The Senate on Wednesday targeted the long wait times veterans are experiencing for health care by overwhelmingly passing legislation that will let many go outside the Department of Veterans Affairs system for care.
The bill will also expand veteran care by authorizing the VA to enter into leases with 26 medical facilities across the U.S. and Puerto Rico.
Sen. John McCain, R-Ariz., urged the entire Senate to vote in favor of the $2 billion legislation, calling it an emergency exemplified by the VA Medical Center in Phoenix, Arizona, where some veterans died while on a secret appointment wait list.
"The FBI has opened a criminal investigation [into the events in Phoenix]," McCain said. "If that's not an emergency I don't know what is."
McCain and co-sponsor Sen. Bernie Sanders, I-Vt., agreed that the bill was not everything they wanted, but said it included provisions and funding necessary to resolve the current scheduling crisis at the Department of Veterans Affairs.
Sanders reminded the chamber that it authorized the wars in Afghanistan and Iraq with emergency funding -- wars that are expected to cost up to $6 trillion by the time the last veteran of the conflicts is taken care of.
"If we can spend that kind of money [the wars] we can certainly spend one-tenth of that amount to care for those veterans," said Sanders, who chairs the Senate Veterans Affairs Committee.
The senators now expect to work with members of the House, where a related bill has already passed. Sanders said he believes a compromise can be reached and a bill quickly sent to President Obama.
A key provision of the McCain-Sanders bill would provide veterans facing time delays or long distance travel in seeking care the option of going outside the VA system. They would be able to go to a private hospital or clinic taking Medicare, a federally qualified health center, or facilities funded by the Defense Department or Indian Health Service.
A VA audit released on Monday revealed that more than 57,000 veteran patients have waited longer than 90 days for appointments at VA hospitals and clinics, and about 64,000 others who entered VA health care over the last 10 years were never seen by a doctor.
The issue came to light in April after CNN reported that up to 40 veterans may have died before getting an appointment at the Phoenix VA hospital. VA officials have since confirmed that 18 veterans on a secret wait list died before seeing a doctor.
The VA's Inspector General as well as auditors subsequently confirmed that hospital officials and schedules at many facilities across the U.S. were playing fast and loose with appointment schedules in order to make it appear they were meeting VA performance standards.
Under the standard, a first-time VA patient was supposed to be seen within 14 days of asking for an appointment. The VA has since concluded the 14-day standard was not realistic.
The McCain-Sanders bill targets management by giving the VA secretary more authority to fire or demote personnel, including those in the Senior Executive Service. The new clout has been pushed for some time by the House Veterans Affairs Committee, and the full House passed authorizing legislation in May.
The Senate began taking the proposal more seriously following revelations that many VA medical facilities have been manipulating patient wait times, and that some executives benefited from the gaming by picking up performance bonuses.
The just-passed Senate bill also paves the way for the immediate firing of poor-performing employees, and stipulates that the workers would receive no pay while appealing termination.
The legislation also would make it easier for the VA to hire more doctors and nurses, using unobligated funds, and expand health services by entering into leases with 26 major medical facilities.
The bill also would improve health care access to military sexual assault victims, and establish independent commissions to review patient scheduling and care and capital planning.
It would also establish a task force to review the VA's current scheduling needs, and give it funding authority to implement recommendations.
The bill also includes provisions not related to health care, including one giving veterans going to school on the Post 9/11 GI Bill in-state tuition at public colleges and universities, regardless of where they go to school and the home of record.
The bill will also extend the GI Bill education benefits to surviving spouses of men and women who died in the line of duty.
-- Bryant Jordan can be reached at firstname.lastname@example.org