In the Hampton, Virginia, region, where many of health facilities are old and overburdened, the Department of Veterans Affairs hopes two newly constructed medical clinics will help ease the strain.
"This area happens to be one of the fastest growing populations of veterans, just because of all the installations here," VA Under Secretary for Health Shereef Elnahal said last year at the ribbon cutting for one of the facilities, a clinic inside Joint Base Langley–Eustis.
But veterans will have to wait longer for a second clinic, an outpatient facility in Chesapeake that the VA planned to open in 2024. It's now not expected to be ready for patients until April 11.
The VA cites problems with permitting, installing IT equipment and weather delays, according to agency spokesman John G. Rogers.
Hiring also has been an issue. With the new opening dates roughly 90 days away, the Hampton VA hasn't found candidates for more than two-thirds of the 527 people needed to run the clinic, Rogers said.
Stacy Shorter of the American Federation of Government Employees Local 53, which covers the area, said three months is not enough time to hire that many employees in time for the opening.
"There's hundreds of different types of disciplines that run a hospital," Shorter said. "You can't run a hospital with all doctors. Who's going to do the scheduling? Who's going to do the cleaning? Who's going to sterilize the equipment?"
The union is concerned that President Donald Trump's executive order to freeze federal hiring will exacerbate problems at the VA, which has experienced staff shortages in many health facilities nationwide.
At the VA, the hiring freeze has become a moving target. Shortly after Trump's order was made public, the VA announced 300,000 of roughly 485,000 positions will not be subject to the freeze, mainly critical care positions like doctors and nurses.
The Hampton VA went further, stating the entire Chesapeake clinic is exempt from the freeze.
Retired psychiatrist Dr. Harold Kudler, a former VA executive who ran the mental health program in the Hampton region, said a number of things created the personnel shortage, including major legislation that expanded VA benefits in 2022.
"This hiring problem at the VA did not begin with the Trump administration," he said. "The PACT Act was the icing on the cake as a rapid expansion. Literally, more than a million, close to 2 million, people enrolled in VA based on that."
The VA went on a hiring spree after the law passed, but began cutting back last year, faced with a budget deficit. Kudler said the price of care also ballooned under the 2018 Mission Act, which allowed more veterans to opt for care by non-VA providers in the community.
Shorter, the union official, said hiring delays can lead to a snowball effect that can have a long-term effects if it causes veterans to seek care outside the VA.
"We don't have the staff; we can't see the patients. Everyone's going to community care. So we send all our money out there, so even if the hiring freeze ends, we don't have any money to hire new staff," she said.
And then there is concern about Trump's order requiring federal employees to return to the office if they've been working remotely. The VA doesn't have space for workers hired specifically to work remotely or clinicians who share a office, said Sheila Elliot, another union official.
"We don't have the space to sit everybody in a seat," Elliot said. "When you have people who are seeing veterans for their health conditions and so forth, those people have to be in private offices."
She said it has been difficult for staff to get consistent answers from VA leaders, who may not know themselves how the new policies will be implemented.
A statement from the Hampton VA said despite the changes, "the facility has no plans to reduce any care, virtual or in person, that we provide to our veterans."
This story was produced by the American Homefront Project, a public media collaboration that reports on American military life and veterans.
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