Martha Roby: New law, policy change are good news for veterans
I was honored to be on hand at the White House as President Donald Trump signed the Department of Veterans Affairs Accountability and Whistleblower Protection Act into law. It was one of two recent developments that will bring significant improvements to veterans’ services in this country. For the last several months, Congress has been working to build upon the VA reforms we passed in the wake of the 2014 veteran wait list scandal. That law took an important step to increase accountability by making it easier to remove high ranking VA officials. However, our efforts to extend that flexibility to fire problem employees down the chain of command to rank-and-file workers were unsuccessful due to objections from the Obama Administration and the then-Democratic Majority Senate. I’ve always maintained that senior managers aren’t the only ones responsible for misconduct at the VA. Everyone entrusted with the care of veterans should be accountable for a high standard of service and integrity. Another improvement we’ve needed is protection for whistleblowers who come forward to expose wrongdoing. The brave whistleblowers who told me the truth about the misconduct and abuse at the Central Alabama VA faced serious retaliation for their efforts, and many others around the country have reported similar treatment. The new law grants Secretary of Veterans Affairs Dr. David Shulkin increased flexibility to fire, suspend, or demote any VA employee for poor performance or misconduct. It increases protections for whistleblowers and establishes a new independent office within the VA specifically to look out for those who bring misconduct to light. Another important provision of the new law streamlines the hiring process for VA medical center directors. I personally advocated for this new authority after bureaucratic problems delayed the hiring of a new director for the Central Alabama VA for more than two years. To be clear, most VA employees care deeply for veterans and work hard to offer the best care and service, but for too long a culture of complacency has allowed some to get away with poor performance, negligence, or misconduct. Our veterans deserve the very best care we can give them, and I believe those who depend on the VA will be better served as a result of these reforms. Earlier this month, Secretary Shulkin announced the VA is finally modernizing its patient health record system and bringing it in line with the platform used by the Department of Defense. This is long overdue. It has never made sense to me that the VA would use a different health record system than the military. Think about a veteran who has recently returned from a deployment who has symptoms of PTSD or another battlefield injury. They need access to care right away, but too often they have trouble because the systems don’t communicate properly. We hear from veterans every day who face these gaps in health care, and it is past time the problem was fixed. Congress has prioritized funding for modernizing the health record system, and I am very pleased Secretary Shulkin is using his authority to make this change. Our new reform law and this important policy change within the Department of Veterans Affairs show that Congress and the Trump Administration are working together to turn around the VA and improve services for veterans. I appreciate President Trump and Secretary Shulkin for their commitment to working with lawmakers to put these important changes in place. Three years after the waitlist scandal erupted in our own backyard, I remain directly engaged in pushing for improvements at the VA facilities Alabama veterans count on. Last week I met with VA Inspector General Michael Missal and his staff in my office for an update on their efforts to perform facility inspections and investigate allegations of wrongdoing. I also held my regular call with Central Alabama VA Director Dr. Linda Boyle and her team to go over various issues facing the system. On both a national and local level, the endless saga at the VA has demonstrated the importance of strong, consistent oversight. As your Representative in Congress, I intend to keep applying that oversight and I will continue to keep you updated on our progress. ••• Martha Roby represents Alabama’s Second Congressional District. She lives in Montgomery, Alabama with her husband Riley and their two children.
Quilts of Valor designed to give comfort to Vietnam Veterans
Two local Vietnam veterans were recently presented with their own Quilts of Valor, honoring them for their military service. The two men, Raymond Paul Phillips and John McKiven, have been best friends since they met in Vietnam. Phillips served in the U.S. Marine Corps after training in 1966 at Parris Island, South Carolina. He spent time in Puerto Rico, Vietnam, and Okinawa during his service. He received six ribbons, including two Purple Hearts, the Vietnam Medal of Honor and the Good Conduct Medal. McKiven completed Marine basic training in 1968, at Camp Lejeune, North Carolina. He also spent a week in Twentynine Palms, California, where he learned to shoot a 50-caliber machine gun. He was awarded the National Defense Service Medal, Vietnam Service Medal, Vietnamese Cross of Gallantry with Palm, Vietnamese Campaign Medal and the Rifle Marksman Badge. When McKiven arrived in Vietnam, Phillips was the first Alabamian he met, sparking their friendship. McKiven showed him a photograph of his first cousin, Nancy Faye McKiven, and Phillips began writing her. Phillips returned home before McKiven