Acting Veterans Affairs Secretary Sloan Gibson says he is focused on reducing wait times and fixing systemic scheduling problems. (Chip Somodevilla / Getty Images)
It only took a few weeks after reports that Veterans Affairs Department hospitals falsified waiting lists and let people wait months to receive treatment before VA secretary Eric Shinseki resigned and President Obama promised to push for reform.
But in the wake of the scandal, lawmakers, veterans groups and employee unions are clashing over the VA’s future and what role the agency should have in providing care to veterans, with some arguing for a reduced role for the VA in providing health care to veterans.
Senators Bernie Sanders, I-Vt., and John McCain, R-Ariz., have outlined legislation that would authorize $500 million for new doctors and nurses at the VA and allow the agency to enter into 28 new major medical leases across the country.
The bill would also allow veterans who live more than 40 miles from a VA facility to be able to go to private health care providers under the supervision of the VA and would authorize presidential commissions into patient care and future construction needs.
But the bill contains provisions allowing the VA secretary to fire members of the senior executive service, which would be counterproductive and leave employees such as whistleblowers open to retribution, according to Max Stier, president and CEO of the Partnership for Public Service.
The legislation would give the senior executive one week to appeal the dismissal, and would then give the Merit Systems Protection Board three weeks to render a decision. During that time the executive would not be paid.
He said while the new safeguards offer more due process than previous versions of bills that had no right at appeal, the time frames are still too short to make sure an employee gets a fair hearing.
“You don’t want to be making decisions without the right information, and sometimes the right information takes a little bit of time,” he said.
Stier said Congress should not be rushing to pass legislation but should instead focus on fixing systemic problems with more thoughtful reform that takes into account management practices, incentives and hiring to help fix systemic issues at the VA. He said Congress should take the time to have hearings on legislation and with VA experts to determine the best way forward.
“A rush to action that is not thoughtful frequently leads to worse consequences than the underlying conduct that it was meant to fix,” Stier said. “There is no question that the stuff that happened was bad, but the response has to be thoughtful and that takes more time.”
Jennifer Mattingley, the legislative director at the Senior Executives Association, said allowing the VA secretary to fire members of the SES could mean that future secretaries can come in and fire as many people as possible, and it would be difficult to replace them. There are currently about 381 senior executives overseeing 340,000 VA employees, according to Mattingley.
“How on earth are veterans going to get the care they need if there are not enough people overseeing the agency?” Mattingley said.
Meanwhile acting VA secretary Sloan Gibson said he is focused on reducing wait times and fixing systemic scheduling problems while analyzing the underlying causes at the agency and working internally to solve the problems.
He said the agency is deploying a dedicated human resources team to support hiring additional staff and using temporary staffing measures to help fill gaps until permanent employees are found. The agency is also revising and enhancing its training for its scheduling system and will keep auditing hospitals and health care facilities for compliance.
Ray Kelley, the legislative director of the Veterans of Foreign Wars, said the VA already has the ability to offer veterans private providers but that any expansion of that must focus on reducing wait times and increasing accountability.
He said in many areas access to private care providers can take months, and that veterans forced to operate in this system might not be able to get the care they need in the right time — which is the entire point of reform, Kelley said.
“Long wait times is what got us into trouble in the first place, and just because you add more doctors doesn’t mean you are fixing those problems,” Kelley said.
He said a system where the VA contracts with a company that coordinates care, ensures shorter wait times and allows for greater accountability could work if done well, but that sending veterans out into the private market without safeguards would not lead to better medical care.
William Dougan, president of the National Federation of Federal Employees, said he supports the provision to hire more doctors and nurses in order to handle higher veteran populations.
“The health care providers in VA hospitals around the country are working in a pressure cooker of unreasonable expectations, and Congress neglecting to provide the proper resources to the VA is only making the situation worse,” Dougan said.
He said privatizing some of the medical care offered by the VA was “an absurd notion” and that contracting out services would result in higher costs and a loss of agency oversight of veteran care.
NFFE will continue to review the compromise legislation and work to pass the provisions that will help alleviate the shortages of funding and staff resources at the agency.