PRINCIPI says average age of VA facilities is more than 50 years.

In an effort to match its facilities to the current needs of veterans, the Dept. of Veterans Affairs has approved a plan that proposes more than $5 billion in construction and renovation over the next several years, while reducing facilities space elsewhere that it feels is unneeded. VA Secretary Anthony J. Principi, who announced the plan's approval on May 7, said that the department "now stands ready to bring greater access to quality care closer to where most veterans live."

The plan includes construction of new medical centers in Orlando and Las Vegas, four new facilities for spinal cord injuries and two centers for rehabilitation of blind patients. Following the trend in health care toward outpatient care, the VA plan also includes setting up 156 new community health clinics.

The program is the result of three-year study, called "CARES," for Capital Asset Realignment for Enhanced Service. It will be up to congressional appropriations committees to determine how much money VA will get to implement the plan. Lawmakers did approve $181 million in VA's major construction projects account in the current fiscal year to get CARES started. VA is seeking an additional $524 million in fiscal 2005 for CARES-related planning, design, site acquisition and construction. Principi says the department will seek about $1 billion in each of the next several years for the program. While veterans' programs enjoy strong support on Capitol Hill, the pressure of the huge federal deficit will make it difficult for appropriators to squeeze the full amount that VA is requesting into this year's spending bill.

Rep. James Walsh, chairman of the House appropriations subcommittee that oversees VA's budget, had positive comments about the VA decision, saying, "This effort will strengthen our veteran health care network nationwide, especially in rural areas. Walsh adds, "While we may take issue with specific recommendations listed in the plan, over all it is an important step forward for the VA."

In a report on the CARES program, Principi said, "VA's medical infrastructure has become old and outdated," with an average facilities age of more than 50 years, compared with less than 10 years for facilities belonging to what he terms "successful private-sector health care providers."

Principi says the CARES program also will cut vacant space in the Veterans Health Administration by 42.5%, to 4.93 million sq. ft. It also will reduce the cost of maintaining excess space from about $3.4 billion to $750 million over the 2006-2022 period, and allow VA to shift the money to patient care, Principi says.

Principi also notes that "millions of veterans, following the population patterns of the nation as a whole, moved to the South, the West and the Southwest. As a result, many VA facilities are located where veterans used to live rather than where they live now."