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VA recommends sweeping changes for medical facilities, including in Maine

People walk next to the Washington Monument at sunset on Veterans Day in Washington, Thursday, Nov.11, 2021.
Jose Luis Magana
People walk next to the Washington Monument at sunset on Veterans Day in Washington, Thursday, Nov.11, 2021.

Where veterans in Maine go for services from the federal government could change in the coming years. The Department of Veterans Affairs is out with a set of recommendations that would remake its physical footprint across the nation, including in Maine.

The Togus VA Medical Center in Augusta is Maine's only veterans hospital — and the nation's first VA hospital. But it could look quite different if the recommendations from the VA make it through a long fight in Congress.

VA says the hospital is outdated, too big and no longer in the best location to serve the most veterans in the state. It recommends converting the hospital into an urgent care center and moving emergency room, inpatient medical and nursing home services to Portland and other sites in Maine through public-private partnerships.

In that scenario, VA clinicians would share space and resources with a private sector health organization. But if those partnerships aren't possible, VA recommends those services stay at Togus.

Tracye Davis, the medical center director for the VA Maine Healthcare System, said there is flexibility built into all of the recommendations.

"The only way I would even see those services completely being removed from Togus would be if we could successfully do a strategic collaboration somewhere in the south, but frankly we also need it somewhere up north," she said.

The department also recommends building a new VA nursing home in Portland and a new community-based outpatient clinic in Farmington.

Some of the recommendations are already underway. VA opened a brand-new clinic in Portland back in February, which consolidated an existing clinic in Saco and older facility in Portland.

VA is also in the beginning stages of building a new nursing home on the Togus campus, despite a recommendation that VA remove community living services from the Augusta campus.

"That work will not stop," Davis said. "We are continuing with the construction of that facility, and we will not be closing a brand new facility, even if there are recommendations to move these services to other parts of the state."

The VA says the veteran population in Maine is expected to dip over the next seven years, but the demand for long-term care will increase by 22% as veterans grow older.

Nearly 75% of Maine veterans enrolled in VA live in rural regions, according to the department's latest report. But the population has and will continue to shift to southern Maine, VA said.

There are no recommendations to close community-based outpatient clinics in Bangor, Lincoln, Calais or Presque Isle, Davis noted.

"Just because they did not add more services in these recommendations for the northern market does not mean that we cannot put more services north," she said. "When I look at VA Maine and the future of VA Maine, I see three hubs. I see Bangor, I see Togus and I see Portland. Despite what is in the recommendations and what goes forward, we are going to continue to focus on those three locations, because that's what the veterans of Maine need."

Any potential changes are likely years away. An independent commission of veterans experts must review the VA proposals and submit its own recommendations to the president by next year. Congress would then have to approve them.

The proposal comes on the heels of an effort from state lawmakers to keep two Maine Veterans Homes in Caribou and Machias open beyond this spring.

Corrected: April 13, 2022 at 2:40 PM EDT
This piece was updated to reflect that there are no plans to close the community-based outpatient clinics in Bangor, Lincoln, Calais or Presque Isle.
Updated: March 15, 2022 at 2:04 PM EDT
This piece has been updated with more details on the recommendations from VA and comments from the medical center director of the VA Maine Healthcare System.