WASHINGTON, D.C. - Yesterday U.S. Senator Daniel K. Akaka (D-HI), Chairman of the Committee on Veterans' Affairs, introduced S. 2969, the proposed Veterans' Medical Personnel Recruitment and Retention Act of 2008, to address staffing issues in VA. The legislation would give VA additional tools to attract and retain health care providers as VA faces a wave of retirements.
"VA cannot provide quality health care if it cannot recruit and retain a qualified health care workforce. This legislation will help VA to compete for the best health care providers in the Nation," said Akaka. "I am confident that with the solutions proposed by this legislation, VA will have the staff to provide top quality health care to veterans."
S. 2969 addresses a wide range of medical personnel issues and professions. The legislation is a direct result of the Committee's ongoing oversight, especially a hearing Akaka chaired on April 9, 2008, on making VA the workplace of choice for health care providers.
S .2969 would clarify the law governing VA's locality pay system and overtime pay systems to make them more equitable and easier to implement. It would also increase educational benefits for VA employees, both new hires and career employees, so as to improve recruitment and retention and encourage professional development.
Other highlights of the bill include:
Additional locality and comparability pay for nurses, doctors, dentists, senior executives, and pharmacist executives
Removal of annuity and salary offsets for retired employees who choose to return to work at VA
Clarification of laws on alternative work schedules for nurses to facilitate broader implementation
Removal of barriers to hiring part-time nurses
Additional tools to help facilities avoid using expensive contract staffing unnecessarily
The text of Chairman Akaka's introductory statement is below:
Today I am introducing legislation to address personnel issues in the Department of Veterans Affairs. This legislation, proposed Veterans' Medical Personnel Recruitment and Retention Act of 2008, would help ensure that VA has the workforce necessary to serve America's veterans most effectively.
Health care providers are the backbone of the VA system. Yet today, the Department faces a shortage of these professionals. Around the country, too many facilities are understaffed, at the cost of services for veterans. A recent report by the Partnership for Public Service gave the Veterans Health Administration poor marks for pay and benefits, and for family support. VHA also rated poorly among younger employees. To be the health care employer of choice, VA must be able to offer competitive salaries, work schedules, and benefits.
As Chairman of the Committee on Veterans' Affairs, I held a hearing on April 9, 2008, that focused on personnel issues within the VA health care system. We heard detailed testimony from VA administrators and health care providers. Their testimony outlined the challenges VA faces, and suggested possible solutions.
This legislation would benefit a wide range of positions within VA. Here are some of the challenges VA faces, and the solutions I propose.
Local labor markets for health care providers vary widely, and VA must be better prepared to compete in every market. Locality pay surveys are a crucial tool in this effort. However, a recent GAO report on nurse anesthetists revealed a locality pay system that is inconsistent and often dysfunctional. The bill I am introducing would make implementation of locality pay surveys more effective by requiring additional training on proper implementation, and improving transparency to allow for better oversight.
This legislation would also encourage retention of experienced professionals by removing salary offsets for retired employees who choose to return to work at VA. In the coming years, a significant portion of the VA workforce will reach the age of retirement. Eliminating the salary offset by the amount of an employee's retirement annuity would encourage these experienced professionals to return to VA.
Education benefits are often among the chief advantages of employment at VA, and I believe these benefits can be used for an even greater effect. VA has extensive programs to encourage further education within their workforce, and to provide financial assistance for employees with educational debt. This legislation would increase yearly benefit limits on the Education Debt Reduction Program--EDRP--and would broaden the goals of that program to include retention as well as recruitment. In so doing, the EDRP would be made available to both long-time VA employees and new hires. It would also reauthorize the Health Professionals Scholarship Program, and would broaden eligibility to a wider range of health professions.
Further, to make VA more attractive to clinical researchers, this legislation would provide VA with authorities similar to the Loan Repayment Program of the National Health Service Corps. VA would be authorized to use funds from medical services appropriations to help researchers in need of financial assistance to payoff their education loans. This program would compliment EDRP, which is not available to researchers.
In recent years, VA has been challenged to retain top administrators, especially those who have spent their careers at VA. Their expert knowledge is indispensable to the effective management of the VA health care system. However, given the high rates of compensation available outside of VA, retention of these professionals is often difficult. This legislation would provide VA with the authority to pay national administrators additional compensation so as to better compete with the private sector. It would also give VA the authority to increase, under limited circumstances, compensation for pharmacists, doctors, and dentists, in order for VA to be more competitive in local labor markets.
VA faces many challenges in recruiting and retaining nurses. I have worked with VA administrators and nurses to develop solutions to these challenges. This legislation would give VA more tools to attract and keep these employees.
Alternative work schedules are now commonly available in other health care systems. At VA, part-time and alternative work schedules are under-utilized, and as a result, VA loses prospective hires and damages employee morale. This legislation would clarify alternative work schedule and weekend duty rules. By making these schedules easier to implement, it is my hope that VA will expand their use.
This bill would also make it easier for VA to hire and retain part-time nurses by limiting probationary periods and expanding eligibility for overtime pay. For nurses who transition from full-time to part-time, this legislation would eliminate the probationary period they are now required to serve. This provision would be extremely helpful in encouraging experienced nurses to extend their careers at VA beyond the customary age of retirement.
In many locations, VA cannot compete with other health care systems for many nursing positions, particularly certified registered nurse anesthetists--CRNAs--and licensed practical and vocational nurses. A recent GAO report on CRNAs in VA noted that VA spends thousands of dollars on contract nurses to cover staffing gaps. The use of contract nurses, while appropriate in some situations, is not a permanent solution to the long-term staffing shortfall. The bill I am introducing would raise or eliminate pay caps currently placed on these difficult-to-fill positions. These provisions are derived directly from testimony the Committee heard from VA nurses and administrators at the April 9, 2008, hearing.
This legislation would also clarify rules about emergency duty for VA nurses. The use of emergency mandatory overtime has been an issue in many VA facilities, and in other health care systems. I believe this legislation provides a reasonable solution. By standardizing the definition of ``emergency,'' it would facilitate more consistent and equitable use of emergency mandatory overtime.
I believe that this legislation will give VA the tools it needs to recruit and retain the best health care professionals in the Nation. I also anticipate that it will improve employee morale, as well as improving transparency and oversight. As we have heard many times, VA faces a looming retirement crisis. The solutions proposed in this legislation seek to address these challenges.
I urge my colleagues to support the proposed Veterans' Medical Personnel Recruitment and Retention Act of 2008.