VA’s Commission for Care meeting on 18-19 April 2016

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The Commission for Care commissioners met on 18-19 April 2016 to continue to discuss ways to reform the VA. The commission consists of 14 members selected by President, Speaker of House, Majority and minority of both houses.
Commissioners For Care:
Nancy M. Schlichting, Chairperson (Nominated by resident)
Delos M. Cosgrove, MD, Vice Chairperson (Nominated by Speaker of the House, US Air Force) Michael A. Blecker (Nominated by Minority Party, Army)
David P. Blom (Nominated by Speaker of the House, Non Veteran) David W. Gorman (Nominated by President, Vietnam Veteran)
Thomas E. Harvey (Nominated by Senate Majority Leader, Vietnam Veteran Army) Stewart M. Hickey (Nominated by Senate Majority Leader, AMVET, Marine)
Joyce M. Johnson, DO (Nominated by President, US Coast Guard)
Ikram U. Khan, MD (Nominated by Senate Minority Leader, Non Veteran)
Phillip J. Longman (Nominated by Senate Minority Leader, Non Veteran)
Lucretia M. McClenney (Nominated by House Minority Leader, Army (30 years); mental health nursing) Darin S. Selnick (Nominated by Speaker of the House, Air Force)
Martin R. Steele (Nominated by Senate Majority Leader, Marine, 3-Star)
Charlene M. Taylor (Nominated by House Minority Leader, Air Force, Nurse LTC)                                 Marshall W. Webster, MD (Nominated by Senate Minority Leader, Non Veteran).

This Post is politically neutral and is a summary of what occurred.

The Elephant in the room is how much is really going to change? How much is really going to get done? It was mentioned by several commissioners that their is expectation that their recommendations will not be acted on because of an upcoming election that will result in a new President, Secretary of Veteran Affairs and Undersecretary in 20 Jan 2017. A comment was made that a better chance of more than 50 percent chance our recommendations will not be acted on.

April 18

 

The meeting started at 0830, I monitored the meeting remotely via teleconference. It felt like I was listening to a CSPAN program.  I am not sure how you cannot expect politics to play a role when all of the members were nominated by political leaders. Seven of the members caused a firestorm when they publish a reported call “Strawman’. All seven members were appointed by the Republicans. The report basically endorsed eliminating the VA and distribute all of its services to the private sector.

There appeared to be two groups (1) one group defending the VA and the other attacking it. The authors of the “Strawman” stated they were surprise about the uproar from their strawman report. In fact, one of the author (I didn’t know their names because they didn’t identify who was talking,
but they definitely identified themselves as one of the authors), claimed “we aren’t advocating eliminating the VA”, that is not what the “Strawman” report was saying. Another unknown speaker claimed they wrote the “Strawman” report to stimulate dialogue.
• Secretary McDonald and Sloan Gibson spoke and basically stated that progress is happening and ongoing .
• Various Veteran Service Organizations presented. They all agreed that eliminating the VA was not a viable option.
• Various VA official presented but the presentation on Integrating Community care generated the most discussion and questions. For some reason this presentation occurred after 5pm. The presenter agreed to return the next day for more questions

April 19

The meeting began at 0830 led by Chairwoman Nancy Schlichting. She asked for feedback from the commissioners. The atmosphere was a lot more congenial and collaborative. Several commissioners voiced their concern that their recommendations and report would not be acted because of the upcoming presidential election. They stated that by Jan 20, 2017, there will be a new President, Secretary of Veteran Affairs and Undersecretary. One commissioner opined that the release support in June 2016 t was bad timing because it comes just before Congress recesses and then the Presidential election. He guessed that it wouldn’t be until Mar 2017 before it is looked at by the 2017 Legislation.

I will have to be careful not to prematurely state or insinuate what the commission’s recommendations will be in their June report. I will add that there was consensus on the following:

Enhance governance by appointing an independent Board

There should be a major emphasis on integrated care that included community providers
The 40 mile/30 day criteria was not clinically derived and should be relooked. Some felt the veteran’s choice should be unfettered and expanded
The VA Choice was a misnomer. First the choice is dictated by VA and VA has a self- interest not to have a unrestricted choice. Additionally, it was agreed there are multiple criterion that actually restricts the Veteran’s choices.
Secretary of VA tenure is too short.

In closing, the chances of any of the Commission’s recommendation are enacted before the Presidential election is very remote. The report will probably be stored in a secret warehouse(Area 51) next to the Raiders of Lost Ark. I also think the public should have more of a voice in this process.

 

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