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Dallas Morning News: Community clinics are a lifeline for veterans, but bureaucratic missteps remain


Five years after the passage of the MISSION Act, community programs now account for 33% of the VA’s health care demand.


The 2018 MISSION Act was a huge win for the veteran community. The bipartisan effort improved accessibility by streamlining the congealed process that had existed before it through the CHOICE Act. Congress’ intent with MISSION was clear: Increase access to private doctors when the Veterans Health Administration couldn’t provide care in a reasonable time and/or distance.


A veteran’s mental, emotional and physical health should be the Department of Veterans Affairs’ top priority. For the millions of veterans enrolled in the VA, bureaucratic overreach, data disparities and systemic faults have impacted their health and well-being. In the milder cases, this results in manipulated and canceled appointments. At their worst, these issues have resulted in death.


Veterans in rural regions still face lengthy average wait times of 33 to 35 days to see a doctor or mental health specialist. Five years since the passage of the MISSION Act, the reasons for these issues do not include money or authority. MISSION gave VA providers the ability to refer veterans to community health care providers, and Congress has given the VA ample funding.


It’s estimated that the community care program now accounts for 33% of the VA’s total health care demand. But instead of asking why the department is meeting so many of the six required reasons to refer someone to a community provider, or why veterans may simply prefer community providers, last year Secretary Denis McDonough suggested changing the access standards to limit those who use the program to keep more veterans in the VA system, a move that directly contradicts the intention of the MISSION Act to expand access to care.


Congress must hold the VA accountable for bureaucratic missteps in MISSION Act implementation. As the VA is the largest health care system in the country and the second-largest federal agency behind the Department of Defense, it’s understandable why officials have to make some decisions with respect to workforce recruitment and retention, but Congress must ensure the agency’s approach to health care keeps the veteran’s interest first.


As it stands, gaps in the community care program have resulted in cases of misdiagnosis; cutting lifesaving mental health treatments, significantly decreasing veterans’ quality of life; leaving veteran health care decisions with VA officials, not the health care provider; and having medical care removed altogether without reason despite serious health conditions. The MISSION Act’s intention was to increase the standard of care for veterans, but it is clear that significant work must still be done to achieve this.


In the years since Congress passed the MISSION Act, several supplementary bills have been introduced by members of Congress to try to close existing loopholes and establish expanded avenues for veterans to access community care. The Veterans’ Health Empowerment, Access, Leadership, and Transparency for our Heroes Act and the Protecting Veteran Community Care Act are a few examples of ways Congress could expand and protect community care for veterans.


These bills seek to preserve and expand veterans’ ability to make their own health care choices, based on their best medical interest.


Over the past few decades, and particularly since 2018, Congress has invested hundreds of billions of dollars on veteran health care. They must hold the VA accountable if the agency does not meet their intent. The MISSION Act’s bipartisan push to better the health care outcomes for veterans was a step in the right direction. Still, more work must be done to ensure the act delivers to veterans as intended.


Congress must keep veterans at the center of veteran health care.


Cole Lyle is executive director of Mission Roll Call, a nonpartisan organization with over 1 million veteran members that advocates for veteran interests before Congress, focusing primarily on veteran suicide rates, increased accessibility to health care for veterans and the unique needs of veterans in tribal and rural communities. He wrote this column for The Dallas Morning News.

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