A debate over replacing Charleston’s Veterans’ Administration hospital caused a Congressional standoff in the final hours of the session last week. But House members successfully dug in their heels to preserve funding to design the facility, fending off arguments from Senators and the VA itself that the facility wasn’t necessary.
Much like kids in the last days before winter break, it’s hard to get members of Congress to focus. But South Carolina’s legislators tried to educate colleagues on the ingenuity of a new $600 million facility built by the VA, but shared with the Medical University of South Carolina through a lease agreement.
In the end, legislators agreed on a compromise proposal that would authorize $36.8 million to pay for design and engineering for the VA’s separate bed tower and the shared facilities, leaving MUSC to cover the costs to construct it’s adjoining bed tower.
The idea of MUSC and the VA collaborating isn’t anything new. The VA recently approved spending $6.7 million on new equipment that will be housed and operated by MUSC, and the staff for the two facilities isn’t just similar, it’s near identical, according to MUSC’s President Raymond Greenberg.
“Almost all of the staff at the VA has a faculty appointment at MUSC,” he says. “We share a lot of personnel and have shared personnel since the VA was built.”
Now authorized by Congress, the $36.8 million to design the replacement for the 40-year-old Ralph H. Johnson Medical Center will need to be included in an appropriations bill during the next term.
The measure received strong support in the House, led by Veteran Affairs Chairman Steve Buyer (R-Ind.), a Citadel grad, and local Rep Henry Brown (R-S.C.). The problem is that everyone thinks it’s a great idea except for the U.S. Senate and the Veterans’ Administration itself.
“The reality, from what I understand, is that at this point the Secretary of the VA believes there are more pressing capital construction commitments,” says Florence Huchison, acting director of the Charleston VA hospital.
And why not? The Charleston facility may be 40, but it’s faring far better than Denver and Orlando, two towns that were up for new hospitals in the same authorization bill. Both projects would have been stalled without the last-minute compromise.
It’s not because Charleston is the most needy, Greenberg concedes, but because it’s an opportune setting to test a new model, where VAs are paired with traditional facilities. The move could provide a cost savings as dozens of hospitals face replacement demands in the next few decades.
“They’re all coming sooner or later to their natural life expectancy,” Greenberg says. “The question is, can we afford to build 150 standalone VA hospital replacements?”
Birthed in Charleston, the concept of shared space will soon be put into practice in New Orleans, where both the VA and the hospital used by Louisiana State University were destroyed in Hurricane Katrina. Greenberg says that’s a whole different animal because they’re building from nothing, where Charleston would be the test model in designing a shared facility from two standing hospitals.
As for last week’s standoff, as days wore on and the elections passed, the House and Senate each refused to budge on their positions on the Charleston funding. Responding to pleas for action from the Florida delegation, Veteran Affairs Committee Chair Sen. Larry Craig (R-Idaho) and ranking member Sen. Daniel Akaka (D-Hawaii) replied in a Nov. 30 letter that Charleston was the poison in the water.
“This one provision appears to be the linchpin in nearly two years of legislative work in other areas of policy affecting veterans’ health care and benefits,” the letter states.
Veterans and senators have worried over the partnership because of concerns that vets would move to the back of the line for some treatment and would lose the unique companionship among veterans in a standalone facility, but Greenberg says that MUSC has worked to iron out those concerns by assuring that vets will get equal or better priority for medical equipment and they’ll have a separate bed tower exclusively for veterans.
“If we can’t provide the same or better care for the veterans, then it’s a nonstarter,” Greenberg says.
Likely bolstering the talks for compromise was the clear understanding that MUSC and the VA continue to seek out partnerships. The $6.7 million in equipment the VA is putting in MUSC’s new facility includes a first-in-the-state Tomogram that provides targeted radiation treatment and two angiography rooms that will provide high-tech X-ray exams of arteries and veins.
“The benefit for the VA is that we’re currently purchasing these services from MUSC,” Huchison says.
In the end, talks led by Sen. Lindsey Graham provided the compromise, but work will still need to be done to forward the benefits of the shared facility as MUSC moves forward with its construction plans while keeping an eye toward Washington.
“To try to keep that all in sync is going to be amazing choreography,” Greenberg says.
Help keep the City Paper free.
No paywalls.
No subscription cost.
Free delivery at 800 locations.
Help support independent journalism by donating today.