Tester introduces bill to address VA’s chronic workforce shortages

Senator’s DOCS for Veterans Act strengthens recruitment, retention at VA nationwide

(U.S. Senate) – In an effort to reduce chronic workforce issues that affect veterans’ access to care, Senator Jon Tester today released the Delivering Opportunities for Care and Services for Veterans Act.

Tester, during a press conference today, said that his Delivering Opportunities for Care and Services (DOCS) for Veterans Act would provide the VA with greater tools to recruit and retain qualified medical professionals and executives, particularly in rural America. The bill helps build a stronger pipeline of doctors into the VA, expands the VA’s mental health workforce, and gives the department needed flexibility to address workforce shortages and recruit a medical staff that is more capable of meeting the needs of veterans.

“Workforce shortages have plagued the VA for years, reducing veterans access to quality medical care,” said Tester. “The DOCS for Veterans Act incorporates a number of great ideas from folks in the veterans and medical communities that will help address these shortages and will allow the VA to compete for the medical professionals it needs to serve veterans for years to come.”

Tester’s DOCS for Veterans Act:

• creates more opportunities for local affiliates, such as the Billings Clinic, to partner with the VA to establish new residency opportunities for medical professionals
• increases collaboration between the VA and Indian Health Service to establish mental health residency programs in underserved rural areas
• creates a carve-out in the VA’s student loan repayment program to ensure that at least 30 percent of those funds are invested in individuals who commit to working in rural areas
• ensures that the VA is more capable of addressing vacancies in its health care leadership, such as we recently saw at Fort Harrison
• addresses bureaucratic hurdles that hinder recruitment, allowing the VA to compete with the private sector

Tester was joined by Dr. Eric Arzubi, Chair of Psychiatry at the Billings Clinic who discussed the urgent need to expand residency programs recruit highly trained doctors who can help care for veterans.

“Many, many communities are facing a mental health crisis,” Dr. Arzubi said. “This crisis is made worse by our citizens’ inability to access psychiatrists and other mental health professionals. We have to approach this problem differently than we have in the past. We need stakeholders to collaborate in an effort to train and retain psychiatrists locally. The three states with the highest suicide rates, Montana, Wyoming, and Alaska, are the only states that currently don’t host a psychiatry training program. I am excited to work with Senator Tester in tackling this critical problem. It would be a privilege to better serve our veterans’ after what they have done for us.”

Matt Kuntz, the Executive Director of the Montana Chapter of the National Alliance on Mental Illness, also joined the press call to discuss the impacts of the bill on treating mental illness in rural areas.

“The very rural nature of Montana creates unique challenges for our healthcare providers. These challenges are especially difficult for treating serious mental illness because of the complex nature of serious mental illnesses, the level of care required for mental health crises, and the ongoing treatment needs of persons living with these conditions. Our state consistently has one of the highest suicide rates in the country and we are in desperate need of more mental health professionals, particularly in our more rural communities,” Kuntz said. “Senator Tester’s legislation, the DOCs for Veterans Act, takes a number of critical steps to ensure the mental health needs of our veterans are being addressed. In doing so, it calls for common sense reforms that will help ensure the VA can expand its mental health workforce in places like Montana, and is more capable of addressing unacceptable gaps in care for veterans.”

Tester’s bill is supported by numerous advocacy groups in the medical and veterans communities, including the American Association for Marriage and Family Therapy, American Legion; American Mental Health Counselors Association, AMVETS, Blinded Veterans Association, Disabled American Veterans, Military Officers Association of America, Montana Mental Health Counselors Association, National Alliance on Mental Illness, National Board for Certified Counselors, National Guard Association of the United States, Paralyzed Veterans of America, and Veterans Affairs Physician Assistant Association.

SUPPORT FROM MONTANANS FOR THE DOCS FOR VETERANS ACT:

“Billings Clinic is committed to increasing access to quality care for our veterans throughout Montana. We are grateful for Senator Tester’s commitment to finding solutions to increase both physicians and services that will directly benefit Montana’s veterans. Specifically, we appreciate the focus on increasing access to both inpatient and outpatient mental health services for veterans in Montana. We also support every effort to recruit and retain our health care workforce. Working together, we can improve and strengthen the system of health care delivery for veterans in our state.” – Dr. Nicholas Wolter, MD, Chief Executive Officer, Billings Clinic

“I appreciate Senator Tester’s hard work to hold the VA accountable and to fix many of the issues that have prevented Montana veterans from accessing critical care or services from the VA. This legislation will be very helpful in ensuring that more Montana veterans get the health care they deserve while also encouraging the hiring of competent medical professionals. At a time when budget cuts are looming, it is nice to see rational thought being used for the advancement of veteran’s health care.” – Merv Gunderson, National Executive Committeeman, Department of Montana, American Legion

“The MHA supports the DOCS for Veterans Act. This legislation addresses a critical ingredient in making sure veterans receive appropriate medical treatment: the supply of health care providers. The health care system continues to face chronic shortages of physicians and other providers. Residency and loan repayment programs have proven to be effective in addressing these shortages. We are especially pleased with this bill’s focus on loan repayment in rural and underserved areas, its focus on boosting the use of mid-level practitioners, and its call for a demonstration that includes the Indian Health Service. MHA has long supported strategies that break down the barriers between our members and the VA and IHS. We look forward to working with these agencies to implement the goals of this bill.” — Dick Brown, President, Montana Hospital Association