finished his service, and by the time both men were home, Phillips was spending more time in Southside with Nancy than he was at home in Clio. Phillips married Nancy, making him and McKiven relatives as well as friends. The Phillipses had a long marriage until she died last September. Phillips then moved to Gadsden to live closer to McKiven and family. The quilt presentation was held at McKiven’s home, and friends, family and other veterans were in attendance. Lynn Hales, district coordinator for Northeast Alabama for Quilts of Valor, presented the quilts along with Sue Biggard, her assistant. “It shook me up that they gave us those,” McKiven said. “There’s not many people who’ve done stuff for the Vietnam veterans.” He said he felt the same way when Hales originally called him to discuss the presentation. Many Vietnam veterans were not thanked upon their arrival home, Hales said. Some quilt presentations mark the first time that’s happened. The Quilts of Valor Foundation is a nonprofit group that aims to honor, comfort, and cover veterans and service members with handmade quilts. Catherine Roberts started the foundation in 2003, during her son’s deployment in Iraq after she dreamed of a veteran sitting on the edge of his bed, surrounded by war demons. In the next scene in her dream, she envisioned that veteran sitting with a quilt wrapped around his shoulders, which blocked out the demons. The veteran’s demeanor had changed from one of despair to one of hope. The dream led Roberts to organize the foundation in her home in Delaware, before expanding it into what it is today — a widespread entity that awards quilts to veterans and service members all over the nation. More than 159,000 have been presented to date. The quilts are not simply passed out to men and women who served their country; they are awarded in a special ceremony as a symbol of public thanks. Each quilt is different, but all are used to say “thanks” and provide comfort to the recipients. Some have notes from the people who made them by hand; others have specialized colors for the recipient’s branch of service. Hales said each ceremony also is different, but the responses from the veterans and servicemen are heartwarming. A member of Lakeside Quilters, a quilting club in Guntersville, she said she learned about Quilts of Valor when the club began making quilts to be presented to servicemen and women. When the district coordinator role became available, Hales took on the position and has held it for nearly a year. Since then, she has presented quilts to veterans all across Northeast Alabama. Lakeside Quilters made the quilts for McKiven and Phillips. Hales said presenting quilts always warms her heart. “It’s so reminiscent of the men I was raised with who were willing to give and serve,” she said, noting that she had several family members who served in the military. Hales said the reactions from those receiving the quilts is always great. “You know, they’re military men. They’ve been trained to stand straight, show no emotion and do their work,” she said. Still, the response sometimes is more emotional. Hales said veterans who have received quilts have come back later to let her know how much of an impact the presentation had on them and their families. When presented with the quilts and thanked for their service, recipients are always appreciative of the quilt and the recognition. Sometimes, their response is more emotional. She said veterans who have received quilts have returned later to let her know how much of an effect the quilt had them and their families. Veterans can be nominated by anyone, or can nominate themselves. The quilts are made by quilters clubs or volunteers, using donated materials or those purchased through fundraisers. Republished with permission of The Associated Press.
Terminated VA director James Talton hired by Ala. Dept. of Public Health
In 2014, James Talton was the first employee terminated by the Central Alabama Veterans Health Care System (CAVHCS) for neglect of duty following a law that that helped speed up the process of removing top VA executives for poor performance or misconduct. On Friday, the Alabama Department of Public Health (ADPH) confirmed he’s hired by the department and named the new Public Health Administrative Officer. WFSA 12 News reports according to the Alabama State Personnel Department, Talton’s salary with ADPH is $86,390.40. Talton’s firing from the CAVHCS came amid numerous allegations of rampant abuse and mismanagement at a VA health care facility in Phoenix, Arizona. At the time, Alabama 2nd District Rep. Martha Roby said the Phoenix revelations, particularly the scheduling fraud, “sounded familiar” compared to the many complaints she received from veteran constituents. By June, it was reported that CAVHCS employees had engaged in particularly egregious scheduling manipulation. And, even with the artificially inflated numbers, CAVHCS had some of the longest wait times for veterans patients in the country. “Numerous instances of misconduct, negligence and cover-up within the Central Alabama VA led to our system becoming one of the nation’s worst,” Roby said in 2014. Ultimately Roby and her staff began digging deeper to find out what was really happening inside CAVHCS, which ultimately led to Talton being placed on administration leave in August while the administrative and clinical practices of CAVHCS were being investigated. In October, Talton was fired. Roby deemed it “a necessary and important step toward instilling accountability at the VA and building trust within the veteran community.”
