• Wed. May 25th, 2022

Health Administration

Come One, Come All To Health Administration

Omnibus spending bill sets higher maximum salaries for some VA health care workers

Registered nurses and physicians assistants working at the Veterans Affairs Department will soon have a higher maximum salary, as part of an effort in Congress to reduce record turnover among the VA’s health care workforce.

Congress passed the RAISE Act as part of the $1.5 trillion omnibus spending bill for fiscal 2022.

The bill, introduced Rep. Lauren Underwood (D-Ill.), will allow advanced practice registered nurses and physician assistants at the VA to make up to $226,300 annually, while other registered nurses would make up $203,700. Those positions are currently capped at $176,300 a year.

VA Secretary Denis McDonough has repeatedly urged lawmakers to pass the RAISE Act, and said the legislation would go a long way toward helping the agency recruit and retain in-demand health care workers.

The VA is dealing with the highest rate of turnover among its nurses in 15 years.

McDonough said Thursday that the agency, in response, has made the VA workforce its “number-one legislative priority.”

The legislation is part of a 10-point human infrastructure plan the VA released last month.

Congress, as part of the omnibus, also seeks regular updates on the state of VA’s health care workforce, as well as progress reports on the rollout of its Electronic Health Record (EHR).

Congress seeks updates on the state of VA’s workforce

The omnibus directs the Veterans Health Administration with providing the House and Senate appropriations committees with annual reports detailing staffing shortages — including staffing needs for women’s health and employee shortages in rural and remote areas — as well plans the agency has to address these workforce issues.

Lawmakers, however, note the Veterans Health Administration has “made great strides” in dramatically shortening the hiring time for employees, and directs the Office of Personnel Management, as part of its own briefings to Congress, to highlight process reforms used by VHA and other agencies during the pandemic to reduce delays in the federal hiring process.

The spending bill gives $112 billion in discretionary spending to VA, an increase of $7.8 billion above enacted levels.

Omnibus expands telehealth, seeks EHR updates

The omnibus also gives the VA more than $2.4 billion to sustain and increase telehealth capacity, “including in rural, highly rural and underserved communities.”

Meanwhile, the omnibus will expand its telework services to include more mental health and rehabilitation services, and to give lawmakers an update on these efforts within 120 days.

The VA would receive $2.5 billion to continue implementation of the VA Electronic Health Record Modernization initiative, $127 million below the 2021 enacted level.

The omnibus makes 25% of the EHR funds contingent on McDonough providing a plan “with benchmarks and measurable metrics” for deployment, as well as a plan for addressing all required infrastructure upgrades this summer.

Lawmakers specify that the $2.5 billion set aside for the EHR rollout is the “sole source of funding” the VA may use.

“While the committees remain supportive of the EHRM initiative and the secretary’s comprehensive strategic review, as with any acquisition of this size and magnitude, there continue to be implementation concerns,” lawmakers wrote in an explanatory statement. “The funding level and contingency requirement recognize the implementation delays and challenges to date, as well as the need to communicate a clear plan to address infrastructure needs, deploy the new system, monitor progress and demonstrate success.”

Lawmakers also expect continued quarterly briefings from VA on EHR progress, as well as quarterly reports on the topic from the Government Accountability Office.

The VA in January announced it would push back the second rollout of its EHR system because of a shortage of employees available for training amid an uptick in COVID-19 cases.

The VA is delaying the EHR go-live date at its medical care facility in Columbus, Ohio, to April 30. The agency last month expected the system would go live at that facility on March 5.


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