Secretary Shulkin and the State of the VA
On May 31, 2017 Dr. David Shulkin, Secretary of the Department of Veterans Affairs, gave the first-ever “State of the VA” speech from the White House press room. In the speech, Secretary Shulkin highlighted 13 areas of significant risk for VA–ranging from disability claims and appeals to construction projects to veteran homelessness–all problems that have long plagued the VA and spanned multiple administrations.
“I’m a doctor and I like to diagnose things, assess them and treat them,” said Secretary Shulkin, “And so what you’re going to hear today is really a candid assessment of where our problems are in VA, with the focus of a businessman and the skills of a doctor to be able to actually help you with that.”
After discussing the 13 risk areas and touting improvements made in his first 100 days as head of the Department, Secretary Shulkin answered questions from the press. Reporters focused on hot button issues like the planned cuts to individual unemployability benefits in the proposed VA budget, veteran suicide, medical marijuana, and the administration’s focus on the Choice Program.
For a summary of all 13 issues Secretary Shulkin discussed, you can read the VA Fact Sheet published after the speech. In this article, we will take a closer look at some of the issues directly affecting disabled veterans—access and wait times, disability claims and appeals, and the proposed VA budget.
Access and Wait Times at VA Medical Centers
Secretary Shulkin said that all 168 VA Medical Centers (VAMCs) now provide same-day services for primary care and mental health appointments, the services deemed most critical in terms of timeliness. In the same part of the speech, however, he notes that veterans are “waiting 60 days or more for new appointments in primary care and mental health at 30 VA locations nationwide.” So, despite the alleged availability of same-day services at all VAMCs, it is unclear whether veterans are actually receiving those services.
Additionally, there are significant wait times for follow-up appointments. According to Dr. Shulkin, when a provider wants a follow-up within a specific time frame, the veteran is not seen in that time frame 10 percent of the time. This is perhaps in part because 16 percent of VA’s primary care clinics are over 100-percent capacity.
Soon after the Secretary was appointed, he promoted an initiative to publish wait times at VA facilities across the country on the VA website. “There is no other health system in the country that has done anything like that,” said Shulkin at the White House briefing. “And there is no comparison to what the VA is doing in terms of transparency and wait times.”
Recently, however, the AP reported that Senate Judiciary Chairman Chuck Grassley accused VA of lying about actual wait times at the Iowa VA. After being told that no veterans were waiting more than 90 days at the Iowa facilities, Senator Grassley received data from a whistleblower that indicated that over 1000 veterans had waited significantly longer – hundreds had waited for over a year. VA later confirmed the data. And a recent report from the Office of the Inspector General says supervisors instructed employees to manipulate patient wait time data in 40 VA medical facilities in 19 states.
Disability Claims and Appeals
When discussing the disability claims process, Secretary Shulkin informed viewers that over 90,000 disability claims are taking more than 125 days to process. VA aims to reduce that number by half over the next two years. Additionally, he wants VA to make it easier for veterans to get information on the status of their claim, saying “we need to make that process more transparent.”
About a week before Secretary Shulkin’s address, a bill that would restructure the appeals process for disability claims unanimously passed the House and has moved on to the Senate VA Committee. At the White House briefing, the Secretary asked the Senate to act on the appeals legislation “as soon as possible.”
Dr. Shulkin also highlighted the impact of the VA’s vets.gov website. Last year, he remarked, only 10 percent of benefits applications were done online. Now, eight times the number of applications are submitted digitally. VA aims to go paperless in all veterans’ benefit offices by mid-2018.
The Proposed VA Budget for FY 2018
Throughout the address, Secretary Shulkin praised President Trump’s proposed 6 percent increase in the Veterans Affairs budget for Fiscal Year 2018. Responding to a reporter, he said he did not believe that VA would need additional money, with the possible exception of funding to modernize VA’s IT systems.
“I have said that the problems in VA are not largely going to be solved through additional money, said the Secretary. “These are going to be solved through management practices, focus, and some legislation changes.”
One reporter asked Secretary Shulkin if the proposed cuts to Individual Unemployability for veterans over age 62 was in line with the administration’s promise to do better by veterans. Secretary Shulkin first pointed to the overall increase in the budget for veterans.
Secretary Shulkin then defended the cuts, saying, “In the case of IU, I think that what we’ve proposed is not an elimination of it, but a revision to make the program and resources that are going currently to some veterans, to help additional veterans.” He added, “I understand that there is a lot of passion on this, and we will have plenty of time to work with Congress and with our veteran service organizations to make sure that we’re getting this right.”