Veterans Secretary Denis McDonough said the country was poised to approve the “biggest expansion of veterans’ benefits in history” and needed to make infrastructure investments to match that expansion in a talk with governors of the Western states on Wednesday.
“We want the governors to be part of this process. We need the governors to be part of this process,” McDonough said. “And we’ll stay close to you on every step of the way.”
McDonough was not asked by the eight state executives in attendance at Wednesday’s session of the Western Governors Association meeting in Coeur d’Alene about the contentious rollout of an electronic health care records system, first introduced at the Mann-Grandstaff VA Medical Center in Spokane nearly two years ago. Gov. Jay Inslee was not in attendance. The effort, begun before McDonough was appointed by President Joe Biden, has been plagued by increasing cost estimates and internal watchdog reports found nearly 150 veterans had been harmed because of the system.
In an interview with reporters after a session with the governors, McDonough would not say what the future of that system, now delayed in Boise, could be.
“I don’t want to get into hypotheticals,” McDonough said. “But we’re constantly looking at those issues, first among them patient safety.”
Reps. Cathy McMorris Rodgers and Dan Newhouse, along with other lawmakers in districts where the system created by Oracle Health has been deployed, wrote a letter to the VA this week requesting the agency use existing funding for records management to be used to hire more workers for scheduling and other clerical purposes. At a hearing on Capitol Hill last week, a VA official told lawmakers the system was working in Spokane because workers were “putting in double time, double-checking, triple-checking things.”
“The medical centers in our districts should not have to choose between staffing up to continue safely caring for veterans and blowing a hole in their budgets, forcing painful cuts in the future,” the letter reads.
McDonough said he didn’t oppose additional staffing, and noted that had been a priority of the Biden administration.
“It may, in fact, be,” McDonough said of increasing staffing as an answer to records concerns. “Our No. 1 legislative priority this year has been increasing our human resource performance and our human resource availability across the VA.”
In a hearing on Capitol Hill following McDonough’s appearance with the governors, McMorris Rodgers questioned senior VA officials and the director of the Spokane medical center about the delayed care for the 150 veterans, citing specific examples contained in the internal reports. The congresswoman called the effort a “failed (electronic healthcare records) experiment.”
“It’s been frustrating to me, and the veterans in my community, to hear the VA executives brush aside concerns that we’ve been raising since go-live,” McMorris Rodgers said.
McDonough also addressed in the interview ongoing care at the Spokane health care center. A previous recommendation called for the aging military hospital to shift from inpatient to outpatient care. A VA review of that recommendation is not moving forward because of opposition from key U.S. senators, including Washington Democrat Patty Murray, McDonough said.
“That is not going to happen,” McDonough said of the review process. “Period, full stop, next paragraph.”
“We do not envision a change in Spokane in terms of the care that we offer veterans,” McDonough added. “But how we deliver that care, and what those facilities look like, will inevitably have to change over time.”
McMorris Rodgers asked Robert Fischer, director at the Mann-Grandstaff VA Medical Center in Spokane, whether inpatient services were in jeopardy at the facility.
“I can tell you from my perspective, they are not,” Fischer said. “But I’m not the decider in issues related to services.”
To the governors, McDonough made a pitch for “modernizing our facilities, and building new facilities,” noting the age of VA hospitals far surpasses that of most civilian facilities. He said that would come after a review of market conditions that would begin promptly and in consultation with governors, but said he hadn’t yet seen legislation for an infrastructure review introduced this week by Sen. Jon Tester, D-Mont., the chairman of the chamber’s Veteran Affairs Committee.
“We’ll be working with Dr. Teresa Boyd, who runs this region for us, to get to the bottom-line assessment of what the veterans in this market need today, what they’ll need for the coming 30 years, what we can provide, what the private sector can provide, and where we need to modernize those facilities,” McDonough said.
McDonough also anticipated passage of federal legislation that would extend free medical treatment to hundreds of thousands of combat veterans after 9/11 who were exposed to toxic chemicals in “burn pits” used to incinerate waste on battlefields in the Middle East and elsewhere, as well as increasing the number of toxin-related medical conditions covered by VA benefits.
The Senate is expected to send the bill to President Joe Biden as early as this week.
The secretary also said he anticipated the release of a report at the end of this week on the effectiveness of a Trump administration program designed to guide veterans who were facing delayed care at their local VA medical centers into community hospitals. McDonough told the governors he hoped the report would come with additional recommended rule changes, including one that would keep veterans at their VA center if, within a 28-day window, they can see a doctor virtually. Because, McDonough said, if that veteran was referred out into the community, it’s likely they’ll get a virtual appointment, anyway.
“Let’s put our money where our mouth is, which is to say, virtual care is working pretty well,” McDonough said, noting that such a rule change would need to go through a public comment process before taking effect.
McDonough planned visits to the VA clinic in Coeur d’Alene and the Boise VA Medical Center on Wednesday after speaking to the governors.
The Washington Governors Association meeting concludes Thursday morning in Coeur d’Alene, where governors are expected to hear from U.S. Transportation Secretary Pete Buttigieg.
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