Gazette opinion: Remedies for what ails VA Montana health care

Billings Gazette

by Editorial Board

Last week, Republicans and Democrats on the Senate Veterans Committee gathered to announce their support for bipartisan legislation designed to fix multiple problems in the Veterans Affairs Health system. Surprisingly, the senators are hopeful that the Senate will pass that bill this month.

U.S. Senators Johnny Isakson, R-Ga., and Richard Blumenthal, D-Conn., chairman and ranking member of the Senate Committee on Veterans’ Affairs, emphasized that the bill will “will give the VA the tools to fire bad actors, will prohibit bonuses for employees accused of wrongdoing, and will institute protections for whistleblowers.”

The Veterans First Act is about accountability, agreed Sen. Jon Tester, D-Mont., a member of the committee. But Tester emphasized what the legislation aims to do to directly improve veterans care. The bipartisan bill includes his proposed remedies for the Veterans Choice program.

In August 2014, Congress and President Barack Obama created the Veterans’ Choice program in an effort to reduce the waiting time for veterans to see a doctor. The Veterans Choice program, which must contract with a private gatekeeping company, has actually slowed down the process for getting veterans into care.

“Choice is broken and is not working the way it was intended,” said Tester.

One big problem with Veterans Choice is that the money goes with the program, not the veteran. The new bill would change that.

“This gives the VA flexibility to take Choice money and use it for community care not available within the VA,” Tester said.

The state of Montana is one of five sites selected to pilot a partial remedy while Congress works on a comprehensive fix. VA Montana has been authorized to use Veterans Choice funding to contract directly with community clinics when that is the quickest way to have a veteran seen by a qualified physician. Previously, VA Montana had to tap a separate community care fund (which was rapidly being depleted) and wasn’t allowed to use Veterans Choice funds.

This is only a partial fix because the Veterans Choice contract still requires referrals to go to the private gatekeeper (Health Net) and VA Montana must wait for Health Net to send the case back, which can take a week or more.

The pilot has been successful in getting veterans in to see physicians in Montana communities faster than they could be seen through Health Net or within the VA, said Johnny Ginnity, VA Montana director. The pilot is expected to go nationwide soon, possibly later this month.

While senators were finalizing their Veterans First Act on Capitol Hill last week, Ginnity was traveling Montana to meet personally with local clinic leaders in Miles City, Billings, Lewistown, Great Falls and elsewhere. His pitch is a deal for these Montana clinics to work directly with the VA to care for veterans, basically cutting out the third-party administrator. Ginnity told The Gazette that clinic leaders have been receptive. The privatized Veterans Choice drew complaints in Montana and elsewhere that the contract was difficult to work with and that payments for services to veterans were long delayed.

The Senate reform bill aims for other improvements, including:

· Increasing physician residency positions in VA, both to provide more doctors now and to enhance recruiting efforts for the future.
· Boosting efforts to recruit more licensed mental health counselors and marriage and family therapists.
· Improving the process for filling leadership vacancies.
· VA Montana is constantly recruiting doctors, nurses and other health care professionals and office workers. Among the vacancies last week were associate state director, chief of medical staff and three psychiatrists.

A VA reform bill can and should pass the Senate before Congress recesses for Memorial Day week vacation. We call on Montana’s delegation to be leaders in getting veterans’ health care legislation to President Barack Obama’s desk early this summer.

Among 97,000 veterans who call Montana home, 47,000 are enrolled in VA and about 38,000 receive VA treatment every year. Just about everyone in Montana is a veteran or knows a veteran who needs VA health care.