Tuberville Highlights Community Care and the Importance of Modernizing the Veterans Health Administration During SVAC Hearing

WASHINGTON - Yesterday, U.S. Senator Tommy Tuberville (R-AL) spoke with The Honorable Doug Collins, Secretary of Veterans Affairs (VA), The Honorable John Bartrum, Under Secretary for Health at the VA, Mark Engelbaum, Assistant Secretary for Human Resources and Administration atthe VA, and Gregory Goins, Active Chief Operating Officer of Veterans Health Administration (VHA) at the VA. They spoke about the long overdue plans to restructure the VHA, the importance of strengthening Community Care, and domestic drug production through this reorganization.

Read Sen. Tuberville's remarks below or on YouTube or Rumble.

TUBERVILLE: "Thank you, Mr. Chairman.

Gentlemen, thanks for being here today and testifying. I'm grateful that Secretary Collins, under your leadership, our veterans are finally being put first in this reorganization plan. Mr. Secretary, and Mr. Engelbaum, you might wanna follow in on this too. I wanna talk about this graph behind me.

The red depicts the growth in employees since Fiscal Year 2019, and the blue shows the number of patients encountered over the same time. Between those five years, there was a 14% increase in the VHA employees, but only a 6% increase in patient encounters. Mr. Secretary, my colleagues across the aisle are saying rightsizing the VA hurts veterans, but this graph doesn't support that. To me, it looks like we're over-hired and you're simply rebalancing the books to put more money towards our veterans. Is this correct?"

COLLINS: "Senator, you are correct. And I think one of the things that we've looked at in this whole organization is, for example, […] I have a sheet here listing out a hospital that had a 33% FTE growth, while only a 14% patient encounter growth. We had a 24% growth in FTE and a -6% in patient encounters. This is what we're seeing. Mr. Engelbaum can explain that a little bit further."

ENGELBAUM: "Thank you, Senator. And I'll tag team with Mr. Goins a little bit on this.

But this is exactly what I said as I initially came on. I've always believed and firmly believe that the VA has provided wonderful medical care. What we haven't done is done that in a cost-effective manner. That's actually done more effectively. And the idea that throwing more employees at something actually increases our effectiveness is actually counter to what reality is. You've got more bureaucracy, more overhead that actually leads to slowing down, and it actually removes folks from actually supporting our veterans. So, we've been committed from the outset to do that, to reduce that, to bring that back into balance, and that's what we've done.

We stated from the outset, and we looked at our reductions, but that is always tied to veteran care. We are committed to veteran care. We are committed to reducing bureaucracy and making sure that we enforce […] that as our standard, not just numbers of people that are employed by the Veterans [Affairs] Administration."

TUBERVILLE: "Thank you."

COLLINS: "Senator, could we get Greg Goins on this? Because he actually had to experience this in the field over the past few years."

GOINS: "So there's a couple of reason why this is really important, Senator. One, we don't have a direct connection between workload and the number of resources we assign generally as an enterprise. That creates a tremendous imbalance where we offer people resources in the facilities, and it ends up becoming a wish list. It's not directly connected to the actual demand that the veterans and their families have in that system. The reason that's so important on an enterprise level is when we open a new clinic or an HCC, a healthcare center like in Fredericksburg, Virginia, and we need to add a lot of resources there because it's a new organic location to serve a growing veteran population. We don't have the ability to look at them and say, 'Here are the resources.' We ask them to take it out of hide. I have to look at a network director and say, 'You've got a new clinic coming on board-figure out where to get the resources.' Because, we factually have not looked at the places where we are losing veterans and tried to right size the workforce to match the demand. So, what we saw at the beginning of COVID is a massive ramp up in resources because we didn't know what the demand was gonna be, and I understand that. The same thing happened in the private sector. We did the same thing when the PACT Act came along in anticipation of an increased demand. Frankly, that did not fully realize. We saw more reliance but not a full workload increases like we might expect. What happened in the private sector post-COVID is they went and laid off workers, and I'm happy we don't do that. However, what we've got to do is understand our organization cannot withstand over time and be sustained with a 14% increase of personnel to support a 6% increase in workload over that same period. It's unsustainable and it's not right for the taxpayers."

TUBERVILLE: "Thank you. I got two questions. I'm gonna put them into one, but they're very different because you'll cut me off if I don't ask them at the same time. Number one, in my state of Alabama, we're 40-I think all over the country-[our veterans are using] 42% Community Care. Where does this fit in in your reorganization?

Because we have to have it. And number two is, we need more domestic made drugs in the VA. And we've got people that can do it. But let's start treating our veterans with domestic made drugs."

COLLINS: "Yeah, Senator, thanks for that. Community Care is a huge part and it's also most everybody that's been in Congress for any time voted for this and it's the law that we have to make Community Care available. It is a balancing act. We're seeing that in our different states.

Some use it a little more depending on-and remember, I have to also make sure when anybody complains about a wait time for Community Care-that is the doctors in the community that are causing that, not me. I mean, so we have to look at that. So, but Community Care is important. The new contract that we have-CCN contract, next-gen contract-is gonna help us with third party administrators going forward as we, you know, we look at this. So, I think that's gonna address your needs and concerns. And making sure this Administration, in particular, has looked at some our supply chains and supply lines so that we can't have more American-made products so that we're not caught behind."

TUBERVILLE: "Yep. One thing about Community Care. I have complaints about Community Care hospitals and the VAs communicating. They've got to communicate better. Well, you know, they're holding back MRIs and things like that. I'm just passing along-"

COLLINS: "Yeah, we'll be happy talk about that. Again, another question will be-Mr. Chairman, we will be happy to talk about the reasons on that as we go."

TUBERVILLE: "Okay."

GOINS: "Can I add a comment here? I know them over time, Sir. I apologize.

But the very nature of that HSA, that new element within our organizational redesign, it is meant to directly address that. We have someone that is directly engaged with community stakeholders to include those community partners to make sure that that kind of stuff is corrected [in] real time instead of waiting for after the fact and being reactive."

Senator Tommy Tuberville represents Alabama in the United States Senate and is a member of the Senate Armed Services, Agriculture, Veterans' Affairs, HELP and Aging Committees.

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