Proposal to create board of directors to help run VA draws widespread opposition


By NIKKI WENTLING | STARS AND STRIPES Published: September 7, 2016

WASHINGTON — A proposal to establish a board of directors for the Department of Veterans Affairs drew opposition Wednesday from a House committee intent on changing the VA’s culture.

The recommendation was part of an 18-point final report from the Commission on Care, created to roadmap a transformation for the beleaguered VA.

While the commission decided with near-unanimity to create a board of directors, President Barack Obama, VA Secretary Bob McDonald, and many members of the House Veterans’ Affairs Committee expressed their opposition to the suggestion.

About a dozen veterans service organizations also weighed in on the proposal, with most opposing it. The Vietnam Veterans of America referred to the board as a “paper tiger” that would have no real authority because it wouldn’t have “power of the purse.”

“Given the crisis that seems to erupt anew on an almost daily basis where the VA is concerned, any effort to shield the VA healthcare system from executive and legislative branch oversight is a non-starter,” said Rep. Jeff Miller, R-Fla., chairman of the committee.

The Commission on Care report, about two years in the making, calls for an 11-member board to oversee the VA. Nancy Schlichting, who chaired the commission, said the recommendation was intended “not to usurp Congress, but to get performance up.”

“The commission saw the VA governance structure as ill-equipped to carry out a transformation,” Schlichting said. “There’s frequent turnover in senior leadership. We recommend establishing a board of directors with the authority to direct focus and long-term strategy.”

In Obama’s response to the report last week, the president cited concerns with the board idea, saying the Department of Justice advised that creation of a board would be unconstitutional.

McDonald also voiced his opposition to the idea, saying in a response last week that a board would be “neither feasible nor advisable for both constitutional and practical reasons.”

Schlichting on Wednesday said there “may be ways around” the constitutional issue, but gave no specific changes to the recommendation.

Rep. Tim Walz, D-Minn., said the proposal “tied me in knots.” He asked Schlichting if it was important enough to “fight this fight” about its constitutionality.

“Giving away that authority is very, very hard to do,” Walz said. “But I absolutely hear where you’re coming from.”

In its testimony Wednesday, Concerned Veterans for America (CVA) expressed support for a board, saying Obama’s opposition amounted to “defense of the VA status quo.”

Darin Selnick, who is part of CVA and participated in the Commission on Care, said the recommendation to establish a board was critical to reforming the VA.

“There was 100 percent agreement that if any reform is actually going to happen you have to have that board of directors,” Selnick said.

The commission’s recommendation also sets a five-year appointment for the VA under secretary of health – a position that carries out the day-to-day operation of the veterans’ health administration.

That idea gained support Wednesday, and in his response last week, Obama said it would remove the position “from the turmoil and turnover of the political cycle.”

Committee members were also supportive of ideas to invest in the VA’s information technology, modernize its human resources department and better manage its facilities.

Some committee members and veterans service organizations balked at an idea to expand options for veterans to receive outside health care at the VA’s expense, pushing back against any more moves toward privatized care.

The report recommends the VA do away with its temporary, $6 billion Choice Program and replace it with community-based health care networks. Schlichting said what’s suggested is a “balance” between over-broadening what the VA would pay for in private health care and existing limitations that are “causing really undue problems for veterans.”

Schlichting was referring to a rule that veterans had to live at least 40 miles from a VA facility, or had waited more than 30 days for treatment before the VA would pay for private care.

In his response, Obama said he favored a VA initiative, the “Plan to Consolidate Community Care,” which McDonald has said would consolidate the VA’s community health care programs and address gaps in how and when private care is administered.

Schlichting and Toby Cosgrove, vice chairman for the Commission on Care, were the only two people testifying at Wednesday’s hearing. Ranking minority member Mark Takano, D-Calif., said he was “disappointed” that an official of the VA was not invited to attend.

The Senate Veterans’ Affairs Committee announced Wednesday it would hold a hearing on the report Sept. 14.

“We’ve identified areas Congress does need to take action,” Schlichting said. “This is a bipartisan issue. These are our vets, and it’s critically important we find a way to deliver better health care.”

Twitter: @nikkiwentling

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