October Legislative Roundup

Below you’ll find a list of bills and important resources introduced in the U.S. Congress since our last Mission Critical News Report:

U.S. Senate

Bill No. – S. 1723

Title: Strengthening Veterans Health Care Act of 2017
Click Here for the Bill’s Text
Sponsor: Sen. Bernie Sanders (I-VT)
Cosponsors: There are no cosponsors

What would the bill do, if passed?

  • Allocate $5 billion to the Department of Veterans Affairs specifically to hire more doctors. nurses, and other medical professionals

What’s the overall impact on veterans?

  • The VA has struggled with more than 30,000 vacancies over the last few years
  • By committing funds specifically to hire more staff, the agency would be able to address its highest priority — developing capacity to deliver timely and high-quality care to veterans and their families
  • This bill is supported by Disabled American Veterans (DAV)

Bill No. – S. 1881

Title: Prioritizing Veterans Access to Mental Health Care Act of 2017
Click Here for the Bill’s Text
Sponsor: Sen. Joni Ernst (R-IA)
Cosponsors: John Cornyn (R-TX), Chuck Grassley (R-IA), Thom Tillis (R-NC)

What’s the overall impact on veterans?

Although stating it is “breaking down barriers to access” the bill doesn’t actually address any barriers to offered care. However, it does break down VA’s ability to manage utilization and control costs. In so doing, it would erode VA’s funding to provide care.

Private-sector mental health providers are often not trained to handle veterans’ complex issues.
Surveys report that private sector therapists do not use recognized best practices in treating veterans’ mental health problems.

U.S. House of Representatives

Bill No. – H.R. 3459

Title: VA Staffing and Vacancies Transparency Act of 2017
Click Here for the Bill’s Text
Sponsor: Rep. Anthony Brown (D-MD-4)
Cosponsors: Rep. Peter DeFazio (D-OR-4), Rep. Denny Heck (D-WA-10), Rep. Barbara Lee (D-CA-13), Rep. Madeleine Bordallo (D-GU-At Large), Rep. Charlie Crist (D-FL-13), Rep. Eleanor Holmes Norton (D-DC-At Large), Rep. Sanford Bishop Jr. (D-GA-2), Rep. Robert Brady (D-PA-1), Rep. Stephen Lynch (D-MA-8), Rep. Brian Higgins (D-NY-26).

What would the bill do, if passed?

This bill would require the Secretary of the U.S. Department of Veterans Affairs (VA) to post the number of job vacancies at the VA and report to Congress on what steps the Department is taking to reach full staffing capacity.
It is estimated that 34,000 VA positions are currently vacant, with little push to fill them

What’s the overall impact on veterans?

  • This bill would help address the chronic understaffing across the Veterans Health Administration.
  • It would allow Members of Congress to be continually aware of the critical needs at the VA.
  • It would build capacity for VA to offer care, rather than have to send veterans out to the community where care is more expensive.

Bill No. – H.R. 3874

Title: Accountability for Quality VA Healthcare Act
Click Here for the Bill’s Text
Sponsor: Rep. Derek Kilmer (D-WA-6)
Cosponsors: Rep. James Renacci (R-OH-16), Rep. Mark Amodei (R-NV-2), Rep. Susan Brooks (R-IN-5), Rep. Salud Carbajal (D-CA-24), Rep. David Joyce (R-OH-14), Rep. Mike Kelly (R-PA-3), Rep. Raja Krishnamoorthi (D-IL-8), Rep. Seth Moulton (D-MA06), Rep. Donald Norcross (D-NJ-1), Rep. Scott Peters (D-CA-52), Rep. Kathleen Rice (D-NY-4), Rep. Bradley Schneider (D-IL-10), Rep. Dan Newhouse (R-WA-4), Rep. Daniel Webster (R-FL-11), Rep. Stephanie Murphy (D-FL-7), Rep. Peter Welch (D-VT-At Large), Rep. Lou Barletta (R-PA-11), Rep. John Rutherford (R-FL-4), Rep. David Valadao (R-CA-21), Rep. Andy Barr (R-KY-6)

What would the bill do, if passed?

  • The bill directs the VA Secretary to make certain improvements relating to inspections of Department of Veterans Affairs medical facilities and improving care for women.
  • The Secretary would also be forced to evaluate the organizational structure of the Veterans Health.

Other Resources: Is the VA Being Privatized?

Fighting for Veterans Healthcare has also posted on its website Suzanne Gordon’s document “10 Ways to Kill the VHA – A Checklist.”

