On Monday November 6, 2023, NAVAPD held a town hall for our members. NAVAPD’s guests were staffers from the Senate VA Committee on the Republican side.  Our previous town hall guests were staffers from the Senate and House VA Committees on the Democratic side. 

The town hall was attended by over 25 of our members. The staffers gave a presentation on legislation that they are working on that directly affects VA Physicians and Dentists. The topics presented by the staffers are the same topics NAVAPD has been advocating for over the past two years.

A summary of the legislation being worked on in the Senate is below:

The first legislation the staffers presented was the VA CAREERS Act. The bill has many provisions, but of note to physicians and dentists, the CAREERS Act would give VA a waiver of the $400,000 salary cap currently imposed on the VA. The Act would also make VA undergo a new Market Pay System to decrease disparity in pay for physicians and dentists when compared to the private sector. Other provisions in the Act allow VA to increase the pay for medical center directors and increase funding and training for those taking care of aging veterans.

The staffers discussed legislation they are working on that would improve the system for veterans being sent out on community care for Dental care. Congress understands the burden put on VA staff dentists who are attempting to manage community care referrals while treating a full patient load.

There is a pilot program being tested in several VISNs where the VA has hired dentists at the facility level whose sole role is to manage, coordinate, approve, and track dental community care referrals; as well as track the amount of administrative time required to complete these community care responsibilities, and track the time taken to complete care that has been sent out to the community versus that same care completed in-house.  The legislation proposes solutions for dental coverage to eligible veterans in rural areas and proposes the use of mobile dental clinics to meet the veterans where they live.

The Elizabeth Dole Home Care Act would expand home based care, nursing home care, medical foster home care and allow VA to hire an increased number of home health aides.

The RESPECT Act would improve the caregiver program. It would also make assessments easier for veterans with mental health and other neurological issues. Additionally, this bill would increase mental health support for caregivers of veterans.

The HEALTH Act is follow up legislation to the 2014 CHOICE Act and the 2018 MISSION Act. These bills seek to expand access to care that veterans receive in the community. This bill would have VA move to a Value Based Care model such as is used by Tricare and Medicare. Value-based care is a term that Medicare, doctors, and other health care professionals sometimes use to describe health care that is designed to focus on quality of care, provider performance and the patient experience. The “value” in value-based care refers to what an individual values most. In value-based healthcare models, medical care does not exist in silos. Instead, primary, specialty, and acute care are integrated.  The bill seeks to increase transparency in reporting measures and will expand the VA Center for Care and Payment Innovation.

The staffers then answered questions from NAVAPD members on a variety of topics such as the roll out of the new electronic health record which we were informed is currently in, what was described as, “a strategic pause”.  Congress is well aware of the problems at the sites where the EHRM was already rolled out and is acutely aware that the vendor, Cerner-Oracle, has not yet fixed a lot of the issues. The plan is to halt all further rollouts until such time that Congress is confident that expansion of the new system will work for physicians, dentists, nurses, and all the front line healthcare providers without putting veterans lives at risk.

Long term funding for the PACT Act was discussed and NAVAPD learned that part of the Act created a Toxic Exposure Fund or TEF. The TEF is dedicated funding for treatment and research into toxins and their subsequent health effects. The Pact Act also changes the eligibility for combat veterans from 5 year to 10 years as some of the effects of toxic exposure may not present for many years. The TEF funding is set to be a line item in the annual budget and with this funding not only will it allow new enrollees into the VA Healthcare System, but it builds in reliance to the existing veterans who already use VA for their healthcare. The PACT Act also allows VA to “buy out” contract providers in order to get more physicians into the VA.

An open forum allowed NAVAPD members to ask their questions directly to the staffers and those members expressed their concerns that the way legislation is intended is often not the way it is implemented by VA. These concerns were heard and a robust discussion followed.

It is NAVAPD’s intention to continually advocate for our members and we are happy that a lot of the concerns we have brought up in the past two years are being addressed by bipartisan members of Congress.  NAVAPD needs your voice, we need to hear your concerns.  Your voice will be heard if you join NAVAPD today, and encourage all your colleagues to join NAVAPD.  NAVAPD will continue to hold town halls and continue to advocate for physicians, dentists, and podiatrists.  Please follow us on Facebook and LinkedIn.