• Congress Passes VA Reform

    Last Thursday night the Senate approved and sent to President Barack Obama a bill to improve access to health care for veterans and reform the Department of Veterans Affairs.

    Forged through negotiations between the Senate and House Veterans’ Affairs Committee chairmen – Bernie Sanders (I-VT) and Jeff Miller (R-FL) – the $16.3 billion bill passed the Senate by a vote of 91-3. The House of Representatives voted 420-5 on Wednesday to approve the same measure.

    While TREA is saddened that it was even necessary for such a bill to be passed in the first place, we would like to thank the Chairmen and all of the members of the House and Senate Veterans’ Affairs committees for their hard work in passing crucial legislation in a relatively short time period. Expanding access to healthcare for America’s veterans took precedence to election-year pressures, and for that we thank you.

    While the bill addresses the immediate need to hire more doctors, nurses and medical professionals at the VA, to allow veterans who can’t get doctors’ appointments to be seen by private physicians, and to fire senior executives who fail to perform their jobs in an honest or satisfactory manner, it is important to note that hard work remains to be done. The VA system has been shown to have systemic problems when it comes to scheduling doctors’ appointments, physician staffing levels, how it handles whistleblower complaints as well as in dealing with the claims backlog on the Veterans’ Benefits Administration (VBA) side of the house. TREA will continue to keep a laser-like focus on these issues.

    Further, it may be necessary to examine the Veterans Integrated Service Network (VISN) system and to make improvements. This has the possibility of being a multi-year project to position the VA for success in the 21st century.

    The measure provides $5 billion for the VA to recruit more doctors, nurses and other medical providers to care for the surging number of veterans returning from wars in Iraq and Afghanistan.

    Veterans on long VA waiting lists and those who live far from VA facilities may see private doctors or go to community health centers, Department of Defense facilities and Indian Health Centers. The bill has $10 billion for that emergency provision for veterans who cannot get an appointment within 30 days or live more than 40 miles from a VA clinic. Another $1.3 billion will pay for leasing 27 new clinics in 18 states and Puerto Rico.

    Additionally the bill includes 2 very important education provisions that will help veterans and widows/widowers whose servicemember spouse died on active duty after 9/11.

    The bill major provisions:

    To improve access to and quality of care for veterans, the bill would:

    • Require VA to offer an authorization to receive non-VA care to any veteran who is enrolled in the VA health care system as of August 1, 2014, or who is a newly discharged combat veteran if such veteran is unable to secure an appointment at a VA medical facility within 30 days (or a future published goal established by VA) or resides more than 40 miles from the nearest VA medical facility, with certain exceptions.
    • Require VA to provide a Veterans Choice Card to eligible veterans to facilitate care provided by non-VA providers.
    • Provide $10 billion for the newly-established “Veterans Choice Fund” to cover the costs of this increased access to non-VA care.
    • Require an independent assessment of VA medical care and establish a Congressional Commission on Care to evaluate access to care throughout the VA health care system.
    • Extend the ARCH (Access Received Closer to Home) pilot program for two years.
    • Extend for three years a pilot program to provide rehabilitation, quality of life, and community integration services to veterans with complex-mild to severe traumatic brain injury
    • Improve the delivery of care to veterans who have experienced military sexual trauma as well as care for Native Hawaiian and Native American veterans.

    To expand VA’s internal capacity to provide timely care to veterans, the bill would:

    • Provide $5 billion to VA to increase access to care through the hiring of physicians and other medical staff and by improving VA’s physical infrastructure.
    • Authorize 27 major medical facility leases in 18 states and Puerto Rico.

    To provide real accountability for incompetent or corrupt senior managers, the bill would:

    • Authorize VA to fire or demote Senior Executive Service (SES) employees and Title 38 SES equivalent employees for poor performance or misconduct.
    • Provide an expedited and limited appeal process for employees disciplined under this authority. Appeals would go to a Merit Systems Protection Board administrative judge, who would have 21 days to decide on the appeal. If a decision is not reached within that 21-day period, then VA’s decision to remove or demote the executive is final.
    • Prohibit SES employees from receiving pay, bonuses and benefits during the appeal process.
    • Reduce funding for bonuses available to VA employees by $40 million each year through FY 2024.

    To improve education benefits for veterans and dependents, the bill would:

    • Require public colleges to provide in-state tuition to veterans and eligible dependents in order for the school to remain eligible to receive G.I. Bill education payments.
    • Expand the Sgt. Frye Scholarship Program to provide full Post 9/11 G.I. Bill benefits to spouses of servicemembers who died in the line of duty after 9/11.

    According to current CBO estimates, the bill would result in nearly $17 billion in spending over a 10-year period, with 10-year offsets totaling roughly $5 billion, making it less expensive than previous VA reform packages passed by the House and Senate.
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