 

Panel of Experts Examines Potential Privatization Disaster

The American Federation of Government Employees (AFGE), an AFL-CIO-affiliated union that represents Law Enforcement Officers, Defense workers, VA caregivers, and workers at nearly a dozen federal agencies, held a Privatization Roundtable on Capitol Hill in Washington, D.C.

The panel addressed creeping VA privatization to more than 100 Congressional staffers, reporters, and interested citizens. Representatives Julia Brownley (D, CA-26), Mark Takano (D, CA-41) and Anthony Brown (D, MD-04) all stopped by the make remarks and pledge their support for the VA and their opposition to VA privatization. Sen. Bernie Sanders was supposed to appear but was forced to cancel because of a budget meeting.

On the Panel:

  • Iraq and Afghanistan Veterans of America (IAVA) Research Director Jackie Maffucci who moderated the panel
  • Psychologist and Association of VA Psychologist Leaders (AVAPL) representative Thomas Kirchberg,
  • Disabled American Veterans (DAV) Deputy National Legislative Director Adrian Atizado
  • Veteran, registered nurse at the Memphis VA Medical Center, and AFGE Local 3930 President Kathleen Pachomski
  • Veteran, Federal Correctional Worker, and AFGE National Bureau of Prisons Union President Eric Young
  • Suzanne Gordon, Author, Journalist, Patient Advocate, and Board Member of Fighting for Veterans’ Healthcare

Outsourcing Veterans’ Eligibility Claims

Kirchberg discussed attempts by VA’s leadership to outsource the Veterans Benefit Administration’s Compensation and Pension hearings. These hearings are held when veterans make claims for eligibility for VA services and compensation for service connected problems and pensions.

The hearings have traditionally been conducted by VA psychologists and medical staff. These experts rigorously conduct the hearings and understand the complex conditions and problems from which veterans suffer.
Now, in the name of easing the backlog of claims at an agency — the Veterans Benefit Administration has been chronically under-funded and short staffed — they are being farmed out to Lockheed Martin, a defense contractor with no expertise in veterans’ health problems.

Kirchberg eloquently stated that the Comp and Pen evaluation is the face of the VA for many veterans. Often, the hearings are the first time they tell their story to a stranger. That stranger, he argued, should be someone knowledgeable about military health problems.

Kirchberg worries that new contractors hired to do the job will cut corners, take less time with veterans, and be involved in box-checking exams where compassionate attention is sacrificed for processing more claims.
While claims must be evaluated, the question is by whom? If these claims aren’t carefully evaluated, then there will be more costly appeals and more delays in getting needed care to veterans.

Veterans Caring for Veterans

Pachomiski spoke eloquently about her commitment to deliver high-quality care to veterans. She also receives care at the VHA.

Young went beyond condemning efforts to privatize the VA. He also described the denial of due process rights to federal employees — but as a Navy veteran who receives care at the VHA. He has been treated for kidney problems and hypertension that threatened his life and the VHA saved him time and again. He would, Young said, never get care anywhere else.

Finally, Suzanne Gordon spoke about the salami strategy of privatization that she outlines in her “Ten Ways to Kill the VHA” document. Gordon who is a journalist writing about VHA healthcare, not a veteran, concluded her remarks by holding up the FFVHC Save Our VA bumper sticker. “I am not a veteran,” Gordon said. “But I consider the VHA my VA. I pay for it as a taxpayer. I benefit from its research, teaching and models of clinical care. It is my VA, our VA, even if we are not veterans. Congress,” Gordon asked the group and the political representatives in the building in which the forum was held,” Please, Save Our VA.”

Unanimous Support for $5 Billion VA Funding Bill

All the panelists supported Bernie Sanders “Strengthening Veterans Health Care Act of 2017“ which would allocate $5 billion to the VA to hire more doctors, nurses and other medical professionals to fill these vacancies and ensure that veterans continue to get the best care in a timely manner.

They also supported a bill put forward by Representative Anthony Brown. The VA Staffing and Vacancies Transparency Act of 2017 would require the Secretary of the U.S. Department of Veterans Affairs (VA) to post the number of job vacancies at the VA and report to Congress on what steps the Department is taking to reach full staffing capacity. It is estimated that between 35,000 and 50,000 VA positions are currently vacant, with little push to fill them.

Atizado also spoke at the roundtable and raised DAV’s concerns about and opposition to privatization.

Partnering for Veterans’ Healthcare

FFVHC has been sharing information and ideas with the Texas Vets Care for Health Care group, which is made up of VA stakeholders and state and local representatives of VSOs in Texas.

