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January 5, 2015

Officials see many benefits in VA site plan

PHOTO/COURTESY This aerial image, provided courtesy of University of Massachusetts Medical School, shows the location of the proposed VA facility (outlined in yellow) on Belmont Street in Worcester.

Local veterans advocates and health care leaders are waiting for the U.S. Department of Veterans Affairs (VA) to sign off on a proposed joint venture between the regional VA health care system and UMass Medical School that would expand health care for area veterans and strengthen ties between the two organizations.

But stakeholders nationwide will also watch at how the project plays out, said Denis Leary, executive director of Veterans Inc., a Worcester-based nonprofit that serves veterans at risk for homelessness.

“It's going to be a marvel for the rest of the country,” Leary said.

Leary praised medical school chancellor Michael Collins and Col. John Collins, regional director of the VA Central Western Massachusetts Health Care System, the health care provider for local veterans eligible for federal benefits. Leary said the two have drafted a viable proposal to build a VA treatment facility large enough to accommodate Worcester County's sizeable veteran population and expand clinical services to treat more types of illnesses locally, sparing veterans the trip to Boston or Northampton for specialty treatment. Medical school students, in turn, would benefit from greater exposure to veterans' medical issues.

UMMS would also build a 100,000-square-foot building on the side of the campus abutting Route 9 and lease a large part of it to the VA health care system. It has the authority to lease up to 40,000 square feet under a bill passed by Congress to improve veterans' access to health care. This would boost the system's clinical capacity in Worcester since an outpatient clinic on Lincoln Street is too small (25,000 square feet) to serve current needs.

Col. John Collins, who joined the Central Western Massachusetts Health Care System in September after retiring as chief of military health care in Europe, said one of his top goals is to increase the number of veterans that the local VA health care system treats; so, increasing space and the scope of services is a pressing need.

The Lincoln Street clinic, which provides limited specialty services, treats about 7,000 area veterans but there are about 50,000 living in Worcester County alone, the highest among the counties Collins oversees, he said. Not all of the 50,000 are eligible for VA health care benefits (veterans are usually eligible if they have a service-related illness or condition, or meet low-income guidelines), but Collins said many eligible veterans don't use the clinic.

“Our penetration of that market has a lot of opportunity if we can increase our services,” Collins said.

Increased services are a key ingredient to meet the health care needs of more local veterans. Under a separate, yet complementary, project, the VA plans to expand into a 13,000-square-foot annex in Biotech Park on the UMMS campus. Audiology services will be added, and podiatry and optometry relocated from Lincoln Street. It will also house an expanded research program, a collaboration between the VA and UMMS. The project has already been approved, Collins said, and is expected to be complete in September.

Meanwhile, the larger facility and joint venture under review have been received favorably, according to Dr. Michael Mayo-Smith, director of the VA New England Health Care System, which includes Central Western Massachusetts. But the joint venture is the first of its kind,and subject to a thorough review, he said, now that a letter of intent has been approved by VA leaders in Washington.

Mayo-Smith said there have been similar joint ventures involving the VA, but UMMS and the local VA system are blazing a new trail because no similar arrangement has ever been established with an academic medical school.

“We're very optimistic, but a decision hasn't been made,” Mayo-Smith said.

The proposal was submitted in September and a decision is expected within six months, according to Mayo-Smith.

The other factor is the lease for the facility UMMS plans to build. The local VA health care system has the authority to move forward with that, but the VA's planned lease is subject to an open-bidding process since it's a government contract. The joint venture doesn't stipulate that UMMS lease the space to the VA, though that's the school's intent. UMMS has proposed moving the state Department of Transportation's regional offices, located at the edge of the campus next to Route 9, elsewhere on the campus to make room for the new facility.

Mayo-Smith said a private firm, for example, could submit a bid to build and lease the facility to the VA, but one criterion is that the space lend itself to plans for the clinical venture with the school.

Medical school chancellor Collins said planning will begin as soon as the VA approves the venture. He expressed excitement at the prospect of improving access and learning opportunities for students, especially in light of the Veterans Affairs report released in May that detailed how poor management at many VA clinics across the U.S. resulted in lengthy wait times, and in some cases, deaths. The Central Western Massachusetts system, including the Worcester site, was singled out as having some of the longest wait times. While more physicians have since been added in Worcester to cut wait times, the chancellor said UMMS welcomes an opportunity for further improvement.

“Every now and then it's good to have a sort of idealistic view of things,” Collins said.

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