VA Task Force Considers Private and Academic Partnerships with N.H. Hospitals

Jan 10, 2018

A pipe burst from the cold weather on the first floor of the Manchester VA, which caused some flooding.
Credit Peter Biello / NHPR

It’s been nearly six months since problems at the Manchester VA made national headlines.

Whistleblowers came forward with accusations of dangerous delays in care and unsanitary conditions. A task force formed in the wake of those accusations has been meeting to figure out the best way to deliver care for New Hampshire veterans.

Morning Edition Host Rick Ganley spoke with NHPR's Peter Biello who attended a meeting of the task force yesterday.


(Editor's note: this transcript has been edited lightly for clarity.)

Okay, remind us of why this task force exists.

A couple of reasons why the task force exists. First, the accusations of a dozen whistleblowers of mismanagement at the Manchester VA. Some of the allegedly most problematic employees have been removed from their positions or they have retired. But problems with managing veterans care remain. This task force is not an investigative body. It's not meant to figure out who did something wrong if anything wrong was actually done. But the problems were severe enough that VA Secretary David Shulkin thought a closer look was necessary.

The second reason for this task force is that there is an infrastructure problem at the Manchester VA. A pipe burst last July causing massive flooding that has left some space at the Manchester VA unusable to this day. It's still under construction. So there are other problems at the building as well, and the task force is trying to figure out what the VA can do on site for vets, versus what it should farm out to private doctors. And it's also trying to figure out what, if anything, it should do to the physical building to improve the infrastructure at the Manchester VA.

Okay Peter, so what happened at this latest meeting yesterday?

Much like the other meetings, they've been gathering information. There was more deliberation yesterday, but the task force has been gathering information about how veterans get their health care now, both within the VA and in the private sector. They've also been looking at what the VA does well, and what it can't do right now. And they're going to make recommendations on what the VA should do.

Right now there's a blend of services in-house and then a reliance on private hospitals. At yesterday's meeting the unofficial theme seemed to be partnerships. How would veterans benefit from partnerships with hospitals in the area? How might academic partnerships work? The White River Junction VA in Vermont has an affiliation with Dartmouth-Hitchcock, and that seems to be working well for that hospital. Could something similar be setup here? Is that something that could work? They're considering that.

And what hospital would the Manchester VA be able to partner with?

They've actually got some partnerships in place right now. They've partnered with CMC.  VA doctors at Catholic Medical Center are providing care for veterans. They've been doing that for several months now. That seems to be working out.

There is another partnership that they launched recently with Frisbie Memorial Hospital. That one's on hold. It was formed to allow VA doctors to perform certain procedures like endoscopies at Skyhaven, which is, according to Frisbee's senior vice president, "comprised of the hospital and physicians as investors." They sent a doctor over there, got through a few procedures and then was told Skyhaven is closing. You guys need to leave. So it's unclear why Skyhaven is closing, but the fact of the matter is that this partnership is slowly being restarted. Interim Manchester director Al Montoya says they're working to send that doctor they sent to Skyhaven back to Frisbie, but that agreement is not fully in place yet.


And amongst all of this, meanwhile I hear that the Manchester VA has had another flooding problem.

Yeah, and I should clarify that, you know with the cold weather, a lot of places have had problems. This was a pipe that burst because of the cold. It was in the greenhouse near the solarium on the ground floor of the Manchester VA. It was flooded. Interim Medical Center Director Al Montoya says there was no clinic space that was disturbed. But if you go downstairs to the lower level at the VA, you'll see fans in the hallway drying out the sheet rock.

This I found during a break in the task force's meeting, right after I heard from Garrett Stumb, Chief of Facility Services, who spoke about the construction projects going on at the Manchester VA. One of the things that he said was that he had been sounding the alarm for almost a decade on crumbling infrastructure, bad pipes. He said essentially that he's been telling the administration for years that if you don't maintain this place, it's not going to be a usable building. And so he says as a result of a lack of required maintenance over the years, the medical center is in much worse shape than it should be.

Jennifer McDonald is the new co-chair of the task force created to figure out the best way to deliver care for New Hampshire veterans.
Credit Peter Biello / NHPR

And finally Peter, I think this is worth mentioning. The task force has yet another new co-chair?

Yeah, the task force that met yesterday is meeting again this morning. It has a new coach co-chair. Dave Kenney, a Navy veteran who is also chair of the State Veterans Advisory Committee has been the one constant co-chair. His first co-chair, Dr. Michael Mayo-Smith, was removed because of concerns that Mayo-Smith knew about the problems at the Manchester, but didn't do enough to correct them. After Mayo-Smith was Dr. Jennifer Lee who is based out of central office in D.C., but she got a new job, left the. So now Dr. Jennifer McDonald is stepping in. Dr. McDonald is currently the clinical lead for the Office of Connected Care, which oversees initiatives like telehealth. And she gave a short presentation on telehealth yesterday. So now she is getting caught up on the work that's already been done.

After all this, I know Peter, you've been reporting on this from the beginning. What is the next step after this six months plus of meetings?

Well Dave Kenney, the co-chair of the task force, says they're about halfway done. Their next step is to continue meeting and develop a set of recommendations that they're going to hand up to another committee within the VA, and that committee (the Special Medical Advisory Group, or SMAG) is going to try and help make decisions about where the Manchester VA should go.