Iowa City VA to expand mental health, long-term care under sweeping proposal

IOWA CITY — The Iowa City-based VA health system will open new rehabilitation and long-term care facilities to meet growing patient demand under extensive nationwide proposals for veterans’ care released this week by federal officials.

The Biden administration announced plans Monday to reposition the country’s veterans’ health care system to conform to new needs among patients in the coming years, which would include the closure of hospitals and clinics across the country and the construction of new facilities in areas with greater demand.

The VA Health Care System in Iowa City, which serves veterans and their families in Eastern Iowa and Western Illinois, would not be included in the list of hospitals or outpatient clinics facing closures.

Instead, under this proposal, the local health care system would be approved to build a new 30-bed residential rehabilitation and treatment program to provide mental health services and to invest in a partnership to expand long-term care services in a new community living center.

The proposal also recommends sustaining the level of tertiary care — highly specialized or complex care — offered at the Iowa City VA Health Care System.

These recommendations did not surprise Iowa City VA officials, who identified similar needs and have been working to expand those services independently, said Jamie Johnson, public affairs officer.

Demand for inpatient medical and surgical services are projected to decrease, but demand for inpatient mental health care is expected to increase 6.2 percent by fiscal 2029, according to a VA market recommendation report for Eastern Iowa sent to the federal Asset and Infrastructure Review Commission this week.

The demand for long-term care, on the other hand, is expected to increase by a whopping 64.9 percent by fiscal 2029 here, the report stated.

That demand is mostly driven by the health care system’s largely aging patient population, who mostly live in rural areas, Johnson said. Nearly 63 percent of enrollees in the market live in rural areas, compared with the national VA average of 32.5 percent.

Currently, Iowa City VA patients must travel to Des Moines to receive treatment under a rehabilitation and treatment program, but officials say they consistently face challenges referring patients to that facility “due to distance, transportation requirements and the inability of family members to engage in treatment or visit.”

Because the Iowa City Medical Center campus is landlocked, Johnson said, officials will likely need to identify a new site to construct a stand-alone residential facility. If the proposal is approved on the projected timeline, Johnson said he anticipates construction wouldn’t begin until sometime in 2026.

Johnson noted the hospital is in the process of converting a vacant 14-bed unit into an inpatient psychiatric unit, filling the current gaps in capacity in the meantime.

The market recommendations also stated a new community living center is needed to meet “the short-stay and long-term care needs” among the local veteran population. At least 10 percent of the current patient population at Iowa City’s 12-acre site require dementia care, which indicates the need for at least 22 beds by fiscal 2029, the report states.

Given the current surplus capacity at Iowa City area nursing home facilities, it presents an opportunity for officials “to collaborate with a community provider to establish a (community living center) for dementia and post-surgical care,” the report states.

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