July 18, 2014
Since June, a Senate and House conference committee has been working to build consensus on legislation to address the enormous backlog of veterans waiting for appointments in VA health care facilities. The cost of this fix would range from $34 to $50 billion, according to the Congressional Budget Office.
Acting VA Secretary Sloan Gibson injected his own plan into the discussion at a Senate Veterans Affairs Committee hearing Wednesday.
Gibson would hire more health care providers, greatly expand VA medical leases and patch the system that schedules veterans into the VA. The estimated cost is $17.6 billion.
About $10 billion of the estimate would be used to fill shortages of health care providers in the VA. But Gibson cautioned that the VA does not know exactly what the actual requirements are because past budgets were built from the top down after Congress approves the funding for the VA health system.
The remainder would be used to rapidly expand VA medical leases, the space needed to see more veterans, and to begin overhauling the VA scheduling system.
Neither Gibson nor lawmakers mentioned the “gold card” initiative sponsored by Sen. John McCain (R-Ariz.) that would enable veterans to manage their own care in the community. But Acting Secretary Gibson explained that the VA has already made 430,000 referrals of veterans into private care outside the VA, an increase of over 79,000 referrals from last year. He said the goal is to build VA’s own capacity to provide care internally and gradually lessen the more costly outside referrals.
Gibson acknowledged that the VA has “unacceptable, systemic problems and cultural issues … preventing some veterans from receiving timely care. That breach of trust — which involved inaccurate reporting of patient wait times for appointments — is irresponsible, indefensible, and unacceptable to the Department. We apologize to our veterans, their families and loved ones, Members of Congress, Veterans Service Organizations (VSO), and to the American people. We can and must solve these problems as we work to earn back the trust of veterans.”
Gibson outlined his plan to address the access crisis, including:
- Removing the 14-day scheduling goal to eliminate incentives for employees to game the system
- Getting veterans into care and off waiting lists
- Holding senior leaders accountable and suspending performance awards
- Changing VA culture
- Increasing transparency of patient wait-time data
- Initiating an independent, external audit of scheduling practices
- Modeling best practices in facilities that need improvement
- Quantifying resource requirements
- Protecting whistleblowers
Ranking Committee Member Sen. Richard Burr (R-N.C.) used his time to excoriate the VA on another issue, the veterans’ benefits claims backlog. He quoted a VA Inspector General witness and a witness from the Government Accountability Office (GAO) from a House Veterans Affairs Committee hearing Monday night that there were serious “data integrity issues” on backlog numbers.
Burr questioned why the VA put out a press release a day after that hearing taking credit for halving the claims backlog and reaching 90 percent quality levels. Gibson maintained that great progress was being made in reducing the backlog.
Later in the hearing, Sen. Mark Begich (D-Alaska) cited a 2003 report indicating there were about 240,000 veterans waiting over 6 months for care at that time.
Panel Chairman Senator Bernie Sanders (I-Vt.) said the goal was to build consensus on pending legislation to address the access problem before the August recess.
MOAA agrees that addressing VA health care access is the first step to rectifying the problems exposed by the scandal in Phoenix. But a high-level, independent commission is still necessary to take a broad look at VA health care and recommend reforms for the 21st century.