David Shulkin stresses ‘lot of work to do’ to fix beleaguered VA
Veterans Affairs Secretary David Shulkin warned Wednesday that the VA is “still in critical condition” despite efforts that predate his tenure to reduce wait times for medical appointments and expand opportunities to seek care in the private sector. In a “State of the VA” report, Shulkin, a physician, issued a blunt diagnosis: “There is a lot of work to do.” Veterans can get “same-day” services at medical centers but are still waiting too long – more than 60 days – for new appointments at about 30 locations nationwide. Many primary care centers are understaffed or running out of space. Appeals of disability claims remain backed up with years of wait. Inventory systems at several VA facilities are woefully out of date, and employee accountability is “clearly broken.” Shulkin said the department had about 1,500 disciplinary actions against employees on hold, citing legal requirements that it must wait at least a month before taking action for misconduct. That means people are being paid “for violating our core values,” he said in a 17-page report. “Our veterans and their families have benefited from our early success, but have suffered due to the failures of the past to effect real change,” Shulkin said. Shulkin provided his “top to bottom review” at a critical time. His biggest proposals for revamping the VA – and fulfilling the campaign promises of President Donald Trump – will need to be acted on soon by an increasingly polarized Congress if measures are to be passed by this fall. The wish list includes an accountability bill to make it easier to fire VA employees, expanding the Veterans Choice program of private-sector care and stemming veterans’ suicide. About 20 veterans take their lives each day. “That should be unacceptable to all of us,” Shulkin said at a White House briefing. Other efforts include an overhaul of information technology systems, plans to reduce 400 vacant buildings and 735 underutilized facilities, consolidation at VA headquarters in Washington and partnerships with local governments and the private sector. Shulkin announced that a promised White House hotline for veterans’ complaints should be fully operational by Aug. 15. Testing begins Thursday. The telephone number is (855) 948-2311. During the campaign, Trump promised a 24-hour hotline so veterans’ complaints will not “fall through the cracks.” Shulkin, who served in the Obama administration and was promoted by Trump, described the president as being “deeply engaged” on veteran issues, a subject Trump highlighted during the campaign. He pledged to make the department and its health care system work better for veterans. “His commitment to being involved in veteran issues is one of his top domestic priorities,” Shulkin said at the briefing. “Anything that we need, the White House has been extremely responsive and they are impatient and anxious for us to get on with this.” Trump’s budget plan calls for a 3.7 percent increase in total VA funding, mostly to pay for rising costs of medical care. It specifically calls for $29 billion over the next decade for Choice, which allows veterans to seek outside medical care from private doctors. To cover rising costs, the VA would cap the amount of educational benefits veterans could receive under the GI bill and halt “individual unemployability” benefit payments to out-of-work disabled veterans once they reach age 62. Major veterans’ organizations oppose such cuts, with the American Legion describing the trade-offs as “stealth privatization.” Veterans’ groups worry the Trump administration is seeking to expand Choice to the detriment of core VA programs. Besides Choice, Shulkin said he was seeking to implement another campaign priority: a VA accountability office, established by executive order last month, Shulkin said he still needed the Senate to pass accountability legislation that would give him broader authority, such as lowering the evidentiary standard to fire employees. The Senate is scheduled to vote on the bill June 6. The Associated Press reported this week that federal authorities were investigating dozens of new cases of possible opioid and other drug theft by employees at VA hospitals, a sign the problem isn’t going away after the VA announced “zero tolerance” in February. Since 2009, in only about 3 percent of the reported cases of drug loss or theft have doctors, nurses or pharmacy employees been disciplined. Republished with permission of The Associated Press.
Dems try to enlist military vets in fight for House majority
Democrats hope to enlist military veterans in another type of fight – for majority control of the House. Looking ahead to next year’s elections, Democrats are trying to recruit at least two dozen military veterans to challenge Republican incumbents, arguing that candidates with a military background on their resumes appeal to independent voters and can help the party break the GOP grip on Washington. “Veterans have had the experience of putting the country first, before personal politics” and party dictates, said Rep. Seth Moulton, D-Mass, who did four tours of duty in Iraq, left the Marines as a captain and was elected to Congress in 2014. That tends “to attract the kind of independent voters who are looking for a good leader,” Moulton added. Several veterans already have announced their bids in some of the 79 Republican-held House districts that national Democratic Party leaders have identified as top targets. Decades ago, veterans of World War II, Korea and Vietnam were mainstays in Congress. In 1969-71, 398 veterans served in the House and 69 in the Senate, according to the Congressional Research Service. But the change to an all-volunteer force in 1973 sent those numbers plummeting. The extended post-Sept. 11 conflicts in Afghanistan and Iraq helped reverse the trend, and now there are 80 veterans in the 435-seat House and 20 veterans in the 100-member Senate. For Democrats, struggling to return to the majority, military veterans provide potential candidates as the party deals with an electoral wipeout during Barack Obama‘s presidency, with the loss of more than 1,030 seats in state legislatures, governor’s