By Shelia Watson
Contributing Writer

In the final hours of the 109th Congress, the House and Senate Committees on Veterans’ Affairs forged a compromise on the omnibus bill, S. 3421, known as the Veterans Benefits, Health Care and Information Technology Improvement Act of 2006.

Noting the bipartisan effort to pass the bill, House Committee on Veterans’ Affairs Chairman Steve Buyer, R-Ind., said the bill “makes meaningful improvements in the VA system.”

Among the more controversial provisions, and the one that almost killed the vote due to discrepancies between the House and Senate versions of the bill, was the authorization of $36.8 million for advance planning of a collaboration project between the Ralph H. Johnson VA Medical Center and the Medical University of South Carolina.

Many of the provisions in H.R. 5815 were similar or identical to provisions in S. 3421 and would have similar or identical costs, but the Charleston facility was not included in the Senate version. The House version would have allocated $70 million for the collaboration study for a “co-located, joint-use medical facility” between the RHJ VA and MUSC. The compromise slashed that amount by nearly half.

Part of the controversy over the medical facilities bill was due to a September 2005 testimony from the Government Accountability Office that the Charleston facility needs only minor upgrades. The GAO also reported that the Capital Asset Realignment for Enhanced Services Commission, which produces comprehensive long-range assessments of the capital asset requirements of the VA health care system, had studied the RHJ VA in Charleston and concluded that “the (RHJ VA) Charleston medical facility is in overall good condition and, with some renovations, can continue to meet veterans’ health care needs in the future.”

The GAO report also noted that “the CARES Commission did not recommend replacing the VA’s facility in Charleston as it did with facilities in some other locations.”

The collaboration between the two entities would effectively raze the Ralph H. Johnson VA Medical Center and erect a new structure that would be part of MUSC. The ultimate cost of that project is estimated at around $600 million.

Other concerns have centered on sharing medical equipment and operating rooms in a shared facility, with some veterans’ groups concerned that such an arrangement could lead to access problems.

Dr. Florence Hutchison, acting director of the RHJ VA, addressed the concerns in a letter to VA constituents clarifying questions about mergers, priority for care and funding.

Responding to a question on a “merger” between the Charleston VA and MUSC, she stated, “No. The discussion has always focused on how the Charleston VA and MUSC can enhance their relationship by increasing collaboration and sharing to improve the delivery of health care for veterans and the citizens of South Carolina.”

Responding to the question of whether the VA is buying MUSC new equipment, she wrote, “One of the collaborative options being considered is for the VA to buy $6.7 million dollars in radiology and radiation therapy equipment, which will be housed in MUSC facilities. The lease agreement covering this equipment would provide a revenue stream to the VA to support patient care and/or lower the cost of specialty services purchased by the VA. The contracts for this venture are currently in negotiation. Veterans would have equal access to the equipment operated by MUSC.”

In a press conference held Dec. 16 at the RHJ VA, Rep. Henry Brown, R-S.C., and Sen. Lindsey Graham, R-S.C., joined with representatives from MUSC and the VA to provide an end-of-session update on the legislation.

“VA and MUSC began exploring mutually beneficial sharing opportunities more than four years ago,” said Brown. “Since that time, we in Congress have sought to support their efforts for the good of our region’s veterans. I am pleased and excited to announce that we have reached another milestone with the authorization of $36.8 million for advanced planning and design.”

“This shared approach to the delivery of medical care to our veterans and the public is ground-breaking,” Graham said. “It also ensures we have the finest health care services available and is an efficient use of taxpayer dollars. The ability of the VA and MUSC to coordinate, collaborate and share joint facilities will dramatically increase service to veterans and enhance MUSC’s capability to serve the public.”

The shared facilities include MUSC’s 641,000-square-foot Center for Advanced Medicine, due to open next summer, as well as access to MUSC’s advanced technology, according to Dr. Jerry Reves, vice president for medical affairs and the dean of the College of Medicine at MUSC, who also spoke at the conference.

“The enhanced collaboration envisioned in Charleston is an innovation that will serve as a national model,” said Buyer in a statement. “It will increase access to better health care for veterans today and into the future.”

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