The Veterans Access, Choice and Accountability Act (VACAA) was enacted in late spring 2014 in response to the Veterans Health Administration Scandal.  Drastic measures were not unexpected given the gravity of investigative findings, which indicated the central issue of falsified patient wait times, and resultant delays in care delivery to veterans.

The most urgent need addressed by this bill was improving the wait list for veterans to receive care.  Investigations revealed that the VHA’s stated goal of patient care within 14 days of making an appointment was unattained at even the best facilities, with veterans routinely waiting weeks or months for service.  To counteract this, employees, supervisors, and facility heads alike appear to have “gamed the system” or create “unofficial waiting lists” that resulted in large numbers of veterans being denied the care that the agency mission pledged, while facilities appeared to be in compliance as far as the oversight committee in Washington was aware.

In order to immediately address this issue, the VACAA created a $10-billion “Veterans Choice Fund” that increases veterans’ access to non-VA care providers.  The fund was created as a short-term solution while the longer-term foundations were addressed, and will end either when funds are exhausted or after 3 years of enactment, whichever occurs first.  The option to seek care from non-VA providers applies to veterans  unable to secure an appointment at a VA facility within 30 days of request; reside more than 40 miles from a VA facility; experience transportation hardships such as requiring a boat or plane to reach a VA facility; or are separated from a VA facility by large physical barriers such as a mountain range.

VACAA also immediately addresses the area of employee accountability, especially on a supervisory level.  This was an important component needed to instill confidence in VHA and begin to repair its stained image.  In order to introduce greater employee accountability, VACAA authorizes immediate firings and demotions to Senior Executive Service (SES) employees, suspends all bonus and incentive pay during the appeals process, and cuts the funding for VA bonuses by $40 million per year.

Another chronic shortcoming was insufficient staff to accommodate the increasing number of Veterans seeking care, especially in light of recent wars in Iraq and Afghanistan.  The influx of appointment requests compounded an already existing problem and made the VHA’s goals unrealistic.  VACAA addresses this concern by providing $5 billion to hire physicians and medical staff in the hopes that this initiative will further reduce patient wait times.

VACAA also enacted educational benefits to directly benefit veterans and their eligible dependents by requiring public colleges to provide in-state tuition.  It also expands the Sgt. Fry Scholarship Program, expanding G.I. Bill benefits to spouses of servicemen killed in the line of duty after 9/11.

The combined results of VACAA should be measurable and rapid.  Early indications are that patient wait time has been both dramatically reduced, and displayed with transparency.  The Congressional Budget Office has forecast net spending of approximately $10 billion from 2014-2024, which makes this a reasonably cost effective initiative compared to previous VA reform packages.

For more information, visit the  The Veterans Access, Choice and Accountability Act of 2014 Highlights or visit the Veterans Day Progress Report. 

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