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A new era for Veterans Affairs, and the committee that oversees it

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The Veterans Health Administration is marking its 75th year. Now that Denis McDonough is confirmed as the new veterans affairs secretary, what will his overseers on Capitol Hill be most concerned with? For some answers, Federal Drive with Tom Temin turned to the chairman of the Senate Veterans Affairs Committee, Montana’s Jon Tester (D).

Tom Temin: Senator, good to have you on.

Jon Tester: Tom. Thank you.

Tom Temin: Alright so, we do have a confirmed VA secretary now and you are now the new chairman of the committee in the Senate. What are your expectations writ large for VA in the next couple of years?

Jon Tester: Well, I think first of all, it’s good to have Denis McDonough as secretary of the VA. He’ll be a point of contact that everybody can use in Congress, they’re able to make sure that the VA does the best job possible of getting the vaccines and getting them in the arms of the veterans around this country. I think that’s really critically important. They’ve done a good job so far. But there has been a holdup in the amount of vaccines as has been across the country. I think in the veterans case, many of these folks have comorbidities. So you’ve got to get this vaccine into their arms sooner rather than later. And that’s really what I’m pushing on. I think that’s what Denis McDonough is going to be pushing on coming right out of the chute. But there’s also a lot more for him to do. We’ve had a very successful couple of years in Congress of giving the VA tools that they need to be able to be successful and help our veterans around this nation implementing things like the John Scott Hannon Veterans Mental Health Improvement Act is critically important. As you know, mental health is a huge issue among our veterans, and making sure that the VA has tools to help people and ultimately the veteran has those tools is going to be really, really important. So implementation there is important. The fastest growing group of veterans we have in this country are women veterans. And so the Deborah Sampson Act to make sure that our women’s veterans are treated with dignity, and they have what they need for the challenges that our women veterans have in the VA is critically important. Those are good and important things to do. And then we didn’t even get into the presumptive that were added to the list for Vietnam veterans who were exposed to Agent Orange. But that’s going to be really important too. Overall I will say, I think Dennis is the right man for the job because he knows how to get things done within the bureaucracy. And we’ll be holding him accountable to make sure that he does, as he said, during the hearings that we had with Dennis last week, that veterans are his number one thought when he wakes up in the morning, and they’re his number one thought when he goes to bed at night.

Tom Temin: And getting back to the COVID vaccine question, the Veterans Affairs Department has statutory ability or responsibility to augment the medical system at large. Do you think that the COVID distribution levels right now in the country warrant VA stepping into that role at this time?

Jon Tester: Look, I think the problem is getting the vaccine – I think the VA has a staff to help get it in people’s arms if the private sector can’t do it. I think VA can help in that regard. But right now, we simply don’t have the vaccines across the board, whether it’s in the VA, or whether it’s in the state level. And so I do think that the VA is set and they’re ready to help. And I think they’re more than ready to help. But the key is, Tom, is making sure that we get more vaccines into the agency’s hands and then get them into the arms. Look, in Montana for example, the VA is getting the vaccine into the arm of the veterans about a 92% clip. They get this stuff, it’s going in arms, which is really, really good. But like I said, we need more vaccines.

Tom Temin: We’re speaking with Jon Tester, chairman of the Senate Veterans Affairs Committee, Democrat from Montana. And looking at some of the bigger issues, the community care there was just a [Government Accountability Office] report out saying that they’re having trouble maybe tracking the incompetence, or the people that lose their license, in this vast network of community care. Do you feel that program is well established? Or is that something maybe some more oversight, maybe a little touch up legislation might be needed for?

