Category Archives: Veterans

More funding, accountability for VA Choice program proposed, now what?

Source: Steff Thomas, Federal News Radio, August 7, 2017

Veterans Affairs Secretary David Shulkin received his wish last week as the House passed a bill that will add an additional $2.1 billion for the Veterans Choice Program. The bill, also known as the Choice Act, was introduced just weeks before the current Choice program funding was set to expire, and passed as a last-minute decision before Congress left for the August recess. One question that still lingers is, if passed into law, how will that money be spent? In an interview on the Federal Drive with Tom Temin, Shulkin outlined in detail some of the ways the Veteran Affairs Department would use the extra funds in a system of modernization projects, construction of new facilities and comprehensive public-private sector partnerships.

… These private-public partnerships would allow veterans to get best-in-class care at VA facilities and, when they needed to, take advantage of the services from community providers. It would alleviate some waiting times and give veterans more options for health care. Shulkin strongly urged that this idea was not an attempt to privatize VA operations, but to create a stronger and more modern system. He said even President Donald Trump’s budget proposal was supportive of improving more services within the VA, and not at all representative of someone supporting privatization. …

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How VA Reform Turned Into a Fight Over Privatization
Source: Russell Berman, The Atlantic, July 17, 2017

In 2014, the Department of Veterans Affairs was mired in a scandal. An inspector general’s report had found “systemic” manipulation by government officials to hide lengthy and growing wait times at its medical centers. … Spurred to action, Congress created a program aimed at temporarily alleviating the strain on the VA: Veterans who lived more than 40 miles from a health-care facility or who had to wait more than 30 days for an appointment could take their benefits outside the system and seek treatment from private doctors. …The Choice Program, as it was called, would allow veterans to get the care they needed while giving policy-makers time to make broader fixes at the Department of Veterans Affairs, which suffered from mismanagement and insufficient resources. Three years later, attempts by Republicans in Congress and the Trump administration to extend and significantly expand the Choice Program have given these groups and leading Democrats a new worry: a creeping privatization of the VA. …

Senate Easily Confirms Trump Pick of Shulkin as VA Secretary
Source: Hope Yen, Associated Press, February 13, 2017

The Senate on Monday easily confirmed physician David Shulkin to be secretary of Veterans Affairs, charged with delivering on President Donald Trump’s campaign promises to fix long-standing problems at the department.  Senators voted 100-0 to approve the former Obama administration official, who was the VA’s top health official since 2015, in a rare show of bipartisanship amid partisan rancor over Trump’s other nominees. Shulkin secured the backing of Senate Democrats after pledging at his confirmation hearing to always protect veterans’ interests, even if it meant disagreeing at times with Trump. … The 57-year old physician has ruled out fully privatizing the agency and says wide-scale firings of VA employees are unnecessary, describing the VA workforce as “the best in health care.” … The immediate challenge includes revamping scheduling and access for VA medical appointments following a 2014 wait-time scandal. Shulkin is urging a more integrated VA network where veterans could seek outside private care only in coordination with the VA. He has not sketched out full details. “We’ve yet to hear from him how he’ll pursue President Trump’s vision for a public-private partnership at the VA,” said Dan Caldwell, policy director for the conservative group Concerned Veterans for America. …

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Daily understaffing persists at Grand Rapids Home for Veterans

Source: Amy Biolchini, MLive, August 10, 2017

Understaffing at the Grand Rapids Home for Veterans continues to be a problem, according to an follow-up audit released by the state. That’s after the home entered into a new staffing contract in fall 2016. … However, most other major problems at the Grand Rapids Home for Veterans identified in a blistering state audit in February 2016 have largely been resolved, the report found. …

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Blame for poor care at Grand Rapids veterans home sits at the top, Dems say
Source: Amy Biolchini, MLive, July 27, 2017
 
Democratic State Representatives Winnie Brinks and Tim Greimel say Republican Attorney General Bill Schuette hasn’t gone far enough to hold officials with the Grand Rapids Home for Veterans and the state accountable for the poor conditions at the facility.  “Why did it take so long to get some action? For years, our veterans were literally calling for help, pressing the help button beside their bed, and hearing silence,” Brinks, D-Grand Rapids, said at a Thursday, July 27, press conference in front of the home.  This week Schuette announced felony charges for falsifying medical records against 11 former nursing assistants who worked for the former contractor, J2S Group Healthforce. His investigation found there wasn’t enough evidence to bring criminal charges over the five worst complaints about member treatment, in some of which veterans died. …

