The head of the VA needs to be more transparent about his department's massive budget and work harder to fill important leadership positions that have been vacant too long, senators said Wednesday.
VA Secretary Dr. David Shulkin faced critiques from both sides of the aisle during a hearing before the Senate Veterans Affairs committee about the state of his department. The VA must provide Congress with a realistic view of how much it costs to run its Choice program, which allows some veterans to access medical care closer to home, Sen. Patty Murray, D-Wash., told Shulkin.
“The department has to start being transparent with Congress - it has to,” she said. “About its budget needs and not rating critical programs to cover these shortfalls and to give us a finally a realistic picture of community care spending.”
Sen. Johnny Isakson, R-Ga., the committee's chairman, also pressed Shulkin to fill key agency positions - some of which have been vacant for years - including undersecretary for benefits, assistant secretary for information tech, undersecretary for health, and assistant secretary for accountability and whistleblower protection.
“One thing that concerns me deeply is the four positions that remain unfilled in the department,” Isakson said. “I know you're trying, but this is one of those things where an 'A' for effort isn't enough.”
Before he was tapped to run the VA, Shulkin served as VA undersecretary for health, which he called one of the hardest jobs in America. Brig. Gen. Allison Hickey, USAF (Ret), who serves on MOAA's board, previously served in the position that's been vacant for the longest period: undersecretary for benefits. That position has been unfilled for 826 days.
Funding Choice
The VA requested emergency funds for its Choice program twice in 2017. The bill President Donald Trump signed at the end of December to prevent a government shutdown included $2.1 billion for Choice. The VA got another $2 billion in August to keep the program going.
Being able to explain and predict how much Choice costs “are really basic expectations,” Murray said. She said she was also troubled to learn that the VA tried to move funds away from other programs last year - such as housing for veterans, childcare, and treatment for women - to pay its other bills. Shulkin said spending less on those services was “never their intent,” and that he stopped the move because it sent a bad message.
“There is no desire to do anything underhanded or hide things,” he said. “[The Choice program] is a system in which we're trying to do so much and so fast, and we're obviously making some mistakes and have to do better.”
MOAA is grateful that committee members raised the issue of removing barriers for women seeking health care in VA, said retired Navy Cmdr. René Campos, director of government relations for veterans' health.
“The findings in a recent joint United Health Foundation-MOAA America's health ranking report indicate women who served in the U.S. military are more likely than those who have not served to report being in very good or excellent health despite facing higher rates of mental health challenges and chronic disease,” Campos said. [That provides] a compelling case for VA to do more to invest in women's health.
“MOAA looks forward to seeing the administration's commitment to improving women's health in the President's budget next month,” she said.
Shulkin said he needs help from Congress to properly fund Choice. Right now, he said, the VA has to pay for services at the time they're ordered rather than when they're rendered, Shulkin said. He hopes Congress can change those rules, he added.