Letter to Robert McDonald, Secretary of the Veterans Administration - Veteran Care in Montgomery County

Letter

Dear Secretary McDonald:

We are writing to urge your prompt approval of plans to establish a Community-Based Outpatient Clinic (CBOC) in Montgomery County, Maryland and to urge that it be operational as soon as possible.

The Montgomery County CBOC was first authorized in 2008 and was scheduled to open in 2010. However, greater priority was given to establishing clinics in other parts of Maryland instead of Montgomery. Finally, in the spring of 2013, the VA informed us that it would soon begin identifying potential locations in Montgomery County. Those plans, too, were delayed by the Strategic Capital Investment Planning process (SCIP). We were delighted to learn that the Montgomery County CBOC has now been approved by the VA Hospital Association's Capital Asset Board and is awaiting final approval by the Under Secretary for Health and by you. Given the urgent needs for this facility, we are disappointed that, because of the VA's three-year lease acquisition process, the clinic may not open until January 2018.

As Members of Congress who each represent a portion of Montgomery County, we strongly urge you to approve this project and move it towards implementation as quickly as possible. Together, we represent over 44,600 veterans, the fourth largest concentration of veterans in Maryland. The needs of these veterans are of the greatest priority and the benefits of locating an outpatient clinic in this county are unmistakable.

Of the more than 44,600 veterans living in Montgomery County, more than 10,000 are enrolled in the VA health care system. According to statistics provided by the VA, over 4,000 of these veterans live within easy driving distance of the general area in which a CBOC might be located, which we understand would be in the Rockville/Gaithersburg area. Furthermore, we understand that the VA's goal is for no veteran to be more than 30 minutes from medical care. Gaithersburg is 41 minutes from the VAMC in Washington, D.C. in uncongested traffic. In rush hour, the trip is much longer. And although Gaithersburg is 35 minutes from the Fort Detrick CBOC in Frederick, Maryland, Montgomery County veterans are assigned to the D.C. Medical Center, not Martinsburg, which operates the Fort Detrick CBOC. As the population in areas north of Gaithersburg continues to grow as expected, this problem will worsen.

As stated above, only one-fourth of the veterans in Montgomery County are enrolled in the VA health care system. We suggest that access to care may well be a major reason for this. Looking at poverty rates in the parts of the county in which large numbers of currently enrolled veterans reside, it is logical to surmise that many more of them might avail themselves of the VA for their health care if services were readily available.

The long trips in bad traffic pose particularly difficult problems for veterans needing continuous care. For example, PTSD, one of the most common problems faced by returning veterans, is usually treated with cognitive processing therapy, which, according to the VA, requires at least 12 sessions with a therapist. In Montgomery County, many veterans turn to private psychiatrists because of the dearth of accessible government providers. Furthermore, many who are prescribed psychotropic medications by private psychiatrists are often unable to afford their medicine and sacrifice necessary follow-up care, including critical medication management.

In addition to the clear need for better access to medical care for Montgomery County's current and future veterans, establishing a CBOC in Montgomery County has additional benefits that are beyond the current standard guidelines for a CBOC site. Montgomery County is home to the National Institutes of Health, Walter Reed National Military Medical Center, and the Food and Drug Administration. In addition, a large medical/biomedical research facility anchored by Johns Hopkins University and home to the National Cancer Institute is being developed in Rockville. Together, these facilities offer exciting opportunities for medical collaboration and innovative partnerships with the VA. This proximity to research and innovative technology offers enormous potential that can benefit our veterans while providing invaluable opportunities for VA physicians and researchers.

We strongly urge that the CBOC for Montgomery County, Maryland, be approved quickly and that leasing be accelerated so that it can become operational as quickly as possible. This request is strongly supported by the three members of the U.S. House of Representatives representing Montgomery County, as well as Montgomery County Executive Isiah Leggett, who has written separately in strong support of the project.