Did a 2011 lawsuit against Grand Rapids Home for Veterans predict the future?
Source: David Bailey, WZZM, July 25, 2017
 
The lawsuit was filed by veteran Anthony Spallone intending to stop the on-going privatization at the time.  Gov. Rick Snyder recommended taking state-employed care aides out the home and replace them with nurse aides hired by local contractor J2s.  It was a contentious environment at the time as state aides lost their jobs and were replaced by people they considered to be less-skilled, less-experienced and cheaper.  Union leaders did everything they could to stop the job losses including filing Spallone’s lawsuit.  It alleged the privatization would lead to substandard care and contended J2S had a quote “dangerous track record of care”.   Spallone’s attorney at the time was adamant veterans could be put in terrible situations with the privatization. …

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Privatization Is Changing America’s Relationship With Its Physical Stuff

Source: Brian Alexander, The Atlantic, July 12, 2017
 
… As vague as Trump’s pronouncements have been on the matter, it is clear that the general thrust behind the promised building-and-repair push involves using federal dollars as up-front investment to entice private enterprises to provide most of the financing. While Democrats announced their opposition, the general idea of increased privatization of infrastructure has had a bipartisan cast. President Obama supported a plan to create an “infrastructure bank” that would help finance so-called public-private partnerships (known, for their alliteration, as P3s), but that idea fizzled under the glare of Republican opposition. He also floated the idea of selling off the Tennessee Valley Authority. …

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Selling Back To The Public What It Already Owned: ‘Public-Private Partnership’ Shark Bait
Source: Mercedes Schneider, Huffington Post, June 12, 2017
 
Today, I read two articles centered on this idea, both of which concerned Vice President Mike Pence – and one that concerned Pence’s role in the aftermath of Hurricane Katrina.  One article also included a sprinkling of US secretary of [privatized] education, Betsy DeVos.  A major goal of corporate education reform is to deliver public education to private entities (corporations, or even nonprofits, but don’t think that an entity termed “nonprofit” cannot be a handsome money dispenser for those running the nonprofit and doling out contracts). However, the extreme-right-Republican aim does not end with public education but with delivering the operation of the entire American infrastructure to private entities.  In the end, what this entails is having private corporations front money to state and local governments in order to lease back to the public what the public already owns.

How President Trump Might Carry The Torch Of Privatization
Source: Here & Now, WBUR, May 8, 2017

… Now President Trump is poised to continue privatization and private contracting in all kinds of industries, from education to incarceration. Here & Now’s Jeremy Hobson looks at the history and politics of privatization with Donald Cohen and Shahrzad Habibi of the group In The Public Interest. …

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VETERANS AFFAIRS CONTRACTING: Improvements in Policies and Processes Could Yield Cost Savings and Efficiency

Source: Michele Mackin, US Government Accountability Office, GAO-16-810 September 16, 2016

What GAO Found:

GAO found opportunities for the Department of Veterans Affairs (VA) to improve the efficiency and effectiveness of its multi-billion dollar annual procurement spending in several areas including data systems, procurement policies and oversight, acquisition workforce, and contract management. Shortcomings in VA’s recording of procurement data limit its visibility into the full extent of its spending. A recent policy directing that medical-surgical supply orders be captured in VA’s procurement system is a step in the right direction, but proper implementation is at risk because procedures are not in place to ensure all obligations are recorded. VA’s procurement policy framework is outdated and fragmented. As a result, contracting officers are unclear where to turn for current guidance. VA has been revising its overarching procurement regulation since 2011 but completion is not expected until 2018. Meanwhile, contracting officers must consult two versions of this regulation, as well as other policy related documents. Clear policies are key to ensuring VA conducts procurements effectively on behalf of veterans. The figure below depicts the various sources of regulations, policy, and guidance. Managing workload is a challenge for VA’s contracting officers and their representatives in customer offices. A 2014 directive created contract liaisons at medical centers in part to address this issue, but medical centers have not consistently implemented this initiative, and VA officials have not identified the reasons for uneven implementation. VA can improve its procurement processes and achieve cost savings by complying with applicable policy and regulation to obtain available discounts when procuring medical supplies; leveraging its buying power through strategic sourcing; ensuring key documents are included in the contract file, as GAO found that more than a third of the 37 contract files lacked key documents; and ensuring that compliance reviews identify all contract file shortcomings.

