VA to Merge Clinics and West L.A. Hospital

The West Los Angeles Veterans Affairs Medical Center and the VA’s Southern California System of Clinics will merge, creating the largest regional veterans health care system in the United States, federal officials announced Thursday.

The integrated medical system, with an annual budget of more than $400 million, will serve most of Los Angeles, Santa Barbara, Ventura, Kern and San Luis Obispo counties.

The goal is to reduce administrative duplication and put the savings into improved patient services and expanded access, said Dr. Kenneth W. Kizer, the VA’s undersecretary for health.

Some of the changes will be invisible to patients, officials said, but the biggest difference should be obvious: closer and more convenient care. New clinics will open soon in Lompoc, Oxnard and San Luis Obispo, and six more are in the planning stages, officials said. Also, patient records will be centralized, allowing relatively seamless transfers and referrals, they said.

The new system, which will be transformed over the next several months, is expected to serve more than 75,000 patients at 12 facilities, handling more than 900,000 patient visits a year. The major facilities involved, besides the West Los Angeles hospital, are the Los Angeles Outpatient Clinic downtown and the Sepulveda clinic.

No other VA hospitals--neither the agency’s Long Beach nor Loma Linda medical centers, for example--are part of the current consolidation, but officials did not rule out their inclusion later on.

Kizer said that layoffs are “not anticipated” but that buyouts are possible and that some vacant administrative positions will remain unfilled. Though no money will be added to the system--the Veterans Health Administration’s budget is frozen--any savings will go into increasing medical staffing and adding clinics, he said.

“We’re moving money from paper pushers to clinicians,” Kizer said. “That’s really what it’s all about. We have a fixed budget. We’re trying to provide more care--and we can’t do it with the current mix.”

The network, to be called the VA Southern California Health Care System, will continue existing affiliations with the UCLA and USC medical schools and will conduct rigorous research, officials said.

The consolidation is part of a larger trend in the Veterans Health Administration system--and indeed the health care industry--toward outpatient care as opposed to hospitalization. Kizer said that under his leadership since late 1994, almost half the VA hospitals have closed and 210 clinics have been added nationwide. Staff positions have been reduced by about 25,000.

In the past two years alone, 44 other VA medical facilities have been integrated at 21 locations throughout the country.

Kenneth N. Warr of the Disabled American Veterans said Thursday that he is optimistic that the consolidation in Southern California will reduce redundant functions such as laundry services and ordering of supplies, but he suspects that some of his compatriots are not as sanguine.

“Some of them have been going the same place for 30 years,” he said. Others may believe that all the medical resources will be concentrated at the hospital rather than the clinics, Warr said.

But they will adjust, he added--the same way patients did after the Northridge earthquake in 1994, when the Sepulveda VA hospital was damaged and ultimately was replaced by a clinic.

Thursday’s announcement follows a move last July in which 29 of 211 doctors were laid off at the West Los Angeles VA hospital. The layoffs, which top officials described as very limited in scope, were intended to compensate for what they called overstaffing. (The hospital’s number of beds had decreased from about 1,200 several years ago to fewer than 1,000.) But doctors at the time said the medical cuts at both the West Los Angeles and Long Beach hospitals could create a “lethal crisis” in patient care.