MT veterans help steer VA reforms

by Missoulian Editorial

Important changes are happening in the U.S. Department of Veterans Affairs, which has struggled for years to provide even minimally adequate care to the growing number of our nation’s veterans.

These changes will directly affect the lives of thousands of Montana veterans who receive care through the VA. And hopefully, long overdue improvements at the federal level will provide Montana with the tools it needs to expand access and encourage thousands more eligible veterans to get the care they deserve through the VA Montana Health Care System.

Nearly 1 in 10 Montanans is a veteran, one of the highest rates of service per capita in the nation. Yet at last count, the Montana VA had an enrollment list of only 47,132 veterans, out of nearly 74,000 veterans who are eligible. Those numbers mean that less than two-thirds of eligible veterans are enrolled in the Montana VA health system.

Closing that gap means providing better care, which means making it more accessible, timely and navigable.

Unfortunately, the federal agency has stumbled on all three counts, leaving veterans to wade through an unnecessarily complex system with lengthy backlogs in appointments – while dozens of veterans died waiting for care.

America’s veterans earned their health care and other benefits when they agreed to put their lives on the line in service to their country. That sacrifice should entitle them to the best health services our nation has to offer. The reality, however, is that the United States has fallen far short of meeting its responsibility.

Multiple attempts at reforming the VA system have been hard fought but resulted in only slight improvements. U.S. Sen. Jon Tester, D-Montana, has been on the front lines of these battles as a ranking member of the Senate Veterans Affairs Committee.

Earlier this month, Tester notched another victory for reform with the passage of a bill aimed at fixing the three-year-old Veterans Choice program, a key method of connecting veterans to health care in rural states like Montana. Nationally, the Choice program accounts for about 25 percent of community care.

Essentially, the program was supposed to allow veterans who live more than 40 miles from VA health clinics and hospitals to receive care at medical providers in their own communities. The problem was that it relied on a private contractor to schedule appointments and pay bills, which added yet another hurdle for veterans to overcome and did nothing to shorten the waiting time for an appointment.

In response, Tester cosponsored legislation, signed by President Trump this month, that ends the reliance on third-party contractors and re-establishes the VA as the direct payer of medical bills.

Of course, the Veterans Choice Improvement Act will only live up to its name if the VA does a better job scheduling appointments and paying bills in a timely manner. In this it faces challenges, but has little excuses, given that it is one of very few federal agency to receive a significant increase in President Trump’s proposed budget. If Congress continues to demonstrate broad, bipartisan support for veterans and keeps this increase, the VA’s budget will expand by 6 percent, for a total of $78.9 billion.

In the meantime, Trump has promised a major and much-needed overhaul of the veterans agency. Although the president’s transition team had originally called for greater involvement from private businesses, the troubles experienced with private contractors in the Choice program may have dampened the enthusiasm for public-private partnerships.

Instead, Tester is focusing reform efforts on the Veterans’ Crisis Hotline, which currently cannot handle roughly one-fourth of its incoming calls, according to a recent report from the Inspector General. As Tester’s office recently pointed out, “Despite agreeing with all of the Inspector General’s recommendations from last year to remedy these problems, the VA has not successfully implemented any of those recommendations or even written any policies for the hotline’s operation.” This foot-dragging is inexcusable.

Fortunately, it is unlikely to continue if the latest VA reform is as successful as intended. This past Thursday, Tester joined new VA Secretary David Shulkin and President Trump at the signing of an executive order creating an Office of Accountability and Whistleblower Protection at the VA.

The office, which has not yet named a director, will be primarily charged with locating and eliminating the obstacles that make it difficult to move or fire poorly performing employees. It will also ensure that employees who report deficient conduct are not subject to retaliation.

Much more remains to be done. The VA still counts thousands of unfilled positions, and the Montana VA faces a slew of challenges in recruiting providers to our rural state, where the suicide rate among veterans is 2.5 times the national average.

Veterans in Montana have a listening ear and powerful congressional advocate in Senator Tester. They and their families should make sure to tell him all about their experiences with the Montana VA, so that he make sure to steer the federal department in the right direction as it undergoes critical transformation.