Congressional hearing aims to improve VA care

Minutes after taking part in a special congressional hearing in Fayetteville, Sarah Verardo said it wasn’t enough. Not yet.

Verardo, executive director of The Independence Fund and wife of an 82nd Airborne Division veteran who lost his leg in Afghanistan in 2010, praised the meeting, a special field hearing of the House Veteran’s Affairs Committee, but said words alone would not help the problems her family and others like them face on a daily basis.

She expects more.

“Today was more than symbolic,” Verardo said. “It should fuel action.”

Four House Republicans gathered as part of the hearing, which was hosted by Fayetteville Technical Community College. They included two members of the committee – chairman Rep. Phil Roe of Tennessee and Rep. Neal Dunn of Florida – and two congressmen representing Fayetteville and the surrounding communities – Reps. Richard Hudson and Robert Pittenger.

The oversight hearing included a discussion of bureaucratic hurdles to care through the Department of Veterans Affairs and ways to improve that care through community programs and better relationships with outside health care networks.

The four congressmen heard from a panel of experts that included Verardo; David Catoe, the assistant vice president for patient financial services at Atrium Health; Chief Master Sgt. Daryl D. Cook of the North Carolina Air National Guard; retired U.S. Staff Sgt. Gary B. Goodwin; and DeAnne Seekins, the director of the VA’s Mid-Atlantic Health Care Network.

Roe said the field hearing gave the committee an opportunity to hear from veterans where they live, rather than from officials in Washington. He said the best ideas for reform often come from outside Capitol Hill.

“This is a formal, official congressional hearing and will go into the Congressional Record,” he said.

Dunn, who served at Fort Bragg while in the Army, agreed on the importance of the field hearing.

“We have to come to you,” he said. “We can’t just sit back.”

Roe and Dunn each praised Hudson and Pittenger for their efforts to help local veterans. And the two local congressmen said they were committed to improving access to VA care.

The panel of experts discussed how the massive VA bureaucracy has hampered that care in the past.

Verardo said her husband wasn’t expected to survive his wounds after being injured by an improvised explosive device in Afghanistan. She praised his medical care through the military and from the VA but said VA administrators are often disinterested and more concerned with preventing fraud than taking a common-sense approach.

Her husband has repeatedly been forced to make a three-hour round trip to prove to VA officials that he is missing a leg and still requires a prosthetic. And he’s endured long waits for repairs to his wheelchair.

At times, Verardo said, she has had to fix his leg with duct tape while waiting for VA officials to approve repairs.

She said the VA too often does not take into account the complex cases of catastrophically wounded veterans and asked congressional leaders for separate access and quality standards for those veterans. She also advocated for veterans to be able to choose their own health care provider outside of the VA system.

Catoe addressed the committee as a representative of a major health care network, Atrium Health, formerly known as Carolinas Healthcare System.
Current VA processes put extra work on civilian health care networks and create concerns with patient privacy, he said. Often, hospitals must resubmit medical cords multiple times due to the VA being unable to locate the records. Each request requires printed records that must be mailed.

Catoe said workers at Atrium who deal with the VA are often frustrated and demoralized due to long hold times and a rigid system that often leads to rejected claims.

He asked that the VA look to commercial payer portals for an example of how a more streamlined system could look.

Despite their criticisms, many of the panelists and the congressmen themselves praised the VA for the health care it provides. They said the meeting was not meant to berate the VA.

“We’re not coming here with axes to grind,” Pittenger said. “All we want today are facts. We want to know what’s best for our veterans.”

Goodwin, a Fayetteville veteran, said he has received quality care from the VA in recent years, including during three major surgeries, two minor surgical procedures and numerous hospitalizations and countless emergency room and urgent care visits over the past four years.

But Goodwin, who retired in 2009, said delays in payment for care outside the VA have harmed him financially. He sought care outside the VA in July 2016 following issues related to a surgery. He followed the appropriate procedures and, by January 2017, had been told that his claim had been verified, approved and was pending payment.

Most of those medical bills were paid as of last week, Goodwin said. But not all of them.

The ambulance provider had not been paid as of the hearing, he said, and had taken his account to collections and garnished his tax returns. Goodwin said those actions have dropped his credit score from 820 to 670.

“In today’s world, credit makes the world go ’round,” he said. “You can’t get a loan for a box of doughnuts when you have a credit score of 670.”
Seekins, who overseas VA health care across North Carolina and Virginia, publicly apologized to Goodwin. She said that his bills would be paid and that the VA would help clear the matter from his credit.

The VA recognizes that many community providers have significant challenges with payment from the VA, she said. And said efforts were underway to improve by dedicating additional resources and adding staff.

The Mid-Atlantic Healthcare Network, also known as VISN 6, is the fastest growing region within the VA, Seekins said. And Fayetteville is among the fastest growing veterans communities, growing by 70 percent in the last 10 years.

To keep pace, the VA has added new medical centers and outpatient clinics. In Fayetteville, it has added more than 420,000 square feet of space and hired more than 840 staff members.

The efforts have had results, she said.

Wait times at the Fayetteville VA have improved from more than 20 days for a new patient a year ago to a little more than nine days on average today, the shortest wait in the network.

Seekins said the VA has come to rely on partnerships to serve the area’s veterans, with cooperative efforts between the VA and Fort Bragg and agreements with more than 640 outside providers, including 98 active agreements involving the Fayetteville VA.

Roe said the VA must do better by Goodwin and other veterans like him.

“We can do better,” he said. “We have to do better.”

Roe noted that the VA’s budget has doubled in recent years. He said the country spends more on veterans than any other place in the world.
But he said the VA’s growth spurt hasn’t always led to better care.

“It’s now larger than the U.S. Navy,” Roe said. “Just getting bigger doesn’t make you better.”

As the veteran population changes and grows, Roe said he wanted to see the VA change as well. That could mean allocating more resources in communities like Fayetteville with a large and growing veteran population, while shifting resources from communities in the northeast that do not have those populations.

“What we want is a nimble VA,” Roe said.

Dunn asked VA leaders to have an open dialogue with Congress. How can Congress help improve the VA? And how is Congress getting in the way?
Several veterans service organizations from across North Carolina attended the hearing. Afterward, Hudson and Pittenger encouraged veterans and organizations to reach out to their offices with issues or suggestions to improve care for veterans.

“Veterans all have a voice,” Hudson said. “This is a good opportunity for us to have our voices heard.”