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  • Washington Highlights

    Senate Panel Explores the State of Veteran Affairs Administration

    Matthew Shick, Sr. Director, Gov't Relations & Regulatory Affairs
    Christa Wagner, Manager, Government Relations

    The Senate Veterans’ Affairs Committee held a Jan. 17 hearing titled The State of the VA: A Progress Report on Implementing 2017. At the hearing, VA Secretary David Shulkin, MD, and the Committee discussed progress from 2017, areas for improvement, and goals for 2018.

    Committee Chair Johnny Isakson (R-Ga.) opened the hearing by reiterating the importance of high-quality and reliable care for our veterans. He noted that “we are at the time where there are no excuses … this is all about accountability.”

    In his opening statement, Dr. Shulkin highlighted the Department of Veterans Affairs’ (VA’s) five priority areas, which include: providing greater choice of providers for veterans, modernizing VA’s systems, focusing resources on what’s most important to veterans, improving timeliness of service delivery, and preventing veteran suicide. The Secretary also noted that changes are still needed to how services are delivered to veterans, which will include improvements in interoperability, hosting a full spectrum of care, providing consistent and seamless health care experiences nationwide, and rolling out the Veterans Choice Program as a single entity.

    Ranking Member Jon Tester (D-Mont.) reiterated the work the committee had done in 2017 to introduce the Caring for our Veterans Act of 2017 (S. 2193), which includes provisions to increase the number of graduate medical education (GME) residency positions at VA facilities [see Washington Highlights, Dec. 7, 2017]. Sen. Tester then focused on the many workforce vacancies at VA medical centers, stating that “in my state, it’s getting worse.” Secretary Shulkin responded that Montana has a 23 percent physician turnover rate and a 24 percent vacancy rate for nurses. To aid in retaining providers, VA has announced that “for Montana, an increase of up to $120,000 for primary care providers in educational debt reduction, for … psychologists and nurse practitioners a $10,000 hiring bonus, and for social workers, a $5,000 hiring bonus.”

    Sen. Hirono (D-Hawaii) brought up the Jan. 9 Executive Order on Supporting Our Veterans During Their Transition From Uniformed Service to Civilian Life. She asked if the VA has enough mental health providers to fulfill the Executive Order’s goal to “ensure access to quality mental health care and suicide prevention as a priority” and what the VA plans to do to recruit and retain these providers. Sec. Shulkin noted that the VA has “identified a need for 1,000 additional mental health professionals.” This is a challenging goal due to a nationwide shortage of mental health professionals, but Sec. Shulkin noted that the VA is committed to “increasing the number of trainees in mental health residency programs … and will continue to use recruitment bonuses.”

    Sen. Joe Manchin (D-W.Va.) focused on data collection and the opioid crisis. Secretary Shulkin informed the committee that the VA has started to publish every medical center’s prescribing rate for opioids, and stated, “No other system in the country, no other hospital in the country does this… We’ve made a 41 percent reduction [in opioid prescriptions] since this began in 2010 with our Opioid Safety Initiative.”

    Sen. Tester concluded the hearing by focusing on VA research into chronic pain, noting that the use of medical marijuana is legal in Montana and “if marijuana helps people that have chronic pain, we ought to be doing research on it.” In response to a question on the state of marijuana research at the VA, Sec. Shulkin said the VA can do research on marijuana, but “they are restricted because it is a Class I substance, and have to go through multiple agencies.” The Secretary noted that he is “in favor of exploring anything that will help our veterans and relieve their suffering.”

    Congress is expected to consider VA reform legislation before $2.1 billion provided under the December Continuing Resolution (CR) for the Veterans Choice Program runs out in the Spring [see Washington Highlights, Dec. 22, 2017].