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VA secretary: Privatization not the answer

Source: Steve B. Brooks, American Legion, August 31, 2016

While some are calling for the privatization of health care for the nation’s veterans, the man leading the Department of Veterans Affairs says those calls are not motivated solely by concern for veterans. Addressing The American Legion National Convention in Cincinnati, VA Secretary Bob McDonald said such proposals aren’t driven by veterans’ best interests. … “It doesn’t serve veterans well, and it doesn’t sit well with me. So make sure there’s substance to those discussions, that they’re about veterans’ interests and not something else.” During a 24-minute speech, McDonald admitted VA still has work in front of it but said the agency has the opportunity to make 2016 the year “it turns the corner.” …McDonald pointed to changes in leadership, noting that 14 of the department’s top 17 executives are new since he was appointed in July 2014. “These are world-class, enthusiastic business leaders and health-care professionals,” he said. “Eight of them are veterans themselves.” …

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Obama opposes privatization of VA health care
Source: Associated Press, June 5, 2016

President Barack Obama is opposing suggestions the government privatize the Department of Veterans Affairs to improve health care veterans receive. In an interview with the Colorado Springs Gazette, the president said his administration has made progress modernizing the VA and providing veterans with more timely health care following criticism over wait times. Privatizing the agency would delay that progress, he said. … U.S. Rep. Doug Lamborn, R-Colorado Springs, a member of the Veterans Affairs Committee, agreed with Obama that total privatization would be a mistake, but he said veterans need more options, including private care. To cope with the problems, Obama signed the Veterans Access to Care Act that requires the VA to contract with private providers when a clinic isn’t within 40 miles of the veteran seeking care or the wait time for care is more than 30 days.

The Conservative Plan to Fix the VA Has Vets Hopping Mad
Source: AJ Vicens, Mother Jones, April 5, 2016

Some members of the commission established by Congress to evaluate the Department of Veterans Health Administration have proposed drastically reducing the size of the VHA by closing its health facilities and transferring the care of the nation’s millions of military veterans to the private sector. But in a letter sent to the chair of the Commission on Care, leaders of eight of the country’s most prominent veterans’ advocacy organizations blasted the proposal. … The “Strawman” report, which echoes VA privatization efforts that have been backed by the Koch brothers, says “bold transformation” is needed for the VA to address the needs of its enrolled veterans, and that the system is “seriously broken” with “no efficient path to repair it.” The plan calls for closing many “obsolete” VA facilities and moving toward a model where veterans can seek taxpayer-funded care at private health care facilities. A process similar to the Base Realignment and Closure system—used by the military since the end of the Cold War to decide which bases to close—would be used to evaluate which VA medical facilities would close. Under the plan, there would be no new facilities or major renovations of the existing VA facilities. The plan also called for private doctors to be reimbursed at 5 to 10 percent higher than the Medicare rate, so they would have a greater incentive to participate.

Sioux Falls protests VA privatization

Source: Jack Taylor, KELO, July 26, 2016

If your going by the Sioux Falls VA between 11 a.m. and noon today you’ll see a protest against privatizing the government hospitals. Jane Nygaard with the American Federation of Government employees says the Koch brothers are behind “Concerned Veterans of America” which is working to privatize the VA. Nygaard asks why would the nation privatize VA hospitals when that act wouldn’t provide the specialized care that veterans need. … he says polls nationwide show that 80% of veterans say they do not want the VA privatized.  She says the VA Commission on Care report says the VA gives the best quality care to veterans and for lesser cost to taxpayers. …

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Union, veterans protest potential VA privatization
Source: Matt Murphy, Wyoming Tribune Eagle, July 7, 2016

