VA working to fix problems with Choice Program
Veterans Health Administration Acting Principal Deputy Under Secretary for Health Dr. James Tuchschmidt responds to questions asked during the VA health-care panel in Baltimore. (Photo by Lucas Carter)

VA working to fix problems with Choice Program

Since its implementation, many veterans have expressed concern with the Department of Veterans Affairs Choice Program, which was designed to allow those enrolled in the VA health-care system to get care from non-VA doctors.

During a VA health-care panel Aug. 29 during The American Legion National Convention in Baltimore, the Veterans Health Administration’s (VHA) acting principal deputy under secretary for health admitted attempts to get the Choice Program rolling quickly likely led to some of the issues.

“A lot of work has been done to try and stand this up in extraordinary quick time,” Dr. James Tuchschmidt told members of the Legion’s Health Administration Committee. “When the law was passed, we had 90 days … to implement the program. When we went out to private industry to try and get help to do this, most of the big players walked away from the table and said, ‘This is a two-year project, not a 90-day project.’ They didn’t want the risk, both financially and to their reputations.

“We know that there are problems, and some of those problems have to do with both the infrastructure that (VA contractors) TriWest and Health Net have. Some of it is due to the way we’ve structured a contract. And some of it is our business processes that are, quite frankly, not very user friendly. We are trying to address those issues.”

Tuchschmidt said that Congress has asked for a plan by Nov. 1 to consolidate all of the programs VA has into one program “that they say will be called the Veterans Choice Program. We are working on that. As we have been developing those ideas, we have been meeting with your representatives to bounce those ideas off of them. We will continue to do that.”

Legionnaires heard from a variety of VHA employees during the panel discussion. Janet Murphy, acting deputy under secretary for Operations and Management for VHA, told Legionnaires access to care still concerns her.

“My goal would be for veterans to be able to be seen today if that’s what they want,” Murphy said. “Same-day access should be our goal. We’re not there yet. We have pretty good access for veterans that are already in our system. We have less good access for veterans who are trying to get into our system. That’s one thing I worry about.”

Murphy said VA currently is trying out self-scheduling for veterans as a pilot program in a few areas. “It will be limited to primary care to start with … while we figure it out,” she said.

Quality of care also is a priority for Murphy. “I want to know if veterans are satisfied and happy with the care they get,” she said. “And I want to know that from veterans – not just whether you got an appointment, but were you respected when you came into our facilities? Were (we) able to help you?

“One of my rules is that if (VA employees) are going to cite a regulation in a letter or communication, you also have to help the veteran in some way. You may not be able to get exactly what they’re asking for, but you better be able to demonstrate that you’ve helped them in some way.”

Dr. Marsden McGuire, deputy chief consultant for VHA’s Mental Health Standards of Care, said that access to mental health care, quality of care provided and the veteran’s experience receiving care were priorities for his office.

McGuire said he felt access was improving and said that there were efforts on many fronts to ensure quality of care. “On experience of care, based on the latest results of the Veterans Satisfaction Survey that we conducted involving 10,000 veterans, we’re doing pretty well,” he said. “There were some areas we could identify – areas of concern that match very much with our own concerns.”

VA Voluntary Service Director Sabrina Clark said that American Legion family volunteer efforts at VA facilities are invaluable. More than 840,000 combined hours have been volunteered through the health-care system; donations have totaled more than $5 million.

“If we were to pull those resources – the people, the hours, the (donations) out of VA, it changes the look of VA health care,” Clark said. “It is amazing and to be saluted.”

Clark also relayed a story of how a veteran’s family had gone on vacation on the evening that veteran passed away. VA staff couldn’t reach the family, so they called the volunteer, at 3:30 a.m., who had been working with the veteran.

“The volunteer got up and went to the bedside, and he was with that patient when he (passed away),” Clark said. “The family could not have been more grateful. (The volunteer) was the extended family.

“It really is about the little things. The small things count. The small things make a difference in the life of the veteran.”