VA is asking for billions to treat the “bow wave” of veterans in need of care after the pandemic


The Department of Veterans Affairs is seeing increased demand for health services from veterans who have either postponed care or been unable to get appointments during the pandemic – a surge that VA Secretary Denis McDonough says will add billions to its budget.

McDonough told the House of Representatives Veterans Affairs Committee Tuesday that funding is needed to create more than 19,000 new jobs, including 17,000 healthcare jobs, and to meet rising nursing costs in both departmental facilities and the community. The VA’s final budget request is $ 270 billion.

According to McDonough, in April and May the department saw a “record number” of veterans being cared for in non-VA facilities through benefits under the 2018 Missionary Act. At the same time, VA hospitals and clinics are returning to “pre-pandemic levels” in patient care, he said.

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The VA calls for a 27% increase in its community care budget for fiscal 2022, from $ 18.5 billion to $ 24.4 billion. She also wants another 24% increase from current funding levels for the 2023 budget year – $ 24.2 billion in advance funding, a budget item unique to the VA that ensures veterans’ services are never interrupted by legislative debates or delays.

At the same time, the department is calling for health services at VA medical centers and clinics to be increased by 4%, from $ 56.5 billion to $ 58.8 billion.

“This is not hypothetical,” McDonough told committee members. “We are in the midst of an ‘arc wave’ of care; we see a need for that care.”

While medical centers in VA never closed during the pandemic, planners rescheduled or canceled most of the routine appointments to telemedicine or phone visits. They also postponed electoral processes, causing some veterans to postpone treatment or seek treatment in their local communities.

The VA “took a lot of care in the community as private institutions desperately tried to stay open,” McDonough said.

“The budget for community maintenance is growing. In general, at over 30%, 31% of our cost goes to community care, although it was up to 39% at the height of the pandemic, ”he said.

The VA Mission Act introduced sweeping changes to the department’s community health care program that allowed veterans to seek out private health care providers at the VA expense.

Legislation has greatly expanded access to this care, and proponents have hailed the benefit as an asset to veterans who have faced long waits or who live far from a VA health facility. However, critics said it would pull funds from VA facilities and providers, tantamount to “privatizing” VA health care.

Rep. Mark Takano, D-Calif., Chairman of the House of Representatives Veterans Affairs Committee, and Rep. Mike Bost of Illinois, senior Republican on the committee, expressed concern about the explosive growth of the VA program and budget.

Takano wondered if the program’s expansion was related to the VA’s aging infrastructure, which may be preventing veterans from receiving specialized services.

“Funding requests for care in the community have increased significantly in recent years, largely due to expanded access standards and poor actuarial projections in early 2018,” Takano said. “The Congressional Budget Office suggested the estimated spending on the program over five years at nearly $ 23 billion … but we see that in a year.”

Bost agreed.

“I think we are all concerned about the national debt that exceeds our economy. VA has requested a 10% increase for next year. If this rate of growth continues, the VA budget will be $ 574 billion by 2030. The problem is the number of veterans serving the VA hasn’t increased 10%, “he said.” I’m not suggesting cutting the VA, but budget growth needs to better match demand. “

The VA received $ 36 billion in pandemic relief and recovery funds in addition to its base budget in fiscal year 2021. Another $ 18 billion in the American Jobs Plan is earmarked for VA’s health infrastructure.

The budget proposal for fiscal year 2022 calls for a nearly 100% increase in the department’s suicide prevention budget and an additional $ 1.5 billion in mental health services to meet increased demand.

McDonough said more than 1.6 million veterans received mental health services through the VA last year, and calls to the Veterans Crisis Line nearly doubled.

Under the VA budget proposal, the Veterans Crisis Line would receive $ 142 million, while suicide prevention programs, including a grant program for community organizations focused on suicide, would receive $ 598 million.

Legislators also urged McDonough to respond to proposed legislation that would require the department to reward and support service members with diseases related to toxic exposure, including fire pits and other air hazards such as oil well fires.

Legislative packages currently under discussion could cost up to $ 1.5 trillion. By comparison, President Joe Biden’s budget proposal for the federal government is $ 6 trillion.

“Invoice costs of this magnitude are unknown in the VA. They raise serious questions about our solvency for this legislation called.

McDonough said the department is reviewing current legislative proposals and what they would need in terms of VA staff and support.

But Takano reiterated his commitment to legislation that would support affected veterans.

“Last month, I introduced the Honoring Our Promise to Address Comprehensive Toxics Act to recognize exposure to toxins as a cost of war and to ensure that all veterans can enjoy the care and benefits,” he said. “I look forward to working with VA on this important issue.”

After McDonough testified as part of a panel of veterans service organizations, AMVETS National Executive Director Joe Chenelly criticized the budget proposal, saying there was a lack of detail to improve the quality of life for veterans.

He said a portion of the $ 1.5 billion mental health services should fund a task force that would focus on delivering a holistic approach to veteran’s health, including physical and mental health, as well as workplace and health Home security.

“We need to get out of the business of spending billions on ineffective mental health services and medication that focus only on treating veterans’ symptoms and instead fund proactive programs that train veterans to lead happy, healthy, meaningful lives.” said Chenelly.

– Patricia Kime can be reached at [email protected] Follow her on Twitter @patriciakime

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