mansions and Congress. Moulton and Sen. Tammy Duckworth, D-Ill., who lost both legs and partial use of an arm in a rocket-propelled grenade attack in Iraq, have spoken to veterans in districts ranging from obvious Democratic targets to places where the path to victory isn’t as obvious. The party needs to pick up 24 seats to reclaim a House majority next November. In the Philadelphia suburbs, former Air Force officer Chrissy Houlahan is challenging two-term Republican Rep. Ryan Costello in one of 23 districts where Democrat Hillary Clinton topped Trump in November. Outside Denver, former Army Ranger and combat veteran Jason Crow, a onetime campaign adviser to Obama, is running for the seat held by another veteran, five-term GOP congressman, Mike Coffman. Both mentioned President Donald Trump as factors in their campaign. “All the bravado and the wailing and gnashing of teeth isn’t the way we conduct ourselves as professional service members,” Houlahan said of Trump’s rhetoric. Said Crow: “I’m deeply troubled by President Trump and what he’s trying to do to country and our democracy.” Dan McCready, a former Marine who attended Harvard Business School alongside Moulton, steered clear of Trump as he announced his bid to win the more Republican-leaning North Carolina district of three-term Republican Rep. Robert Pittenger. But all three candidates, along with Moulton, agreed that veterans offer voters an approach rarely taken on Capitol Hill. “We know what it’s like to serve the country in non-political ways, and we’re standing up to say that the system is broken,” said Crow. He added that any military unit brings together “Republicans, Democrats, unaffiliated, every different background, every part of the country, urban rural, every rung of the economic ladder, and they have to come together very quickly … or the mission fails.” Democratic veterans have run notable campaigns in recent years. Louisiana Gov. John Bel Edwards, a West Point graduate and former Ranger, emphasized his record to attract enough voters in a conservative state. In Missouri last year, former Army intelligence officer Jason Kander drew national attention for his U.S. Senate campaign ad in which he assembled an AR-15 rifle while blindfolded. He lost by 3 percentage points, but got 230,000 more votes than Clinton, who lost the state by 18 points. Seth Lynn, who runs the nonpartisan Veterans Campaign, an organization that trains veterans running for office, says research suggests veterans running against a non-veteran get “about a 2-point bump” on average. Lynn isn’t yet tracking exact numbers of veteran candidates, but says he’s seen a “noticeable uptick” among Democrats. Some of that, Lynn says, is the usual clamoring by the party out of power: Republican veterans arose in 2010, the first midterm under Obama, and Democrats’ boasted a large slate in 2006, amid opposition to the Iraq war during President George W. Bush‘s second term. Those veteran candidates did not all win, of course. But those midterm years marked the last two times voters tossed out the House majority in favor of the other party. Republished with permission of The Associated Press.
Feds investigate dozens of thefts of opioids, other drugs at VA facilities
Federal authorities are investigating dozens of new cases of possible opioid and other drug theft by employees at Veterans Affairs hospitals, a sign the problem isn’t going away as more prescriptions disappear. Data obtained by The Associated Press show 36 criminal investigations opened by the VA inspector general’s office from Oct. 1 through May 19. It brings the total number of open criminal cases to 108 involving theft or unauthorized drug use. Most of those probes typically lead to criminal charges. The numbers are an increase from a similar period in the previous year. The VA has pledged “zero tolerance” in drug thefts following an AP story in February about a sharp rise in reported cases of stolen or missing drugs at the VA since 2009. Doctors, nurses or pharmacy staff in the VA’s network of more than 160 medical centers and 1,000 clinics are suspected of siphoning away controlled substances for their own use or street sale – sometimes to the harm of patients – or drugs simply vanished without explanation. Drug thefts are a growing problem at private hospitals as well as the government-run VA as the illegal use of opioids has increased in the United States. But separate data from the Drug Enforcement Administration obtained by the AP under the Freedom of Information Act show the rate of reported missing drugs at VA health facilities was more than double that of the private sector. DEA investigators cited in part a larger quantity of drugs kept in stock at the bigger VA medical centers to treat a higher volume of patients, both outpatient and inpatient, and for distribution of prescriptions by mail. Sen. Marco Rubio, R-Fla., said AP’s findings were “troubling.” He urged Congress to pass bipartisan accountability legislation he was co-sponsoring that would give the agency “the tools needed to dismiss employees engaged in misconduct.” The Senate is set to vote on the bill June 6. “The theft and misuse of prescription drugs, including opioids, by some VA employees is a good example of why we need greater accountability at the VA,” Rubio said. In February, the VA announced efforts to combat drug thefts, including employee drug tests and added inspections. Top VA officials in Washington led by VA Secretary David Shulkin pledged to be more active, holding conference calls with health facilities to develop plans and reviewing data to flag problems. The department said it would consider more internal audits. Criminal investigators said it was hard to say whether new safeguards are helping. “Prescription drug diversion is a multifaceted, egregious health care issue,” said Jeffrey Hughes, the acting VA assistant inspector general for investigations. “Veterans may be denied necessary medications or their proper dosage and medical records may contain false information to hide the diversion, further putting veterans’ health at risk.” Responding, the VA said it was working to develop additional policies “to improve drug safety and reduce drug theft and