- Department of Veterans Affairs (VA) Secretary Robert A. McDonald is defending the agency once again, restating its commitment to improve patient care access and timely appointment scheduling for veterans.
Following President Obama’s final review of the Commission on Care report, McDonald issued a statement asserting that the VA agrees with 15 out of the 18 suggestions in the report, and believes that it is feasible to implement their proposals.
The report, published at the end of June, summarized a number of shortcomings and potential threats to VA’s success, such as inconsistency between facilities, insufficient patient access to care, and staffing and financial needs.
The Commission’s 18 recommendations sought to alleviate these problems and help keep the VA on an upward trajectory toward better veteran care.
These recommendations ran the gamut of improving VA healthcare networks and boosting clinical operations. Another recommendation urged VA to address healthcare equity by allocating resources and personnel to identifying and addressing the root of care equity problems. The Commission also suggested VA create a VHA Health Equity Action Plan.
Although McDonald stated that the agency agreed with a majority of the Commission’s recommendations, he did site specific issue with their suggestion that the VA establish a VHA Board of Directors.
The Commission explained that a VHA Board of Directors could “provide overall VHA Care System governance, set a long-term strategy, and direct and oversee the transformation process.”
Ultimately, the Commission sought to address governance issues which indirectly caused VHA shortcomings such as the appointment availability problems at many of the agency’s facilities.
However, McDonald asserted that an agency board of directors would be inappropriate for “constitutional and practical reasons.”
“Most problematically, this proposal would seem to establish VHA as an independent agency, which would frustrate ongoing efforts to improve the Veteran’s experience by integrating Veterans health care and services across VA, making it more difficult for Veterans to receive the quality care where, when, and how they need it,” McDonald added.
Despite these sentiments, McDonald did say that the VA has established a party of external advice, primarily to counsel the agency’s MyVA initiative, which seeks to improve patient access to care.
The council is comprised of individuals who are both experts in the medical field and in military and veteran life.
“These are innovative, resourceful, respected leaders who are advising us on transformation. They know business. They know customer service. And, they know Veterans,” McDonald said.
The secretary reiterated the agency’s commitment to improving care access for veterans, but underscored the imperative for the VA to remain an independent agency free from privatization. Citing Veteran Service Organizations (VSOs) viewpoints, McDonald stated that the VA is the best place for veterans to access healthcare to meet their unique physical and mental health needs.
“Many VSOs fear that the Commission’s vision would compromise VA’s ability to provide specialized care for spinal cord injury, prosthetics, traumatic brain injury, post-traumatic stress disorder, and other mental health needs, which the private sector is not as equipped to provide,” McDonald explained.
“We share their concern and therefore do not support any policies or legislation that will lead to privatization, which I am pleased the Commission did not recommend outright. Privatization is not transformational. It’s more along the lines of dereliction of duty.”
Ultimately, McDonald concluded, VA requires guidance from Congress, which he says is its “board of directors.”
“If Veterans are to receive the care and services they deserve, Congress must do its job as our board. Abdicating leadership and constitutional responsibilities by creating more bureaucracy hurts Veterans and slows the progress of our MyVA transformation,” McDonald said.
“We, along with VSOs, have worked hard with Republicans and Democrats in Congress to develop these critical pieces of legislation,” he continued. “I call on leadership from both parties to put political expediency aside and do what is best for our Veterans and for taxpayers. Only then will we be able to truly transform VA into the 21st century organization Veterans deserve.”
The agency has repeatedly been called into question regarding the availability of doctor’s appointments for veterans.
In response to those critiques, McDonald cited some of the VA’s progress, stating that between 2014 and 2015 the agency had increased community care appointments by 20 percent.
Just recently, the agency proposed a rule allowing advanced practice nurse practitioners to practice at the top of their licenses. VA intended this proposal to increase access to care by empowering more qualified caregivers.
However, problems still persist. Average appointment wait times are five days for primary care, six days for specialty care, and two days for mental health care. Through the initiatives McDonald has proposed, this wait times may decrease, ideally so that veterans can access all types of care in a timely fashion.