VA, HHS Healthcare Staffing Agreement to Up Vet Care Access

April 28, 2017 - Secretary of Veteran Affairs David J. Shulkin, MD, recently announced a new partnership between the VA and HHS that aims to boost healthcare staffing at VA facilities to improve access to care and care coordination.

The collaboration agreement will allow up to 20 officers from the Public Health Service Commissioned Corps to treat veterans at VA healthcare organizations that require additional healthcare providers and workers. Up to 10 more officers will also be placed at the organizations to support care coordination for veterans receiving non-VA community care.

In the same announcement, Shulkin also reported that the VA will now allow state-owned nursing homes to abide by state, rather than federal, guidelines for construction designs. The new rule intends to reduce red tape and increase access to nursing home care.

The veteran nursing homes will still qualify for the same level of federal grant funding, he added.

“My priority has been to improve access to care for our nation’s heroes,” he stated. “By partnering with our colleagues at HHS, we will enhance the availability of clinical care in those areas most in need.”

Care access for veterans has been a longstanding healthcare issue for the VA. A 2016 Government Accountability Office (GAO) investigation found that 30 out of 180 surveyed veterans were unable to schedule a primary care visit because their local VA facility did not schedule appointments according to VA policy.

But even those veterans who did obtain an appointment faced long wait times between 22 and 71 days.

“VA healthcare is a high-risk area,” GAO stated. “In several cases, newly enrolled veterans were never contacted to schedule appointments, due to medical center staff failing to comply with VHA [Veterans Health Administration] policies for scheduling such appointments or medical center staff being unaware of veterans’ requests.”

A Washington Post report blamed veteran care access challenges on provider shortages in the VA. According to the report, about 6,000 nurses, physical therapists, physicians, psychologists, and physician assistants left their VA job in 2011. By 2015, the number of providers leaving increased to 7,734.

In addition to the recent HHS partnership, the VA also took steps in 2016 to improve veteran access to care by boosting VA nurse authority. The federal department finalized a rule that would give some advanced practice registered nurses full practice authority.

Under the rule, certified nurse practitioners, clinical nurse specialists, and certified nurse-midwives qualified to provide advanced nursing services without physician supervision when they were working within the scope of their VA employment.

The final rule notably did not extend full practice authority to certified registered nurse anesthetists.

Additionally, the Secretary of Veterans Affairs introduced a VA healthcare fraud, waste, and abuse taskforce in the most recent announcement.

The new taskforce intends to pinpoint potential healthcare savings by reducing improper payments to healthcare providers, pharmaceutical companies, and other major contractors.

“Restoring the trust of Veterans and improving system-wide accountability are among my top priorities,” said Shulkin. “It's essential to ensure that all our employees and the companies that we do business with are being good stewards of the resources available to care for our Veterans.”

The VA plans to use private sector and government organizations to develop an advisory committee. The committee’s responsibilities will include identifying and leveraging healthcare fraud detection solutions, coordinating all healthcare fraud detection activities, and reporting their findings across the federal department.

Shulkin expects the VA healthcare fraud initiative to “save tens of millions of taxpayer dollars currently at risk, for fraud, waste and abuse that can be redirected to better serve Veterans.”