From Military.com:
“VA Asks for Billions to Treat
'Bow Wave' of Veterans Needing Care After Pandemic”
The Department of Veterans
Affairs is seeing increased demand for health services from veterans who either
deferred care or couldn't get appointments during the pandemic -- a surge that
VA Secretary Denis McDonough says will add billions to its budget. McDonough
told the House Veterans Affairs Committee on Tuesday that funding is needed to
add more than 19,000 new positions, including 17,000 health care jobs, and to
cover the growing cost of care both at department facilities and in the
community. The VA's latest budget request is $270 billion. According to
McDonough, the department saw "record high levels" of veterans
receiving care at non-VA facilities in April and May through benefits provided
under the 2018 Mission Act. At the same time, VA hospitals and clinics are
returning to "pre-pandemic levels" of patient care, he said.
The VA is asking for a 27% boost
in its budget for community care for fiscal 2022, from $18.5 billion to $24.4
billion. It also wants another 24% increase from current funding levels for
fiscal 2023 -- $24.2 billion for advanced appropriations, a budget item unique
to the VA that ensures veteran services are never interrupted by legislative
debate or delays. At the same time, the department is asking for a 4% increase
for health services at VA medical centers and clinics, from $56.5 billion to
$58.8 billion. "This is not hypothetical," McDonough told committee
members. "We are in the midst of a 'bow wave' of care; we are seeing a
demand for that care."
While VA medical centers never
closed during the pandemic, schedulers moved most routine appointments to
telehealth or telephone visits or canceled them. They also postponed elective
procedures, prompting some veterans to delay care or seek treatment in their
local communities. The VA "underwrote a lot of care in the community when
private facilities were trying desperately to stay open," McDonough said. "The
community care budget is growing. As a general matter, upward of 30%, 31% of
our costs are care in the community, although it got as high as 39% at the
height of the pandemic,” he said. The VA Mission Act implemented sweeping
changes to the department's community health care program, allowing veterans to
see private health care providers at the VA's cost. The legislation greatly
expanded access to that care, and supporters have praised the benefit as a win
for veterans who faced long wait times or who live far from a VA health
facility. But critics said it would draw funds away from VA facilities and
providers, amounting to the "privatization" of VA health care.
Rep. Mark Takano, D-Calif.,
chairman of the House Veterans Affairs Committee, and Rep. Mike Bost of
Illinois, the committee's ranking Republican, have expressed concern over the
explosive growth of the program and the VA's budget. Takano questioned whether
the expansion of the program was related to aging infrastructure at the VA that
may prevent veterans from receiving specialized services. "Funding
requests for care in the community have grown substantially in recent years,
due in large part to the expanded access standards and poor actuarial
projections in early 2018," Takano said. "The Congressional Budget
Office suggested estimated outlays for the program over a five-year period
would be just under $23 billion ... but we're seeing this in one year." Bost
agreed. "I think we are all concerned about the national debt outgrowing
our economy. VA has requested a 10% increase next year. If that rate of growth
continues, the VA budget will be $574 billion by 2030. The problem is the
number of veterans using the VA services is not up by 10%," he said.
"I'm not suggesting cutting VA, but the budget growth has to be more in
line with demand."
The VA received influxes of
funding in fiscal 2021 in addition to its base budget, including $36 billion in
pandemic relief and recovery funds. Another $18 billion in the American Jobs
Plan is marked for VA health care infrastructure. The fiscal 2022 budget
proposal includes a nearly 100% increase in the department's suicide prevention
budget and an additional $1.5 billion for mental health services to meet
increased demand. McDonough said more than 1.6 million veterans sought mental
health services through the VA last year and Veterans Crisis Line calls have
nearly doubled.
Under the VA budget proposal, the
Veterans Crisis Line would receive $142 million, while suicide prevention
programs, including a grant program for community organizations that focus on
suicide, would receive $598 million. Lawmakers also pressed McDonough for a
reaction to proposed legislation that would require the department to provide
pay and benefits for service members with illnesses related to toxic exposures,
including burn pits and other airborne hazards such as oil well fires. Legislative
packages now under debate could cost up to $1.5 trillion. By comparison,
President Joe Biden's budget proposal for the federal government is $6
trillion. "Bill costs of this magnitude are unheard of in the VA. They
raise serious questions about our ability to pay for this legislation. They
also raise questions about VA's ability to implement and to do so without
compromising service for veterans in other areas," Bost said. McDonough
said the department is reviewing the current legislative proposals and what
they would require in terms of VA personnel and support. But Takano reaffirmed
his commitment to legislation that would support affected veterans. "Last
month, I unveiled the 'Honoring Our Promise to Address Comprehensive Toxics
Act' ... to recognize toxic exposure as a cost of war and ensure all veterans
can utilize the care and benefits," he said. "I look forward to
working with VA on this important issue." Testifying after McDonough as
part of a panel of veterans services organization representatives, AMVETS
National Executive Director Joe Chenelly criticized the budget proposal, saying
it lacks specifics to improve veterans' quality of life. He said that part of
the $1.5 billion for mental health services should fund a task force that would
focus on providing a holistic approach to veterans' health, including physical
and mental health and job and home security. "We need to get out of the
business of spending billions on ineffective mental health services and
pharmaceuticals focused only on treating veterans' symptoms, and instead fund
proactive programs that train veterans how to live happy, healthy lives of
purpose," Chenelly said.
^ I agree that the VA should get
more funding to cope with Covid and the extra services it is required to
provide to new Veterans, but I also believe that there needs to be an
Independent Third Party Group that comes in and makes sure the VA is effectively
using its funding for their Patients and are not wasting it or giving sub-par
treatment as they have in the past. ^
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