Transcripts For CSPAN2 Senate Veterans Affairs Hearing On VA

CSPAN2 Senate Veterans Affairs Hearing On VA Community Care Program July 12, 2024

[inaudible conversations] good morning, everyone. The committee will come to order. I welcome our witnesses in person at those appearing distantly. We look forward to the testimony and getting a better understanding of where the department of Veterans Affairs and the thirdparty administrators are in administering the mission act. Also very interested in hearing more today about the caregivers implementation as well. Almost every member of our committee though not physically present at the moment, some are joining us in person and others will be joining us almost every member of the committee will be participating. The focus of todays hearing is the implementation of title i under the mission act by the department of Veterans Affairs, relating to the Veterans Community care program and the program of comprehensive assistance for family caregivers. Io i scheduled this hearing because of my dissatisfaction with the pace of mission implementation. While v. A. Officials were invited to participate iny todays hearing to discuss these critical programs they oversee, the department chose to decline our invitation. This committee and the v. A. Shared the common goal to pass the mission act in 2018 to better serve veterans and their families, and we continue to Work Together to address important issues for our nations veterans. I would expect them to be herere for this conversation, to share all they have accomplished since the v. A. Was transformed with this legislation and to discuss what needs to be improved. The v. A. Is an integral part off this dialogue which is why i plan to schedule a subsequent hearing with va officials tohy discuss title i implementation. I would be remiss to not recognize the unprecedented challenges of this year due to the covid19 pandemic. The dedicated staff on the v. A. s frontlines deserve both our thanks and recognition for their essential role in caring for veterans and in fulfilling v. A. s fourth mission. However, at a time when accessing health care is of the utmost importance, the v. A. Has struggled to uphold the mission acts requirement of providing t veterans access to Community Care. My staff and i continue to hear complaints from veterans and providers related to poor. Communication, lapses in continuity of care, and network inadequacies. Third party administrators, like triwest and optum here with us today, are valued and essential partners in the delivery of care to veterans through the Community Care network. They play an Important Role in building a robust and resilient Community Care network that is able to provide veterans timely access to care and make Certain Community providers receive prompt payment for the care and services they provide. When the v. A. Released stringent access standards for Community Care, i was encouraged to see more veterans would finally be able to access timely, quality care closer to home. However, my staff and i have since learned that v. A. s contracts with third partyan administrators use a completely different set of standards to determine how veterans access care. Under the contract terms, rural and highly rural veterans could be forced to drive up to 3 hours for care, which is completely unacceptable and contradicts the spirit of mission. Ive discussed this inconsistency with va officials but despite v. A. s assurances publicly and privately, it is uncertain whether the v. A. Has modified the terms. We hope to learn more today. It appears to meet possible veterans have different access for care certainly than the law, the mission act requires, different from the regulations of the v. A. And perhaps different from based upon the contact visit to visit based on the contract terms of thirdpartyhi administrators. As i i said we hope to learn me about this today. The Community Care network is central to the mission acts aim to transform v. A. Health careo into an innovative and responsive 21stcentury Health Care System capable of addressing the challenges veterans face today and providing access to the care veterans deserve under this law. As such, i want to ensure that mission act success and utilization of the Community Care network is accurately accounted for because there are sufficient numbers of local providers in the network for veterans to utilize. Ed much has changed in our country since this Committee Held ars hearing on the implementation of the Community Care Network Earlier this year, but the intent and goal of the mission act has not. We remain committed to making certain that veterans who qualify for care in the community are able to get that care, without unnecessary scheduling delays, through a mature and geographicallydispersed network of Community Providers that upholds v. A. s access standards, and that those providers are paid in timely manner. Congress has the responsibility to oversee the v. A. s execution of the laws that govern the agencys responsibility to serve veterans and we take this responsibility seriously. I believe some of the v. A. ste most Senior Leaders might agree with me that while progress may be underway, it must move faster to enable the Community Care network to serve veterans as we all envisioned. I want to know how the v. A. Is making progress in working with their third party administratoro to transform the v. A. And offer veterans access to the healthth care they deserve. Another essential component of the mission act is the expansion of eligibility