HEARINGS BEFORE THE INDEPENDENT OFFICES SUBCOMMITTEE OF THE COMMITTEE ON APPROPRIATIONS EIGHTY-NINTH CONGRESS FIRST SESSION VETERANS' ADMINISTRATION Special Hearing on Proposal to Close 11 Hospitals and 4 46-630 APRIL 9, 1965 Printed for the use of the Committee on Appropriations U.S. GOVERNMENT PRINTING OFFICE WASHINGTON: 1965 J60 89th V. 2 DOCUMENTS CLOSING OF VETERANS' ADMINISTRATION FACILITIES FRIDAY, APRIL 9, 1965 U.S. SENATE, INDEPENDENT OFFICES SUBCOMMITTEE OF THE COMMITTEE ON APPROPRIATIONS, Washington, D.C. The subcommittee met, pursuant to call, at 10:45 a.m., in room S128, U.S. Capitol, Hon. Warren G. Magnuson (chairman of the subcommittee) presiding. Present: Senators Magnuson, Saltonstall, Young, Mundt, Allott, and Cotton. Also present: Senators Mansfield, Curtis, Yarborough, and Metcalf. CLOSING OF VETERANS' ADMINISTRATION FACILITIES STATEMENT OF W. J. DRIVER, ADMINISTRATOR; ACCOMPANIED BY A. H. MONK, ASSOCIATE DEPUTY ADMINISTRATOR; DR. J. H. MCNINCH, CHIEF MEDICAL DIRECTOR; DR. M. J. MUSSER, DEPUTY CHIEF MEDICAL DIRECTOR; A. W. STRATTON, CHIEF BENEFITS DIRECTOR; R. C. FABLE, GENERAL COUNSEL; JOHN D. SHYTLE, CONTROLLER; AND D. I. ROSEN, DIRECTOR, REPORTS AND STATISTICS SERVICE, DEPARTMENT OF MEDICINE AND SURGERY PURPOSE OF MEETING Senator MAGNUSON. The committee will come to order. The chairman wants to state that the purpose of the meeting is to discuss with the Veterans' Affairs Administrator the proposed closing of several hospitals and office units of the VA which has been subject to congressional action, and recently the President of the United States appointed a commission to reexamine the matter. And several of the Senators in whose States these closures are to take place are vitally interested in this matter; and we thought it would be good to have a meeting, which will be very informal in nature, to discuss the matter. This involves, of course, the appropriations of the Veterans' Administration which is in this subcommittee. But this is not to be considered a hearing in any sense regarding the routine fiscal 1966 budget. We are discussing this matter separately. And we will discuss it maybe further when we hold our hearings on the independent offices during the middle part of May, after the House gets through with the bill. I will place in the record the letter of January 13, 1965, addressed to me on this subject, and the press release of April 4 on the naming by the President of a group to study this matter. 400 (The material referred to follows:) VETERANS' ADMINISTRATION, OFFICE OF THE ADMINISTRATOR OF VETERANS AFFAIRS, Hon. WARREN G. MAGNUSON, Chairman, Subcommittee on Independent Offices of Committee on Appropriations, U.S. Senate, Washington, D.O. DEAR MR. CHAIRMAN: In accord with our policy of keeping you informed, I want to tell you of our plans to streamline operations in the Veterans' Administration through adjustments to be made in our field structure. These changes provide for continued high-quality service to veterans and a savings to taxpayers in administrative or overhead costs amounting to some $23,500,000 in fiscal year 1966. The past decade has seen many changes in all programs administered by the Veterans' Administration, as well as significant changes in the management of these programs. Many of the benefit programs established to assist veterans in readjusting to civilian life are phasing out and will terminate in the not too distant future. Indeed, some have already done so; and, as is to be expected, participation in many of these programs has dropped sharply. At the same time, we have improved and simplified our operational procedures to maintain maximum efficiency at the lowest cost. As a part of our management improvement program, we have converted some of our benefit programs to automatic data-processing, utilizing the most versatile electronic computers yet devised. Still other programs and functions, such as personnel data and payroll, are presently being converted to automatic data-processing. In our medical programs, we have seen significant breakthroughs in medical science which have greatly altered the type and nature of medical care and the facilities necessary for providing such care. Tuberculosis is a good example of this. Where formerly we had 21 hospitals devoted exclusively to long-term care of veterans with tuberculosis, today, as a result of chemotherapy, we have little need for entire hospitals devoted to nothing but the care of tuberculosis patients. The progress of medical knowledge requires additional diagnostic and therapeutic tools. The inability to provide these within the confines of existing physical plants has made some of our hospitals obsolete. These obsolete hospitals must be inactivated and replaced with modern