VA Hospitals Story Archives - West Virginia Public Broadcasting

Veterans Ask Questions About Potential VA Health System Changes

A group of West Virginia veterans came together to discuss their concerns about proposed changes to the VA health system.

Sen. Joe Manchin organized the listening session and included Sen. Shelley Moore Capito and Ted Diaz, the cabinet secretary for the West Virginia Department of Veterans Assistance as well.

In March, the U.S. Department of Veterans Affairs released recommendations from the Asset and Infrastructure Review (AIR) Commission. Those recommendations included downsizing three of the four VA hospitals in West Virginia. That would force veterans to travel longer distances or send them to private hospitals for care.

In response to a question from Todd Morris from Montgomery, Diaz said the private sector isn’t ready.

“The West Virginia health care system is not ready to have 72,000 veterans that are receiving VA health care in the state right now,” he said.

Manchin said he thought the VA’s recommendations were “deeply flawed.”

“The VA’s recommendations to the AIR Commission are skewed against rural states like West Virginia, which would see a reduction in services at three of our four VAMCs, forcing our brave veterans to travel farther for the same care they’ve received close to home for years,” Manchin said. “I will continue fighting tooth and nail to prevent the loss of a single VA service or facility in West Virginia, which is why I reintroduced the bipartisan Elimination of the VA Asset and Infrastructure Review (AIR) Commission Act yesterday to dissolve the commission and ensure our Veterans continue to receive the care they earned and deserve.”

Diaz said he received a briefing about the AIR recommendations when they were released.

“At that time, I recognized the recommendations for what they were, a reduction in services, a reduction in access to healthcare, a reduction in access to Mental Healthcare for our Veteran population in West Virginia,” he said. “Since then, I have been working closely with the governor’s office, our state legislature, Senators Manchin and Capito, and our congressional delegation to bring awareness throughout the state, making sure our veterans are aware of the impact these recommendations will have should they come to fruition. We are united in saying that the AIR Commission must be eliminated now.”

Under the current timeline, after public hearings, the VA will submit final recommendations to President Joe Biden by January 31, 2023.

Background on the AIR Commission:

In 2018, Congress passed the Asset and Infrastructure Review Act as part of the VA MISSION Act.
Senators Rounds and Manchinintroduced legislation in 2019 which would have eliminated the AIR Commission.
The VA MISSION Act established a new process for the development, review, approval and implementation of a list of recommendations for the modernization and realignment of VHA medical facilities. The VA MISSION Act requires the VA Secretary to develop an initial list of recommendations, including the acquisition of new space, the modernization of existing space and the disposal of unneeded space. The Secretary was required to publish these recommendations in the Federal Register by January 31, 2022.
The VA MISSION Act also established an AIR Commission, a panel comprised of nine members nominated by the president and approved by the Senate, which is meant to review the recommendations submitted by the VA Secretary.
However, the panel does not yet exist as all of the nominees have yet to be assessed by the Senate Veterans Affairs Committee and voted on by the full Senate.
Once it is stood up and receives the department’s recommendations, the commission will conduct its own hearings and investigations, make its own recommendations and send the recommendations to the White House.
The AIR Commission is required to submit a final list of recommendations to the president by January 31, 2023.
The president is to notify the commission and Congress if he approves or disapproves the list by February 15, 2023. If disapproved, the commission may revise the recommendations and submit a new list by March 15, 2023.
The president has until March 30, 2023, to approve the commission’s initial or revised recommendations in their entirety and submit them to Congress, or the modernization and realignment process terminates.
If the president approves the recommendations, Congress has 45 days from the date of approval to terminate the process by enacting a joint resolution of disapproval. If Congress does not enact a joint resolution of disapproval, the VA is required to implement the recommendations.

Beckley VA Asks Veterans To Consider End Of Life Decisions

A national effort called Health Care Decision Day (April 16) asks adults to consider what medical interventions they would be comfortable with at the end of their life. The VA hospital in Beckley is hosting workshops on the topic this week.

Death can be a hard thing to talk about, but social workers say it’s essential to make sure one’s medical and financial wishes are understood before it’s too late.

A national effort called Health Care Decision Day (April 16) asks adults to consider what medical interventions they would be comfortable with at the end of their life. It can bring up tough questions like “How will I manage the pain?” and “Who will speak for me when I can’t?”

The VA hospital in Beckley is hosting workshops on the topic this week.

“We really honor and respect our veterans input and their wishes as it is related to their own health care. So the idea is to empower our veterans to be their own decision maker,” said Anessa Sherrod, a social worker at the VA.

Legal Aid of West Virginia is offering legal and financial planning as well. Veterans that can’t attend can get in touch with their VA case worker.

Sherrod says veterans should walk away either ready to have these tough conversations with their children, spouse or doctor. Some might even be ready to start writing up legal documents, like a medical power of attorney or an advanced care directive. Workbooks are available that can get someone thinking about their medical and personal values as it relates to end of life care.

“Anyone 18 and up really needs to be taking this into consideration,” Sherrod said. “It’s not necessarily about someone that is sick, and is in the end stage of life, so to speak. But even a healthy individual may want to be able to have these conversations with their loved ones, because you don’t know what will happen.”

Appalachia Health News is a project of West Virginia Public Broadcasting with support from Charleston Area Medical Center and Marshall Health.

