NAVAPD Meeting with Staffers from House and Senate VA Subcommittees on Health
On Tuesday, January 24, 2023, NAVAPD President, Dr. Joseph Abate, met with staffers from the Democratic House VA Subcommittee on Health, Oversight and Investigations and Workforce Retention, Recruitment and Modernization.
NAVAPD was directed to this subcommittee through our request to meet with Congressman Takano. The Subcommittee on Health has legislative, oversight and investigative jurisdiction over the Veterans Health Administration including medical services, medical support and compliance, medical facilities, medical research, and major and minor construction.
A robust discussion was held on issues facing NAVAPD members including Physician and Dentist pay, Recruitment and Retention, HR Modernization, the Electronic Health Record, the MISSION Act and the PACT Act, and Asset and Infrastructure Review.
NAVAPD learned, at this meeting, that there is bipartisan support for, and a bill has been introduced, in consultation with VA, that would essentially restructure pay scales in VA for Physicians, Dentists, Podiatrists and Optometrists. The proposed bill would remove the $400,000 salary cap that Physicians and Dentists are under and allow VA to pay specialists closer to a rate commensurate with their peers who work for non-VA medical centers. This is a proposed bill that has a long way to go before becoming law, however the staffers seemed confident that this bill should come up for a floor vote in the next several weeks. The question was posed that if this proposed bill eventually passes, and becomes law, will VA address the salaries of existing Physicians and Dentists. This bill has a provision written into it that will require VA to review existing pay nationwide for its existing workforce and make changes in accordance with the new bill. Another provision written into the bill would require VA to review market pay (also known as locality pay) and make adjustments based on workforce data that is currently available. NAVAPD is cautiously optimistic about this proposed bill because several of our recommendations that were made to the Workforce Steering Committee on Physician and Dentist pay have been written into the new bill.
HR Modernization was discussed. The staffers seem to be acutely aware that HR Modernization is not working, especially in terms of recruitment of new Physicians and Dentists. They have heard from NOVA (Nurses Organization of Veterans Affairs) and NAVAO (National Association of VA Optometrists) among other VSO’s (Veterans Service Organizations) about issues related to HR, Recruitment, Timeliness of Onboarding, and loss of qualified practitioners due to the length of time it takes to bring new recruits onboard and the length of time it takes to transfer existing VA practitioners to a new VA facility. NAVAPD gave specific real-world examples of departments where it took 6 months to bring new physicians and dentists onboard, as well as specific examples where due to the lack of speed, staff were lost or took other positions at non-VA medical centers. Similar issues and examples have been provided to the staffers by the other VSOs with which they have spoken. NAVAPD pointed out that there needs to be a streamlining of tasks in HR and that, although OPM requires certain items for onboarding (that is beyond VA’s control), there needs to be accountability as well as a strict timeframe to completion of onboarding. A maximum of 30 days was discussed as a reasonable timeframe from selection of a candidate to completion of onboarding tasks and staring New Employee Orientation. It was also discussed that since HR processes were removed from the local VA medical centers to the VISN level there is no longer any local accountability and too much segregation of tasks among too many people making it difficult for hiring managers to know where their prospective employees are in the pipeline. This not only leads to frustrations but lack of access to care for the veteran. The staffers indicated the 118th Congress is very much interested in hearing from NAVAPD’s members regarding loss of qualified physicians and dentists (as well as ancillary staff) due to HR issues.
The Electronic Health Record was discussed. NAVAPD made it clear to the staffers that we fully support a complete stop to the deployment of the Oracle Cerner product until such time as all issues identified from the existing sites that are using it have been solved to VA’s satisfaction. The Oracle Cerner product is an off the shelf product designed for medical centers where billing insurance companies, billing patients, and collections from patients and insurances are of paramount importance for the profits of the organization. VA does not operate this way. Oracle Cerner did not have experience designing software for the Federal Government (DOD and VA). Instead of designing something that meets the Federal Government’s needs, which is completely different than industry, Oracle Cerner is trying to jam their “square peg” software into a round hole. A myriad of patient safety issues related to the software was discussed. The staffers indicated that they would like to hear from our membership regarding issues they are having using the new software.
Other topics that were discussed included MISSION and PACT Acts and the Asset Infrastructure Review. NAVAPD noted that the vast majority of VA medical centers and CBOCs are aging, decrepit structures, and that the infrastructure does not meet the needs of the expanding patient base, especially given the expansion of benefits and presumably expansion of the patient base as a result of the recent passage of the PACT Act. Of note, NAVAPD learned that the Asset Infrastructure Review process has been dispatched by Congress. Instead, a market assessment of VA’s infrastructure will occur every 3-4 years. On the positive side a provision in the PACT Act will now allow VA to lease additional infrastructure over 10,000 square feet without having to have Congressional approval. This will allow VA to lease more buildings to accommodate more patients.
Overall, the meeting was very productive, the staffers were genuinely concerned about the working conditions facing VA’s Physicians and Dentists and genuinely want to make improvements where improvements can be made. NAVAPD will be having a town hall in the very near future (date to be determined), and we have invited these staffers to be present at the town hall. They indicated that they would love the opportunity to speak directly to you, our members, and to answer any questions or concerns that you may have.