VA Halts Proposal to Close New Hampshire Emergency Facility at Night
VAHOSPITALS
The Eagle-Tribune
Bryan McGonigle
Boston University Washington Newsroom
Sept. 21
WASHINGTON, Sept. 21 – The U.S. Department of Veterans Affairs will keep the VA Medical Center in Manchester, N.H., open 24 hours a day as Congress considers legislation to restrict the department’s ability to cut emergency room hours.
Last fall, the department proposed curtailing Manchester’s emergency room hours, closing the facility from 10 p.m. to 6 a.m. and possibly on weekends. The proposal was not limited to Manchester and could have eventually affected VA hospitals nationwide.
Rep. Jeb Bradley, R-N.H., introduced legislation in May that would require that Congress be informed of any such proposal. The department would then have to wait 180 days before implementing the cuts in hours. Rep. Charles Bass, R-N.H., co-sponsored the bill, which was referred to the Committee on Veterans’ Affairs.
Bradley also wrote three letters to VA Secretary James Nicholson urging him to reconsider the proposal.
“What we asked is why are you potentially closing emergency rooms when you clearly have responsibility to the patients and not allowing these patients, if you’re potentially going to close an emergency center, to go to another facility?” Bradley said.
The department agreed to halt its proposal on cutting emergency room hours Tuesday while the legislation goes through Congress.
Jim Thompson, spokesman for the Manchester facility, said the issue had to do with patient transfers: About 20,000 veterans from southern New Hampshire and northern Massachusetts use the Manchester VA Medical Center, and the facility does not have in-patient services. Patients who get emergency care there and need in-patient care must be transferred. The hours specifically chosen for closing were based on availability of staff.
“We have an agreement with Catholic Medical Center here in Manchester to provide hospital care whenever it’s needed,” Thompson said. “It’s easier to transfer in the daytime. There’s more staff here during the day.”
But non-departmental hospitals often pose financial complications for veterans, Bradley said. Patients are not always reimbursed for what they pay outside the department’s system and are stuck paying out of pocket.
A patient in Salem, N.H., or Derry, N.H., who has a heart attack in the middle of the night should go to Parkland Medical Center in Derry, Bradley said. But with reimbursement policy so unclear, many will drive the extra miles to go to Manchester VA Medical Center – endangering their lives during the first crucial moments of the emergency, he said.
“The VA has a very complex formula for reimbursing vets for emergency care outside the VA,” Thompson said. “Of course there are definitely vets that would go out of the way to come to the VA emergency room when they really should be going to the closest emergency room.”
Paul Chevalier, past state commander of the New Hampshire Veterans of Foreign Wars, said it is not as simple as going to another hospital, since patients must be referred by a VA hospital before going to a non-VA hospital.
“If you go to the VA emergency room, even though they probably can’t take care of you there [with in-patient care], they refer you to the local hospital,” Chevalier said. “If the emergency room is closed and you show up at Catholic Medical Center, you’re on your own” in paying the bill.
Bradley said he wants to see the VA’s policies clarified.
“Congress is probably going to have to authorize reimbursements to make sure it’s crystal clear to other facilities,” he said. “That’s so that people in Laconia, when they’re faced with that emergency in the middle of the night, they go right to Lakes Region General, as opposed to driving to Manchester, where they know they’re not going to be on the hook for the bills.”
The bill before Congress would require that if an emergency center’s hours are reduced, the VA secretary must take steps to ensure that an alternative facility is available to veterans without financial burden to them.
“I’m hoping that in the waning days of this session, or certainly in the next session of Congress, my legislation will go forward,” Bradley said. “The whole point is to get our veterans a health care system that works for them.”
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