Concern over Congress privatizing Veterans Affairs health-care services led local union members and military veterans to protest near Cheyenne’s VA Medical Center Wednesday morning. A couple dozen people stood on either side of Pershing Boulevard near the roundabout at Converse Avenue beginning at about 7 a.m. They waved small American flags and held blue signs with gold lettering that read, “Veterans for a Strong VA,” “Staff the VA” and “VA Workers for a Strong VA.” … If the system is privatized, he said, there is concern that level of care will be lost. Further, Massan said there is concern that portability, or the ability for military veterans to use VA facilities nationwide, could disappear. Talk of privatizing VA medical services has come up at the federal level through the years, including this year. The Commission on Care, a panel created by Congress to analyze the services provided by the VA, has been studying the issue for several months – including privatization. The panel issued its final report Tuesday, which recommended overhauling the VA system and expanding access to private health care, but not full privatization, according to the Federal Times and the Wall Street Journal. …

Local private sector help for VA projects backed at Senate hearing
Source: Joseph Morton, Omaha World-Herald, June 30, 2016

A proposal to build new veterans health facilities through public-private partnerships received a warm reception Wednesday at a Senate Veterans Affairs Committee hearing. Sen. Deb Fischer, R-Neb., presented legislation to allow those partnerships, saying Americans’ confidence in the care provided to veterans has been shaken. … It’s a key issue for the Omaha area, which has seen a $560 million replacement for its aging VA hospital stalled by cost overruns and delays on other VA projects. Local donors have rallied to the idea of a public-private partnership that would instead construct a $136 million ambulatory care facility — a scaled-down but presumably much more achievable approach. Involving the private sector in VA construction projects can help them progress more smoothly, Fischer said. … It’s unclear exactly when the bills will come up for votes, but Ashford and Fischer talked about seeking congressional action by September and certainly before the end of the year. Several veterans organizations on Wednesday offered testimony supporting the legislation. The VA also offered its strong support for the bill while raising a technical issue on some of the language.

Local union workers and veterans protest VA privatization
Source: Ethan Levin, Michigan Daily, June 22, 2016

About 50 veterans, union employees and family members gathered at the Ann Arbor Veterans Affairs Hospital Wednesday to protest the proposed federal privatization of veteran health care. The protest was organized by the American Federation of Labor and the American Federation of Government Employees (AFGE). … Amie Pounds, a national organizer for AFGE, and James Jr. agreed that the congressional commission’s assessments have been not only inaccurate but also swayed by private corporations’ profit interests. According to Pounds, of the 15 members on the commission, not one can be linked to a mainstream veterans service organization. Rather, the panel is comprised of primarily private hospital executives who stand only to benefit financially from privatizing the VA. …

Vet Groups Uniting To Oppose Privatized Care, Defend VA
Source: Terry Howell, Military Advantage, June 23, 2016

The nation’s leading veteran services organizations are rallying behind the Department of Veterans Affairs and its beleaguered health care system, touting the experience of staff, the breadth of services and its holistic approach to care delivery that they argue the private sector cannot match. The VSOs are warning of politicians and groups with agendas that constantly criticize VA health care, refuse to acknowledge reforms and thus advance a camouflaged campaign to dismantle VA health care. They also say it is time to better educate their own members on actions being taken to improve to the healthcare system that millions of veterans rely upon. …

Behind shrinking middle-class jobs: A surge in outsourcing

Source: Don Lee, Los Angeles Times, June 30, 2016

Globalization and the offshoring of U.S. manufacturing jobs to China and other cheap-labor countries are commonly blamed for driving down the wages and living standards of ordinary American workers, but there is another, less-known factor behind the shrinking middle class: domestic outsourcing. From human resource workers and customer service reps to cooks, janitors and security guards, many occupations have been farmed out by employers over the years. No one knows their total numbers, but rough estimates based on the growth of temporary-help and other business and professional service payrolls suggest that one in six jobs today are subcontracted, or almost 20 million positions, said Lynn Reaser, economist at Point Loma Nazarene University in San Diego.  Separate Labor Department data show that some of these occupations have seen a significant decline in inflation-adjusted, or real, wages over the last decade. In 2005, there were 138,210 workers nationwide who repaired ATMs, computers and other office machines, earning a mean annual salary of $37,640. Ten years later, the number of such jobs had shrunk to 106,100, with most of them subcontracted at annual pay of $38,990. But after accounting for inflation, that’s a drop of about 15% from 2005. …

