VA plan would move all services to Uptown Division despite Downtown Division ties with AUMC

The Downtown Division of Charlie Norwood VA Medical Center would see drastic change under a realignment plan by the U.S. Department of Veterans Affairs. Most services for veterans in the Augusta area would be consolidated into one of two divisions of the Augusta VA. Previous realignment efforts at the VA have scrutinized closing one or the other VA hospital in Augusta without results. The Downtown Division is also entwined with services at the neighboring AU Medical Center.

The VA released its lengthy and detailed Asset and Infrastructure Review report earlier this week, which seeks to create a more efficient care system "with the right facilities, in the right places, to provide the right care for all Veterans, including underserved and at-risk Veteran populations in every part of the country," the VA said when it released the report. The recommendations will go to a commission that will review them before sending final recommendations to President Biden next year.

Under the plan for the Augusta market, which is expected to see increased demands for VA health care, a replacement patient care tower would be built at the Uptown Division off Wrightsboro Road. The existing building was constructed in 1991 and is considered ill-suited for modern care, according to the report. That site has 30 acres available for future growth on its 105-acre campus.

The Uptown Division's blind rehabilitation program would be increased from 15 beds to 35 and take in patients currently served by the Birmingham (Ala.) VA. The distinguished Spinal Cord Injury Unit at the Downtown Division would also move to the new facility at the Uptown Division and become the hub for those patients now being served in Alabama and South Carolina VAs under the plan.

All inpatient and outpatient care at the Downtown Division, which was built in 1980, would be transferred to the Uptown Division, although the report does not explicitly mention closing the facility as it does with others, such as the Dublin and Atlanta VA hospitals.

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Downtown Division linked to AU Health

The Downtown Division has close ties to Augusta University and its medical center. There is bridge over Harper Street connecting the Downtown Division to AUMC used by patients and staff to go back and forth. Many Augusta University faculty have dual appointments at the Augusta VA, and some do the bulk of their practice on the VA side, said Dr. Phillip Coule, chief medical officer for AU Health System.

"There is a wide variety of interactions on multiple different levels, both in terms of our patient care that we provide in this facility as well as that more academic and research component," he said.

In some cases, a patient may start off at the VA Downtown Division but get transferred quickly to AUMC.

"We provide in some cases time-sensitive care for heart attacks and strokes and things like that where we are able to do advanced therapies that the VA is not capable of doing," Coule said.

The report appears to be long-range planning and however it happens "we remain supportive of caring for our veterans as well as supporting (the VA) in caring for our veterans," Coule said.

Athens, Savannah services would expand

Noting increased demand for care outside the hospital setting, the plan supports increasing services at a VA community clinic in Aiken, and adding mental health services, where enrollment is expected to increase by 9.5%, from 6,883 to 7,535, by Fiscal Year 2029, according to the report.

That increased demand is also why the clinic in Athens would get more specialty services and increased care, with the number of patients expected to jump by 10.3%, from 2,093 to 2,308 by FY2029, the report said.

Savannah would benefit from a VA proposal for a "strategic collaboration" with existing providers in the community to provide inpatient medical, surgical and mental health care there as opposed to the Charleston VA hospital 100 miles away, according to the recommendations. Savannah would also get a new community-based clinic with increased capacity to serve an expected 30.7% increase in patients. The plan also calls for starting a residency program in Savannah in conjunction with Mercer University.

Nursing union says plan would harm veterans

The VA recommendations overall have already drawn fire from National Nurses United, a union that represents many VA nurses, including those in Augusta. The union contends the plan would close "vital" medical centers and is part of an attempted privatization of the VA health care system.

"There is no better place for veterans to get care than in the VA,” said Augusta nurse Irma Westmoreland, who is vice president of the union and its Veterans Affairs chair. “We see that every day in our hospitals and clinics. We know if VA facilities close, veterans will be dumped into the fragmented, hard-to-navigate private sector, which threatens their well-being and their lives.”

Previous VA efforts to streamline its facilities have targeted Augusta and other cities where there are multiple VA hospitals. A 2003 effort zeroed in on closing the Uptown Division, although an analysis of that move showed it would be costly to the VA and might force patients to move elsewhere to receive care. That plan drew the ire of the state of Georgia as a result. The Uptown Division was ultimately spared.

Recalling that closure attempt and perhaps another in the 1990s, "the reality is not much has changed," Coule said.

This article originally appeared on Augusta Chronicle: VA plan moves all Augusta services Uptown, leaves Downtown in limbo