WASHINGTON — House and Senate negotiators announced an agreement Monday on legislation that would allocate about $17 billion to overhaul the Department of Veterans Affairs’ sprawling and beleaguered health care system. But the deal does not give the department everything that officials there have said is needed to fix its problems.
The agreement set off a frantic rush on Capitol Hill to gather signatures from members of the conference committee working on the bill so that it could be put to a vote of the full House and Senate before lawmakers adjourn for an August recess on Friday.
If approved, the legislation would end a sometimes rancorous standoff over how much to spend to begin to fix the department, and it would help ensure that veterans who face long waits to see doctors at the department’s facilities could get appointments more quickly with private physicians. A few details were still being worked out even after the chairmen of the House and Senate Veterans Affairs Committees announced the agreement Monday at an afternoon news conference.
The most expensive part of the three-year measure would provide $10 billion for certain patients — who either live more than 40 miles from a department site or face a wait of more than 30 days for an appointment — to receive government-paid care from a private doctor. The private care would still largely be coordinated by the Department of Veterans Affairs, which in most cases would be involved in the scheduling and retain a copy of medical records from the visit, according to a person briefed on the provision.
In addition, most of a separate $5 billion allocation would pay for additional doctors and nurses to drive down patient wait times, although it is unclear how many clinicians the department could hire quickly when there is a shortage of medical care providers in many parts of the country. An additional $1.5 billion or so would be spent to secure leases at 27 major facilities to give the department more space for clinicians to treat patients.
The acting Veterans Affairs secretary, Sloan D. Gibson, has said the department requires almost $18 billion for overhauls, mostly for new clinicians and building space, just to meet current demand. Department officials did not respond to questions about whether they would go back to Congress to seek the rest of the money for doctors and office space that Gibson said was needed. The person briefed on specifics of the deal, who was not authorized to speak publicly and spoke on the condition of anonymity, said it did not include money to upgrade the department’s outdated scheduling system, as had been expected and which Gibson had suggested was crucial.
The measure would also authorize the department’s secretary to fire senior executives deemed incompetent or to have committed misconduct, subject to a 21-day appeal.
The proposed legislation is in response to a scandal at the department this past spring, when many facilities were found to have been manipulating patient waiting lists to disguise long delays caused in part by shortages of doctors and nurses.
Pressure for patients to be seen within 14 days — a goal tied to many administrators’ performance reviews and bonuses — played a significant role in deceptions about wait times, officials later suggested. The delays and doctored waiting lists became a political liability for the Obama administration and led to the resignation of the secretary of Veterans Affairs, Eric Shinseki, in May.
All attention now turns to whether Congress can pass the bill before the August break — and whether some lawmakers, including Republicans concerned about the price tag, will balk.
Rep. Jeff Miller, R-Fla., who is chairman of the House Veterans Affairs Committee, said he was confident that he could win Republican support for the bill despite the cost.
“There will be an education process that will have to take place,’’ Miller said at the news conference announcing the deal. “Obviously, some of our members will need a little more educating than others.’’
His counterpart in the Senate, Bernard Sanders, a Vermont independent, likened the spending to important national security funding.
“Planes and tanks and guns are a cost of war,’’ Sanders said. “So is taking care of the men and women who use those weapons and fight our battles.’’
Garry Augustine, the Washington executive director of Disabled American Veterans, one of the largest groups of former military service members, said that the $5 billion portion of the bill allocated mainly for doctors and other clinicians was a good start, but that more would be needed.
“We like to look at it as a down payment’’ on Gibson’s request to fully fund the department, Augustine said. He said that he would wait to see how the $10 billion for private care would work in practice, and that it was important that the department keep a close connection to veterans who visit private doctors.