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Race to the Bottom: How Outsourcing Public Services Rewards Corporations and Punishes the Middle Class
Source:In the Public Interest, June 2014

From the summary:
As state and local governments outsource important public functions to for-profit and other private entities, what happens to the quality of life for the workers who provide these services, and the communities in which they live? A growing body of evidence and industry wage data suggest an alarming trend: outsourcing public services sets off a downward spiral in which reduced worker wages and benefits can hurt the local economy and overall stability of middle and working class communities. By paying family-supporting wages and providing important benefits such as health insurance and sick leave, governments historically created intentional “ladders
of opportunity” to allow workers and their families to reach the middle class. This is especially true for women and African Americans for whom the public sector has been a source of stable middle-class careers. Low-road government contracts reverse this dynamic. While corporations rake in increasing profits through taxpayer dollars and CEO compensation continues to soar, numerous examples in this report show that workers employed by state and local government contractors receive low wages and few benefits.

Report: Privatizing public service jobs a disaster
Source: Mark Gruenberg, People’s World, June 12 2014

Privatization widens economic inequality and punishes communities
Source: Donald Cohen, The Hill, June 6, 2014

A growing body of evidence suggests an alarming trend: outsourcing public services is accelerating the downward spiral in which reduced worker wages and benefits hurt the local economy and overall stability of working and middle class communities. This growing income gap, driven by local and state government contracting, rising CEO contractor salaries and falling worker wages, is the subject of a new report from In The Public Interest (ITPI) titled “Race to the Bottom: How Outsourcing Public Services Rewards Corporations and Punishes the Middle Class.”

Civil Servitude
Source: Phil Mattera, Dirt Diggers Digest, June 7, 2014

Privatizing Government Services Doesn’t Only Hurt Public Workers
Source: David Moberg, In These Times, Working in These Times blog, June 6, 2014

How Outsourcing Whacks the Middle Class
Source: Gregory N. Heires, The New Crossroads, June 9, 2014

One percent’s twisted new heist: What’s really behind privatization
Source: Elias Isquith, Salon, June 6, 2014

Outsourcing government not only leads to poor services — it’s killing the middle class, an expert tells Salon…To explain how that is — and why it’s important that people committed to economic justice push back against the practice — Salon recently spoke with ITPI research and policy director Shar Habibi. Our conversation is below and has been edited for length and clarity….

The High Cost of Low-Wage Public Service Outsourcing
Source: Rob Garver, Fiscal Times, June 3, 2014

In the late 1990s, as part of a rush to save money by privatizing government services, many school districts in New Jersey turned over their school lunch programs to private contractors. For the school districts, the results were what they expected – costs dropped. But a study set for release this afternoon suggests that the overall cost to New Jersey may have been higher than the amount saved by individual school districts – a warning that could apply to states, municipalities, and the federal government alike. The study, “Race to the Bottom: How Outsourcing Public Services Rewards Corporations and Punishes the Middle Class,” was produced by In the Public Interest, a watchdog group that monitors privatization of government contracts. Its central finding is that when the government outsources its services, “local communities suffer the consequences of lower quality services and middle class jobs being replaced with poverty-level wages” while “far-away corporate executives benefit from lucrative government contracts.” …

How privatizing government hollowed out the middle class
Source: Timothy Noah, MSNBC, June 3, 2014

Two decades ago, liberals and conservatives found common ground in the doctrine of government privatization. … A generation later, the federal government employs more than three times as many contract workers as government workers, and state and local governments spend a combined $1.5 trillion on outsourcing. … Now a new report by In the Public Interest, a nonprofit group that tracks government contracting, argues that privatization at the state and local level “contributes to the decline of the middle class and the rise in poverty-level jobs, thereby exacerbating growing economic inequality.” … Much of the “efficiency” realized by privatization lies in reducing former middle-class workers to poverty wages. Jared Bernstein of the Center on Budget and Policy Priorities, a Washington nonprofit, argued in the conference call that even from an efficiency point of view, privatizing low-end government jobs was self-defeating.

