10 August 22-28, 2024 miaminewtimes.com | browardpalmbeach.com New Times | music | cafe | culture | Night+Day | News | letters | coNteNts | Month XX–Month XX, 2008 miaminewtimes.com MIAMI NEW TIMES | MUSIC | CAFE | FILM | ART | STAGE | NIGHT+DAY | METRO | RIPTIDE | LETTERS | CONTENTS | across the main hospital, community living center, spinal cord injury facility, and mental- health center. Budget submissions show that of the doz- ens of renovation and construction projects planned at the hospital, many have yet to commence — a lumbering pace of modern- ization not uncommon at VA facilities nation- wide. The 2023 fiscal year budget listed more than $200 million in estimated costs in a long-term plan for projects at the Miami VA. Patrick Murray, legislative director of the nonprofit Veterans of Foreign Wars of the United States, more commonly known as the VFW, says the national budget shortfall for VA hospital construction and maintenance projects is mammoth and getting bigger. The upshot: Routine projects at aging facilities are being put off year after year, in some cases causing what would be moderately expensive repairs to snowball. The VA’s 2023 budget for construction and maintenance amounted to roughly $5.5 bil- lion. That may sound like a lot, but Murray notes that it’s a small slice of the $130 billion required to modernize the VA’s healthcare system nationwide. “Bringing the VA hospital system up to date would be a massive undertaking and take a transformational amount of money. The system does not prioritize projects until things break and people’s health and safety are affected,” says Murray, who has testified to Congress about inadequate funding for veterans’ hospitals. “The more you let these projects go, the worse they get,” he adds. “The work that needs to be done has skyrocketed, and they’re doing nowhere near enough to keep up with it. When a major incident hits the news, maybe Congress gets involved and they’ll fix that one issue. Meanwhile, another 100 are left to business as usual.” When It Rained, It Poured — Into the Miami VA The former Miami VA doctor says that al- though leaks were common knowledge among Miami VA staff, the 12th-floor hospital wing shutdown caught them by surprise. Sev- eral patient beds had to be taken out of com- mission owing to water damage. “It wasn’t like a planned, structured clo- sure,” the doctor explains. “Everything was so geared toward trying to paint these issues better than they are and skate over problems rather than ever actually addressing them.” Containers filled with water from leaks have been a common sight in the hallways of the Miami VA complex over the past year. The roofs over the nursing home building and main hospital were dilapidated and in need of repair, by all accounts. “You could walk the hospital and see drain hoses going into buckets,” union leader Fro- gameni says. “So much of this has been from yearslong neglect, and it’s just baffling why it was not dealt with. It’s not good for the vets, and it’s not good for the staff who serve the veterans.” The regional VA office confirmed to New Times that beds were moved to a dry area ear- lier this year while temporary repairs ad- dressed the leaks. “Roof leaks have occurred during heavy rain events,” VISN 8 said in its statement. “Projects for the replacement of two roofs are on the upcoming operating plan.” Asked whether the VA tackled that and other maintenance issues at the hospital in a timely fashion, VISN 8 responded, “The Mi- ami VA leadership team, along with engineer- ing and construction experts, regularly review the need for recurring maintenance and new construction projects. Projects are developed at the local facility level annually or more fre- quently if required. From there, project re- quests go through a formal approval process and then are executed by the medical center.” The VA says permanent repairs are slated for completion on the nursing home roof in December 2024 and on the main roof by the fall of 2025. The nurses union calls the progress a “good development.” The doctor who spoke with New Times believes the VA can get away with deferring projects more easily than private hospitals because it has a “captive patient population.” Federal data shows that out of 23 regions in the VA healthcare system nationwide, Florida has the sixth-highest percentage of veterans with incomes less than $35,000. A 2023 survey found that 30 percent of VA healthcare enrollees under the age of 45 and 24 percent of those between the ages of 45 and 64 had no alternate insurance. “It’s easy to defer maintenance and up- keep if you’re not competing for commercial dollars. A lot of private healthcare is hospital- ity,” the former Miami VA doctor asserts. “The harsh reality is that if a private hospital was dealing with these issues, people wouldn’t go there.” “Hospital-Wide Mess” Medical workers and patients who’ve stayed at the Miami veterans’ hospital in recent years are familiar with air-conditioning fail- ures in the middle of summer heat waves. Critical care nurse Riezel Paraiso, the associ- ate director for National Nurses United in Miami, recalls that the AC system floundered during the COVID-19 pandemic, stifling proper airflow and ventilation deemed criti- cal to stem the spread of the virus. But when temperatures started climbing inside the medical center in August 2023, Paraiso and her colleagues realized the con- ditions were worse than ever. The facility’s “spot coolers” — portable cooling devices brought in to compensate for the failing air conditioning — weren’t up to the task. The hospital temporarily halted elective surgeries. Two out of the Miami VA’s three medical-surgical units were shut down and patients were transferred en masse, creating a situation that nurses’ union leader Bill Froga- meni describes as “a hospital-wide mess.” One patient who was thought to have an aortic aneurysm was transferred to a nursing home-style unit that lacked telemetry devices needed to monitor his heart activity, respira- tory rate, and oxygen levels, according to the union. Paraiso and the since-departed physician who spoke to New Times both recall that while the hospital scrambled to restore the AC, some patients were held in the emer- gency department for more than a day — a breach of medical standards, which require prompt triage and transfer of patients to ap- propriate units. (Emergency departments are meant to stabilize patients, not provide ex- tended treatment, since they are not always equipped with staff and resources to provide specialized care, according to the doctor.) The two medical workers say the hospital administration’s attempt to downplay the se- verity of the situation frustrated them as much, if not more, than the air-conditioning breakdown itself. While briefing staff in a town hall-style meeting a few days after the air conditioning failed in August 2023, the di- rector of the Miami VA Healthcare System claimed “no patient safety issues” arose from the breakdown. The Bruce W. Carter Department of Veterans Affairs Medical Center west of Overtown in Miami State of Decay from p8 “The harsh reality is that if a private hospital was dealing with these issues, people wouldn’t go there.” Miami VA Healthcare System photo via Flickr
