By Sandra Basu
WASHINGTON—VA made progress in filling its vacancies last year with a net increase of 8,303 employees, but the agency still struggles to find enough mental health professionals, especially in light of a new executive order increasing eligibility for that care.
“We hired close to 40,000, but it’s a net increase of 8,303,” VA Secretary David Shulkin, MD, told lawmakers at a recent hearing. Despite this, he said the VA needs to hire more healthcare professionals, including 1,000 mental health professionals, to help fulfill a recently announced executive order that will give all transitioning servicemembers mental healthcare for 12 months.
“Unfortunately, the country at large has a shortage of mental health professionals. This is going to be difficult,” Shulkin conceded. “We work hard with psychologists and psychiatrists to train as many as we can. We want to do more. We will continue to use efforts like our recruitment bonuses and to acknowledge that VA is actually a terrific place to work if you are a mental health professional.”
Shulkin made his comments at a hearing on VA’s efforts to implement VA reform legislation. Among a range of topics that he was asked about were vacancies, including his former position of assistant secretary for health, the assistant secretary for accountability and whistleblower protection, the undersecretary for benefits and the secretary of information technology.
“I know you are trying, but this is one of those things that ‘A’ for effort is not good enough. We have to find a way to get the best people in the United States of America in these disciplines working for the Veterans Administration and working for our veterans,” said Senate Committee on Veterans Affairs Chairman Sen. Johnny Isakson (R-GA).
When it comes to the vacant key leadership positions, Shulkin told lawmakers that the VA has an executive in charge for the accountability and whistleblower protection office and is working to fill the other positions.
For those positions that will need Senate confirmation, Sen. Dan Sullivan (R-AK) asked that there be “no games” with his colleagues in the confirmation process once the nominations are sent to the Senate. “Let’s get them going; let’s get them confirmed. We don’t need 40 hours of debate on some of these, they are not going to be controversial,” he said.
Ranking Member Sen. Jon Tester (D-MT) added that he “will put pressure on my side of the aisle to get them through the Senate as soon as possible.”
Shulkin was also asked about direct hiring authority that VA was given in a bill that became law last year. He pointed out that the new law “unintentionally” capped salaries at lower than what is already offered for medical center directors (MCD) and network directors and suggested that Congress will need to make a legislative change so that the new authority can be used.
“It is a very small technical change,” he said.
In his written statement, Shulkin explained that, during calendar year 2017, the agency reduced the time to hire MCDs by about 23%. Currently, he said that 125 of 140 MCD positions are filled, and, of the remaining 15 positions under recruitment, “10 have a potential hire identified and are either going through the [Office of Personnel Management (OPM)] approval process or have an established entrance on duty date.”
That new law also gave VA the ability to expand direct-hire authority for critical employees.
“We have gone to OPM with 15 different critical occupations that they have agreed to move forward with us on direct-hiring authority,” Shulkin told lawmakers.
Lawmakers also voiced concern about the need to fill medical vacancies in their districts. Tester pointed out that, in his state, Montana, clinical shortages appear to be getting worse, stating, “We are at a crisis.”
Shulkin conceded that the VA has “to hire more staff” there and make sure the agency can keep them.
“We have announced for Montana an increase of up to $120,000 for primary care physicians in educational debt reduction, for psychologists and nurse practitioners a $10,000 hiring bonus and for social workers a $5,000 hiring bonus. That is a beginning to start to [get] people to begin looking at VA as a place to come to work,” he said.
Sen. Mazie Hirono (D-HI) asked whether VA needs more tools to hire the necessary people, pointing to 166 medical staff vacancies in Hawaii that need to be filled.
Shulkin said the agency will come to Congress if it needs additional help.
“Right now, we have three hiring authorities that we have to hire employees under Title 5, Title 38 and a hybrid system. It’s complicated. The more we can move our healthcare employees toward Title 38, it makes the process faster and more competitive with the private sector,” Shulkin said.
With a long history of point of care testing at both of its predecessor organizations, the Walter Reed National Military Medical Center (WRNMMC) laboratory services staff were keenly aware of the advantages of using portable testing devices to obtain rapid patient assessments.
Legislation that would streamline VA’s community care programs into one program and expand VA’s caregiver program to veterans of all eras was signed into law earlier this month..