Opening Senator Johnny Isakson
I would like to thank you all for coming today to this hearing on an issue that is very important to me: providing the best healthcare possible to our veterans. Access to care within the Veterans Health Administration has seen dramatic changes in recent years. The VHA has been transformed from a hospital-based provider to one that relies on more outpatient care.
The VHA plans to continue to increase the number of community-based outpatient clinics. This change in strategy has improved access to primary care, and veterans have rated the care they receive at the clinics highly.
A Community-Based Outpatient Clinic is geographically distinct or separate from the parent medical facility, and can either be operated directly by VA or staffed by a contracted health care provider. Every health care facility must have the necessary professional medical staff, diagnostic testing and treatment capability, and referral arrangements needed to ensure continuity of health care for currently eligible as well as potentially eligible veteran clients.

These clinics provide primary care and basic mental health services. Providing primary care in the communities both helps veterans by making their health care more convenient, and by alleviating the strain on the VA hospitals.

In January 1994, the VA hospital in Amarillo, Texas, established what is generally recognized as the first VHA community-based clinic.  Until the establishment of this clinic, VHA had strict criteria to establish outpatient facilities apart from the hospitals. In 1995, VA issued a directive to eliminate these restrictions and reorganized its health care delivery network into 22 geographically defined Veterans Integrated Service Networks (VISNs).

Since that time, VA has opened over 700 community-based outpatient clinics, helping to alleviate strain on urban VA hospitals, and extending the reach of VA into rural communities.

Until VA altered its overall strategy to provide care, some veterans living in rural communities had to drive hours to their nearest VA medical centers. What should have been routine trips to the doctor turned into day-long ordeals, often made worse by the challenges facing veterans with disabilities.

There are almost 3,000 veterans here in Wayne County. Under the old VA strategy, these veterans would have to drive two and a half hours to the Dublin VA Medical Center. Thankfully, with the advent of the clinics, more and more veterans living in rural areas like Wayne County are able to obtain primary care from clinics in nearby communities.
 
In December 2006, VA announced its intention to open a number of clinics in Georgia. Two of those clinics, planned for Brunswick and Hinesville, will help bring timely and quality healthcare to veterans in the rural communities of southeast Georgia.
One of the objectives of this hearing is to examine the process by which VA determines the placement of clinics. I have asked representatives from different levels of the VA to discuss the factors that lead to the decision to open a clinic, and to discuss how VA plans to continue to expand its reach to rural communities using clinics.
Since the December 2006 announcement, there have been delays in opening the clinics. Hinesville’s clinic has been pushed back for good reason, as VA decided to double the size of the initial proposal in order to provide mental health services tailored specifically to the large population of recent veterans serving in the Third Infantry Division, based at Fort Stewart.
The clinic planned for Brunswick has also been delayed, although for reasons that are less clear. I would like for the panel to discuss these delays and to give an update on the status of the two clinics.
The second panel is made up of Georgians who know more about what is on the minds of Georgia’s veterans than anyone. I would like for them to discuss how veterans view the care provided by the clinics and any concerns regarding the clinics that they commonly hear from Georgia’s veteran community.
That concludes my opening remarks, and at this time I would ask the first panel to present their opening statements.