VA seeks $17.6B for more clin­i­cal staff, fa­cil­i­ties

Modern Healthcare - - NEWS - By Vir­gil Dick­son

The Vet­er­ans Af­fairs Depart­ment is ask­ing Congress for $10 bil­lion in new fund­ing to hire 10,000 additional clin­i­cal staff over the next two years and to pay for vet­er­ans’ care de­liv­ered by pri­vate providers. It also wants an additional $7.6 bil­lion to build eight new VA fa­cil­i­ties around the coun­try and to lease 77 additional fa­cil­i­ties, among other in­fra­struc­ture im­prove­ments.

Only 1,500 of the new hires would be doc­tors, while the rest would be staff such as nurses and physi­cian as­sis­tants, act­ing VA Sec­re­tary Sloan Gibson tes­ti­fied last week be­fore the Se­nate Vet­er­ans’ Af­fairs Com­mit­tee.

The fund­ing re­quest last week is in ad­di­tion to leg­is­la­tion be­ing ne­go­ti­ated be­tween the House and Se­nate that would fund non-VA health­care for vet­er­ans who live more than 40 miles from a VA fa­cil­ity, or who face long waits at their lo­cal VA fa­cil­ity, which the Con­gres­sional Budget Of­fice said would cost about $33 bil­lion an­nu­ally. The cost is­sue has de­layed ac­tion.

Gibson said the additional money is needed to en­able the VA it­self to meet the cur­rent de­mand for care. “I be­lieve that the great­est risk to vet­er­ans over the intermediate to long term is that additional re­sources are pro­vided only to sup­port in­creased pur­chase of care in the com­mu­nity, and not to ma­te­ri­ally rem­edy the his­toric short­fall in in­ter­nal VA ca­pac­ity,” Sloan said.

Repub­li­can sen­a­tors said they want to help vet­er­ans get the care they need but don’t nec­es­sar­ily trust the VA’s data. Sen. Richard Burr (R-N.C.) pointed to the VA’s re­cent claim that it had re­duced its vet­er­ans’ care claims back­log by more than 55% from its peak of 611,000 claims in March 2013. The agency re­leased those num­bers even though a rep­re­sen­ta­tive from the VA’s Of­fice of In­spec­tor Gen­eral said dur­ing the Se­nate com­mit­tee hear­ing that the OIG doubted the ac­cu­racy of the fig­ure. “You’ve got to gain the trust of this com­mit­tee and the coun­try,” Burr said.

Sen. Mike Jo­hanns (R-Neb.) also ex­pressed doubt. “This com­mit­tee has been very, very gen­er­ous to the VA,” he said. When for­mer VA Sec­re­tary Eric Shin­seki re­quested additional money, “It was al­most like we’d salute and he’d walk out the door with more money, and al­ways with the prom­ise we’re do­ing bet­ter,” he said.

When asked what would hap­pen if the agency didn’t get the additional funds, Sloan re­sponded that “the wait times just get longer.” But ex­perts say it will be a dif­fi­cult chal­lenge for the VA to hire so many doc­tors, nurses and other clin­i­cal staff, given the short­age of pri­mary-care providers.

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