The Health Subcommittee of the House Veterans Affairs (VA) Committee March 15 held a hearing on the President’s FY 2019 budget request for the Veterans Health Administration (VHA). Testifying were representatives from four veterans service organizations (VSOs) and Dr. Carolyn Clancy of the Veterans Health Administration.
Regarding the research budget, both the Disabled American Veterans (DAV) and Rep. Gus Bilirakis (R-Fla.) highlighted the need for improved funding for the VA’s Medical and Prosthetic Research Program. Dr. Clancy commented that she is always happy to hear a call for more research funding, but that VA research, especially for the Million Veterans Program, has a “huge return on investment… in terms of productivity [per grant], but also because of our proximity to the delivery system where we can translate those findings into practice and improve care for veterans.”
Several committee members brought up workforce and graduate medical education (GME) issues occurring at the VA. Subcommittee Chair Brad Wenstrup (R-Ohio) asked for an updated vacancy rate at VA medical facilities. Dr. Clancy cited current estimates at 36,000 vacancies, and noted that a new Office of Manpower has been established to manage vacancy filling across the entire VHA.
Rep. Mark Takano (D-Calif.) asked VSO representatives for their thoughts and concerns about VA staff recruitment and retention issues. Veterans of Foreign Wars (VFW) noted that student debt forgiveness is crucial for VA to keep highly-trained staff, and asked members to keep Public Service Loan Forgiveness (PSLF) intact through the PROSPER Act as it is debated in the House [see Washington Highlights, Dec. 15]. DAV noted that VA staff should simply be paid better, and receive higher pay increases than VA is requesting in the FY 2019 budget.
Rep. Takano continued by asking about GME vacancies. The 2014 Veterans Choice Act allowed for an additional 1,500 residency positions; nearly half remain unfilled. Dr. Clancy stated that recruitment has been slower than expected because VA is prioritizing rural areas, which involved a process of discussions with academic affiliates and building infrastructure to comply with accreditation requirements. She continued that she expects osteopathic residents will begin to play a bigger role in filling those GME slots, especially in rural primary care residency programs. Rep. Takano concluded with a hope to continue working with the VA to address the workforce shortages.
Finally, Ranking Member Rep. Julia Brownley (D-Calif.) asked the panelists their opinion of the administration budget’s request to merge VHA’s community and medical care budgets. While the panel agreed that streamlining care for veterans is a priority, VSOs noted their concerns about oversight as a combined budget item. Rep. Brownley noted she shared that concern about oversight, as well as transparency and accountability in terms of VA’s reporting to Congress.
Congress continues its consideration of VA health reform legislation to allow veterans to receive health care in the private sector. Funding for the current Veterans Choice Program is expected to run out in May or June [see Washington Highlights, Dec. 7, 2017].