diversion across the entire health care system.” “We have security protocols in place and will continue to work hard to improve it,” Poonam Alaigh, VA’s acting undersecretary for health, told the AP. In one case, a registered nurse in the Spinal Cord Injury Ward at the VA medical center in Richmond, Virginia, was recently sentenced after admitting to stealing oxycodone tablets and fentanyl patches from VA medication dispensers. The nurse said she would sometimes shortchange the amount of pain medication prescribed to patients, taking the remainder to satisfy her addiction. Hughes cited in particular the risk of patient harm. “Health care providers who divert for personal use may be providing care while under the influence of narcotics,” he said. AP’s story in February had figures documenting the sharp rise in drug thefts at federal hospitals, most of them VA facilities. Subsequently released DEA data provide more specific details of the problem at the VA. Drug losses or theft increased from 237 in 2009 to 2,844 in 2015, before dipping to 2,397 last year. In only about 3 percent of those cases have doctors, nurses or pharmacy employees been disciplined, according to VA data. At private hospitals, reported drug losses or theft also rose – from 2,023 in 2009 to 3,185 in 2015, before falling slightly to 3,154 last year. There is a bigger pool of private U.S. hospitals, at least 4,369, according to the American Hospital Association. That means the rate of drug loss or theft is lower than VA’s. The VA inspector general’s office said it had opened 25 cases in the first half of the budget year that began Oct. 1. That is up from 21 in the same period in 2016. The IG’s office said the number of newly opened criminal probes had previously been declining since 2014. Michael Glavin, an IT specialist at the VA, says he’s heard numerous employee complaints of faulty VA technical systems that track drug inventories, leading to errors and months of delays in identifying when drugs go missing. Prescription drug shipments aren’t always fully inventoried when they arrive at a VA facility, he said, making it difficult to determine if a drug was missing upon arrival or stolen later. “It’s still the same process,” said Glavin, who heads the local union at the VA medical center in Columbia, Missouri. The union’s attorney, Natalie Khawam, says whistleblowers at other VA hospitals have made similar complaints. Criminal investigators stressed the need for a continuing drug prevention effort. The VA points to inventory checks every 72 hours and “double lock and key access” to drugs. It attributes many drug loss cases to reasons other than employee theft, such as drugs lost in transit. But the DEA says some of those cases may be wrongly classified. “Inventories are always an issue as to who’s watching or checking it,” said Tom Prevoznik, a DEA deputy chief of pharmaceutical investigations. “What are the employees doing, and who’s watching them?” Republished with permission of The Associated Press.
Agreement reached on stalled VA accountability bill
Congressional Republicans and Democrats have reached agreement on a bill to make it easier for the Department of Veterans Affairs to fire its employees, part of an accountability effort touted by President Donald Trump. The deal being announced early Thursday could smooth the way for final passage on an issue that had been largely stalled since the 2014 wait-time scandal at the Phoenix VA medical center. As many as 40 veterans died while waiting months for appointments as VA employees created secret waiting lists and other falsehoods to cover up delays. The Hill deal followed a fresh warning from the VA inspector general’s office of continuing patient safety problems at another facility, the VA medical center in Washington D.C. After warning of serious problems there last month, the IG’s “rapid response” team visited the facility again on Wednesday and found a patient prepped for vascular surgery in an operating room, under anesthesia, whose surgery was postponed because “the surgeon did not have a particular sterile instrument necessary to perform the surgery.” The team also found “surgical instruments that had color stains of unknown origin in sterile packs,” according to the IG’s letter sent Wednesday to the VA. The IG again urged the department to take immediate action to ensure patients “are not placed at unnecessary risk.” The new accountability measure, led by Sen. Marco Rubio, R-Fla., softens portions of a bill that had passed the House in March, which Democrats criticized as unfairly harsh on workers. Sens. Jon Tester of Montana and Johnny Isakson of Georgia, the top Democrat and the Republican chair on the Senate Veterans’ Affairs Committee, agreed to back the new bill after modifications that would give VA employees added time to appeal disciplinary actions. House Veterans Affairs’ Committee Chairman Phil Roe, sponsor of the House measure, said he would support the revisions. “To fully reform the VA and provide our nation’s veterans with the quality care they were promised and deserve, we must ensure the department can efficiently dismiss employees who are not able or willing to do their jobs,” Rubio told The Associated Press. It comes after Trump last month signed an executive order to create a VA Office of Accountability and Whistleblower Protection, with an aim of identifying “barriers” that make it difficult for the VA to fire or reassign bad managers or employees. VA Secretary David Shulkin had urged the Senate to act quickly to pass legislation. The GOP-controlled House previously approved an accountability bill mostly along party lines. Rep. Tim Walz, D-Minn., argued the House should embrace language instead from a bipartisan bill by Isakson from last year with added due process protections for workers. The Senate bill to be introduced Thursday adopts several portions of that previous Isakson bill, including a longer appeal process than provided in the House bill — 180 days vs. 45 days, though workers would not be paid during that appeal. VA executives would be held to a tougher standard than rank-and-file employees for discipline. The Senate bill also codifies into law the VA accountability