Report recommends closure for Jack C. Montgomery VA Medical Center

Mar. 15—Department of Veterans Affairs officials cited declining enrollment and increased demand for long-term and outpatient care as grounds for recommending the closure of Jack C. Montgomery VA Medical Center once a new hospital and other veterans health facilities are built and open in Tulsa.

These recommendation and others were included in a comprehensive report to the AIR Commission, which was created by the VA MISSION Act of 2018. The commission was created for the purpose of realigning and modernizing veterans health care.

The report, which was published Monday, notes the veteran population within the Eastern Oklahoma Market "is concentrated in the Tulsa area." A cost-benefit analysis shows it would cost just about as much to shutter the Muskogee VAMC and realign services with the veteran population in Tulsa than stay the course as previously planned.

"Once the new VA hospital is developed, the aging Muskogee VAMC will decant inpatient services to the new hospital and all other services to other VA locations, and close," VA officials state in the report, noting plans to expand outpatient services. "The strategy for the market is intended to provide Veterans today and in the future with access to high-quality and conveniently located care in modern infrastructure."

The report also recommends moving inpatient mental health treatment from the Muskogee-based VAMC to community care providers in the area until a new behavioral health hospital is built. The re-missioned Sheridan, Wyoming, VAMC "will offer a well-developed array of mental health services and will serve as the mental health destination campus for VISN 19. "

Three members of Oklahoma's congressional delegation — U.S. Senators James Lankford and Jim Inhofe, and U.S. Rep. Markwayne Mullin — released a joint statement Monday after the report was published. All three supported passage of the VA MISSION Act of 2018, which authorized the review intended to "modernize and realign" veterans health care.

"It's appropriate for the VA to conduct reviews like this to ensure we continue to serve veterans in the best ways possible," the three said in the joint statement. "But we are not convinced that the contents of this report accurately reflect the needs of veterans' health care, especially mental health, in our state right now."

They referenced previous commitments by the Trump administration for an expansion of Tulsa facilities and a new Tulsa hospital. That commitment included the conversion of Muskogee VAMC to a behavioral health facility.

"The arrangement for the expansion of the facility in Tulsa assumed we would increase mental health and substance abuse for our veterans, not contract it as this proposal suggests," Lankford, Inhofe and Mullin said. "The need for direct access to mental health and behavioral health for veterans in our state has only increased."

Challenges at Jack C. Montgomery cited by VA officials include a $67.9 million in facility condition assessment deficiencies. Other challenges, according to the report, "range from aged domestic water and steam distribution infrastructure to slope destabilization and poor electrical distribution."

Estimated annual cost of operating and maintaining VA Medical Center in Muskogee is $8.06 million, according to the VA report. The projected cost of carrying out the recommendations to the AIR Commission is $8.78 million, just slightly more than the $8.56 million cost of maintaining the status quo.

Key elements of the market strategy recommended for veterans health care in eastern Oklahoma include:

—Providing equitable access to outpatient care at modern facilities located close to where veterans live, integrating the use of virtual care.

—Enhancing VA's strengths in caring for veterans who have complex needs.

—Providing equitable access to inpatient medical and surgical care through the optimized use of care delivered by VA facilities in partnership with community providers and through virtual care.

The recommended closure of Muskogee VAMC would be accompanied by establishing a new community-based outpatient clinic at Muskogee. Outpatient services also would be available in Tulsa.

Oklahoma's congressional delegation expressed concern the surrounding community might be unable to accommodate the influx of mental health patients while a new behavioral health hospital is being built.

"We are committed to veterans' access to quality healthcare and will continue to assess the full impacts of this report to see what is in the best interest of our Oklahoma veterans," Lankford, Inhofe and Mullin said. "We just received this report, and there will be many questions that need to be answered before going forward."

During the next year the AIR Commission will conduct public hearings, visit VA facilities, meet with employees and partners, and gather input from veterans. AIR Commission members will assess recommendations, make necessary revisions, and then forward them to the president.

President Joe Biden will decide whether to submit the recommendations to Congress, which can accept those recommendations as a whole by inaction or reject them by passing a joint resolution. If the recommendations are approved, the VA must begin implementation within three years — timelines for completion will vary by market according to priorities and funding.