The House Committee on Veterans' Affairs Subcommittee on Health invited a variety of stakeholders, including The American Legion, to take part in a roundtable discussion that focused on the Department of Veterans Affairs procurement program for medical and other equipment, which became a centralized operation last year. Since then, the subcommittee has heard from panelists at several of its hearings that the reformed procurement program, managed directly by VA's Central Office in Washington, has been experiencing some problems.
An April 9 letter written by the subcommittee's chair, Rep. Dan Benishek, R-Mich., to American Legion National Commander James E. Koutz reported that some veterans had complained about "lengthy and unacceptable delays in care, and from providers that the reforms have resulted in lengthy and unacceptable delays in the procurement of needed medical devices and equipment."
The American Legion's concerns were expressed at the roundtable by Jacob Gadd, deputy director of health in the Legion's Veterans Affairs & Rehabilitation Division:
• The Veterans Health Administration (VHA) decided to centralize the procurement of prosthetics, pharmaceuticals, information technology and other key products/services as a cost-savings measure; the Legion is concerned that VHA may be over-emphasizing cost over the quality of health care it provides for veterans.
• Many of VHA's contracting officers make decisions on "fair" prices without having any relevant expertise, i.e., determining which cardiac stint devices to purchase but having little or no knowledge of them.
• Contracting officers are not always on site, which sometimes results in unnecessary delays in the review and approval process. For example, the bio-hazardous waste at a Boston VA medical center built up for two days because a disposal service contract had lapsed, even though it had been turned in with adequate time for review.
• Selection of equipment is sometimes based more on price than quality and accessibility. For example, the VA medical center in Little Rock, Ark., submitted a request to purchase elevators from a local vendor; the contracting officer decided to buy them from an Oklahoma company. When the elevators broke down, repairs took much longer because an out-of-state vendor had been chosen.
The American Legion recommended that VA decentralize its contracting authority so that VA medical centers can take responsibility at the local level for the procurement process.
The Legion also recommended that VA restore contract-making authority and IT programs to its local medical centers and regional offices.
Last October, the Legion's voting membership passed a resolution  that highlighted procurement and other centralization problems within VA, and called up the department to decentralize its decision making, "accompanied by a demarcation of responsibilities and a plan for holding it decision-makers accountable."
Besides The American Legion, several other veterans service organizations participated in the roundtable, including Disabled American Veterans, Veterans of Foreign Wars, Paralyzed Veterans of America and Vietnam Veterans of America.