office created under Trump’s order, but with changes to give the head of the office more independent authority and require the office to submit regular updates to Congress. Conservative groups praised the bill. “These new measures will disincentivize bad behavior within the VA and further protect those who bravely expose wrongdoing,” said Dan Caldwell, policy director of Concerned Veterans for America, pointing to a “toxic culture” at VA. The agreement comes in a week in which Senate Democrats are standing apart from Trump on a separate issue affecting veterans, the GOP bill passed by the House to repeal and replace the nation’s health care law. Sen. Tammy Duckworth, D-Ill., warned the House measure would strip away explicit protections to ensure that as many as 8 million veterans who are eligible for VA care but opt to use private insurance would still receive tax credits. Many veterans use a private insurer if they feel a VA facility is too far away, or if they don’t qualify for fuller VA coverage because they have higher incomes or ailments unrelated to their time in service, said Duckworth, a combat veteran who lost her legs and partial use of her right arm during the Iraq war. A group of GOP senators is working to craft their own health bill. “Trumpcare threatens to rip health care out of their hands,” Duckworth said at a news briefing this week. “The question left is what will Senate Republicans do?” Congress has had difficulty coming to agreement on an accountability bill after the Phoenix VA scandal. A 2014 law gave the VA greater power to discipline executives, but the department stopped using that authority after the Obama Justice Department deemed it likely unconstitutional. Critics have since complained that few employees were fired for various VA malfeasance, including rising cases of opioid drug theft, first reported by the AP. Republished with permission of The Associated Press.
VA limiting new hiring as it aims to widen private care
Despite the lifting of a federal hiring freeze, the Department of Veterans Affairs is leaving thousands of positions unfilled, citing the need for a leaner VA as it develops a longer-term plan to allow more veterans to seek medical care in the private sector. The order by VA Secretary David Shulkin is described in an internal April 14 memorandum obtained by The Associated Press. The VA indicated it would proceed with filling open positions previously exempted under the hiring freeze. Noting that the White House had ordered all departments to be leaner and “more accountable,” the VA indicated that more than 4,000 jobs would still be left vacant unless they were specially approved “position by position” by top VA leadership as addressing an “absolute critical need.” These positions include roughly 4,000 in the VA’s health arm and 200 in benefits, plus more than 400 information technology positions and over a 100 human resource positions, according to VA data provided to the Senate Veterans Affairs Committee earlier this month. Government auditors have previously faulted the department for recent shortages in IT and HR, which it said had hurt its ability to recruit and hire key staff department-wide. Major veterans organizations also worry this could be a sign of future tightening at the VA, coming after the department had previously warned it would need “hiring surges” to address a rapidly growing disability backlog. The groups have cautioned against any “privatization” efforts at the VA that could expand private care for veterans while reducing investment in the VA itself. “It seems to be a reversal of what they have been saying, and it’s disappointing,” said Garry Augustine, executive director of Disabled American Veterans’ Washington headquarters. Carlos Fuentes, legislative director of Veterans of Foreign Wars, said his group was concerned the VA would overlook positions that didn’t directly affect health care, such as staffing of its suicide prevention hotline. The VA said in a statement Wednesday that the hiring restrictions were needed to “streamline VA’s corporate structure and administrative positions.” While President Donald Trump‘s budget blueprint calls for a 6 percent increase in VA funding, the memo indicated that the government’s second-largest agency with nearly 370,000 employees was no different from other departments that needed to improve “efficiency, effectiveness and accountability.” It left open the possibility of “near-term” and “long-term workforce reductions.” Shulkin is also putting together a broader proposal by fall to expand the VA’s Choice program of private-sector care. “This memo lifts the federal hiring freeze. However, this does not mean business as usual for hiring,” stated VA chief of staff Vivieca Wright Simpson. She said VA leadership aimed to proceed in the coming months with “deliberative hiring strategies” as it seeks to build “a future VA of Choice.” The memo comes as the Trump administration seeks to highlight accomplishment and accountability at the VA. During the 2016 campaign, Trump repeatedly criticized the VA as “the most corrupt” and pledged to expand private care. Trump planned to sign an executive order Thursday at the VA to create a new Office of Accountability and Whistleblower Protection. The head of the office will report directly to the secretary to help VA officials identify “barriers” that impede the reassignment of employees who are no longer deemed fit to work at the department in the service of veterans, Shulkin said at a White House briefing. Existing employees will staff the office. Shulkin said he didn’t have an exact figure on what the office would cost. Shulkin also has signaled, without naming specific locations, that underutilized VA facilities will have to close. “There are some parts of the country where facilities are sitting empty, and there is no sense in keeping them empty,” he has said. The Republican-led House last month approved legislation to make it easier for the VA to fire, suspend or demote employees for poor performance or bad conduct. But the measure has been slow to move in the Senate after Democrats and unions cast it as an attack on workers’ rights. Republished with permission of the Associated Press.
