Veterans Health Administration needs stronger recruitment methods

Two hundred members of the American Federation of Government Employees, the union that represents staff at the Veterans Health Administration (VHA), recently rallied at the VA’s DC headquarters.

Joined by Sen. Bernie Sanders (I-Vt.) and Rep. Mark Takano (D-Calif.) as well as Rick Weidman, Executive Director of Vietnam Veterans of America, they were protesting the agencies failure to adequately staff the healthcare system that serves nine million veterans.

{mosads}In his state of the union address, President Trump boasted that he has hired “talented people who love our vets as much as we do,” In fact, nothing is further from the truth.

While Congress and the administration have made it easier to fire VHA employees and proudly launched a website which publicly lists every VHA employee who has been disciplined, suspended, or fired, it has consistently failed to address serious staff vacancies. 

In 2014, as VA Under Secretary for Health, David Shulkin who is now the The Secretary of the Department of Veterans Affairs, estimated that there are 34,000 VHA vacancies.

Refuting American Federation of Government’s claims that there are now 49,000 vacancies. VA spokesman Curt Cashour, insists that there are only 35,554 vacancies.

That’s up 1500 from Shulkin’s initial estimate. Cashour admitted that while the VA had hired 900 mental health professionals over the past year, it had lost 945 during the same period.

Whatever the number, the administration’s policies have made it difficult for medical facilities to hire the administrative staff to do things like the coding and billing necessary to running a high functioning health-care system.

Of the 35,000 plus vacancies at least four thousand are for human relations, logistics, and procurement staff. A recent VA Office of the Inspector General (OIG) report stated that lack of resources prevents the VHA from collecting accurate patient information needed to measure quality and safety.

All across the country, thousands of positions for primary care physicians, mental health providers, physical therapists, social workers and others go unfilled.

In a House Veterans Affairs Committee meeting on Feb.15, Rep. Mark Takano (D-Calif) and Tim Walz (D, Minn.) sharply questioned Secretary Shulkin about Trump administration plans that would make things even worse.

The president plans to freeze federal pay, prohibiting pay raises. This would hamper recruitment efforts, Takano insisted.

Housekeepers that keep hospitals clean, Takano stated, are already in short supply because of the fact that they are offered salaries that aren’t competitive with the private sector.

Takano also added that he had reports that VA central office was directing human relations department to stop doing the kind of surveys of salaries offered in various private sector markets that provide VA directors with information essential to recruitment.

And then, there’s the troubling news that what looked like an increase in funds — $4 billion — for much needed repair of VHA infrastructure — won’t in fact go to providing needed clinical and exam space and other repairs but will instead be channeled to further outsourcing of care to the private doctors and hospitals under Choice.

This is particularly disturbing given a recently released study by the prestigious National Academies of Science, Engineering and Medicine on mental healthcare services delivered to veterans of the Iraq and Afghanistan conflict.

The report documented that the majority of veterans who accessed the system had “positive experiences” and appreciated VHA staff’s “courtesy and respect toward patients.” However, staff shortages and shortages of clinical and office space were leading to staff burnout and high turnover rates that were jeopardizing their care.

These problems may get worse the administration has also extended eligibility for hundreds of thousands of other than honorable discharged veterans as well as newly transitioning veterans — without providing any new staff to handle a significant influx of patients.

This will further boost the caseloads of already overburdened VHA caregivers. That, in turn, will lead to more staff burnout, higher turnover, and patient complaints about appointment delays.

Sadly, the Trump administration, congressional Republicans —and even some Democrats ideologically committed to privatization — respond to all this by shifting more and more money away from the VHA and its dedicated staff.

As Walz stated in the Feb. 15 hearing, between 2014 and 2017, the budget for outsourced care rocketed by 49 percent  while that of the VHA increased by only 9 percent.

The majority of veterans say they want these problems to be addressed so that the VHA, which they say is their first choice, can be strengthened not dismantled.

To do this requires streamlining cumbersome hiring procedures, providing more funding for new hires, and making VHA salaries competitive with those in the private sector.

Veterans and all of us need to ask why these measures are not being given serious attention by the White House or Congress.

Suzanne Gordon is the author of The Battle for Veterans’ Healthcare: Dispatches from the Frontlines of Policy-Making and Patient Care.