MARK R. WARNER Wnited States Senate ee RULES AND ADMINISTRATION July 19, 2019 ‘The Honorable Mick Mulvaney Director Office of Management and Budget 724.17" Street NW Washington, DC 20503 Dear Director Mulvaney: I write to urge the Office of Management and Budget (OMB) to expeditiously approve the prospectus on a Veterans Affairs (VA) outpatient clinic in the Hampton Roads area of Virginia, which was submitted on May 8, 2019 by the General Services Administration (GSA). Further delays will only prolong a process that is already significantly and unnecessarily behind schedule. In 2017 Congress authorized leases for 28 VA facilities around the country, two of whieh are in the Commonwealth of Virginia. The VA passed procurement authority to the GSA for six of the projects, including the Hampton Roads outpatient clinic, in an effort to ensure timely completion of the facilities. GSA has been conducting the lease procurement process for the Hampton Roads facility since March 2018, and is currently in the “prospectus authority” phase of the project. This clinic is essential to reducing VA wait times in a region with one of the fastest-growing veterans populations in the country. From 2012 to 2016, patient visits at the Hampton VA Medical Center increased by 21.4 percent, a rate nearly triple the national average of 7.3, petvent. As of March 2019, patients were waiting an average of 57 days to access primary care at the Hampton VA Medical Center. Meanwhile, at the region’s other VA facility, an outpatient clinic in Chesapeake, veterans experienced wait times of 59 days for primary care. Any further delays constructing and opening this new health facility will only exacerbate the VA’s existing capacity challenges in Hampton Roads, where the veterans population is anticipated to increase approximately 22 percent between 2017 and 2027. As you know, OMB approval is required for lease projects over $3.095 million. GSA cannot proceed on this lease procurement until both OMB and Congress authorize the prospectus document. However, congressional authorization cannot be sought until OMB approves the prospectus. Therefore, in order for this project to move forward, your approval is urgently needed. According to GSA estimates, this project can be completed and turned over to the VA in the fall of 2023 — approximately six years after the leases were tardily approved by Congress. However, this timeline was produced by GSA on the assumption that OMB would approve the project by the end of June. Now that we are more than halfway into the month of July, each additional day that goes by without OMB approval is one more day that Hampton Roads veterans could have to wait to see this long-promised facility up and running.ask that OMB do everything possible to expedite the review and approval of this prospectus document within the next week. The prospectus document is no more than a few pages — should not take OMB over two months to review the proposal. Once OMB is finished, I will do my part to ensure that the Senate conducts our approval process in an expedited manner, and together I hope that we can put this lease project back on track so that veterans in need of the facility will be able to use it as soon as possible. I look forward to your response, or even better, to the notice that OMB has approved the lease prospectus. Sincerely, Wk. © Nome, Mark R. Warner United States Senator