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GAO-03-1103R 1 (2003-08-18)

handle is hein.gao/gaobaamha0001 and id is 1 raw text is: i Accountability * Integrity * Reliability United States General Accounting Office Washington, DC 20548 August 18, 2003 The Honorable Everett Alvarez, Jr. Chairman, CARES Commission Department of Veterans Affairs Subject: VA Health Care: Framework for Analyzing Capital Asset Realignment for Enhanced Services Decisions Dear Mr. Chairman: On May 14, 2003, at your request, we briefed you on our preliminary views on the Capital Asset Realignment for Enhanced Services (CARES) process initiated by the Department of Veterans Affairs (VA). On July 29, 2003, we met with your staff to share our additional perspectives, which they indicated would be helpful to the Commission as it considers the draft National CARES Plan that VA presented on August 4, 2003. For this reason, we are providing, for your consideration, an overview of the approach that we plan to use during our continuing review of CARES. As you know, VA operates one of the nation's largest health care systems, having provided health care services to almost 4.3 million veterans in fiscal year 2002. In 1999, we reported that better management of VA's large, aged capital assets- consisting of a real property infrastructure that includes over 4,700 buildings and structures and 15,000 acres of land-could significantly reduce funds used to operate and maintain underused, unneeded, or inefficient properties.' We also noted that these funds could be used to enhance health care services for veterans. Specifically, we recommended that VA develop market-based asset-restructuring plans2 that are consistent with guidelines from the Office of Management and Budget (OMB), which provide key principles and concepts for disciplined, cost-effective management of real property. In response, VA initiated the CARES process in October 2000. 'See U.S. General Accounting Office, VA Health Care: Capital Asset Planning and Budgeting Need Improvement, GAO/T-HEHS-99-83 (Washington, D.C.: Mar. 10, 1999), and VA Health Care: Improvements Needed in Capital Asset Planning and Budgeting, GAO/HEHS-99-145 (Washington, D.C.: Aug. 13, 1999). 2VA subsequently defined a health care market as a geographic area having a sufficient population and geographic size to benefit from the coordination and planning of health care services and to support a full health care delivery system. 3Office of Management and Budget, Capital Programming Guide, Version 1.0 (Washington, D.C.: July 1997). GAO-03-1103R Enhancing VA Health Care by Realigning Assets

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