WASHINGTON — Today, U.S. Senator Tommy Tuberville (R-AL) grilled Under Secretary for Benefits at the Department of Veterans Affairs (VA) Joshua D. Jacobs and Under Secretary for Health at the VA Shereef M. Elnahal, M.D. about the $15 billion budget shortfall at the VA. The hearing came after Senator Tuberville sent a letter and penned an op-ed calling on Senate Veterans’ Affairs Committee (SVAC) Chairman Jon Tester (D-MT) to hold a hearing to evaluate the budget lapse and the extent to which mismanagement contributed to it.
Leading up to the hearing, Senator Tuberville also joined Senator Dan Sullivan (R-AK) in introducing the PRO Vets Act, which ensures transparency by requiring quarterly, in-person VA budget briefings to Congress about budgetary shortfalls.
Read excerpts from Senator Tuberville’s remarks during the hearing below or watch on Rumble and YouTube.
ON FINANCIAL TRANSPARENCY AT THE VA:
TUBERVILLE: “Thanks for being here today, both of you. Very important. You know, our VA, especially in my state, we have so many veterans […] we do it the right way. We give our [veterans] the best possible care, biggest healthcare system in the world. I get more complaints about this than probably anything that I do, but we just got to make sure our taxpayer dollars are spent in the right way. But we want to take care of our veterans. First of all: bonuses. Mr. Jacobs, are these for doctors or administrators, these bonuses?”
JACOBS: “The majority of the CSI payments that have been paid out by the department are going to frontline workers and that ranges from environmental technicians who are keeping the hospitals clean to HR staff. The CSI payments that were provided inappropriately were done to leadership in the central office.”
TUBERVILLE: “Is this merit-based or seniority?”
JACOBS: “So, the requirements under the law are that they are positions that are in high demand and short supply and the jobs that are relative to their specific position and critical skill.”
TUBERVILLE: “We talked about projections. How often are your projections internally verified? I mean, do you internally go back [and] have people checking? How often does that happen?”
JACOBS: “It’s several times a year. We work to update our projections. We have two teams, one in the office of field operations, one in our what we call the PII (Performance Analysis and Integrity) team that they run different models and they work against one another to verify the projections and to stress test it. We then do that again as we did most recently in June where we work to update the projections versus actuals based on the new real time data that we’ve identified.”
TUBERVILLE: “As much money as we’re talking about here, do we use any outside accounting or entities to go through these projections at all? Or is it just all in house?”
JACOBS: “I believe it’s in house. I’d have to double check and make sure that I’m not unaware of any additional outside review for the VBA process.”
ON THE BUDGET SHORTFALL:
TUBERVILLE: “Alright, Mr. Elnahal. […] I think my staff was briefed that we’re gonna have a $22.6 billion shortfall [in 2025]. Is that correct?”
ELNAHAL: “It’s about a $12 billion potential shortfall into fiscal year 2025 for medical care.” […]
ON GULF COAST VA HEALTHCARE SYSTEM:
TUBERVILLE: “Okay. Mr. Elenhal, since the PACT Act, the VA has announced that they have hired more personnel than ever before. And at the same time, community care referrals, especially in my state, have continued to go up. Healthcare providers in the Gulf Coast VA healthcare system have told me and my staff that they’re overwhelmed with patients, and they’re having to heavily lean on community care, which the VA claims is a leading cause of the VHA’s budget problem in the first place. How can we be confident in the VA’s long-term hiring strategy, given the increase in hiring should mean less community care. I mean, to me, that’s an oxymoron there.”
ELNAHAL: “Well, senator, we need this $12 billion to grow both direct care and community care. And we’re up 10% in established patient appointments, nearly 7% in new patient appointments. That’s right. So, we’re delivering more care in the direct care system center. At the same time, we’re also at about a 14.5% growth rate in the community care budget. So, the $12 billion will support growth in both accounts, direct care and community care for veterans and also help us pay for increasing costs for pharmaceuticals and prosthetics that veterans need.”
ON PRIORITIZING MENTAL HEALTHCARE:
TUBERVILLE: “And with this PACT Act we were hoping this would happen. People would come and take advantage of this. So, what is the VA’s plan to prioritize healthcare worker hirings, especially in mental health?”
ELNAHAL: “Well, senator, even during this fiscal year, which has been a tighter picture than […] recent years, we have told our medical centers to strategically hire, especially in mental health, but where veterans needed clinical care the most. And, so, as a result, we’ve actually grown by just over 2% this fiscal year, even though our original goal in terms of maintaining our all-time high veteran trust, quality and patient safety outcomes. We thought we could achieve that goal with level staff. But our medical centers did the right thing and hired anyway because that’s what they felt we needed and they’ve been delivering on it with more productivity and more care to veterans. So, the additional money will allow us to grow further by an additional five thousand employees to be able to meet even further needs.”
TUBERVILLE: “So, since the PACT Act the last two years, have we seen more people come for help with mental health?”
ELNAHAL: “Yes, senator, this mental health demand is significantly up—15% more new patient appointments in mental health this year than last year. And we also have increases in all categories of mental health, including telehealth episodes of care.”
TUBERVILLE: “I hope we’re looking at the new avenues of mental health, helping mental health. And there’s some things that hopefully we get in the next budget that we can help doctors with that are really helping PTSD. I know for a fact that they’ve helped in the VA and in Arkansas. A friend of mine runs the VA there and that’s really helped. So, it’s gonna cost money, which everything does, especially in healthcare, but thank you very much.”
Senator Tommy Tuberville represents Alabama in the United States Senate and is a member of the Senate Armed Services, Agriculture, Veterans’ Affairs, and HELP Committees.
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