By Sandra Basu
WASHINGTON—Calling it another “tangible improvement” for veterans, VA Secretary David Shulkin, MD, lauded the VA Choice and Quality Employment Act of 2017, which was signed into law last month.
The law authorizes $2.1 billion in Choice funding, temporarily extending that program for six more months. In addition, the law provides $1.8 billion for leases for 28 major medical facilities and for hiring and workforce improvement.
“This bill allows us to continue to be able to provide care in the community for our veterans. … Already this year, in the first six months of this year, we have authorized over 15 million appointments for veterans in the community. That is 4 million more than what was experienced at this time last year,” Shulkin said at the signing of the bill by President Donald Trump.
Shulkin pointed out that the new law was only a “temporary fix” for the Choice program.
“We still have more work to do with Congress and with the president’s support. We have to collapse eight different ways of paying for community care into a single program and to simplify it,” he explained.
The current bill passed with bipartisan support.
Ranking member of the House Committee on Veterans’ Affairs, Rep. Tim Walz (D-MN), noted that the new bill “ensures that veterans will be able to seek care in their own community when it makes sense for them, while also making investments in the VA by expanding the department’s capacity to recruit and retain top of the line physicians and caregivers.”
An earlier version of the bill—which only contained Choice funding—failed after meeting with resistance from veteran service organizations (VSO) who voiced concerns that more resources needed to be put in VA care.
“If new funding is directed only or primarily to private sector “choice” care without any adequate investment to modernize VA, the viability of the entire system will soon be in danger,” eight VSO’s said in a joint statement about the the original bill.
That same group of VSO’s voiced their support for the version passed by Congress, however, pointing to the authorization of the 28 medical facility leases and the new tools and authorities to hire and recruit personnel. Still, they noted that “we must immediately turn our attention to the coming debate over how to strengthen and modernize the VA healthcare system, and how community care should be integrated to ensure timely and convenient access for all enrolled veterans.”
Meanwhile, the American Academy of Physician Assistants (AAPA) said the bill will “ensure PAs are offered competitive salaries by the VA through a provision to move PAs to a locality-based pay system, similar to the pay systems already in place for NPs [nurse practitioners] and physicians.”
“On behalf of all PAs, we are pleased that through this important competitive-pay legislation, Congress continues to recognize PAs as a solution for increasing timely access to quality patient care for our nation’s veterans,” said L. Gail Curtis, president and chair of the board of AAPA.
Also supporting the bill was Partnership for Public Service president and CEO Max Stier, who noted that the VA Choice and Quality Employment Act of 2017 will “give the VA better tools to recruit, hire and retain the talent it needs.”
“Over 45,000 positions at the Department of Veterans Affairs are currently unfilled, including mission-critical clinical positions,” he said.
Meanwhile, Concerned Veterans of America Director Dan Caldwell said in a statement that “this bill took far too long to get to the president’s desk and is $1.8 billion more expensive than it needed to be.”
“What we saw during this process was a preview of how choice opponents will behave in upcoming months as Congress works on broader reform,” he said.
When it comes to recruiting, the new law mandates that VA establish a single database that lists each vacant position critical to the mission of the agency, difficult to fill, or both, including each vacant mental health position.
The database also must contain information on qualified individuals who applied for a position within VA and were not chosen but could be qualified for other similar VA positions elsewhere. VA would be required to use the database of qualified applicants in an effort to fill prolonged vacant positions
To boost recruitment, the bill directs VA to establish a program to encourage military personnel with an occupational specialty related to healthcare to seek employment with the VHA after finishing their military service.
The bill also states that the VHA secretary must provide training to human resources professionals in VHA on how to best recruit and retain employees, including recruitment and retention matters that are unique to the agency.
An executive management fellowship program is also established and will provide 18-30 eligible VBA and VHA employees with a 1-year fellowship for training and experience in the private sector. In return, 18-30 eligible private sector employees will serve a fellowship with training and experience in VA.
Additionally, the bill directs the VA secretary to conduct an annual performance plan for each VA political appointee, similar to the annual performance plan conducted for a VA employee who is a career appointee.