11th Congress, second session: Reinstate Capacity Reporting Mandate for Specialized Systems of Care
The Department of Veterans Affairs has not maintained its capacity to provide for the unique health care needs of severely disabled veterans—veterans with spinal cord injury/disorder, blindness, amputations and mental illness—as mandated by P.L. 104-262, the “Veterans’ Health Care Eligibility Reform Act of 1996.” This law requires VA to maintain its capacity to provide for the special treatment and rehabilitative needs of catastrophically disabled veterans.
As a result of P.L. 104-262, the VA developed policy that required the baseline of capacity for SCI/D centers to be measured by the number of staffed beds and the number of full-time equivalent employees assigned to provide care. The VA was also required to provide Congress with an annual “capacity” reporting requirement to be reviewed by the Office of the Inspector General. Unfortunately, this reporting requirement expired in 2004.
Currently, within the Spinal Cord Injury/Disorder (SCI/D) System of Care, the VA is not meeting capacity requirements for staffing and the number of inpatient beds that must be available for SCI/D veterans. Reductions of both inpatient beds and staff in VA’s acute and extended care settings have been continuously reported throughout the SCI/D system of care. VA has eliminated staffing positions that are necessary for SCI/D centers or clinics to maintain its mandated capacity to provide care, or the facilities are operating with vacant health care positions for prolonged periods of time. When this occurs veterans’ access to VA care decreases, remaining staff becomes overwhelmed with increased responsibilities, and the overall quality of health care is compromised.
The VA’s capacity to provide health care through its specialized health systems is based on disabled veterans having access to quality care in VA rehabilitation programs. To provide such care, as a component of workforce planning, the VA tracks the status of vacant and staffed health care positions throughout the Veterans Health Administration, as well as the number of veterans utilizing health care within the specialized systems of care. With this information readily available, the VA would be able to use and compile the collected data for annual reports and assess its ability to meet the capacity mandate.
Paralyzed Veterans of America recommends that Congress reinstate the aforementioned reporting requirement for VA specialized services to complete an annual capacity report without a specific end date to prevent future expiration of the mandate. This requirement will make certain that catastrophically disabled veterans’ access to care is not decreased due to the VA’s failure to meet mandated capacity requirements, and hold VA accountable for having the requisite number of available inpatient beds for veterans, as well as required levels of staff to deliver quality care.