House approves new deal to prevent VA budget crisis for Choice program
By NIKKI WENTLING | STARS AND STRIPES Published: July 28, 2017
WASHINGTON — House lawmakers voted unanimously Friday on a deal to fund the nearly depleted Veterans Choice Program and avert the threat of interrupted medical care for thousands of veterans.
The bill, a bipartisan compromise negotiated between House and Senate lawmakers, would inject $2.1 billion into the Choice program to keep it going for the next six months. The program allows veterans to receive health care in the private sector, and VA Secretary David Shulkin warned in June that it would be completely depleted of funds by mid-August. Friday was the last day for House lawmakers to act before leaving for a monthlong recess. Lawmakers voted 414-0 for the bill.
House Democrats initially rejected the bill Monday after hearing from eight veterans groups that argued it prioritized the private sector while neglecting VA services. During negotiations this week, the bill was revised to include funding for recruitment and retention efforts and new VA facilities.
“We could not come to an agreement, but instead of the theatrics of partisanship and politics of destruction, instead of sulking away, we came back together to try to find compromise,” Rep. Tim Walz, D-Minn., the ranking Democrat on the House Committee on Veterans’ Affairs, said before the vote. “Let us send a strong signal, not just to veterans, but to our fellow citizens that this democracy still can function and find answers.”
Besides the $2.1 billion for Choice, the bill provides $1.8 billion to help fill the some 49,000 vacancies in the department and authorize 28 leases for new VA clinics. It would be paid for by extending pension reductions for Medicaid-eligible veterans in nursing facilities and continuing fees on VA-guaranteed home loans.
Sen. Johnny Isakson, R-Ga., and Sen. Jon Tester, D-Mont., the chairman and ranking Democrat on the Senate Veterans’ Affairs Committee, announced their support late Thursday, signaling a clear path for it to pass that chamber. Senators are finishing up work the next two weeks before adjourning for recess.
“We are glad that veterans will continue to have access to care without interruption and that the VA will be able to improve the delivery of care by addressing critical infrastructure and medical staffing needs,” Isakson and Tester said in a joint statement. “While this is only a short-term fix to the problem, we pledge to continue working together to address the various barriers to timely care for our nation’s veterans.”
Preview of a larger debate
If the deal passes both chambers and is signed into law, as expected, it will be viewed as a win for the veterans groups leading into a larger discussion about reforming how the VA handles private-sector care.
Rep. Phil Roe, R-Tenn., chairman of the House Committee on Veterans’ Affairs, said Friday on the House floor: “This is just the first step, though a major one, in a transformative process.”
Those fighting against the original bill included AMVETS, Veterans of Foreign Wars, Disabled American Veterans, Iraq and Afghanistan Veterans of America, Military Order of the Purple Heart, Vietnam Veterans of America, Military Officers Association of America and Wounded Warrior Project.
The coalition’s concerns about the VA sliding too far into the private sector signals a challenge for Shulkin in gaining the veterans groups’ support for his ideas to change community care programs in the long term. Shulkin has described a plan that allows more veterans to seek care in the private sector in areas of the country where VA care isn’t up to par with other health care providers in the community.
“With the Senate expected to approve this legislation in the next week… we will have avoided an unnecessary crisis in the short term, and made critically important investments in VA health care capacity for the long term,” the eight veterans groups said Friday in a joint statement. “While we will be gratified when this legislation is enacted, we must immediately turn our attention to the coming debate over how to strengthen and modernize the VA health care system, and how community care should be integrated.”
Boosting VA workforce, footprint
The bill passed Friday aims to increase the VA’s workforce and its overall footprint.
It would create a fellowship program for VA managers, establish a recruiting database for critical openings, give Shulkin more direct-hiring authority, require more training for human resources personnel, establish standardized exit surveys and ensure more competitive pay for physician assistants. It would also require Shulkin to fill all vacant medical director positions within 120 days after the bill is enacted.
Another large addition to the original bill is a measure authorizing the VA to move forward with 26 leases for clinics, one for research space and one for a business office. Because of bureaucratic disputes, some of the leases have been held up by Congress for more than two years.
Rep. Julia Brownley, D-Calif., introduced the provision. One of the leases, for an outpatient clinic in Oxnard, is in her district.
“The demand for VA health care is increasing, and many veterans face long wait times because outdated facilities are too small to accommodate the growing number of men and women seeking care,” Brownley said Friday on the House floor. “Veterans in my community and communities across the country have waited long enough for these expanded services.”
If passed by the Senate, the VA would be authorized to open in Gainesville, Fla., in addition to Pike County, Ga.; Pittsburgh; Birmingham, Ala.; Santa Rosa, Calif., and Oxnard.
Replacement clinics could be located in Ann Arbor, Mich.; Charleston, S.C.; Corpus Christi, Texas; Daytona Beach, Fla.; Fredericksburg and Hampton Roads, Va.; Indianapolis; Jacksonville, Fla.; Missoula, Mont.; northern Colorado; Ocala, Fla.; Portland, Maine; Raleigh, N.C.; Rochester, N.Y.; San Diego; Tampa, Fla.; Lakeland, Fla.; Terre Haute, Ind., and Rapid City, S.D.
New research space would be opened in Boston and a replacement business office opened in Denver.
Other veterans bills clear the House
House lawmakers also passed four other veterans-related measures Friday in the wind-down before their five-week recess.
One bill would clear the way for a Global War on Terror memorial on the National Mall. Law currently requires a conflict to be over for 10 years before a national commemorative can be established. Advocates have said veterans of the now 15-year war need a place, like the Vietnam Wall, to gather and reflect. The Global War on Terror Memorial Foundation will be responsible for raising funds for design and construction.
Another bill passed Friday would offer free child care for veterans who have medical appointments at VA facilities. A pilot program offering the service is already in place, but it’s set to expire Oct. 1 and limited to only some VA locations. The bill would make the program permanent and expand it.
One proposal aims to train and recruit more former servicemembers into the VA as physicians assistants.
Lastly, the House passed a bill requiring the VA secretary to approve reassignments of senior executives from one VA facility to another and report to Congress each year why the executives were moved.