Market Recommendations Released For Chillicothe VAMC

Presented By Ross-Chillicothe Convention & Visitor’s Bureau

UPDATED: 10:30am 3/15/22

The lengthy Veterans Affairs Recommendations on the future of the Chillicothe V.A. Campus to the AIR Commission have been officially released, which includes closing many of the building at the Chillicothe site. The Chillicothe V.A. Campus is under VISN10 Market.

Much of the lengthy report can be found below, along with a link that allows you to pick up on (the remainder of the recommendation), that now goes to the Congress and President for their consideration.

Watch Mike Smith’s interview with Stacia Ruby on a LitterMediaLIVE-Special Edition, talking about what the recommendations mean.

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Facility Overview
Chillicothe VAMC: The Chillicothe VAMC is located in Chillicothe, Ohio, and offers inpatient medical, inpatient mental health, CLC, RRTP, and outpatient services. In FY 2019, the Chillicothe VAMC had an inpatient medical average daily census (ADC) of 12.7, an inpatient mental health ADC of 16.0, a CLC ADC of 154.3, and an RRTP ADC of 63.4. The Chillicothe VAMC was built in 1938 on 308 acres. The main hospital was most recently renovated in 2012. The Chillicothe VAMC totals 1.1 million square feet and 93% of the campus square footage is listed as historic. Facility condition assessment (FCA) deficiencies are approximately $75.3 million, and annual operations and maintenance costs are an estimated $10.9 million.

1. Modernize and realign the Chillicothe VAMC by:
   1.1. Establishing a strategic collaboration to provide inpatient medical services and discontinuing those services at the Chillicothe VAMC. If unable to enter into a strategic collaboration, utilize community providers: The Chillicothe VAMC offers inpatient medical and mental health services, as well as sub-acute services including CLC and RRTP. The VAMC does not have a surgical program. Although demand is sufficient to sustain inpatient mental health, CLC, and RRTP services, demand for inpatient medical services has been declining in recent years. In FY 2019, the inpatient medical program at the VAMC had an ADC of 12.7. Projections indicate bed demand for inpatient medical services at the Chillicothe VAMC will continue to decrease to a projected ADC of 10.8 in FY 2029. In addition, the enrollee population in the Chillicothe area (Ross County) is projected to decrease by 8.5% to 3,196 enrollees by FY 2029. VA will pursue a strategic collaboration with the DoD Wright-Patterson AFB Medical Center to provide Veterans with access to inpatient medical services. VA’s recommendation will maintain access to high quality inpatient medical care for Veterans in the market.
   
2. 1.2. Relocating inpatient mental health, RRTP, CLC, and outpatient services currently provided at the Chillicothe VAMC to current or future VA facilities and discontinuing those services at the Chillicothe VAMC: Although the VAMC has low demand for inpatient medical services, the VAMC had an inpatient mental health ADC of 16.0 in FY 2019, the CLC and RRTP had an ADC of 154.3 and 63.4, respectively. Many of these patients come from outside of the Chillicothe, Ohio area. FY 2029 in-house projections indicate sufficient demand in the future; inpatient mental health has a projected ADC of 16.4, CLC has a projected ADC of 113.5 ADC, and RRTP has a projected FY 2028 ADC of 49.5. Relocating inpatient mental health, RRTP, and half of Chillicothe’s CLC program to the Dayton VAMC (Western Ohio Market), and the second half of Chillicothe’s CLC to a new stand-alone site in Circleville, Ohio (Pickaway County), will allow VA to meet the future demand for these services closer to where Veterans live. The Dayton VAMC is located an estimated 90 minutes from the Chillicothe VAMC. Circleville, Ohio is an estimated 33 minutes south of the Columbus HCC. Additionally, a new MS CBOC in the vicinity of Chillicothe, Ohio (Ross County) will be constructed to maintain access to outpatient care in the area.
   
   1.3. Closing the Chillicothe VAMC: The Chillicothe VAMC is not optimally located as it is an estimated 60 minutes south of Columbus, Ohio, the largest population center in the state. In addition to the projected decrease in bed need for inpatient acute care services at the VAMC, the enrollee population in the Chillicothe area (Ross County) is projected to decrease by 8.5% to 3,196 enrollees by FY 2029. Consolidating inpatient mental health and RRTP services to the Dayton VAMC and establishing a new stand-alone CLC in the Circleville, Ohio (Pickaway County) area will allow VA to continue to meet the demand for these services.

2. Modernize by establishing a new stand-alone CLC in the vicinity of Circleville, Ohio: Given the. considerable current and projected demand for CLC in the market and proposed closure of the Chillicothe VAMC, CLC beds must be appropriately located in a new facility. Establishing a standalone CLC in Circleville, Ohio (Pickaway County) will allow VA to provide CLC services closer to a larger enrollee population in Columbus, Ohio, while continuing to serve the Chillicothe area. Circleville is an estimated 30 minutes from Chillicothe. The projected FY 2029 CLC demand in this market is 108.7 ADC, and 70% of this demand will be met through the new stand-alone CLC in Circleville, which will include 80 beds. The remaining beds will be transferred to the Dayton VAMC.

