Committee Skeptical of Extra VA Funding, Citing Ballooning Staff Size

Members of the House Veterans’ Affairs Committee expressed reluctance today to approve a $17.6 billion Veterans Affairs supplemental funding request for additional clinical staff and expanded facilities, in part, because the size of the Veterans Health Administration’s central office staff jumped more than tenfold from the mid-1990s to 2012.

Acting VA Secretary Sloan Gibson testified before the committee the extra funding he requested last week will go a long way toward resolving resource issues that have left veterans seeking care stuck in wait-list limbo.

An article published today in the New England Journal of Medicine, written by Dr. Ken Kizer who served as VA undersecretary for health in the 1990s, and Dr. Ashish K. Jha, who works in the Boston VA hospital, reported, “Inadequate numbers of primary care providers, aged facilities, overly complicated scheduling processes, and other difficult challenges have thwarted the VA's efforts to meet soaring demand for services.”

But Rep. Jeff Miller, R-Fla., chairman of the committee, said he would not buy in to the administration's budget request based on that same article. The size of the central VHA office, which oversees “nearly every aspect of care delivery,” has “grown markedly — from about 800 in the late 1990s to nearly 11,000 in 2012," the article reported. 

Miller, in his opening statement, said oversight hearings this summer showed VA “has clearly lost sight of its mission and that extra funding requested in the past didn’t go to improving patient care “but toward ancillary pet projects and an ever-growing bureaucracy.” 

The 9,200-person increase in VHA central office staffers since the 1990s illustrates “VA’s shift of focus to building bureaucracy as opposed to fulfilling its duty of providing quality patient care,” Miller added. “VA needs to return to what it was intended to be, a patient-centered-care agency for our veterans.”

Gibson told the committee VA needs the extra funds to hire additional primary-care physicians to help whittle down patient wait times as well as to beef up its staff of mental health care providers. Rep. Phil Roe, R-Tenn, who said he has fully backed every VA budget request while serving on the committee, said he viewed the $17.6 billion extra funding request as “mind boggling” based on the reported growth in the VHA central office staff.

VA, Roe told Gibson, “needs to get better before it get even bigger.”