House and Senate strike deal on Veterans Affairs revamp

U.S. House and Senate negotiators Monday announced a deal on a bipartisan Veterans Affairs bill that includes a green light for two long-delayed health clinics in southwest Louisiana.

The bill, which covers an array of VA issues, is a response to the national uproar over veterans’ health care following reports that surfaced in April that as many as 40 veterans may have died while waiting an average of 115 days for appointments at the Phoenix VA hospital or its clinics. Since then, investigators have found long wait times, and falsified records covering them up, at other VA facilities nationwide.

Congress hopes to complete action on the bill and send it to the White House by the end of this week, when the House and Senate adjourn for the August recess that extends past Labor Day. Members from both parties have said completing a bill on veterans’ health care is a top priority.

The deal authorizes $1.5 billion to lease space for 27 delayed medical clinics in 18 states, including ones in Lafayette and Lake Charles. Plans for the clinics were cast in doubt when congressional budget officials adopted a new, higher-cost formula for estimating lease expenses. A 2013 House-approved bill to authorize the leases fell victim to procedural wrangling in the Senate early this year.

Authorization of the leases puts them on the VA’s to-do list but does not provide money for them. That would require separate legislation.

The 27 clinics have been designated by the VA in its budget requests as necessary to satisfy unmet needs for veterans’ medical care. The VA network — the largest single health care provider in the nation — treats 9 million patients at 150 hospitals and 820 clinics.

The VA operates a small clinic in Lafayette now and has set up a mobile clinic in Lake Charles, but neither is considered sufficient by the agency.

Members of the Louisiana congressional delegation praised the inclusion of the clinics in the deal, which was announced at a news conference by U.S. Sen. Bernie Sanders, I-Vt., and U.S. Rep. Jeff Miller, R-Fla.

“The fight for these clinics has not been easy, nor has it gone as smoothly or as quickly as I had hoped, but today’s deal represents a major step forward,” U.S. Rep. Charles Boustany, R-Lafayette, said in a statement. His congressional district also includes Lake Charles. “We are now closer than ever to breaking ground on these much-needed clinics that will provide the access to quality care that our veterans deserve.”

U.S. Sen. Mary Landrieu, D-La., credited Boustany for his work in the House on behalf of the clinics. “The 50,000 veterans who call the greater Lafayette and Lake Charles region home will soon have quality health care in their local communities,” Landrieu said in a statement.

And U.S. Sen. David Vitter, R-La., said in a statement, “This is really great news.

“I’ve been pushing to get these authorized for years now to make sure those who served our country have access to quality health care without having to travel long distances,” he said.

U.S. Rep. Bill Cassidy, R-Baton Rouge, singled out a pet project of his that is included in the bill: the three-year extension of a pilot program for treatment of traumatic brain injuries. “Ensuring our veterans have the power to choose their rehabilitation services is a priority,” Cassidy said.

U.S. Rep. Vance McAllister, R-Swartz, also saluted the news of the agreement. “While I’m very encouraged by today’s deal and believe it is a major step forward, there is still more work to be done,” he said.

Sanders and Miller led the negotiations in a conference committee to reconcile the Senate and House versions of the reforms. The deal requires approval by the committee of House and Senate members as well as votes in the full House and Senate to go to the president for his signature.

White House press secretary Josh Earnest said President Barack Obama welcomes the deal. “There are much-needed reforms that need to be implemented,” Earnest said.

The White House is especially pleased that the bill includes emergency spending “to provide VA the additional resources necessary to deliver timely, high-quality care to veterans through a strengthened VA system,” Earnest said.

A total of $17 billion to fix the problems is identified in the bill. The agreement includes $10 billion in emergency spending to make it easier for veterans who can’t get prompt appointments with Veterans Affairs doctors to obtain outside care. It also includes $5 billion to hire doctors, nurses and other medical staff.

The bill also would expand a scholarship program for veterans to include surviving spouses of military members who died in the line of duty, allow all veterans to qualify for in-state college tuition and grant the Veterans Affairs secretary authority to immediately fire senior executives, while providing employees with streamlined appeal rights.

The bill “makes certain that we address the immediate crisis of veterans being forced onto long waiting lists for health care,” Sanders said. The bill also “strengthens the VA so that it will be able to hire the doctors, nurses and medical personnel it needs so we can permanently put an end to the long waiting lists,” he said.

Miller said the bill would “go a long way to resolve the crisis” that is gripping the Department of Veterans Affairs. The scandal forced VA Secretary Eric Shinseki to resign in late May.

Sanders and Miller reached agreement on a plan to reform the VA over the weekend after more than six weeks of sometimes testy talks.

The compromise measure would require the VA to pay private doctors to treat qualifying veterans who can’t get prompt appointments at the VA’s nearly 1,000 hospitals and outpatient clinics or those who live at least 40 miles from one of them. The bill would limit the number of veterans who can get outside care by restricting it to those who are enrolled as of Aug. 1.

The proposed restrictions are important in controlling costs for the program. Congressional budget analysts had projected that tens of thousands of veterans who currently are not treated by the VA would likely seek VA care if they could see a private doctor paid for by the government.

An updated audit by the VA this month showed that about 10 percent of veterans seeking medical care at VA hospitals and clinics still have to wait at least 30 days for an appointment. About 46,000 veterans have had to wait at least three months for initial appointments, the report said, and an additional 7,000 veterans who asked for appointments over the past decade never got them.

Acting VA Secretary Sloan Gibson has said the VA is making improvements but said veterans in many communities still are waiting too long to receive needed care.

The Senate is expected to vote this week to confirm former Procter & Gamble CEO Robert McDonald as the new VA secretary, replacing Gibson.

Associated Press writer Michael Daly in Washington contributed to this report. Follow Gregory Roberts, of The Advocate Washington bureau, on Twitter, @GregRobertsDC.