for the program of comprehensive assistance for family caregivers to all generations of veterans. Many caregivers have been providing essential services for their loved ones without this support for years, and in some cases, decades. As veteran caregivers are often the main caretakers for their loved ones, many can experience depression, anxiety and other Mental Health conditions attributed in part or solely to their experience of caregiving. The stress associated with caring for a spouse or Family Members with complex Health Care Needs is a real and present concern for veteran caregivers. It is essential that in v. A. s support for caregivers, these Mental Health challenges be addressed effectively. Mission outlined a twophase process to expand these supportive resources with an anticipated start date of october 1, 2018 for phase i. Phase i implementation only just began on october 1 of this year, two years behind schedule. This delayed rollout will result in caregivers needing to wait even longer to be part of this vital support program. I look forward to hearing the testimony from everyone who will be taking part in todays hearing about issues that you face in your work to help care for and serve veterans, and steps the v. A. Can take to make certain both of these important programs are functional and ablo to deliver good results and outcomes for veterans and caregivers. I apologize. My Opening Statement is longer than the usual practice, but i had sufficient desire to say a few things this morning as we begin this hearing, and i dont want to yield to the Ranking Member and author, senator tester. Thank you, mr. Chairman. I want to thank you for holding todays hearing, and im looking forward to the discussion among our panelists of witnesses but i, like you, and very disappointed the administration chose not to participate in this dialogue. I do not know why something as important as implementation of the mission act doesnt rise to that important in the v. A. Theyre out campaigning across the country. The fact is, is this committee has serious issues with the administration on the implementation of the Va Mission Act and its important, its unfortunate the va couldnt be here to finding solutions for those programs. When congress creates programs to benefit their veterans and families, and its important to implementation and congress intended. Were not here as a nuisance, we do things and have expectations. So the executive branch sent folks here with the creation of the Va Mission Act, congress sought to provide better and greater options for Community Care when the department could not provide care in a timely manner or when veterans were forced to travel long distances to the va facilities. The latest data from the va, made 4. 1 referrals in the beginning of fiscal year 020 to june. Nationally, it took va nearly 22 days to Schedule Health Care Services after a request was made. Thats not acceptable. Thats a problem. Veterans should have shouldnt have to wait for the va to navigate a bureaucratic process before their appointments are scheduled. Then veterans wait an average of 20 days for their appointments after theyre scheduled. That doesnt work. That dog doesnt hunt. If the va was here find a way to reduce the red tape. They need to explain how to get down the number of days veterans get scheduled for care in the community and the last year, theres not been much improvement in this timeline. Rather than speaking with this broken process, the Administration Needs to find out a better path forward. I have a bill, the accountability and department of Veterans Affair scheduling consult Management Act passed out of Committee Last august. It would help the va to do just that. It would require the va to take a hard look at scheduling process and then report how long it takes to get through that process. It would also require scheduling honest and review of rating of physicians involved in scheduling because too often personnel leave these for better communities elsewhere. My bill would also help veterans make better informed decisions where they can get care because they would have the information they need to make those decisions. It would also help congress exercise oversight of va scheduling to make sure its working the way we intend. Another is the newly looked program. And caregivers many of whom waited for years for the same stipends for post 9 11 veterans and caregivers, im concerned the administration too narrowly wrote the rules. And tightened eligibility for the Current Program are not mission act driven and were undertaken solely by the administration in an effort to limit eligibility for the program and the veteran it impacts. Im concerned that the administration was in rush to meet a new selfimposed deadline after missing the mark for a while and prepared little time preparing stakeholders for when the program would go live causing confusion when it actually did. I do want to thank the Elizabeth Dole foundation for being here today to shed light on issues to make sure this program a functioning well for veterans and caregivers. With that, mr. Chairman, i want to thank you again for calling this important hearing. Senator tester, thank you. Now let me introduce our witnesses. Dave macintyre is the ceo. Trisha, the ceo of optimum. And steve is of the liz both Dole Foundation. And molly from the Elizabeth Dole foundation. And jenny, caregiver and liz bo both Elizabeth Dole foundation. Thank you for being here so we can understand your goals of meeting the needs of veterans of our country. Well