A planned overhaul of the Veterans Health Administration will improve veterans care by creating a centralized system that better supports hospitals and clinics, which, in turn, will increase their focus on patients, Veterans Affairs Secretary Doug Collins said Monday.
The department released an overview in December of its plans to reduce the VHA’s administrative footprint — to include eliminating roughly 26,000 open positions — with an aim to streamline what the administration calls an “overburdensome and complex bureaucracy.”
Under the plan, the VHA will reduce administrative duplication, increase accountability and oversight and improve focus on patients, according to officials.
Some lawmakers and veterans advocates say the cuts will further strain a system that lost 30,000 employees to early retirements and resignations last year, resulting in more patients heading to the private sector for medical care or facing longer wait times at the VA.
But speaking to reporters at the Veterans Affairs Medical Center in Baltimore, Maryland, on Monday, Collins said the reorganization could result in improvements to services, with clinics and hospitals “on the front lines” and everyone else in VHA supporting them.
Citing the Baltimore facility as an example, Collins noted that the hospital downsized by roughly 200 people two years ago and saw wait times decrease and quality increase.
“The issue is not how many people we have; it’s how well we are using those people,” Collins said, according to a recording of the press briefing reviewed by Military Times.
According to Collins, details of the reorganization plans, including personnel changes, will be released in early February, with the changes expected to take at least 18 months. Some of the reforms spelled out in the broad documents include reducing the number of regional networks from 18 to five and reorganizing smaller district offices, eliminating several key administrative jobs and shifting program offices.
VA officials said last month that they looked at national health care models and organizations at top health care systems to craft their plans.
Members of National Nurses United held a rally Thursday in the Bronx to protest cuts at New York City’s VA facilities — 383 across four boroughs. The cuts, they said, would exacerbate “already dire staffing shortages” and could lead to a “drastic deterioration of veteran care.”
“It is absolutely gut wrenching to see this administration take their axes to the VA and brutally hack away at this world class institution, the only health care system in the country specifically designed to care for veterans and to address their unique needs,” Sharda Fornnarino, a registered nurse and secretary of the VA division for National Nurses Organizing Committee/National Nurses United, said in a statement.
Collins said that the VA is striving to preserve provider positions and the jobs slated to be eliminated have been vacant for more than a year, with VA leadership and hospitals approving the reductions.
“There is a safety valve for every hospital and clinic in this system. If they need somebody, they can hire somebody. There is nobody telling them not to,” Collins said.
Critics of the plans point out that while preserving doctor and provider positions is admirable, administrative roles play an important part in functioning, ensuring that clinicians can focus on patients without having to do support work.
One hospital administrator told Military Times that after a manager moved to a different job in another state, a medical facility was left without a top administrator because the position left open by the transfer was eliminated.
“It must be noted that a lot of these support positions are very important to the function of the VHA,” said the administrator, who asked that their name and location not be used because they were not authorized to speak to the press.
Veterans service organizations such as Paralyzed Veterans of America and Disabled American Veterans have expressed favor for reducing what they have called “administrative barriers” to care and say they look forward to learning more about the reorganization.
“Based on the way this was briefed, if it works the way it is intended, it gives us hope that many of these administrative barriers — and there are many of them across VHA — will be knocked down,” said Carl Blake, CEO of PVA.
Referring to a mantra of the National Cemetery Administration, Collins said the VHA has to get it right.
“I love the saying [the NCA] has, and that is, they have ‘one chance to get it right.’ I think that should be the thing for all of us at the VA: We have that one chance to get it right,” Collins said.
Details of Collins’s visit to the Baltimore VA were first reported by Politico Pro.
Patricia Kime is a senior writer covering military and veterans health care, medicine and personnel issues.
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