The Veterans Affairs Department will close three hospitals in Pennsylvania, Ohio and Mississippi and build two new ones in Nevada and Florida as part of much-anticipated restructuring plan, The Associated Press has learned.

The agency also will add or remove medical services at dozens of other facilities.

VA Secretary Anthony Principi also has endorsed building 156 community-based outpatient clinics by 2012, with an emphasis on serving rural areas. Local VA officials had sought 270 clinics.

Principi was to release the plan Friday in Las Vegas. Several congressional officials who had seen it described the contents to the AP in advance.

The department undertook the restructuring two years ago to shift services to areas where veteran populations are increasing and to modernize outdated buildings and shed vacant space.

Under the plan, the VA expects to reduce costs for maintaining vacant space from $3.4 billion to $750 million by 2022 but projects spending $6 billion on new construction during that time.

A draft plan last summer that recommended closing seven hospitals drew opposition from local officials and veterans in those communities. An independent commission examined that plan and narrowed the list of closures.

After reviewing the commission recommendations, Principi decided to close three hospitals, in Pittsburgh, Brecksville, Ohio, and Gulfport, Mississippi. The hospitals must have a plan for closure by September. It was not immediately clear when they will shut their doors.

A fourth hospital, in Livermore, California, will have all its services except long-term care transferred elsewhere. However, a new VA nursing home will be established there.
Construction and closings

The VA plans to continue studying ways to cut costs. Representatives from veterans groups who met with Principi on Thursday were told the agency would not close or eliminate services at any other locations before new or replacement services are available elsewhere in the area.

Veterans group leaders were reluctant to comment on the report because they had sketchy details and promised Principi they would withhold comment until the report was publicly released Friday. But the groups have tried to ensure the restructuring plans didn’t hurt veterans.

“We have been concerned about trying to take things too fast because when they looked at medical care and said what’s our access they were not looking at mental health and long-term care,” said John Brieden, American Legion national commander. “We didn’t want the VA to make decisions based on only partial information that would impact those areas.”

The department will build new hospitals in Las Vegas and Orlando, Florida. The VA also wants to build new rehabilitation centers for the blind in Biloxi, Mississippi, and Long Beach, California, and place new spinal cord centers in Denver, Minneapolis, Syracuse, New York, and in a city that can serve Louisiana, Oklahoma, Arkansas and part of Missouri.

Among the VA facilities that will lose services is the hospital in Canandaigua, New York. It had been on the list to be closed, but Principi decided instead to transfer inpatient psychiatric beds to Buffalo or Syracuse and ordered officials to come up with a plan for making the campus more efficient. The hospital was built for nearly 1,000 beds but has only 166 patients on average.

“Overall, it’s not an A-plus for New York, but it’s still an A,” said Sen. Charles Schumer, D-New York.

But Michigan officials were unhappy with a decision to close acute inpatient psychiatry beds in Saginaw. Rep. Dale Kildee, D-Michigan, is “appalled” by the decision, said spokesman Peter Karafotas.

“Eliminating inpatient care will have a devastating impact on the quality and access of medical care for over 60,000 veterans in mid-Michigan,” Karafotas said. He said Kildee will continue to push House and Senate bills that would block the closings.

Congress will review Principi’s decision. It cannot change the plan but does have authority to determine whether to fund the changes. Congress had been unwilling to approve money for construction until the department came up with a restructuring plan.

There are an about 25 million veterans in the country, with more than 7 million enrolled in VA health care.