To Serve W.Va.'s Veterans, Clarksburg VA Hospital Prepares For Coronavirus

You can still find West Virginians sporting WW2 and Korean War vet hats, wars that were fought more than 70 years ago, as well as hats representing Vietnam, the Gulf War, Iraq and Afghanistan. More than 145,000, or nearly 10 percent, of the state’s population have served their country.

Over the course of their service, many were exposed to everything from heavy smoke, to oil fires, to the highly-toxic chemical Agent Orange. This means many vets are either elderly or they have preexisting conditions, making the veteran population particularly susceptible to the new coronavirus.

“Agent Orange has been associated with certain cancers, like Hodgkin’s disease, lymphomas, lung and upper respiratory cancers and also Parkinson’s disease [and] diabetes,” said Dr. Prasad Devabhaktuni, a pulmonologist and the head of the emergency department at the Louis A. Johnson VA Medical Center in Clarksburg. “If the individual has associated burn pit lung injury or problems like hyperreactive airways or asthma, then we would consider they are at increased risk for complications. Complications, pneumonia or respiratory failure, things like that.”

Louis A. Johnson VA Medical Center in Clarksburg, W.Va. The main screening tent is in the center background of the photograph, while the mobile testing unit is on the right background.

At the Department of Veterans Affairs hospital in Clarksburg, all visitors and staff are being screened for the new coronavirus before they can enter the hospital.

George Smith normally works as a clerk, but on this day he’s screening visitors at the temporary carport erected at the hospital’s entrance. Smith asks if the visitor if they’ve been in high risk coronavirus areas, met someone who has the coronavirus or who are they feeling sick. If they don’t, he gives them a green arm band to wear while they’re on the hospital grounds.

Helping Smith work the carport are a VA dentist and her assistant. It’s an unlikely team, but since President Donald Trump declared a state of national emergency, the VA has reorganized resources to address the crisis, including assigning people to where there is need.

Right now, the need is at the hospital entrance. Staff has been trained in to safely screen patients and visitors for the coronavirus, according to Dr. Glenn Snider, the director of the facility.

“Training on things such as how to apply and utilize a protective mask, how to utilize an N95 mask, how to use portable ventilator equipment that are used, that is used to protect staff from airborne droplets and viruses,” he said.

George Smith (left) screens patients before they’re allowed to enter the Louis A. Johnson VA Medical Center in Clarksburg, W.Va.

Behind Smith’s temporary carport is a tent where staff are also screened. If the staff or visitor replies “yes” to any of Smith’s questions, they are directed to an area where two registered nurses are garbed in full protective gear — with gowns and portable ventilators — that look like bicycle helmets with face masks and tubing. The nurses are armed with thermometers and coronavirus test kits, which allows them to check temperatures and swab for the virus.

“If the individual is minimally symptomatic, they’re sent home with instructions on how to manage themselves at home,” Snider said. “They’re also given phone numbers to call in to speak to staff if they have an acceleration of symptoms or if they have other questions.”

An acceleration of symptoms means shortness of breath, or persistent pain or pressure in the chest. Snider said if you do plan to come to the hospital, please call beforehand so they can be ready for your arrival.

“Our goal being, ‘Let’s reduce exposure to as many veterans and as many staff as is possible,'” he added. “But of course, if the individual is in respiratory distress, then the best course of action is to present to the emergency department immediately and for many veterans that means calling 911 for medical transportation.”

In the front lobby of the hospital, there is a newly constructed negative air pressure hallway that is made up of walls made from plastic sheeting, wooden wall joists and duct tape sealing the plastic to the floor. When the hospital gets a coronavirus patient, they’ll go from outside straight into this special hallway, avoiding the lobby. Here, the air is sucked in, and can’t pass out, protecting other patients and staff from potential exposure to the coronavirus.

The waiting room is empty of veterans and their families as the Louis A. Johnson VA Medical Center prepares for coronavirus patients.

In the emergency room, which is normally packed, but there aren’t any patients. Although the hospital is open, staff said veterans are apparently staying home in accordance with the governor’s stay at home order.

While the VA focuses mostly on veterans, in 1982, Congress passed a law mandating that the agency provide backup healthcare services to the country in times of crises. Dr. Snider said if the VA was ordered to it would help the general public.

“At this time, I don’t believe that has been invoked, but if it were to be invoked, the medical center is aware of that mission of the VA and we would do everything we could to work with community partners in serving not only veterans, but those in our community,” he said.

And while current cases in West Virginia remain relatively low, if hospitals were to see an increase in veteran patients, then Snider said the VA currently has everything they need to care for vets.

Closeup of a coronavirus test kit. The swab is in the back of the kit, and after swabbing it is placed in the tube labeled “Transport Medium.”

“Based on the calculations we’ve been given from central office, we should be able to handle any projected surge that were to occur, but as a reminder, sometimes we can’t predict the behavior of some viruses in some populations,” he said. “So, I can’t guarantee 100 percent, but I can tell you that today we have everything that we need to care for our patients.”

In the meantime, the Clarksburg VA hospital is tracking everything from lab materials, to protective equipment, to hand sanitizer, to ventilators to ensure that if it’s needed, they’ll be ready.

If you’re a veteran located in north-central West Virginia, you can reach the Clarksburg VA at 304-623-3461, extension 3450. For veterans in other parts of the state that are experiencing symptoms, call your local VA hospital or outpatient clinic.