A proposal to build a $70 million medical facility in Charleston, S.C., could stall efforts to pass an omnibus Department of Veterans Affairs bill before the end of the lame-duck session next month, CQ Today reports (Yoest, CQ Today, 10/27). The proposal is part of a VA medical facilities bill (HR 5815) passed by the House on Sept. 13. The legislation, sponsored by Rep. Henry Brown (R- S.C.), also would authorize the reconstruction of VA medical facilities in Biloxi, Miss., and New Orleans that both were affected by Hurricane Katrina. In addition, the legislation would allocate $406 million for a new facility in Las Vegas; $378 million for a site in Orlando, Fla.; and $98 million to purchase a site in Denver. The bill also would create a position to oversee the projects. A Senate version of the bill (S 3421) does not authorize funds for the Charleston or Denver projects (Kaiser Daily Health Policy Report, 9/14). The omnibus bill could include the VA medical facilities bill, a bill (HR 5835) that would complete a technology overhaul at the VA and a provision of a Senate VA omnibus bill (S 2694) that would allow veterans to hire attorneys during the VA's claims appeals process.

Opposition
However, some lawmakers and veterans' groups oppose the medical facilities bill because VA facilities usually are selected through recommendations from independent commissions appointed by the VA secretary and because Charleston already has a medical facility that only needs minor upgrades, according to September 2005 testimony from the Government Accountability Office. In addition, the proposed facility would have to share some medical equipment and operating rooms with the University of South Carolina. Some veterans' groups are concerned that sharing equipment could lead to access problems. Steve Robertson, legislative director for the American Legion, said, "We don't want the VA to lose its identity and the veterans to become secondhand patients." However, Raymond Greenberg, president of the Medical University of South Carolina, said the proposed VA hospital could generate revenue from the leased equipment by the hospital. If the VA omnibus bill fails, lawmakers could seek separate authorizations for medical facility construction, according to aides. Rep. Bob Filner (D-Calif.) said lack of compromise on the attorney representation bill also could stall the VA omnibus bill (CQ Today, 10/27).

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