The Senate Veterans’ Affairs Committee March 21 held a hearing on the President’s fiscal year (FY) 2019 budget for the Department of Veterans Affairs (VA). VA Secretary David Shulkin, MD, testified and was accompanied by senior staff members from the VA.
A few senators focused on the existing Choice program. Chairman Johnny Isakson (R-Ga.) opened the hearing by asking about funding levels for the current Choice program. Secretary Shulkin stated that at the current rate of $370 million per month, the Choice program will run out of funds around the first week of June.
Sen. Patty Murray (D-Wash.) noted her concerns with the budget request’s merging of the Medical Community Care and Medical Services accounts. She commented that the merge may divert funds from the VA to force veterans to see private providers, and asked the Secretary, “What specific restrictions and reporting requirements does the Department recommend to provide transparency…and make sure the VA system is not raided.” Secretary Shulkin responded that the VA is “committed to transparency on how [the VA] spends money” both for the VA and for community care and would recommend providing that data on a monthly basis.
Sen. Mike Rounds (R-S.D.) noted concerns about timely payments for community physicians, and asked how the Secretary plans to garner those providers’ trust to participate in the future Choice program. Secretary Shulkin responded that the VA has “developed rapid response teams to deal with those [providers] that the VA owes the most money to and that are in high priority areas, particularly rural areas…we are trying to re-establish trust and it is a priority for us.”
Sen. Bill Cassidy, MD (R-La.) focused on veterans’ access to high quality organ transplant services. He cited better rates of survival and decreased adverse events for veterans that receive kidney transplants in non-VA community facilities that perform a higher volume of transplant procedures. Sen. Cassidy supports veterans’ ability to be referred for transplants at medical facilities closer to their homes rather than being forced to undergo transplant procedures at lower-volume VA medical centers.
Sen. Bernie Sanders (I-Vt.) questioned the VA’s progress in filling workforce vacancies at VA medical centers. Secretary Shulkin stated the VA has a net gain of 8,700 employees last year and the current year budget calls for a net gain in over 5,700 staff. In addition, the Office of Personnel Management has increased the VA’s ability for direct hiring. Secretary Shulkin noted that filing the staffing vacancies is a “major priority.”
Sen. John Boozman (R-Ark.) focused on suicide prevention at the VA, highlighting the FY 2019 budget request’s $8.6 billion (5.8 percent) increase in funds for veteran mental health services. He noted that only 6 of 20 veterans that commit suicide every day are in the VA health system, and asked what type of outreach VA is using to connect with those veterans not engaged with VA health care. Secretary Shulkin said that VA is looking to utilize the support of the entire community on this initiative. For example, the VA has begun suicide prevention training with mayors, a social media campaign called “Be There” and implemented community veteran experience boards and continues to look for ways to engage the community in veteran suicide prevention.
The House and Senate will likely continue their consideration of VA health reform legislation to allow veterans to receive health care from community providers in April [see Washington Highlights, Dec. 7, 2017].