The Washington Post
WASHINGTON — 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 deal 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.
Despite expected opposition from some conservatives concerned about the cost of the 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.
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 of the proposal.
“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.”
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 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 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 VA’s performance in medical care and scheduling as well as its construction and technology needs.
Sen. Marco Rubio, R-Fla., who pushed the Senate to quickly give the VA secretary new firing powers, said in a statement that he would carefully review the bill and is “optimistic” that Congress will quickly pass “important reforms.”
The agreement is expected to be debated by the full Senate next week and to be sent to the Republican-controlled House, which already has passed at least nine measures in recent months to improve veterans’ education, employment and health care. The House Veterans’ Affairs Committee also plans to hear testimony Monday evening from watchdog agencies about patient scheduling mishaps at VA facilities.
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 healthcare 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.
As VA seeks to address problems of inadequate patient care, the agency also faces an investigation by the Office of Special Counsel into allegations that officials retaliated against 37 whistleblowers, including some who tried to report actions related to the recent scheduling scandal. The investigative agency that protects federal employees from reprisals announced its investigation Thursday.
The Justice Department is also reviewing whether to launch a criminal investigation into the allegations against VA officials, Attorney General Eric Holder said Thursday.
“We are trying to make a determination as to whether there are criminal violations that would warrant a full Justice Department inquiry,” Holder said in an interview with The Washington Post while traveling in North Dakota. “So, that process is ongoing. I mean, we are certainly involved.”