VA proposes more services for veterans in Spokane and Richland, fewer in Walla Walla under sweeping plan

WASHINGTON – The Department of Veterans Affairs on Monday unveiled a sweeping set of recommendations that would expand health care services in Spokane, Richland and Yakima while downsizing the VA hospital in Walla Walla, if Congress and an independent commission accept the proposal.

The recommendations are part of a process, mandated by Congress in 2018, that aims to modernize and adapt VA’s network of 171 hospitals and more than 1,100 clinics to meet the changing needs of the more than 9 million veterans who rely on them. The average VA facility was built nearly 60 years ago, according to the department, and in that time the nation’s veteran population has shifted away from the Northeast and Midwest and toward the Southwest, leaving some clinics and hospitals relatively empty while others are overburdened.

In an introduction to the recommendations, VA Secretary Denis McDonough said the goal of the review is to “ensure that the infrastructure that makes up VA in the decades ahead reflects the needs of 21st century Veterans – not the needs and challenges of a health care system that was built, in many cases, 80 years ago.”

In the Inland Northwest, the report recommends relocating a residential rehabilitation program to Spokane from its current location in Walla Walla, whose VA medical center would be downsized to become an outpatient clinic similar to those in Coeur d’Alene and Wenatchee, offering only primary care and mental health services. Other specialty care currently available at the hospital in Walla Walla would be relocated to Richland, where the current outpatient clinic would be replaced by a new, larger facility somewhere in the Tri-Cities area.

While the report projects the total number of veterans in the Inland Northwest – more than 71,000 as of 2019 – will fall slightly by 2029, it anticipates growing demand for inpatient medical and mental health care along with a large increase in demand of more than 61% for long-term care.

The recommendations released Monday were mandated by the MISSION Act of 2018, legislation signed by then-President Donald Trump that sought to have more veterans get their health care from private providers outside the VA system.

While VA under McDonough has been less aggressive in pushing to privatize care than during the Trump administration, the recommendations still call for greater reliance on outside providers, especially in rural areas. In Stevens and Pend Oreille counties, the report recommends a partnership with the Northport Community Health Center to provide primary and mental health care without requiring veterans to drive to Spokane.

VA health care facilities include hospitals that provide inpatient care, like the Mann-Grandstaff VA Medical Center in Spokane; outpatient clinics that provide specialty care, like the one in Coeur d’Alene; and more limited outpatient clinics, like those in Yakima and Lewiston. Nationwide, the report recommends closing more than a dozen VA medical centers – none of them in the Northwest – while opening others, along with 140 additional outpatient clinics that provide multiple kinds of specialty care.

West of the Cascades, the recommendations include a new medical center in Everett and upgrades to make Portland’s existing hospital better prepared to withstand earthquakes.

In the coming months, an independent commission of veterans’ advocates will hold public hearings around the country and make its own recommendations to President Joe Biden in early 2023. Even if the White House signs off, Congress will have a chance to block the proposed changes. With lawmakers likely to resist any plans seen as reducing services for their constituents, the yearslong process promises to be fraught.

In a statement Monday, Sen. Jon Tester of Montana, the Democratic chairman of the Senate VA Committee, signaled the recommendations won’t get through Congress easily.

“As I’ve said in the past, any effort to kneecap our veterans’ health care is a nonstarter for me,” said Tester, who is up for re-election this year. “I will fight tooth and nail against any proposals that blindly look to reduce access to VA care or put our veterans at a disadvantage.”

Rep. Mike Bost, the top Republican on the House VA Committee, also promised to protect services in his Illinois district but took a more cautious tone in a statement Monday, saying, “Modernizing our VA system is critical, as is ensuring that our veterans can get the care they need when and where they need it.”

The full set of recommendations is available on the VA website at va.gov/aircommissionreport.