VA tests partnership with CVS to reduce veterans’ wait times
Some ailing veterans can now use their federal health care benefits at CVS “MinuteClinics” to treat minor illnesses and injuries, under a pilot program announced Tuesday by the Department of Veterans Affairs. The new program, currently limited to the Phoenix area, comes three years after the VA faced allegations of chronically long wait times at its centers, including its Phoenix facility, which treats about 120,000 veterans. The Phoenix pilot program is a test-run by VA Secretary David Shulkin who is working on a nationwide plan to reduce veterans’ wait times. Veterans would not be bound by current restrictions under the VA’s Choice program, which limits outside care to those who have been waiting more than 30 days for an appointment or have to drive more than 40 miles to a facility. Instead, Phoenix VA nurses staffing the medical center’s help line will be able to refer veterans to MinuteClinics for government-paid care when “clinically appropriate.” Shulkin has made clear he’d like a broader collaboration of “integrated care” nationwide between the VA and private sector in which veterans have wider access to private doctors. But, he wants the VA to handle all scheduling and “customer service” — something that veterans groups generally support but government auditors caution could prove unwieldy and expensive. On Wednesday, President Donald Trump plans to sign legislation to temporarily extend the $10 billion Choice program until its money runs out, pending the administration’s plan due out by fall. That broader plan would have to be approved by Congress. “Our number one priority is getting veterans’ access to care when and where they need it,” said Baligh Yehia, the VA’s deputy undersecretary for health for community care. “The launch of this partnership will enable VA to provide more care for veterans in their neighborhoods.” Sen. John McCain, R-Ariz., a long-time advocate of veterans’ expanded access to private care, lauded the new initiative as an “important step forward.” “Veterans in need of routine health care services should not have to wait in line for weeks to get an appointment when they can visit community health centers like MinuteClinic to receive timely and convenient care,” he said. The current Choice program was developed after the 2014 scandal in Phoenix in which some veterans died, yet the program has often encountered long waits of its own. The bill being signed by Trump seeks to alleviate some of the problems by helping speed up VA payments and promote greater sharing of medical records. Shulkin also has said he wants to eliminate Choice’s 30-day, 40 mile restrictions, allowing the VA instead to determine when outside care is “clinically needed.” Despite a heavy spotlight on its problems, the Phoenix facility still grapples with delays. Only 61 percent of veterans surveyed said they got an appointment for urgent primary care when they needed it, according to VA data. Maureen McCarthy, the Phoenix VA’s chief of staff, welcomed the new CVS partnership but acknowledged a potential challenge in providing seamless coordination to avoid gaps in care. She said a veteran’s medical record will be shared electronically, with MinuteClinic providing visit summaries to the veteran’s VA primary care physician so that the VA can provide follow-up services if needed. The VA previously experimented with a similar program last year in the smaller market of Palo Alto, Calif., a $330,000 pilot to provide urgent care at 14 MinuteClinics. CVS says it is pleased the VA has opted to test out a larger market and says it’s ready to roll the program out nationally if successful. CVS, the biggest player in pharmacy retail clinics, operates more than 1,100 of them in 33 states and the District of Columbia. “We believe in the MinuteClinic model of care and are excited to offer our health care services as one potential solution for the Phoenix VA Health Care System and its patients,” said Tobias Barker, chief medical officer of CVS MinuteClinic. Republished with permission of The Associated Press.
