President Donald Trump signed Sen. Jon Tester's bill securing a lease for a larger Veterans Affairs clinic in Missoula on the first day of August, marking a positive step for a facility that's long been in need of expansion.

Now, the state's senior senator is asking the VA to expedite the process.

Tester this week sent a letter to VA Secretary David Shulkin asking the agency to move the process forward, saying the region's demand for VA care is projected to increase 43 percent over the next 20 years.

While it traditionally takes the VA as long as five years to open a new clinic once authorization is given, Tester said the Missoula facility is needed sooner rather than later.

“To the greatest extent possible, I urge the department to expedite the process for leasing the recently authorized replacement of the outpatient clinic in Missoula in order to better meet current and future patient demand,” Tester wrote. “I urge the VA to move with all due speed to procure this facility.”

Trump signed Tester's VA Choice and Quality Employment Act in August, which included the leasing authority allowing the VA to secure a larger facility in Missoula.

The authorization will nearly triple the clinic's size, providing additional parking, clinical space and the medical services needed to meet the growing demand for VA care in Missoula, the state's second largest city.

Tester's communications director, Marnee Banks, said the VA was authorized to pursue 28 major medical leases under the latest bill, including one in Missoula. The lease allows for a 60,000-square-foot facility with an estimated rent just under $2 million a year.

“It will provide primary care, mental health, specialty care and some outpatient surgeries,” Banks said. “The VA intends for the clinic to be located in the same general area as the existing clinic.”

Banks said it often takes the VA about two years to develop the specific facility requirements once it begins working on the lease. Another year is needed to negotiate with developers prior to issuing a construction award.

That's followed by an additional two years to build the facility.

“The former Deputy (VA) Secretary (Sloan) Gibson had been working to bring this timeline down,” Banks said. “The VA will need to obtain a delegation of authority from GSA to award the Missoula clinic lease.”

The effort to securer a larger Missoula clinic dates back to at least 2014 when Tester began pushing the VA to expand the facility. Back then, a VA consulting team had toured the small clinic and recommended a modest expansion.

Nearly a year later, the General Services Administration began studying the possibility of converting the vacant Federal Building in downtown Missoula to a new outpatient clinic. That effort was later deemed cost prohibitive, leaving the clinic's future in limbo.

At the same time, the VA fell into controversy, resulting in the resignation of then-VA Secretary Erick Shinkseki, who was replaced by Robert McDonald and later by Shulkin, who now heads the agency under the Trump administration.

The Montana Department of Veterans Affairs and its own health care system has also seen a parade of new leaders, including Christine Gregory, Johnny Ginnity and Kathy Berger, who took the agency's helm in late 2016 and pledged changes to the system.