Jon Tester: Tom, there needs to be continued oversight on this. As I’ve said many times, you can delegate the job of health care, but you cannot delegate the responsibility. The responsibility has fallen squarely on the VA and will continue to and so it is really important that the VA is monitoring what’s going on in the private sector to make sure that our veterans are going to people who are good folks – the best as they are in the VA, I might add – and making sure that if there’s any problems that we’re doing our best to stay ahead of the curve to stop those problems from happening in the private sector before they do happen. And I know there’s probably going to be some pushback from some on that committee that just thinks that veterans can go anywhere they want and no questions asked, but that’s really not practical. The VA needs to make sure that when these veterans are going to the private sector, that they’re directed in a way that meets the needs of those veterans. And that’s the challenge, by the way, with community care is that in the VA, we’ve got docs, we’ve got nurses that understand that these folks have comorbidities and quite frankly, it takes more than a 15-minute appointment to be able to determine all the support that they need. In the private sector they turn and burn them a lot faster and that doesn’t work with our veterans.

Tom Temin: And switching gears, I want to ask about the labor relations in the Veterans Affairs Department. That’s been really a contentious few years we’ve had under the Trump administration for a variety of reasons. What do you expect Mr. McDonough and maybe the oversight committees to do to maybe get that back, righted, so there’s some semblance of normalcy in that relationship?

Jon Tester: I think it’s a really good question, Tom, because the truth is, is that the folks that are working in the VA are the point of contact for our veterans. And if they’re not happy, the experience in the VA isn’t going to be near as good. That being said, you know, employees need to be held accountable. And I’m going to expect Denis McDonough, who is the secretary of the VA, to hold people accountable when they screwed up. I also think there needs to be, as I’ve said, many times, you got two ears and one mouth – act accordingly. He needs to continue to listen to the on-the-ground employees to make sure the VA is doing the best they can, for example, personal protective equipment – we should not be expecting our frontline healthcare workers to be going in with substandard personal protective equipment. So that’s the kind of things that he needs to be talking about. We also need to be making sure that sexual harassment has no place anywhere within the VA, or anywhere within the folks who contract with the VA or anywhere as far as that goes. And so I think Denis is going to do a good job making sure that people understand the rules and that they live by them. But, as any good manager of people knows and Denis McDonough has managed a lot of folks over his career, it’s about lifting, and it’s about acting, and it’s about holding people accountable. And when somebody screws up, you need to hold them accountable. everybody’s watching if you don’t hold them accountable, it has negative impacts on the entire system. I think his strong suit really is management and being able to get things done through the bureaucracy.

Tom Temin: Is the Senate committee convinced that the electronic health record project is on track and reasonably within budget and scope?

Jon Tester: I’m not. I think that he’s gonna have some challenges, we’re gonna have some challenges, we’ve got to hold him accountable. And we’ve got to do major oversight to make sure this continues to move forward quickly and meaningful and make sure we’re not wasting taxpayer dollars in the process. Look, electronic health records have been around longer than I’ve been in the U.S. Senate. And I’ve been here for 14 years. And I think that there’s a lot of frustration about the lack of progress on this effort. And once again, I think that in a bipartisan way, we’re going to be holding the secretary’s feet to the fire on this issue. Because it’s really important when it comes to taking care of our veterans. And you know, we talked about community care a minute ago. It’s really important when you start talking about community care to make sure everybody’s on the same page, and electronic health records ensures that that’s the case.

Tom Temin: It sounds like then the committee feels that or at least you feel that the statutory framework for now is in place, is just a matter of execution on quite a number of fronts.

Jon Tester: Tom, I couldn’t have said it better if I’d have said it myself – exactly correct. Now is the time where we passed – and look, we’ve got some other things we’re gonna have to do -but we’ve passed a lot of really good bills. Now they got to get implemented the way Congress intended them. I think they will be. I do think that we have to continue watching. I think that the department needs to continue to be open with the Inspector General. So when they screw up, the ag can inform us of those kind of challenges. And when they’re doing things good, they can do the same. So yeah, you’re exactly right. It’s about oversight, mainly, at this moment in time.

Tom Temin: Montana Democrat Jon Tester is chairman of the Senate Veterans Affairs Committee. Thanks so much.

Jon Tester: Tom, it’s always a pleasure. Thank you very much.

Tom Temin: We’ll post this interview at Subscribe to the Federal Drive at Apple Podcasts or wherever you get your shows.

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