Martha Roby honors Wounded Warrior Project members at White House
Alabama 2nd District U.S. Rep. Martha Roby attended a special White House event honoring wounded service members and veterans at the White House on Thursday. During a special ceremony for the Wounded Warrior Project’s Soldier Ride — a four-day cycling opportunity meant to help those who have suffered war injuries overcome the physical and psychological burdens resulting from their service — Roby showed her support and appreciation for America’s wounded warriors. “For so many wounded warriors, the road to recovery can be long and difficult. Soldier Ride offers wounded service members and veterans a unique opportunity to help each other build confidence by participating in a challenging physical activity,” Roby said. “I appreciate the President and First Lady hosting this special event and for inviting me to attend so I could pay tribute to some of the men and women who have sacrificed for our country. I am proud to represent a state that truly honors the service and sacrifice of our military families and veterans, and I’m grateful for projects like the Soldier Ride that are making a difference.” Hosted by President Donald Trump and First Lady Melania Trump, the event welcomed 50 Wounded Warriors to the White House to kick-start the annual Soldier Ride bicycling event Thursday. “You’ve earned our freedom with your sweat and your blood and your incredible sacrifice,” the president remarked at the event. “On behalf of the country, let me extend to all of the riders and your families the warmest possible welcome to the people’s house. I call it the people’s house. It’s the White House, but I call it the people’s house. You are all so amazing. You’ve risked all that you have, all that you possess, to keep our people safe and our democracy secure. We are going to keep it going for a long time folks. You’ve earned our freedom with your sweat and your blood. We salute you, we salute your service.”
Senate agrees to extend VA’s program of private-sector care
The Senate on Monday approved legislation that would extend a troubled program aimed at widening veterans’ access to private-sector health care, the first step in an overhaul of programs at the Department of Veterans Affairs. The bill passed by voice vote. It would allow the VA to continue operating its Choice program until its money runs out, expected to occur early next year. Without legislation, the program will expire on Aug. 7 with nearly $1 billion left over in its account. The VA says that money can provide stopgap care until a broader revamp is designed. The Choice program was put in place after a 2014 wait-time scandal at the Phoenix VA medical center in which some veterans died. Intended to provide veterans more timely care, the Choice program allows veterans to go outside the VA network in cases where they had to wait more than 30 days for an appointment or drive more than 40 miles to a facility. Yet it often encountered long wait times of its own due to bureaucratic glitches and other problems. The Senate bill calls for fixes in the program to address some of those concerns, by helping speed up VA payments and promote greater sharing of medical records. It now goes to the House, which was expected to easily pass the measure Wednesday. “This bipartisan legislation cuts some of the red tape that slows down veterans’ access to care in their communities,” said Montana Sen. Jon Tester, the top Democrat on the Senate Veterans’ Affairs Committee. “I’m proud that Republicans and Democrats in Congress worked together to provide these solutions for veterans.” Tester sponsored the bill along with Republican Sens. John McCain of Arizona and Johnny Isakson of Georgia. Major veterans’ organizations and Democrats were not opposed to continuing the Choice program as a stopgap. But they are closely watching the VA’s subsequent overhaul, after President Donald Trump‘s transition team signaled last year that it would consider a “public-private” option in which veterans could get all their medical care in the private sector, with the government paying the bill. Veterans groups generally oppose that as a threat to the viability of VA medical centers. While VA Secretary David Shulkin has promised not to privatize the department, he says he wants to build stronger partnerships with the private sector to improve VA care. A newly formed White House Office of American Innovation led by Trump’s son-in-law, Jared Kushner, is also now examining ways to improve the VA. Republished with permission of The Associated Press.
Martha Roby introduces legislation to offer veterans better resources
Veterans receiving mental health care and substance abuse treatment through the Department of Veterans Affairs stand to gain a powerful new ally under legislation introduced by Alabama 2nd District U.S. Rep. Martha Roby. H.R. 1712, the Protection and Advocacy for Veterans Act, would empower state and local Protection and Advocacy agencies to directly investigate the quality of mental health care and substance abuse treatment provided to veterans at the VA and allow these agencies to advocate for patients found to be receiving inadequate care. Protection and Advocacy agencies monitor the quality of state-operated hospitals, clinics, psychiatric wards, prisons, and other facilities. Their agents have the authority to inspect medical records and take legal action on behalf of patients when necessary. Roby’s bill would authorize funding for a pilot program testing the feasibility of utilizing Protection and Advocacy agencies to provide this service at the VA. “For 40 years, Protection and Advocacy agencies in Alabama and around the country have provided a critical service by monitoring the quality of care in state-operated hospitals, clinics, and other facilities,” said Roby in a news release. “I believe bringing this degree of expertise in patient advocacy to the VA would greatly benefit veterans, particularly those in need of mental health care or substance abuse treatment.” Roby continued, “In recent years, Congress has boosted funding for mental health care services and enacted legislation making it easier for the VA to attract mental health care professionals. This is a step in the right direction, but I believe we can do better. We owe it to our veterans to bring all available resources to bear to ensure access to proper treatment.” Roby’s bill has been referred to the House Committee on Veterans Affairs. Watch Roby discuss her new bill below:
