VA Health Care:

VA's Plan for the Integration of Medical Services in Central Alabama

HEHS-98-245R: Published: Sep 23, 1998. Publicly Released: Oct 1, 1998.

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Pursuant to a legislative requirement, GAO provided information on the Department of Veterans Affairs' (VA) plans to integrate services at the medical facilities located in Tuskegee and Montgomery, Alabama, focusing on: (1) whether VA's plan provides the information that stakeholders need to understand the proposed integration of services at these two facilities; and (2) assessing stakeholder understanding of, and support for, the plan.

GAO noted that: (1) VA's plan contains the necessary information to understand the proposed integration of services at the Montgomery and Tuskegee facilities; (2) moreover, it explains how proposed changes should occur, such as consolidating most acute medical services at Montgomery and all long-term care at Tuskegee while maintaining outpatient care at both facilities; (3) VA's plan also contains the necessary information to understand how such changes could benefit veterans and employees, including how VA intends to reinvest savings of $6 million; (4) it also explains how VA will reduce the workforce by 157 full-time equivalent employees through attrition or buyouts, while ensuring that employees will not be transferred involuntarily from one facility to another; (5) in addition, VA's plan discusses changes intended to minimize adverse effects on veterans' access to care and employees' commutes, such as enhancements to a VA-operated transportation system; (6) most of the veterans responding to GAO's survey believed VA's plan contains the necessary information to understand the proposed integration of the Montgomery and Tuskegee facilities; (7) some stakeholders, however, indicated that the plan could have included more details about the transportation system and resource reinvestment; (8) most veterans supported VA's plan because they believe that integrating the two facilities will increase VA's capacity to provide health care, in part by enhancing veterans' access to care and the quality of the care they receive; (9) GAO believes VA's plan is essentially sound; (10) the plan seems to position VA's two Central Alabama facilities to meet veterans' health care needs in a more effective and efficient manner; and (11) while more detailed information could be included, such information is not, in GAO's view, critical to obtaining an overall understanding of VA's plan, because the plan contains the information necessary to understand the proposed integration.

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