plans, VA facilities in Jamaica Plain and West Roxbury may be consolidated.) Then there is the baseline option: Keeping open all four VA medical centers in Bedford, Brockton, Jamaica Plain, and West Roxbury.

The future of the Bedford campus and the rest of the region's VA medical centers have been in limbo since 2003, when the VA embarked on a nationwide effort to update and streamline its facilities and lease out any unused property. As part of this initiative, known as Capital Asset Realignment for Enhanced Services, or CARES, the VA awarded a $10.5 million contract to PricewaterhouseCoopers to conduct studies of VA facilities at 18 sites across the country. At one point during the process, in 2005, there was talk of closing the VA medical centers in Bedford, Brockton, Jamaica Plain, and West Roxbury, and building a new VA medical megacomplex in Boston. That plan is no longer being considered.

PricewaterhouseCoopers in July issued a report that describes the potential uses of the Bedford VA campus. The report suggests that 100 clustered, single-story townhouses for seniors could be built on 13 acres there. Seniors moving into this new housing development would pay a deposit of about $200,000 per unit, and then would be charged a monthly fee, according to the report. ("Residents can generate the entry fee through sale of their existing house, and can recoup the entry fee when they leave the elderly community," the report states.)

Builder Hearthstone Associates has also proposed an 80-bed assisted-living facility for people with Alzheimer's on the Bedford campus, according to the report.

Hearings would be held and a competitive bid process would be held before the VA enters any leases, Halpern said.

The US Department of Veterans Affairs is in a position to consider these options because it is one of the only federal agencies authorized to enter leases with private companies. In April 2005, the VA awarded a $60.5 million contract to MicroTech LLC to provide assistance with "enhanced-use lease" projects that benefit the VA.

The VA broke ground on one of the first public-private partnership projects of this kind last November, when it leased the former Fort Howard VA Medical Center in Maryland to a private developer who plans to build a "veterans-focused" retirement community called the Bayside at Fort Howard. Market-rate rents at this 1,300-unit development will range from $1,100 to more than $4,500, depending on the unit: Two-bedroom assisted-living apartments will start at $4,420; assisted-living studio apartments at $2,491; cottages for people 55 and older at $3,078; and studio apartments for people 55 and older at $1,045. Veterans will be eligible for a 5 to 15 percent discount on a limited number of these units; they would be eligible to get a 20 percent discount on skilled nursing services at Bayside, which cost up to $175 per day.

Edith Nourse Rogers Memorial Veterans Hospital, a 437-bed facility, specializes in geriatric, psychiatric, and long-term care. It has 789 full-time employees and serves veterans in Eastern Massachusetts, southern New Hampshire, and southern Maine.

When the various restructuring proposals were discussed Monday at a public hearing in Boston, many veterans and local officials said they did not want to see any VA medical facilities closed; if anything, they'd like to have more.

Richard J. Hand Jr., legislative officer for the American Legion Post 147 in Rockland, criticized the VA's overall restructuring initiative, and questioned the focus on renovating or consolidating all four VA facilities simultaneously, instead of one at a time.

"Why do all four at once?" he asked at the hearing. "Large amounts of cash are being spent on these CARES studies. This process goes against everything the United States of America stands for. . . . All the praises and flag-waving aren't cutting it. We need more [services], not less."

US Representative John F. Tierney's testimony on Monday also questioned the CARES process. Tierney noted a recent Government Accountability Office report that found that the VA does not centrally track or monitor the results of its CARES decisions.

Tierney's prepared testimony, as it appears on his website states: "If VA is not monitoring the implementation of the current CARES decisions, what data do they have to support the claim that 'synergies' or 'more enhancement' may result if Bedford's unique programs are transferred to Brockton? Just saying 'synergies' or 'more enhancement' may happen certainly doesn't make it so."

Emily Sweeney can be reached at esweeney@globe.com.

What do you think?
The public can submit comments to the VA online at va.gov/cares, or by mail to VA Cares Studies - Boston Study, PO Box 1427, Washington Grove, MD 20880-1427. The public comment period ends Oct. 1.

Share your opinions with us anytime at boston.com/northwesttalk, or e-mail us at globenorthwest@globe.com with your name, hometown, and a daytime phone number (for verification only).