WASHINGTON, D.C. – U.S. Sen. Sherrod Brown (D-OH) is pushing the Department of Veterans Affairs (VA) for answers on plans to consolidate staffing levels at the Chillicothe VA Medical Center (VAMC) and surrounding Community Based Outpatient Clinics (CBOCs). In a letter to VA Network Director RimaAnn O. Nelson, Brown requested detailed responses concerning the impact that consolidating specific positions will have on the availability of quality and timely care for veterans in the region.

 “It has come to my attention that VA is in the process of consolidating positions within the facility, and neither the decision to do so nor the process has been transparent with veterans, their families, or local stakeholders. Any decision to consolidate services at a facility or close a medical service line should be transparent and provide for opportunities for the community to provide feedback,” Brown wrote. “I am aware that the Chillicothe VAMC sent you a proposal to consolidate positions, shift care to the Community Care Network, and close down a CBOC.

Brown continued, “As I mentioned in my earlier letter to you, when Congress passed the VA MISSION Act, it was to supplement existing VA healthcare, not replace those services. If you are considering this plan because the VISN needs additional funding, I recommend VA bring the budget deficits to Congress instead of putting a finger on the scale in favor of sending more veterans out into the community. If you have already approved this sweeping plan, then I’d like a detailed breakdown of how this will impact patient care.”

Brown is requesting detailed responses on what employees have been transferred from the Chillicothe VAMC and its surrounding CBOCs to other VAMCs or CBOCs in Ohio, and what factors contributed to VA’s decision to consolidate some positions and whether the VISN has approved new consolidated positions. The senator also questioned whether the VAMC plans to rely more heavily on Contract EMS providers to fill EMS vacancies and prevent gaps in care.

A copy of Brown’s letter can be read here and below.

Dear Ms. Nelson:

I write to share my concerns regarding staffing levels at the Chillicothe VA Medical Center and surrounding Community Based Outpatient Clinics (CBOCs) and the impact that this will have on quality, timely care for the region’s veterans. Earlier this year, I wrote to you to ask whether the VISN was consolidating specific positions because of budgetary restraints and now it appears that it is. Understanding that COVID-19 has caused certain disruptions in the way that veterans normally receive care, this shift to consolidate staff and possibly close a CBOC, which could push more veterans into the community, is a serious concern. I request a detailed response to my questions below and a briefing with you as soon as possible.

It has come to my attention that VA is in the process of consolidating positions within the facility, and neither the decision to do so nor the process has been transparent with veterans, their families, or local stakeholders. Any decision to consolidate services at a facility or close a medical service line should be transparent and provide for opportunities for the community to provide feedback. I am aware that the Chillicothe VAMC sent you a proposal to consolidate positions, shift care to the Community Care Network, and close down a CBOC. As I mentioned in my earlier letter to you, when Congress passed the VA MISSION Act, it was to supplement existing VA healthcare, not replace those services. If you are considering this plan because the VISN needs additional funding, I recommend VA bring the budget deficits to Congress instead of putting a finger on the scale in favor of sending more veterans out into the community. If you have already approved this sweeping plan, then I’d like a detailed breakdown of how this will impact patient care

My staff was informed that some services at Chillicothe would be closed due to the pandemic. They have also heard some startling information about the treatment of COVID patients at the facility. I recognize some steps need to be put in place to properly care for patients and limit exposure risks, but if this plan is an attempt to whittle down services at the facility that is unacceptable. If the details that have been shared with me are true, this shift could affect the quality care veterans have come to trust from VA. I request a copy of the proposed consolidation plan, the staffing models and other veteran analysis that went into pushing this proposal. In addition, I encourage you to invite community feedback from veterans, their families, and other southeast Ohio stakeholders before moving forward with any decision.

As I mentioned in my earlier letter, VA should increase communication with Congress, its workforce and their representatives, and the veterans that VA serves to ensure they receive the care that they need where they prefer to receive it, at VA. Because each VA facility has a specific patient care model that represents the number of medical professionals needed to provide the quality health care that veterans have come to rely on within the VA medical system, this practice of consolidating positions will have a negative impact on patient care. My office has heard directly from VA front line employees about the proposed consolidation and how it would significantly increase the workload of employees, and without proper resources, could affect veteran care. Additionally, I have heard that there is undue pressure for long-time employees at Chillicothe VAMC to retire early in order to create a position opening that can be combined with another role.

My office periodically holds roundtable discussions veterans, Veteran Service Office employees, and VA employees, and from those discussions, we have heard about long wait times for primary and specialty care. It is unclear how consolidating positions and closing a CBOC will help improve wait times for veterans. I urge you to have all VA leadership meet regularly with veterans, their families, and frontline employees to consult workers and stakeholders before VA makes decisions that will affect the workforce and patient care. VA should ensure that the Chillicothe VAMC is staffed to meet the needs of their veteran population.

Therefore, I respectfully request responses to the following questions by December 30.

How many positions have you consolidated at the Chillicothe VAMC and the surrounding CBOCs in the last year?

How many employees have been transferred from the Chillicothe VAMC and its surrounding CBOCs to other VAMCs or CBOCs in Ohio? Please identify the position/specialty of each employee who was transferred, and the date of their transfer.

Did the Chillicothe VAMC see less patients this year, or were there other deciding factors for combining these positions?

As Chillicothe planned to consolidate some positions, did it also approve creating new positions? If so, please provide a full breakdown of all initial positions, the new consolidated positions, and any newly created positions. Please all break down via role and General Service level.

Does Chillicothe VAMC plan to rely on the Community Care Network to provide care instead of expanding services within the Medical Center? If so, has VAMC leadership worked with local community providers and the Third Party Administrator to ensure that there are providers to meet veterans’ care needs?

Please provide details of Chillicothe VAMC’s proposal to encourage employees to retire early, in order to combine positions with another?

Has Chillicothe VAMC submitted a staffing attrition proposal to the VISN for approval? Has it been approved and if not, what is the timeline for this decision?

Has Chillicothe VAMC proposed closing down any CBOCs? If so, which CBOC(s) and why was this recommendation made?

Does the Chillicothe VAMC plan to rely more heavily on contract EMS providers? Will contract workers be used to fill EMS vacancies that occur through attrition?

Sincerely,

###