Senate reaches broad VA deal

Washington PostJune 5, 2014 

— Senators announced a broad proposal Thursday to address health care failures at the Department of Veterans Affairs that would provide the agency with $500 million to hire more doctors and nurses, allow veterans to be cared for outside the overburdened system and give the next veterans secretary greater authority to fire employees for incompetence.

The bipartisan agreement comes less than a week after Veterans Affairs Secretary Eric Shinseki was forced to resign when investigators reported that thousands of veterans were routinely subjected to long delays before they could get the care they needed and that employees took extensive steps to cover up the problem. Polls showed outraged public reaction to the revelations, and Congress was under growing pressure to address the issue.

“Right now we have a crisis on our hands, and it’s imperative that we deal with that crisis,” Senate Veterans Affairs Committee Chairman Bernard Sanders, I-Vt., said as he announced the deal Thursday afternoon.

In the Phoenix area, the death toll for long wait times was revised upward, The Associated Press reported. An additional 18 veterans whose names were kept off an official electronic Veterans Affairs appointment list have died, the agency’s acting secretary said Thursday – the latest revelation in a growing scandal over long patient waits for care and falsified records covering up the delays at VA hospitals and clinics nationwide.

Acting VA Secretary Sloan Gibson said he does not know whether the 18 new deaths were related to long waiting times for appointments but said they were in addition to the 17 reported last month by the VA’s inspector general.

Despite expected opposition from some conservatives concerned about the cost of the Senate deal, chances of passage are good given the public uproar over the scandal and the political goodwill that veterans issues enjoy on Capitol Hill. The House, for example, has already passed several of the management reforms.

Plea for cooperation

Sanders held four days of talks with Sen. John McCain, R-Ariz., whose state was home to a hospital that was the target of the most damning allegations of mismanagement.

“This is not a perfect document,” McCain said, but he praised Sanders’ efforts, describing his colleague as a “fighter.”

Both senators heralded the deal as a rare opportunity for lawmakers to show Americans that Congress can act swiftly in response to a government scandal. Aware of the difficult partisan climate in Congress, they also implored their colleagues not to delay consideration of the bill. One potential hang-up is how to cover the cost.

“Can we sort of pledge that we are committed to seeing this all the way through? I would urge our colleagues to do that,” McCain said. “Let’s not get hung up on certain other aspects of our differences that most people would view as gridlock in this body.”

Proposed VA changes

The agreement merges about a dozen major proposals advanced by House and Senate lawmakers in recent weeks. Republicans have strongly supported giving the VA secretary stronger firing powers and veterans more flexibility to seek medical care outside the VA system. Sanders and supportive Democrats have been seeking to revive a far-reaching veterans’ bill that was defeated in February by Republicans.

A key provision of the deal, already approved by the House, would allow the VA secretary to clear out the department’s clotted bureaucracy by immediately firing or demoting senior officials tied to mismanaged or delayed medical care for veterans.

The worker would be immediately removed from the payroll but, in a nod to concerns that career government employees were at risk of losing their due process rights, the Senate deal gives the worker up to seven days to appeal the decision to the Merit Systems Protection Board, a federal panel that hears such appeals. The board would have three weeks to issue a decision.

The agreement also would give veterans greater flexibility to seek medical care at facilities not run by the VA if they are experiencing long wait times or live more than 40 miles from the nearest VA hospital or clinic. Veterans could choose instead to seek care at private facilities that accept Medicare, at federally qualified health centers, Indian Health Service facilities or medical facilities run by the Defense Department.

The bill would authorize the VA to sign leases for 26 major medical facilities in 18 states and Puerto Rico and to spend $500 million on new doctors and nurses with expedited hiring authority to meet growing demand for medical care from older, aging veterans and younger veterans trying to adapt to civilian life after the wars in Iraq and Afghanistan.

Aides said the legislation would be paid for with emergency supplemental spending that exceeds budget limits approved earlier this year – a move that might keep dozens of fiscally conservative Republicans from supporting the deal.

The agreement would also expand medical care to veterans who were raped or sexually assaulted while in the ranks, provide further tuition assistance to military veterans who joined the ranks after the Sept. 11, 2001, terrorist attacks and establish two independent commissions to review the VA’s performance in medical care and scheduling as well as its construction and technology needs.

In a sign of potential resistance among House Republicans to the Senate deal, Rep. Bill Cassidy, R-La., who is running for a Louisiana Senate seat, blasted Senate Democrats for taking so long to address the scandal.

“Only after news broke that our veterans are dying because of inadequate health care did Harry Reid and Senate Democrats take action,” he said in a statement.

Since Shinseki’s departure last Friday, VA officials have reached out to all of the approximately 1,700 veterans that a Phoenix VA hospital placed on unofficial wait lists that hid treatment delays. Acting Secretary Sloan Gibson visited the Phoenix facility Thursday and said he will release the results of a department-wide audit Monday.

“The data will demonstrate the extent of the systemic problems we have discovered,” Gibson said.

Post writers Sari Horwitz and Josh Hicks contributed.

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