VA privatization debate to hinge on coming report

Source: Travis J. Tritten, Stars & Stripes, June 29, 2016

The coming week could be a watershed moment in the volatile debate over privatizing more health care at the Department of Veterans Affairs. A panel created by Congress to overhaul the VA is expected to release final recommendations July 6 that are two years in the making and will likely include the option of private care for the millions of veterans who now use the federal system of hospitals and clinics. It will come amid controversial proposals to give all veterans a card to access private doctors and to turn the VA into a not-for-profit corporation. Those efforts to push the department toward privatized care caused near universal blowback from national veterans groups. Unionized VA employees were staging opposition rallies across the country due to fears over privatization in the lead-up to the commission’s VA report. … [American Federation of Government Employees] is concerned that the Commission on Care is bent on significantly expanding the use of private care to treat veterans – a move that Cox said could result in the closure of 12 to 15 VA health care facilities annually due to a lack of need. … Eight veterans groups, including the American Legion and the Veterans of Foreign Wars, strongly criticized the plan and warned they would reject any final recommendations aimed at privatizing the VA health care system, which is the largest integrated health care network in the country. …

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Room for Debate: Should the Veterans Health Care System be Privatized?
Source: New York Times, June 28, 2016

The federal Commission on Care, set up to study the future of Department of Veterans Affairs health care, is to present its final report this week. Seven of its 15 member have released recommendations that some veterans groups say would privatize the system. Would privatization of V.A. health care improve the system or undermine it?

Debaters:

PHILLIP LONGMAN: Phillip Longman is the author of “Best Care Anywhere: Why VA Care Would Work Better for Everyone.” He serves on the Commission on Care, which has been tasked by Congress and President Obama with crafting a strategic plan for the future of veterans health care.

AVIK ROY: Avik Roy is the opinion editor at Forbes. He co-chaired the Fixing Veterans Health Care Taskforce, along with former Representative Jim Marshall (D.-Ga.), former Senator Bill Frist (R.-Tenn.) and Michael Kussman, a former Veterans Heath Administration director.

The State Paid Nearly $28 Million for a Flawed System That Fails to Meet the Needs of Its Veterans Homes

Source: California Department of Veteran Affairs, Report 2015-121, June 2016

Our audit concerning the development and implementation of the California Department of Veterans Affairs’ (CalVet) Enterprise-Wide Veterans Home Information System (system) revealed the following:

  • The system has not improved the efficiency of the homes’ process for documenting medical care nor has it reduced reliance on paper because of system flaws.
  • System instability and concerns about functionality resulted in CalVet implementing fewer system functions at some homes, thereby limiting CalVet’s ability to provide more efficient care for veterans. …
  • CalVet did not exercise adequate oversight of its system project. It did not complete or partially completed six of the 12 required management oversight plans to ensure effective project management. It hired one contractor to provide both independent project oversight and independent verification and validation services, and those services were inadequate.

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Fix For VA Health Snarls Veterans And Doctors In New Bureaucracy

Source: Quil Lawrence, Eric Whitney, and Michael Tomsic, Kaiser Health News, May 16, 2016

Veterans are still waiting to see a doctor. Two years ago, vets were waiting a long time for care at Veterans Affairs clinics. At one facility in Phoenix, for example, veterans waited on average 115 days for an appointment. … Congress and the VA came up with a fix: Veterans Choice, a $10 billion program. Veterans received a card that was supposed to allow them to see a non-VA doctor if they were either more than 40 miles away from a VA facility or they were going to have to wait longer than 30 days for a VA provider to see them. The problem was, Congress gave them only 90 days to set up the system. Facing that deadline, the VA turned to two private companies to administer the program — helping veterans get an appointment with a doctor and then working with the VA to pay that doctor. … Wait times have gotten worse. Compared to this time last year, there are 70,000 more appointments where it took vets at least a month to be seen, according to the VA’s own audit. …

… This is playing out in a big way in Montana. That state has more veterans per capita than any state besides Alaska. … Hospitals, clinics and doctors across the country have complained about not getting paid, or only paid very slowly. Some have just stopped taking Veterans Choice patients altogether, and Montana’s largest health care network, Billings Clinic, doesn’t accept any VA Choice patients. … The delays have become a frustration within the VA, too. Tymalyn James is a nurse care manager at the VA clinic in Wilmington, North Carolina. She said Choice has made the original problem worse. When she and her colleagues are swamped and refer someone outside the VA, it’s supposed to help the veteran get care more quickly. But James said the opposite is happening. …