AAMC Chief Health Care Officer Janis Orlowski, M.D., MACP, June 7 testified before the House Veterans Affairs Subcommittee on Oversight and Investigations at a hearing titled “VA and Academic Affiliations: Who Benefits?” The hearing examined VA’s clinical and research agreements with academic affiliates, including a new U.S. Government Accountability Office (GAO) report titled “Improvements Needed for Management and Oversight of Sole-Source Affiliate Contract Development.”
Echoing previous statements by AAMC, Dr. Orlowski highlighted the value of graduate medical education and medical research conducted at the VA, and emphasized the ways in which joint ventures, sole-source contracting, and proposed VA “Core Network” improve access and quality of care for veterans [see Washington Highlights, March 25].
While members of the subcommittee noted the importance of academic affiliates, they were critical of VA’s lack of oversight in sole-source and research contracting, describing the system as “broken,” despite pushback from witnesses. Most witnesses described VA’s academic affiliations as a successful private-public partnership that will celebrate its 70th anniversary this year.
Subcommittee Chair Mike Coffman (R-Colo.) raised the issue of VA’s intellectual property rights and questioned whether NIH grants should be administered through academic affiliates. Rep. Beto O’Rourke (D-Texas) discussed the GAO report and oversight failures in sole-source contracting. Rep. Tim Huelskamp (R-Kan.) expressed concern regarding VA’s ability to track research equipment and its use at academic affiliates. Rep. Phil Roe, M.D., (R-Tenn.) noted the importance of VA’s recent expansion of its graduate medical education program to help address physician workforce shortages.
The GAO report found that “it took nearly 3 years on average to develop and award 11 selected high- value, long-term sole-source affiliate contracts (SSAC) from three of the five [VA] medical centers” it visited and recommended internal control standards to help ensure high-value, long-term SSACs are developed in a timely manner. The report also found VA “uses short-term SSACs to overcome lengthy high-value, long-term SSAC development time frames, but lacks effective oversight for the development and use of short-term SSACs,” and many did not adhere to VA policy for development of short-term SSACs. The GAO recommended ensuring adequate time to develop and award short-term SSACs and increased training for contracting officers.
VA Chief Academic Affiliations Officer Robert Jesse, M.D., Ph.D., Acting VA Chief Research and Development Officer David Atkins, M.D., Acting VA Chief Procurement and Logistics Officer Ricky Lemmon, Nancy Watterson-Diorio, board member of the National Association of Veterans’ Research and Education Foundations, and Randall Williamson, director of healthcare at GAO, comprised the rest of the witness panel.