A planned restructuring of the Veterans Health Administration will cost an estimated $312 million over five years and require an initial investment of $521 million, according to a top congressional appropriator.
The reforms, known as the Restructure for Impact and Sustainability Effort, or RISE initiative, are expected to begin this year with an aim to reduce the VHA’s administrative overhead and improve hospital services and clinical care.
Initial VA briefings to congressional lawmakers did not include the potential costs of the restructuring, but Rep. Debbie Wasserman Schultz, D-Fla., said Wednesday she initially was told it would be “cost neutral.”
During a House Veterans Affairs Committee hearing, however, Wasserman Schultz, the senior Democrat on the House subcommittee that funds the VA, said the up-front costs will be more than a half billion dollars,but that would be reduced over five years to $312 million as a result of savings.
She pressed VA Secretary Doug Collins on his plans for funding, given that the department’s fiscal 2026 budget is set.
“You’re planning on doing this immediately in this fiscal year, is that correct?” Wasserman Schultz asked. “Do you expect that you’ll be sending the committee a reprogramming request for approval?”
Collins said he believed that the VA could cover the costs “inside our current authorizations for appropriations” without having to ask for extra funds or file a request to Congress.
“This is going to come out of our regular account funds. We’re just moving people here. There’s not an accounting for this in that situation,” Collins said.
In May, the VA moved $343 million from funds marked for contracts and administration to pay for outside health care without asking Congress. Reprogramming requests require detailed accounting from the department as well as approval of both the House and Senate Appropriations Committees, but Collins insisted that the shifting the funds, obtained from the closure of the VA’s diversity and inclusion offices and cancellation of hundreds of contracts, did not require such a request.
The VA notified Congress after the fact — a move that irritated both Republican and Democrat lawmakers.
“This should have come in the form of a reprogramming request,” House Appropriations Committee Chairman Tom Cole, R-Okla., said at the time. “Obviously, we have authority there and the chairman has authority there.”
On Wednesday, Wasserman Schultz asserted that the appropriations subcommittees for military construction, Veterans Affairs and related agencies is responsible for funding the VA’s reorganization and must approve any internal transfers to cover its costs.
“I look forward to the report that you are statutorily required to submit to the Appropriations Committee so we can see on paper exactly what your plan entails, including robust and appropriate justifications,” she said.
Wasserman Schultz also noted that according to a briefing she received, the VA expects to save $1.7 billion from “personnel actions” resulting from the organization — the first time a dollar amount has been announced on the potential savings of the plan.
Under the reorganization, the VA will decrease the number of Veterans Integrated Service Networks, or VISNs, which provide oversight, administrative, budgetary services and support to VA medical centers, from 18 to 5 and create health service areas, or HSAs, within the VISNs to focus on medical centers and the communities where veterans get medical care.
The VA has lost 30,000 personnel in the past year as a result of resignations, retirements and attrition, as well as plans for an additional reduction of 24,000 jobs, which officials say were mainly positions created during the COVID-19 pandemic that are no longer required and have been vacant for at least a year.
Wasserman Schultz wanted to quiz Collins on the projected personnel savings but was not given additional time for her questions, which came at the end of a two-hour hearing.
House Veterans Affairs Committee Chairman Rep. Mike Bost, D-Ill., had established a hard stop at the start of the event and held lawmakers to strict time limits during the hearing, which was marked by combative exchanges between Collins and Democrats upset by the administration’s response to the death of Minneapolis VA Medical Center nurse Alex Pretti.
Numerous Democrats took Collins to task for a social media statement he made after the killing of Pretti by federal agents.
“You lead a large organization with employees that are hurting in the wake of this killing … it would be helpful to show just some of the courage that our many veterans have shown in their service by standing up and calling out what is wrong, particularly with respect to Mr. Pretti and his life, his life’s work,” said Rep. Herb Conaway, D-N.J. “Will you stand up for him and show just a little bit of the courage that our veterans show every day?”
Collins said repeatedly throughout the hearing that he would not answer questions regarding Pretti or the investigation into his death. In response to Conaway, he bristled.
“I show the courage of a 27-year veteran sitting in front of you and will not be spoken down to. I’ve been asked and answered the question,” Collins said.
The administration has not released its proposed fiscal 2027 budget, which was due the first week of February. Collins said an updated cost estimate for the RISE initiative will be included in the budget.
“That’s being put together now,” Collins said.
Patricia Kime is a senior writer covering military and veterans health care, medicine and personnel issues.
Read the full article here
