Bill would expedite VA health care spending

Legislation introduced on Thursday would fund veterans health care for two years at a time so the Veterans Affairs Department would not have to rely on the sluggish annual budget process for those appropriations.

"There's only one thing more important than having the right resources in the Veterans Affairs Department, and that's having them in a timely, predictable fashion," said Rep. Bob Filner, D-Calif., chairman of the House Veterans Affairs Committee, who introduced the legislation in the House. His committee counterpart in the Senate, Daniel Akaka, D-Hawaii, introduced a similar bill. "Without that, you can't hire, you can't fill vacancies, you can't purchase equipment. You essentially ration health care."

Beginning in fiscal 2011, the bill would provide funds to VA health care programs for the current and subsequent fiscal years. Akaka said the budget process now is so slow that VA has received its appropriations in 19 of the last 22 years after the start of the annual fiscal year, which is Oct. 1.

"The largest health care system in the country -- to which millions of wounded and indigent veterans turn to for care -- does not know what funds it will receive, when it will be funded, or in reality, whether vital programs will receive funding at all," Akaka said during a Thursday press conference.

Paul Rieckhoff, executive director of Iraq and Afghanistan Veterans of America, said he had worked with veterans who relied on clinics that are able to operate only a few days during the week because they must conserve their lean budgets.

The legislation is a major priority for the American Federation of Government Employees, which represents VA health care workers. The union said that inconsistent funding for VA makes it difficult to hire doctors and nurses when necessary, or make long-range plans for the health care workforce.

"We can't hire anyone [in the second half of the year] because we don't know what the budget's going to be," said J. David Cox, AFGE's national secretary-treasurer. "Then, we get our funding in February, and we need to hire everybody, but nurses aren't coming out of school then. They're coming out in May and June."

The union also is planning to push for expanded collective bargaining rights for VA registered nurses, physicians' assistants, and dentists. Cox said the union would advocate strongly for both the funding legislation and the collective bargaining legislation, which Filner introduced on Feb. 10. The National Federation for Federal Employees also is supporting the collective bargaining bill, saying that increasing workers' rights and input would improve conditions at VA.

Congress and the Government Accountability Office have expressed concern about growing vacancy rates in the VA's health system, especially among certified registered nurse anesthetists, whose vacancy rate is 13 percent. At 43 medical facilities GAO examined nationwide, 15 said that 40 percent or more of their CRNA positions were vacant.

During Thursday's press conference, Sen. Mark Begich, D-Alaska, said he placed some local programs on two-year funding cycles when he served as Anchorage mayor, which gave the city more time to concentrate on how to improve them.