11 August 22-28, 2024 miaminewtimes.com | browardpalmbeach.com New Times | Contents | Letters | news | night+Day | CuLture | Cafe | MusiC | miaminewtimes.com MIAMI NEW TIMES | CONTENTS | LETTERS | RIPTIDE | METRO | NIGHT+DAY | STAGE | ART | FILM | CAFE | MUSIC | “The biggest problem is that there are is- sues. And rather than address the issues, it was a constant reaction of trying to cover it up and spin it,” the since-departed doctor says. Adds Frogameni, “Contrary to what the administration has been at pains to say, clearly patients were in danger. Clearly, safety was compromised.” Documents reviewed by New Times show that AC repairs at the main hospitals had lin- gered on the VA’s repair list for a decade. And as the years passed, the cost of planned up- grades crept higher and higher. A planned infrastructure upgrade that in- cluded the installation of new air-conditioning chillers, water pumps, and a chiller for drink- ing water appeared on a fiscal year 2014 bud- get submission at a cost of $2.35 million. Six years later, the budgeted price tag to address the deficiencies and increase cooling capacity was pegged at $7.7 million. Plans to replace the chillers reappeared in the VA budget in March 2021 and again in early 2023 — by which time the tab had risen to $9.9 million. Though the temporary units brought in last August restored reasonable temperatures in the hospital, the nurse’s union says spot coolers have remained in place, namely around patient rooms prone to heat up from windows facing the afternoon sun. In response to questions from New Times, VISN 8 says the August 2023 AC failure re- sulted from a breakdown during routine maintenance. To this day, the VA maintains that patient care wasn’t significantly affected. “We are happy to report that there were no major disruptions to care or services,” the regional office stated. Critical Projects SCIPed Failing infrastructure at VA facilities isn’t unique to Miami. The median age of a VA acute-care medi- cal center in the U.S. is 58 years. Many date back even further, to the post-World War II era. The Department of Veterans Affairs op- erates more than 170 hospitals that serve more than nine million veterans. According to the Independent Budget vet- erans’ service organizations — which collec- tively make funding recommendations to the VA on behalf of the Disabled American Veter- ans, Paralyzed Veterans of America, and the VFW — the VA’s healthcare system has amassed a backlog of roughly $20 billion in repairs and other nonrecurring maintenance projects nationwide. “I worked for a general contractor for years and witnessed problems with national infrastructure firsthand — what the true need is versus the pitiful amounts of dollars we throw at these things. The VA is no different,” the VFW’s Patrick Murray tells New Times. “What would have cost you a dollar today is going to cost you two dollars tomorrow. That’s VA construction in a nutshell.” In 2010, the VA implemented the Strategic Capital Investment Planning (SCIP) pro- gram, which was designed to streamline the process of maintaining VA facilities. Under SCIP, regional offices assign scores to projects based on their impact on improving patient care, treatment access, and infrastructure, among other criteria. Murray and Veterans of Foreign Wars have criticized the system, contending that it pits aspects of VA services against one an- other, forcing the agency to choose between adequately funding maintenance, construc- tion, and veterans’ benefits. “At best, SCIP provides nonbinding sug- gestions to the VA budget process, which are regularly ignored, resulting in an ever-in- creasing backlog of overdue maintenance and construction projects,” the group said in a statement in response to the VA’s 2023 fiscal year budget. “Furthermore, as long as fund- ing for VA infrastructure remains part of its discretionary budget, it must compete with other VA healthcare and benefit delivery pri- orities in an era of rising deficits and debt, budget caps, and sequestration.” The Independent Budget collective has cautioned that cooling-system upgrades, in particular, might fall by the wayside. “The need for heating and cooling system repairs, or generator upgrades, may not im- mediately stand out as critical, but failures of these systems could lead to life safety issues,” the group warned in 2019. The VA maintains that the system objec- tively prioritizes projects with respect to funding resources: “The process determines the relative criticality of projects for the bud- get year, and long-range potential projects, af- ter a rigorous evaluation process using specific criteria.” As it happened, plans for major repairs the Miami VA medical staff deemed essential ap- peared on the SCIP list, only to face delays. The chiller upgrade, which ranked 160th out of 582 one-time maintenance projects on the 2020 budget, is still in the design stage. Meanwhile, Frogameni says some bath- rooms at the hospital remain in a dilapidated state, with the worst of them located on the first floor in the community living center. The union leader claims that the restroom, which staff members no longer use, has been in that condition for as long as he can recall. Another staff bathroom on the second floor, which is still in use, had peeling finishes on the ceiling and a detached sink sitting on the floor for years, Frogameni says. It was re- cently patched up, though a toilet remains wrapped in plastic and out of commission. In Murray’s view, even if the VA received the tens of billions of dollars required to up- grade its infrastructure nationwide, delays would persist unless the administration hires an army of new managers to help initiate and oversee projects. His group has recom- mended hiring 350 new employees for that task — a number that does not include adding necessary personnel at individual hospitals. “We Are There to Give Back” In recent years, the debate over how to mod- ernize the Veterans Health Administration and its facilities has grown as heated as the Mi- ami VA during an air-conditioning breakdown. In 2022, Congress stymied a federal initia- tive that sought to close down dozens of VA medical centers and privatize a significant portion of veterans’ care. The plan would have abandoned the Miami VA and con- structed a new, smaller facility, in part to re- flect an ongoing decrease in the veteran population. Opponents decried it as an at- tempt to drastically downsize VA hospital care and divert dollars to private companies to the detriment of veterans. With the Bruce W. Carter VA Hospital slated to remain open for the foreseeable fu- ture, projects to upgrade the campus are still on the table. The current list includes improvements to the facility’s critical-care unit and surgical suites — steps the former VA physician who spoke to New Times sees as encouraging. “One thing people have to understand: We love what we do,” says the nurse who de- clined to be named in this story. “We love the VA. We love the veterans, and we appreciate the sacrifice that they made. That’s why we are here to give back. A lot of them are dealing with issues that other people do not have be- cause of the sacrifices they made: homeless- ness, mental issues, medical issues related to their service — the VA has done so much for them, and we can appreciate that. “It’s the lack of investment and attention to infrastructure — that’s what caused the big problems,” the nurse adds. “There’s a lot of politics, red tape — there’s that side of it. I don’t think it should be that difficult.” [email protected] An abandoned bathroom on the first floor of the Miami VA hospital Photo by Miami VA staff member
