Plans to replace the Bedford VA Healthcare System’s sprawling hospital complex on Springs Road have been thwarted by a group of U.S. Senators that opposes the agency’s recommendations on a national level.
The proposal, said Sen. Jon Tester, a Montana Democrat, “would put veterans in both rural and urban areas at a disadvantage, which is why we are announcing that this process does not have our support and will not move forward.”
That process centered on an eight-member panel called the Asset and Infrastructure Review Commission (AIR), established in 2018 to review current VA healthcare facilities and identify opportunities for realignment and modernization. The commission requires Senate confirmation.
Several weeks ago the Department of Veterans Affairs acknowledged that it would recommend replacement of the 94-year-old Bedford facility, somewhere near the current location but not necessarily in this town. The senators’ roadblock appears to indefinitely delay any change of that magnitude.
However, Tester’s statement also noted, “The commission is not necessary for our continued push to invest in VA health infrastructure.”
And Bedford’s Congressman, U.S. Rep. Seth Moulton, agrees, according to his communication director, Ron Eckstein. “He does not see any process – or lack of a process – that will keep us from continuing to push for those improvements,” Eckstein wrote in an email.
“The existing facility will need to be renovated soon, regardless of any outcome in the Senate,” Eckstein wrote. “At some point soon, the VA and Congress will have to agree on a plan that brings many of the older VA hospitals into the 21st century. He noted that Moulton, a Democrat from Salem, “gets his own healthcare through the VA system.”
The VA recommendation acknowledged that in Bedford, “There are significant facilities maintenance issues, investment requirements, and architectural and engineering challenges. The physical layout of the buildings creates inefficiencies that are impacting clinical, administrative, and facility support services. Services are distributed among multiple buildings, requiring veterans, providers, and staff to travel through antiquated tunnels to access and provide care.”
Meanwhile, daily life goes on at Bedford’s VA Hospital. Melissa Bailey, the healthcare system’s chief of public affairs, said in an email, “We’d like to tell the story of who we are, what we do, and the great job we’ve done managing the challenges of the aging infrastructure.”
The VA planned to inform the AIR Commission that in Bedford, “Facility condition assessment deficiencies are approximately $345.2 million and annual operations and maintenance costs are an estimated $12.4 million. The infrastructure does not meet current design standards for modern health care and presents challenges to VA’s ability to make necessary upgrades.”
But currently, Bailey pointed out, “as a healthcare system with a hospital and three community clinics, we continue with our core missions of delivering exceptional long-term care and mental health services, serving more than 25,000 veterans each year. We serve veterans in Middlesex and Essex counties in Massachusetts, at the hospital and community-based outpatient clinics in Lynn, Haverhill, and Gloucester.”
The hospital opened in July 1928 about a mile north of the town center, a quiet pre-Hanscom enclave nestled in the woods alongside the narrow-gauge railroad serving the Bedford Springs resort.
According to Bailey, “Our first veterans were transferred here from West Roxbury and Brockton VAs and had served in World War I, the Spanish-American War, and the Civil War. At that time, patients were provided with a ‘serene environment,’ whatever ‘containment was needed,’ and social entertainment from volunteer groups.”
For many years it was a neuropsychiatric hospital, with as many as 1,800 inpatients following World War II. Now the 181-acre site is home to almost 900,000 square feet of space and 1,500 full-time employees. Fifteen buildings are dedicated to patient care and three to research. Bailey said there is no unused space at the hospital. “Many of the outbuildings house maintenance works for heating and plumbing,” she said.
Today’s Bedford hospital primarily serves outpatients. Last fiscal year, Bailey said, more than 27,000 veterans visited more than 200,000 times for treatment. The current year, which ends Sept. 30, has seen 21,566 individuals – 1,329 of them female veterans – and 163,796 visits.
According to the national VA, “Outpatient specialty care demand is projected to increase by 45.4 percent across the market from fiscal year 2019 to fiscal year 2029. In 2019, there were 81,063 enrollees within 60 minutes of the proposed replacement site.”
The health care system still provides inpatient mental health, a residential rehabilitation treatment program, and community living center – a nursing home. For fiscal year 2019 the total inpatient daily average was 321, of which 70 percent were in the nursing home. Bailey said during the current fiscal year, the average daily census is down to 260.
Also on the hospital campus are accommodations for formerly homeless veterans—Bedford Green and Bedford Veterans Quarters. Bailey pointed out that, unlike the inpatient population, “residents there are private citizens of the Town of Bedford. Both facilities are fully managed by private companies for their operations.”
For inpatients, “Our mental health programs include vocational services, peer services, homeless services, and outpatient mental health services,” Bailey said. “Our mental health service line is a nationally recognized leader in the areas of psychosocial rehabilitation, research, and education.”
The VA’s recommendations to the AIR centered on building a replacement medical center incorporating all of the current services as well as urgent care and outpatient specialty care, all “in the vicinity of Bedford.” The current site includes “only 25 acres available for future development.”
The VA also hopes to achieve “a strategic collaboration to add outpatient surgical and endoscopy services,” through a “sharing agreement.” In addition, “VA providers from the greater Boston area would provide cardiology, ophthalmology, dermatology, general surgery, neurology, and otolaryngology services in the Bedford area.”
“Our research department is internationally recognized for its study of geriatric and behavioral research,” Bailey reported. “We use non-VA funding sources like universities, charitable foundations, and for-profit companies to fund our research and education. In doing so, we support the health and well-being of veterans and the general population.”
She said major research areas include Alzheimer’s disease, Parkinson’s disease, schizophrenia, substance abuse, basic neurobiology, cancer, immunology, infectious disease, and cellular biochemistry.
“We have ongoing training programs and partnerships with more than 90 associated health and nursing academic affiliates,” she added. “We’re proud of our partnerships with top institutions and organizations that support the educational mission of VA.”
The Bedford facility is a teaching hospital, with “state-of-the-art technology,” Bailey said. She enumerated the academic affiliations: Boston University School of Medicine, University of Massachusetts Medical School, Massachusetts General Hospital, Lahey Hospital, Greater Lawrence Family Health Center, St. Elizabeth’s Hospital, and Steward Carney Hospital.
Several years ago the Bedford facility was named for U.S. Rep. Edith Nourse Rogers, a Lowell Republican who served in the House of Representatives from 1925 to 1960 and was best known as an advocate for veterans and the military.
Recommendations to the AIR Commission are accessible at https://www.va.gov/aircommissionreport/.
Mike Rosenberg can be reached at firstname.lastname@example.org, or 781-983-1763