facilities, if we are to continue to provide American veterans with the broadest possible spectrum of medical care. Hospitals also were established in some areas that now have a more than proportionate declining veteran population. As the number of hospital beds we may provide is limited, it is important that in establishing replacement beds, we place them where the greatest need exists and near the medical schools with which we are affiliated. The characteristics of our domiciliary members have also undergone significant changes in recent years. This program was initially established to provide a home for indigent veterans who could not sustain themselves in their communities. Today we have a vast social security program which, together with increased veteran pensions, is providing more and more veterans with assurance of freedom from financial want. Additional wide-ranging programs on both the Federal and local level are also providing more facilities to these veterans as well as to the rest of the population. As you know, to cope with these changes, we have, in recent years, adjusted and readjusted our organizational pattern to keep pace with the changing needs. We have closed some hospitals; we have relocated others; we have merged some regional offices; closed a number of small VA offices, and consolidated program functions. We have recently completed a thorough analysis of our programs and operations, both in the Department of Medicine and Surgery and the Department of Veterans Benefits. We find that additional organizational changes must be made if we are to continue to achieve maximum operational efficiency and economy, and at the same time maintain our high standards of service. Accordingly, I have approved the following actions: Close the following hospitals: VA Center Bath, N.Y. VA Hospital Lincoln, Nebr. VA Hospital Castle Point, N.Y. VA Hospital Rutland Heights, Mass. VA Hospital Grand Junction, Colo. VA Hospital Dwight, Ill. VA Hospital Fort Bayard, N.Mex. VA Hospital Brecksville, Ohio (Broadview Heights Division) VA Hospital Sunmount, N.Y. Close the following domiciliaries: Thomasville, Ga. White City, Oreg. Clinton, Iowa 1 Brooklyn and New York functions will be consolidated under 1 manager, but remain in the same physical locations. To insure that uninterrupted service will be continued at the same level, a VA office in the former regional office city will continue direct personal services to veterans, their beneficiaries, and others involved in VA program activities. A staff of employees will be retained at these offices for this purpose. In our Department of Veterans' Benefits, for a number of years we have been adjusting our resources to the changing demand for benefits. These adjustments began soon after the peak workloads of the postwar years had passed. Initially, our actions involved the reduction of employment in regional offices and insurance activities, and in the past 10 years staffing dropped over 50 percent. In more recent years, major changes to the field organization were accomplished, reducing substantially the number and size of our offices in the local community. In recent years, four regional offices have been merged with other offices. In each instance it was determined that the office into which the workload was consolidated could serve the VA public effectively and efficiently. This has been substantiated by actual experience. One of the immediate benefits to be achieved by the consolidation of these offices is a substantial recurring annual salary savings. The economy factor is important, but continued provision of high-quality service to veterans requires equal emphasis. Our planning considerations took this into account. Since the VA's major objective is to provide high-quality service to all veterans and their beneficiaries on a timely basis regardless of their location with respect to regional offices, we have given much thought to the important factors that contribute to provisions of service. We considered especially the factors of communications and distance as they affected service. In a recent analysis of regional offices, it was found that in fiscal year 1964 approximately 90 percent of contacts with regional offices were by mail and about 10 percent by personal contact or telephone. Further exploration to determine whether distance was a deterrent in securing benefits confirmed our belief that it has had no adverse effect. Veterans who are great distances from regional offices rely on the mails more heavily than do those who live nearby, but they obtain the same effective service. In the scheduled consolidations, we are generally merging small offices with larger offices. This has the advantages of causing the least disruption of opera |