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VA's McDonald sets 12 'breakthrough priorities' for 2016

By DIANNA CAHN | STARS AND STRIPES Published: January 21, 2016

WASHINGTON — In a bold move Thursday before the Senate Committee on Veterans’ Affairs, Secretary Bob McDonald identified 12 “breakthrough priorities” that the VA will accomplish by the end of 2016.

All 12 would improve care for veterans, but the promises come from an agency that has been engulfed in scandal for the past two years over its inability to meet the needs of the 2.2 million veterans it serves.

On the list are fixes to some of the biggest problems veterans face with the Department of Veterans Affairs:

  • Providing same-day service for clinical needs
  • Enabling veterans’ access to any VA medical center
  • Addressing a severe backlog on appeals when disability claims are rejected, with some languishing for as long as eight years.

The appeals backlog has climbed to over 400,000 cases. If Congress pushes through the necessary legislation, McDonald said Thursday, the VA will simplify the appeals process and by 2021, will reduce the appeals backlog by 90 percent.

Streamlining the Choice Act and Veterans access to community care also made the list. The Choice Act was aimed at giving veterans access to care outside the VA, easing burden on VA facilities.  But complications have left many veterans mired in bureaucracy and deeply frustrated by the continued lack of ability to get care.

Thursday was first time McDonald committed to a specific schedule for MyVA, the overhaul plan he rolled out last year. But critics say the reforms don’t go far enough.

The American Legion issued a statement to the Senate committee Thursday saying that the MyVA program “missed the mark right out of the gate” and though well-intentioned, will not transform and modernize the VA to the extent it needs considering the steady rise of veterans and their needs in recent decades.

“It is still too early to tell what if any success in meeting the needs of veterans the MyVA plan is delivering,” the Legion statement said.  “It is possible that MyVA may in fact change VA and provide a better experience for veterans. It is also possible that it will only add another layer to an already bloated bureaucracy.”

The American Legion also raised issue with the exclusion of most veterans’ service organizations from the advisory committee set up to help design and implement MyVA.

Committee chairman Sen. Johnny Isakson, R.-Georgia, pressed McDonald on Thursday to include the groups in the process. He said the American Legion was “the eyes and ears” of the committee, helping it hold the VA accountable.

Concerned Veterans for America, which has been harshly critical of the VA, issued a statement to the committee saying that modernization of the VA would require a much more comprehensive overhaul of “outdated structures and methods.” It called on the VA to examine the highest functioning healthcare systems around the country and restructure along those lines.

The organization questioned McDonald’s promised deadlines, saying the VA promised to fix its backlog on wait times but has continually pushed back that deadline.

In his list of priorities, McDonald promised to fix the appointment backlog. He said the VA increased its scheduled appointments to 1.2 million and completed over 96 percent of them in October within 30 days.

The secretary said the backlog on claims has been reduced from 611,000 at its peak in 2013 to 82,000 today, and the process has made the full transition from paper to electronic. Last year, the VA processed 1.4 million disability claims, the highest in VA history for a single year, he said.

McDonald promised that if Congress can pass the necessary legislation, the VA will start to consolidate and streamline its community care network, enabling veterans to see a community provider within 30 days of referral.

He also promised that the VA will be able to pay community providers quickly -- 85 percent within 30 days -- a big complaint that has led community providers to refuse to work with the VA.

McDonald and VA health care chief David Shulkin acknowledged that the agency was having trouble recruiting health care workers, in part because of the recent scandals.

Shulkin said 34 VA Medical Center director positions were open. He urged Congress to pass legislation that would give the VA access to incentive funding to recruit top-notch directors.

“Quite frankly, I have had a significant challenge convincing any of my colleagues from the private sector to look at VA as a career,” Shulkin said in his testimony. “And I desperately need that talent.”

Other changes involve bringing computer systems and data up to 21st century standards, since the agency’s scheduling system dates back to 1985; improving the workplace experience for employees; and training leadership to encourage employees to speak up to affect positive change -- including rewards for whistleblowers.

McDonald also promised to keeping pushing to change the culture at the VA, promising to focus on care, not regulations. He said that out of the top 16 executives at the VA, 10 were new to their positions since he took office in 2014.  All have business backgrounds, ranging from a banking industry chief financial officer to a retired Disney executive who spent 2010-2011 “enhancing the patient experience” at Walter Reed medical center.

McDonald countered recent criticism that the agency does hold corrupt officials accountable, saying that since Aug. 2014, 2,600 employees have been removed from their jobs, including senior executives. He did not say how many of those were fired or transferred.

Several of McDonald’s promises are subject to legislation being considered by Congress, including funding to modernize the VA’s antiquated IT system, expanding the West Los Angeles campus and overhauling the claims appeals process.

Congress is “not exactly the gold standard” when it comes to getting things done and passing legislation, noted Sen. Jon Tester, D.-Montana.  “Do you have contingency plans?”

“We do,” McDonald said. “It will mean we have to dial back” on deadlines.

dianna.cahn@gmail.com

 

Secretary of Veterans Affairs Bob McDonald at the National Press Club in November, 2015.
Joe Gromelski/Stars and Stripes

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