“The shortage of VA doctors and medical staff has been a great frustration to Montana veterans and has greatly impacted our ability to access the care we need. This is particularly the case in rural parts of our state, such as Glasgow, where the VA has gone more than a year without a permanent doctor to work out of that VA facility and treat area veterans. I am very appreciative of Senator Tester’s ongoing work and his legislation, the DOCS for Veterans Act, which will take a number of important steps to better ensure Montana veterans have timely access to the medical care we have earned.” —Joe Parsetich (Great Falls), National Executive Committee, Disabled American Veterans

“The members of the Western Montana Military Officers Association thank Senator Tester for continuing the fight for better health care for Montana’s 100,000 Veterans. Despite the improvements in scheduling appointments included in the Veterans Choice Program, several of our members have had to drive the 230 miles to the VA Hospital in Helena and back to receive needed medical care with specialists that are not available in Western Montana. In some cases these appointments are delayed due to a shortage of care providers or specialists. I believe that the DOCS for Veterans Act will be a great next step in manning VA medical facilities in rural areas like Montana with the necessary medical and management personnel. As you know Montana is a beautiful state with a low cost of living; it has been unfortunate that the VA continues to have problems filling the medical and management vacancies at their facilities across the state. We appreciate Senator Tester’s ongoing work to improve access to medical care for rural veterans, and are thankful he will continue fighting until Montana Veterans receive the medical care they deserve.” — Col. Gary Swartz, US Army (Ret.) President, Western Montana Military Officers Association

“The Montana Mental Health Counselors Association applauds Senator Jon Tester for the introduction of “The Delivering Opportunities for Care and Services (DOCs) for Veterans Act.” The legislation provides a needed increase in access to mental health services for our nation’s heroes. There is no more worthy cause, and we thank Senator Tester for his continued effort to improve the quality of life for our veterans.” — Dr. Bob Bakko, Chair of the Public Policy & Legislation Committee, Montana Mental Health Counselors Association

“With one in every 10 Montanans having served our nation’s call to duty, Montana has the unique distinction of having a very high capita veteran population, but one that lives largely in rural or frontier areas. Serving these veterans is a priority but getting them critical care or information is a challenge due to their distance from a VA facility. Senator Tester’s proposal to establish a 24/7 Nurse Advice Line program with appointment and cancellation services would help provide each Montana veteran with the opportunity to speak with a registered nurse about any health concern or make an appointment. Appointment setting alone would eliminate a major source of frustration with veterans trying to seek services. This service would provide immediate care to those in an emergency or crisis and give veterans peace of mind for non-urgent needs. Having served around the clock for our nation, a nurse advice line would provide our veterans in need with a service they could access 24/7/365. Such an initiative has already proven successful for Defense Department beneficiaries, and it is time we pursued something similar on behalf of veterans.” — Patrick Bannister (Missoula), Vice President, Leidos, Inc, Responsible Corporate Officer, TRICARE Nurse Advice Line

SUPPORT FROM THE MEDICAL & VETERANS COMMUNITIES FOR THE DOCS FOR VETERANS ACT: 

“The Military Officers Association of America is grateful to Senator Jon Tester for his leadership in sponsoring the ‘Delivering Opportunities for Care and Services (DOCs) for Veterans Act, a bill that will help build a stronger pipeline of medical professionals within the Department of Veterans Affairs (VA), address impediments contributing to workforce shortages, help fill VA Health Administration (VHA) leadership vacancies impacting care and current reform efforts, and identify ways to leverage the workforce to improve access, care, and services to veterans.” — Vice Adm. Norb Ryan, US Navy (Ret.), President and CEO, Military Officers Association of America

“The VA needs to modernize its recruitment of health care professionals after a decade of war in order to meet the growing demands from an expanded veteran population, particularly with behavioral care, in rural areas where trained mental health care providers can be too hard to find. NGAUS strongly supports the proactive ” DOCS for Veterans Act “as a well targeted effort to recruit trained VA medical professionals in underserved rural areas with a needed focus on mental health care providers and marriage and family counselors. This would better address the alarming veteran suicide rate that currently stands at 22 per day. The VA simply needs to do much more to reach out geographically with trained staff to save the lives of our veterans.” — Col. Pete Duffy, US Army (Ret.), Legislative Director, National Guard Association of the U.S.

“The Blinded Veterans Association, the only congressionally chartered veterans service organization exclusively dedicated to serving the needs of our nation’s blinded veterans and their families for 70 years, fully supports “The Delivering Opportunities for Care and Services (DOCS) for Veterans Act.” With the recent problems over improving access to care, this comprehensive legislation will move VHA in the right direction of creating medical resident positions, improved telemedicine, including Licensed Professional Mental Health Counselors and Marriage and Family Therapists as participating professions for our nation’s veterans seeking mental health care, and establishing a VA Nurse Advice Line pilot program targeting rural veterans.” — Thomas Zampieri, Board Director, Blinded Veterans Association

“The Veteran Affairs Physician Assistant Association fully supports “The Delivering Opportunities for Care and Services (DOCs) for Veterans Act.” On many levels, this legislation will improve access and quality of care for veterans especially in the underserved and rural areas. Physician Assistants provide high quality and cost effective medical care, and are part of the solution in improving access to care for our veterans. This bill helps remove some of the challenges in recruiting and retaining PAs in the VA system. VAPAA greatly appreciates Senator Tester’s time, concern, and dedication to this matter and to serving our nation’s veterans.” — Rubina DaSilva PA-C, President, Veterans Affairs Physician Assistant Association

Tester’s DOCS for Veterans Act, which is cosponsored by Senators Claire McCaskill (D-Mo.), Tom Udall (D-N.M.) and Brian Schatz (D-Hawaii), is available online HERE. A summary of the bill’s provisions is available HERE.