- The Washington Times - Monday, August 4, 2014

President Obama will sign a bill this week to begin reforming the Department of Veterans Affairs, kicking off a scramble as the troubled department tries to meet the 90-day deadline Congress set for getting a private health care option up and running.

But analysts said it’ll be a big test to see whether Veterans Affairs officials can even find manufacturers to meet the deadline for printing millions of “choice cards” granting veterans access to private care if they’ve been waiting more than several weeks, or if they live more than 40 miles from a VA facility.

“We don’t know if the current contract holder [for VA identification cards] will be able to supply that new choice card [of] if they’ll have to put a new [request for proposal] out for a new card, a new contract,” said Ray Kelley, the national legislative director at Veterans of Foreign Wars. “Getting that within 90 days might be pretty tough.”

The cards are just one of the deadlines the VA will face under the bill, which Congress wrote to give it a number of chances for oversight over the next six months, including a six-month report on VA staffing levels and an early assessment of the private care option.

Some of the changes are things the VA has failed at before and will likely find challenging to fix now.

Louis Celli, legislative director at the American Legion, said the VA has struggled in the past to keep track of veterans’ medical records when they receive care at a private facility — something required under this legislation. He said veterans sometimes had to get their own records and in some cases even pay to access them.

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“We recognize that’s going to be a challenge for them but also recognize it’s going to be critically important to maintain that continuity of care,” he said.

Other veterans advocates think the VA may fight back against the changes and not make a good faith effort to reform the department. Dan Caldwell, issues and legislative campaign manager at Concerned Veterans for America, said the biggest challenge for the department will be staff who don’t support the reforms trying to undermine them.

“The VA wants to preserve the status quo — they just want more money to do it. They don’t want to see the way they operate fundamentally reformed,” Mr. Caldwell said.

Alex Nicholson, legislative director for Iraq and Afghanistan Veterans of America, however, said it’s unlikely VA officials would want to undermine the major parts of the bill.

The VA has previously objected to private care, since paying for it came from the VA’s main budget. But under the new law, outside doctor visits are covered by a separate pool of money.

Mr. Nicholson also said he expects the VA’s newly installed leadership will not be afraid to use the authority the new bill contains to fire poorly performing senior executives.

The VA said it is looking forward to seeing the new law through.

“The department’s focus and priority is on timely and effective implementation of this highly complex piece of legislation,” the department said in a statement. “VA is fully reviewing the legislation and, as this process continues, VA will work with other departments, Congress, veterans service organizations and stakeholders to ensure that provisions are implemented as quickly and efficiently as possible.”

The private care option was the crux of the deal struck by Congress last month to begin to force reforms at the VA, which has been battling charges of poor care, long wait lists and a culture of indifference to whistleblowers who tried to raise concerns from within.

The bill gives the VA the opportunity, within a two-month time frame, to change how long veterans wait to receive outside care if it finds the 30-day target is unreasonable.

Mr. Kelley said the 90-day deadline for issuing the choice cards isn’t unreasonable, though he said the department should have some wiggle room if they fall short but are making an honest effort.

“We’ve said from the very beginning that we want to get this done quickly, but I think, if they are a little bit behind, if they’re showing good faith in getting it done, they’ll have to get a little bit of leeway,” he said. “But there’s nothing wrong with giving them a short deadline.”

The House cleared the VA bill on a 420-5 vote last Wednesday, and the Senate followed a day later with a 91-3 vote. The bill includes enough money to get the private care option running and to sustain it into 2016, according to an estimate by the Congressional Budget Office.

Lawmakers also included $5 billion to hire more doctors, nurses and other personnel and to lease more facilities — though the list of leases was written based on data the VA admits is not accurate.

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