The Bronx Veterans Administration (VA) Medical Center could absorb an influx of additional patients from the closure of the Manhattan VA facility as early as next year, a possibility that alarms officials and veterans’ advocates. 

According to a current federal proposal, outpatient services at the 378-bed Manhattan VA hospital would move to both the Bronx and New Jersey. Advocates say that the Kingsbridge Road facility is already too strained to absorb such an influx.

"They’re overloaded with patients," said Helene Van Clief, 53, a Bronx veteran who relies on the VA’s services. "It would make it a year and half to get an appointment." 

The U.S. Department of Veterans Affairs first floated the idea of closing the Manhattan facility last year in its national Capital Asset Realignment for Enhanced Services study (or the benevolent-sounding CARES). While the announcement set off a chorus of protest, including from Senators Hillary Clinton and Charles Schumer, the administration is moving forward with a final version of the proposal. 

The overhaul could hit as soon as early 2005, according to Phil Craft, a spokesperson for Manhattan Congresswoman Carolyn Maloney, a leading opponent of the closure. 

While spokespersons for the Manhattan and Bronx VA said it was too early to assess the impact of moving the services to the Bronx, there are clearly concerns.

"We’re obviously hopeful that all the hospitals in the area will remain open," said Jim Connell, a Bronx VA spokesperson.

The Bronx facility is already one of the busiest VAs in the city for outpatient services. Last year they totaled 430,000 visits from vets, according to Connell, while the Manhattan and Brooklyn facilities averaged 300,000 and above. "We stay pretty close to capacity," Connell said.

That’s self-evident to Van Clief who, as a diabetic, must make routine visits to the hospital. But Van Clief, who performed practice maneuvers during the 1980s in Germany, often feels frustrated with the lag time for her appointments. "They say ‘we’re too crowded,’" said Van Clief, who said she was severely disabled as the result of her service.

The VA is implementing a new system that allows patients to get an appointment the day they call, but the kinks are still getting worked out, according to Connell. "We have a lot of walk-in patients," he said.

And increasingly, the Bronx VA treats patients fresh from combat in Afghanistan and Iraq. Connell estimated that the hospital serves "dozens" of soldiers who were recently in battle, with more to come.

Critics charge that the CARES study overlooks these developments. The report bases its recommendations on estimates that the city’s veteran population will sharply decline in the coming decade, but does not include the effects of new casualties.

"They’re just handling Vietnam vets now," said Van Clief, whose husband fought in 
Vietnam. "Do we have enough outpatient clinics to handle the [Iraq war] patients?"

Inpatient and outpatient services offered at the Bronx VA include everything from routine procedures like dialysis to cardiac care and prosthetics. But the Manhattan facility provides many specialized services like neurosurgery, which generates referrals from all around the tri-state area.

Van Clief anticipates using those neurological services if her disability worsens, and if the Manhattan facility closes she will have to trek to the Brooklyn VA for inpatient care. Those using public transportation must take a bus and a train to reach the hospital.

Opposition to the closure is still strong as officials and advocates continue lobbying and letter writing. "It’s not a done deal," Craft said. 

At press time, Van Clief and other VA advocates were traveling to Washington, D.C. to protest the proposed changes.