now begin the hearing with our first witness, lieutenant general, youre now recognized for five minutes to deliver your testimony. Thank you for being here and thank you for the conversation we had nor nearly an hour on sunday evening. [inaudible] on behalf of the [inaudible] can you hear it now . Im sorry. Would you like me to start over . Do you want me to start over . Okay. Good. I had to dig deep into my military voice there, sorry. After 33 years of Uniformed Service the mission is personal to me and our entire organization, were veterans. My Leadership Team has a total of 350 years of service in uniform. Many of us or our Family Members received care from the Va Health System or the community. Since i last appeared before the committee across regions one two and three, our responsibility is to build and manage a high quality Provider Network. Were managing a network of 830,000 providers across 1. 6 million sites of care. We intentionally built a Large Network so veterans could have their choice from a wide variety of timely care options. To date the va has issued more than 1. 5 million referrals for care to our network connecting individual veterans with a high quality provider, one veteran at a time. 100 of our network is fully accredited and credentialed. In addition, as compared to the 15 benchmark set by the va, 54 of providers assessed are designated as high performing providers. The success of our Provider Network goes beyond the data. Underlying the data are hundreds of thousands of individual connections made between care providers and veterans. We understand that health care is local and the choice of a provider is personal. Our network is dynamic, highly reliable, and responds quickly to the needs on the ground. Recently, the leadership at the Lexington Va Medical Center expressed gratitude for our assistance in ensuring a veteran who is battling cancer could be treated by the same provider as his wife. We know that caring for our nations heroes is more than a contractor providing a claim. It means caring about the women and men who have worn the cloth of our nation and doing whatever it takes to help them heal. Every day we work side by side, to advance veterans care and review successes and address challenges and share best practices. These relationships are critical when the unexpected happens. This occurred in august when hurricane laura left 200,000 without water and a million without power in louisiana. Many hospitals were forced to close and my team jumped into action leveraging relationships with the louisiana hospital association. We ensured they had uptodate information on hospitals where they could safely serve veterans. Our network is not a national entity. Its a collection of regional care eco systems designed to be responsive and convenient to veterans. Working with each we have prioritized the credentialing of high quality providers with a history of serving veterans in the community. As a result, weve partnered with 92 of priority providers identified by the va. And 93 of academic affiliates including duke and the university of kansas and for the first time in the vas history, a provider care in the community, partnered with the va to bring the mayo clinic into the care network. While its a dynamic, our restlessness keeps our veterans at the center of everything we do. This year we learned that a veteran was matched with a lifesaving heart more quickly than expected this evoked our warrior ethos of never leaving a fallen comrade behind. Within 24 hours this West Virginia veteran received a new heart. Over the last few weeks, we began fill facilitating dozens of life saving transplants. This is a power of one, one organization working oneonone with va staff, congress, caregivers, vsos and many others to advance the health and wellbeing of one veteran at a time. Mr. Chairman, Ranking Member tester and members of the committee thank you for the ability to appear for you today. As a veteran, Army Sergeant general, wife of a veteran, daughter of a veteran, the proud mother after airborne infantry lieutenant, ensuring veterans have a high quality Credentials Network that meets their needs is important to me and our entire organization. I look forward to your questions. Thank you. General, thank you for your testimony and thank you to you and your family for your service to our nation. Mr. Mcintyre, welcome. Mr. Chairman, Ranking Member tester and the members of the Senate Committee on Veterans Affairs its an honor to appear before you today and pleased to do so with patty and those from the bob and Elizabeth Dole foundation. Weve been serving the military and veterans population for nearly 25 years now. We are privileged helping them respond to the Health Care Needs veterans from pc3 to replacing the health net, its been quite a journey. Weve tried to remain nimble and one objective to support with not compete with the v hamilton for providing timely care for veterans. Through the use of capacity process and leveraging the footprint of our nonprofit owners weve tailored highly, high Quality Networks in collaboration with va to patch the unique demands of each and veterans. Our network will soon contain all academic affiliates for region four has now delivered more than 32 million medical appointments in support of va to give them needed elasticity. This has included everything from merging care within 30 minutes of a Veterans Home to eye appointments, to primary care, to yurology, to womens services, to Behavioral Health and

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