The group, which shares the mission of FFVHC, has held meetings with Congressional representatives and outlined their opposition to proposals to defund or dismantle the VHA. The group has given out 3000 FFVHC style brochures at the Dallas VA Medical Center and is also distributing FFVHC’s I Love My VA bumper-stickers and recording videos about the excellent care the VHA delivers.

Charlynn Johns, founding President of Battle-Buddy Info and advisor to VA stakeholders believes that, “Our efforts are invigorated and energized by combining resources and truth on messaging.” In the spirit of the Alamo, Johns says “We are together in the fight!”

Will Business Interests Trump Veteran Safety?

A recent VA Office of Inspector General (OIG) report highlights the challenges of collaborating with community providers who offer medical care through Choice. Overdose deaths among veterans are elevated when compared to the civilian population, and the OIG reviewed opioid prescribing to determine the risk for patients receiving care within and outside the VA system.

They reported increased risk when patients are prescribed opioids from community providers. Veterans with chronic pain and mental health disorders (63 percent) are at particularly high risk.

The OIG identified several factors for the elevated risk. Stringent opioid prescribing and monitoring guidelines for VA patients may conflict with practices in the community. The risk is exacerbated when information about opioid prescriptions and other medical conditions is not shared between VA and non-VA providers. In addition, VA providers do not routinely check the Physician Drug Monitoring Program (PDMP) database before prescribing, and community providers do not necessarily have access to VA information.

The OIG recommended that all non-VA providers:

  • Are held to the same Opioid Safety Initiative guidelines
  • Include a medical history and a complete and current list of medications in all requests
  • Submit opioid prescriptions directly to a VA pharmacy for dispensing and recording in the patient’s electronic health record

It has been suggested that community providers should not be held to the same standards as the VA, because it would discourage participation in Choice.

What’s Next for the VA?

After significant lobbying on the part of Veterans Service Organizations (VSOs), an effort to fund the Veterans Choice Program that would have furthered eroded Veterans Health Administration (VHA) services, failed. Nine VSOs signed a letter to the Chairs of the Senate and House Veterans’ Affairs Committees protesting efforts to provide funds to private sector providers without adequately funding the VHA. Congress heeded these protests and passed a bill that would provide $2 billion for the Choice program until the end of fiscal year 2018 and $1.4 billion for the VA. Although this was a definite victory for those who support the VHA, the fight is not over.

Support to Limit VA’s Mission Gains Ground

FFVHC representatives in Washington, D.C. met with Senate and House Veterans Affairs Committee Staff during the August Congressional recess. In terms of proposals for Veterans Choice Program 2018 renewal, they learned that it appears that the idea to “Make Choice Cards Universal” is losing support but that “Limit the VA’s Core Mission to Foundational Conditions” and “Allow Choice Eligibility Based On A Composite Community Standard Metric” is gaining ground.

As FFVHC identified in our recent policy analysis, both of these ideas, if implemented, would hasten privatization of the VA.

Bill to Prevent VHA Funding Crisis

Senate Veterans Affairs Committee Ranking Member Jon Tester (D-MT) has developed a draft ‘Veterans Community Care Program” bill which aims to ensure that expensive, outsourced veterans’ care in the community does not bleed VHA dry. Every dollar increase in Choice allocations would be matched by a dollar increase in VHA. The VHA would continue to control utilization. Surveys would be required yearly of veterans’ satisfaction with, and time waiting for, care received via Choice and VHA.

$5 Billion to fill 45,000 Vacancies?

Senate Veterans Affairs Committee Member Bernie Sanders has introduced the The Strengthening Veterans Health Care Act of 2017. This bill would allocate $5 billion to the VA to hire more doctors, nurses and other medical professionals to fill these vacancies and ensure that veterans continue to get the best care in a timely manner.
These are the only proposals to “Strengthen the VA” (with more funding). They have yet to garner sufficient support to get beyond their respective Committees. Expect a contentious battle when Congress takes up the issue now that they’re back from recess.

 America’s Biggest Publicly Funded, Fully Integrated Health-Care System Is Under Attack

 The Veterans Health Administration is a successful example of a single-payer system in the United States. It’s time for progressives to defend it.

 In the Bay Area, public meetings critical of conservatives are not hard to find. But when about 200 San Francisco military veterans jammed into an auditorium in their city’s Veterans War Memorial Building in mid-April, they added diversity to the local “resistance.” Those in attendance—representatives of veterans-service organizations, patients of the Veterans Health Administration, health-policy experts, and local Congresswoman Nancy Pelosi—were trying to educate veterans and the public about proposals that could destroy a single-payer plan for 9 million Americans whose past military service, in combat and noncombat jobs, makes them eligible for VHA coverage. READ MORE