As the Senate, the House and the Department of Veterans Affairs are racing to enact new legislative, regulatory and administrative fixes to VA’s longstanding access problems, DAV (Disabled American Veterans) urges all parties to ensure that any new proposals improve veterans’ health outcomes and preserve the veterans’ health care system by adhering to the following five core principles.
Veterans who are entitled to receive care inside the VA system, but who do not reside within a reasonable distance of a VA facility or who would be required to wait beyond medically reasonable time limits to be treated, should have the choice to either wait and/or travel for a VA appointment or to choose to have VA coordinate and pay for that care based upon medically responsible time and distance standards at local, qualified non-VA providers.
Any proposal to expand or enhance access to care must include full, accurate, honest and transparent funding that is separate from the budget required to operate VA’s existing hospitals, clinics and other health care facilities and programs. If Congress or the Administration is going to create new mandates or programs within or outside VA’s health care system, they must honestly calculate the additional costs and guarantee sufficient new sources of funding; under no circumstances should Congress or the Administration pretend to pay for the cost through budgetary gimmicks such as efficiencies, collections, carryovers or contingency funds. New unfunded mandates for veterans’ health care will only worsen the existing access problems inside VA and further threaten the health of wounded, injured and ill veterans.
VA must remain responsible for ensuring the quality, timeliness and coordination of all health care provided to veterans, whether it is delivered inside VA facilities by VA medical professionals, or at VA clinics operated by outside entities by contract, or through non-VA providers through purchased care programs. Regardless of whether VA is the actual provider or not, the Department and Secretary must remain responsible and accountable for ensuring the best health outcomes for all enrolled veterans. VA must continue to be the entity responsible for coordinating health care treatment and retaining integrated medical records.
Any new legislative or regulatory proposals enacted must not interfere with VA’s emergency access initiative that is currently contacting every veteran found to be waiting for care and arranging for them to receive medical appointments either inside the VA system or through non-VA providers within the next thirty days. Since the creation of new administrative structures and procedures will require significant time before they can be fully implemented and operational, new proposals must not interfere with the ongoing emergency actions VA is taking today to provide immediate medical care for thousands of waiting veterans. Further, VA must work openly and collaboratively with Congress and VSO stakeholders to implement its emergency access program, fully sharing all of the findings from audits and investigations, the details of their plans and the expected and actual outcomes as soon as they are known.
We call on both Congress and the Administration to take the time necessary to thoroughly investigate and analyze the root causes of VA’s longstanding access problems—in collaboration with VSO stakeholders—and then to work together to craft, enact and implement comprehensive, effective, honest, long-term solutions to address the problems identified. Assuring timely access to VA health care for all eligible veterans requires sufficient physical space (infrastructure), enough doctors, nurses and other medical professionals (staffing, funding), administrative capacity to coordinate delivery of services (management, transparency and accountability) and a backup system for when and where VA is unable to deliver such care in a timely manner (purchased care). Unless all four of these areas are openly, honestly and comprehensively addressed, the access problems that have exploded into the public view over recent months will continue, recur and worsen in the future.