House lawmakers suggested Tuesday that Department of Veterans Affairs officials postpone a major expansion of veterans’ access to private-sector doctors, following warnings that its information technology system is flawed and could disrupt patient care.
The department is working toward a June 6 deadline to implement a new community care program for VA patients that was mandated by Congress under the VA Mission Act, a major reform bill. The program aims to replace the much-maligned Veterans Choice Program, which has been in place since 2014.
The U.S. Digital Service – a White House team of software developers that helps federal agencies improve their technology – recommended last month that the VA stop developing its IT system for the new program, which it described as flawed, with the potential to create confusion and disruption for veterans and VA doctors.
“I believe in taking the time to get things right,” said Rep. Phil Roe of Tennessee, the ranking Republican on the House Committee on Veterans’ Affairs. “I would rather VA postpone implementation of this program than to rush to implementation in name only and have veterans pay the price for it.”
Despite the warnings, the VA intends to launch the new program June 6, said Richard Stone, executive in charge of the VA health system.
“Are we concerned about the complexity of the work? Absolutely. But I am optimistic we’re going to get this done now,” he told the committee.
Stone said later in the hearing that the VA didn’t have the option to halt its work.
“The Choice [Program] expires on [June 6],” Stone said. “I have no ability to buy care if we don’t go forward. We must go forward with the Mission Act on June 6.”
The new community care program aims to be more flexible concerning when veterans are eligible for private-sector health care.
As of now, the VA plans to allow veterans to see private doctors when they’re forced to drive more than 30 minutes to reach their VA mental health or primary care providers or wait longer than 20 days for an appointment.
For specialty care, veterans could go outside the VA for medical treatment if a VA provider was longer than a 60-minute drive away or they faced a 28-day wait.
Veterans could also seek private treatment if the services that they need are unavailable at a VA facility, if they live in a state without a full-service VA medical center, if it’s determined to be in their “best medical interest,” or if the VA determines its services in that area don’t meet quality standards.
The Decision Support Tool, software that’s intended to help the VA determine when veterans are eligible for care, presents “significant risks,” the USDS wrote in a report issued March 1. The report was obtained and made public by ProPublica, a nonprofit news agency.
“The Mission Act is a big mandate, and we need to get it right,” said Rep. Mark Takano, D-Calif., the chairman of the House committee. “If the tech experts say the VA should cease development on the Decision Support Tool and for the VA to rethink its approach, we want to understand those recommendations and what the VA is doing about them.”
Stone said Tuesday that if any technical problems do occur, the VA has other methods to make decisions on when veterans are eligible to see private doctors.
“Veteran care will not be disrupted,” he vowed.
IT issues have plagued the VA as its attempted to implement other changes mandated by Congress in the past year.
Critical IT errors resulted last year in thousands of GI Bill recipients receiving late payments.
Technology challenges have also created doubts about whether the agency will be delayed in extending benefits to more veteran caregivers.
Under the Mission Act, caregiver benefits are supposed to become available starting Oct. 1 to veterans who were injured before May 7, 1975. VA Secretary Robert Wilkie told senators last week that the department might miss the deadline.
“I do expect to come to this Congress by the deadline on Oct. 1, hopefully certifying that the commercial, off-the-shelf technology we purchased to support caregivers is in place,” Wilkie said. “I’m not going to certify anything that doesn’t work. We’ve been down that road before.”
IT problems were the subject of a subcommittee hearing earlier Tuesday, where representatives from the Government Accountability Office and VA Office of Inspector General blamed the VA’s issues on the frequent turnover in IT leadership.
In January, Congress confirmed James Gfrerer as the VA’s chief information officer. Prior to his confirmation, three people held the position on a temporary basis since January 2017.
“The average tenure of the VA [chief information officer] is two years, and that’s a major problem,” said Carol Harris, a director with the GAO. “Our work has shown that a CIO needs to be in office roughly three to five years to be effective and about five to seven years for any major change to take hold.”
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