Making Togus healthy

Each of the four members of Maine’s congressional delegation appears sincerely committed to making the Togus Veterans Administration Center and Hospital healthy. But unless the delegation can maintain a focused, coordinated effort, Maine vets more and more often are going to be taking the long drive across the Piscataqua River to centralized services in Boston.

Part of the relentless erosion affecting Togus is also being felt at other hospitals: Out-patient care is the order of the day, and fewer bed days means less staff and, often, a greater imposition on patients. Indeed, the staff at Togus has dropped from 1,000 several years ago to 850 and falling today. Some of the positions that are vacant but need to be filled, according to Rep. Tom Allen, include chief of mental health services, cardiologist, psychiatrist and nursing and therapist jobs. More vacancies are expected by the end of this year through another anticipated buyout.

Even more important than out-patient care, however, is the growing caseload at Togus at a time of flat or falling budgets. The 500-acre hospital campus near Augusta is part of a New England-wide district called the Veterans Integrated Services Network 1 (VISN 1), which faces possible funding reductions based on changing demographics nationwide. The problem is that while VISN 1 is expected to serve fewer veterans as a region, Maine specifically is expected to serve more. In fact, Togus has seen a steady increase of 200 to 400 veterans a year for almost the last decade and will offer care to 17,000 this year.

Hard work by veterans and members of the delegation has kept this issue before the public. The Veterans Administration has taken the positive step of scheduling a review of the facilities next week to answer questions about staffing and productivity levels. Team members might be met with some less than happy comments. Sen. Susan Collins was blunt on the issue: “Service reductions at Togus dishonor the sacrifices of Maine veterans and are an abandonment of our country’s obligation to them,” she said. “We should not force veterans to leave the state to visit a VA center or to receive medical care that should be available here.”

Proposed funding changes are reason enough for the review team to visit Maine, but the team has an opportunity to go further by dispelling doubts about the long-term health of Togus. A VA plan, for instance, has the Togus laboratory facilities being consolidated with other VISN 1 labs in West Roxbury, Mass. Rep. John Baldacci reports that is not expected to happen and, in any event, makes little sense because the lab in Maine has proved more efficient than its counterparts elsewhere in the network. But the existence of the plan should make Maine wary. The VA group cannot answer every question. It can, however, can recognize that veterans have legitimate concerns, based on very real cutbacks, about where their hospital will be trimmed next.

Something else for these officials to keep in mind: A recent VISN-wide study showed that while Togus cares for 12 percent of the patients within the network, it receives 8 percent of the network’s funding. That at least suggests the staff there is doing its job and more. But simply doing a good and efficient job is not always enough. The delegation members, the governor and veterans’ groups need to sit down to develop a coordinated strategy to ensure that the country meets its obligation to veterans.

Sen. Olympia Snowe recently referred to Togus as “the heart which provides the lifeblood for veterans throughout Maine.” For veterans who may have provided their own blood for their nation, a fully staffed and operating medical center at Togus is a small expression of gratitude from their fellow citizens. It is also a promise made to vets that the delegation must work together to keep.