3. Modernize and realign outpatient facilities in the market by:
   3.1. Establishing a new MS CBOC in the vicinity of Chillicothe, Ohio: Although market demand for select inpatient services including long-term care, residential rehabilitation, and SCI/D services is projected to decrease, demand for outpatient care is projected to increase. A new MS CBOC in the vicinity of Chillicothe, Ohio (Ross County) will maintain access to outpatient care in the county and surrounding area. The MS CBOC is proposed to be located in a more accessible location away from the existing Chillicothe VAMC campus proximate to community providers. As of FY 2019, there were 29,137 enrollees within 60 minutes of the proposed MS CBOC site.
   
   3.2. Establishing a new CBOC in the vicinity of Columbus, Ohio: A new CBOC near Columbus, Ohio (Franklin County) will improve access to primary care and outpatient mental health in the county by relocating a portion of primary care and outpatient mental health workload from the Columbus HCC. The vacated primary care and outpatient mental health space at the Columbus HCC will then be used to expand specialty care clinical space. Franklin County has a projected FY 2029 population of 26,480 Veteran enrollees. In FY 2019, there were 32,821 enrollees within 30 minutes of the proposed CBOC site.
   
   3.3. Relocating all services to the Columbus HCC and closing the Columbus-Airport OOS: The Columbus-Airport OOS offers outpatient mental health services and is located an estimated 10 minutes from the Columbus HCC, which includes more space for outpatient mental health and specialty care services, and an estimated six minutes from the proposed Columbus CBOC. Closing and relocating the clinic’s services to the Columbus HCC will allow VA to continue to provide access and meet demand for this service in an area with 57,286 enrollees within 60 minutes.
   
   Complementary Strategy
   In addition to the recommendation submitted for AIR Commission approval, VA also anticipates implementing a complementary strategy that supports a high-performing integrated delivery network:
   
   Central Ohio Market
   • Combine the Central Ohio and Western Ohio markets into a single market: By combining the Western Ohio and Central Ohio markets, the entire continuum of care will be present within this single market. Access to care will be enhanced by facilities in a single market working together to improve the scope, level, and cost effectiveness of services available to the Veterans in the market.
   
   Chillicothe VAMC and Columbus HCC
   • Add geriatric psychiatry services to the Columbus HCC: There is a gap in geriatric psychiatry services in the Central Ohio Market, indicating a need to add VA-provided outpatient geriatric psychiatry services.
   • Realign the Athens CBOC to the Columbus HCC in the VISN 10 Central Ohio Market: The Athens CBOC is located in the Columbus hospital referral region (HRR) 10 and the Columbus HCC will serve as the only parent facility in the Central Ohio Market. VA will realign the Cambridge CBOC to ensure all points of care in the current Central Ohio Market are aligned under the Columbus HCC.
   • Realign the Cambridge CBOC to the Columbus HCC in the VISN 10 Central Ohio Market: The Cambridge CBOC is located in the Columbus HRR and the Columbus HCC will serve as the only parent facility in the Central Ohio Market. VA will realign the Cambridge CBOC to ensure all points of care in the current Central Ohio Market are aligned under the Columbus HCC.
   • Realign the Marietta MS CBOC to the Columbus HCC in the VISN 10 Central Ohio Market: The Marietta MS CBOC is located in the Columbus HRR and the Columbus HCC will serve as the only parent facility in the Central Ohio Market. VA will realign the Marietta MS CBOC to ensure all points of care in the current Central Ohio Market are aligned under the Columbus HCC.
   • Realign the Lancaster CBOC to the Columbus HCC in the VISN 10 Central Ohio Market: The Lancaster CBOC is located in the Columbus HRR and the Columbus HCC will serve as the only parent facility in the Central Ohio Market. VA will realign the Lancaster CBOC to ensure all points of care in the current Central Ohio Market are aligned under the Columbus HCC.
   • Realign the Portsmouth CBOC to the Columbus HCC in the VISN 10 Central Ohio Market: The Portsmouth CBOC is located in the Columbus HRR and the Columbus HCC will serve as the only parent facility in the Central Ohio Market. VA will realign the Portsmouth CBOC to ensure all points of care in the current Central Ohio Market are aligned under the Columbus HCC.
   • Realign the Wilmington CBOC to the Columbus HCC in the VISN 10 Central Ohio Market: The Columbus HCC will serve as the only parent facility in Central Ohio. VA will realign the Wilmington CBOC to ensure all points of care in the current Central Ohio Market are aligned under the Columbus HCC.
   • Expand outpatient specialty care services at the Grove City CBOC, which may result in the classification of the facility as an MS CBOC: Demand for outpatient specialty care services is projected to increase at the Grove City CBOC (Franklin County) through FY 2029. In FY 2019, the Grove City CBOC had 3,443 core uniques 11 and 30,077 enrollees whose closest point of care within a 30-minute drive time is the Grove City CBOC. VA will expand outpatient specialty care services at the Grove City CBOC to increase Veteran access to these services.

Benefits were evaluated based on five key domains: Demand and Supply, Access, Facilities and Sustainability, Quality, and Mission. The CBA leveraged both the costs and benefits to generate a Cost Benefit Index (CBI) – a simple metric used to compare the costs and benefits associated with each COA. The COA with the lowest CBI is the preferred COA. The results of the CBA for the VISN 10 combined Central Ohio and Western Ohio markets are provided in the following table provided in the following link.

For more detailed information on the market CBA, go to the following link and resume reading by CLICKING HERE AND GO TO PAGE 12 OF THE REPORT: