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SUBJECT: Rural Access: Is VA Meeting All Veterans Where They Live?
DATE: January 11, 2024
OVERVIEW: The Committee on Veterans Affairs convened to discuss the effectiveness of the Department in meeting the healthcare and benefit needs of rural veterans. Testimonies highlighted the challenges veterans face in rural areas, including long travel distances, lack of broadband for telehealth, and insufficient access to specialized care. The hearing examined the impact of programs like the Mission Act and Veterans Community Care Program, while also exploring innovative solutions to improve rural healthcare delivery.
HEARING RECORDING LINK: https://www.congress.gov/event/118th-congress/house-event/116705
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Witnesses
- The Honorable Shereef Elnahal, Under Secretary for Health, Veterans Health Administration, VA
- The Honorable Joshua Jacobs, Under Secretary for Benefits, Veterans Benefits Administration, VA
- Ms. Alyssa Hundrup, Director, Health Care, U.S. Government Accountability Office (GAO)
- Mr. Jon Lovald, Chief Operating Officer, Minnesota Assistance Council for Veterans
- Dr. Buu Nygren, President, Navajo Nation
Key Themes & Highlights
- Republican Concerns:
- Limited Accessibility: Highlighted that rural veterans often travel long distances for basic healthcare services, exacerbated by insufficient infrastructure and connectivity.
- Inefficient Spending:: Criticized the $311 million spent on rural veteran programs without clear evidence of significant improvements in access or outcomes.
- Over-reliance on Telehealth: Questioned the emphasis on telehealth when many rural veterans lack reliable broadband access.
- Democratic Concerns:
- Healthcare Workforce Shortages: Urged greater investments in recruiting and retaining healthcare providers in rural areas, particularly in mental health and specialty care.
- Support for Community Partnerships: Advocated for stronger partnerships with local providers and Indian Health Services to address service gaps in remote communities.
- Equity in Care Delivery: Emphasized the importance of meeting the unique needs of women, Native American, and elderly veterans in rural settings.
- Witness Testimonies:
- Shereef Elnahal: Detailed initiatives to improve rural healthcare, including telehealth expansions, mobile medical units, and targeted outreach campaigns. Highlighted efforts to exempt Native American veterans from copayments under the Isakson-Rowe Act.
- Joshua Jacobs: Shared examples of successful outreach efforts, including 13,000 events in FY 2023 that connected rural veterans with VA services. Discussed challenges in delivering benefits efficiently to remote areas.
- Ms. Alyssa Hundrup: Addressed findings from the GAO's report on the VA Office of Rural Health, recommending improvements in communication and measurable performance goals.
- Dr. Buu Nygren: Described challenges faced by Native American veterans in the Navajo Nation, including vast distances to healthcare facilities and limited telehealth capabilities.
- Mr. Jon Lovald: Highlighted housing instability and its impact on rural veterans' ability to access healthcare and maintain employment.
- Contentious Points:
- Republicans: Criticized delays in implementing effective solutions for rural veterans, questioning the VA's allocation of funds and reliance on telehealth as a primary solution.
- Democrats: Advocated for a balanced approach that includes both technology-driven and in-person solutions, emphasizing the need for systemic investments in infrastructure.
- Key Discussions:
- Mission Act and Community Care: Examined the success and limitations of the Mission Act in expanding rural healthcare access.
- Workforce Challenges: Discussed barriers to recruiting and retaining healthcare professionals in rural areas and potential solutions like loan repayment incentives.
- Infrastructure Investments: Explored the need for expanding broadband access and building additional VA facilities in remote regions.
In-Depth Notes
- Chairman Mike Bost (R-IL) criticized VA spending inefficiencies and called for actionable solutions to meet rural veterans' needs where they live.
- Ranking Member Mark Takano (D-CA) highlighted the importance of leveraging partnerships with tribal health programs and addressing systemic gaps in rural healthcare.
- Dr. Shereef Elnahal defended the effectiveness of programs like National Teleoncology and the Rural Recruitment and Hiring Plan.
- Dr. Buu Nygren called for better coordination between the VA and tribal health systems to deliver culturally competent care.