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Chairman Bost Continues Fight for Veterans with Spinal Cord Injuries and Disorders

Today, House Committee on Veterans’ Affairs Chairman Mike Bost (R-Ill.), released the following letter he sent to Department of Veterans Affairs (VA) Secretary Denis McDonough to express his disappointment in the Department’s failure to fully participate in the Committee’s recent oversight hearing on VA healthcare and benefits needs for veterans living with from spinal cord injuries and disorders (SCI/D).

“At the hearing it was revealed that VA’s SCI/D units are chronically understaffed. Regardless of whether the provider vacancy rate is 9%, as VA testified, or 30%, as PVA testified, VA Medical Centers’ (VAMC) are allegedly pulling providers off the SCI/D units to fill staffing vacancies in other departments,” Chairman Bost wrote in his letter. “That is unacceptable.”

There are currently over 20,000 veterans living with SCI/D who have unique needs and receive care at VA at extremely high rates. Yet, the Committee’s June 13th oversight hearing revealed that VA’s SCI/D units face chronic understaffing of the specialized providers who are equipped to meet the care needs of this group of veterans. VA’s failure to provide a witness that was knowledgeable of the SCI/D system hindered the Committee in its ability to get a full understanding of the scope of these staffing shortages and the steps that VA is taking to fix this disservice to our disabled veterans.

Full text of the letter Chairman Bost sent and questions to the Secretary can be found here and below:

Dear Secretary McDonough:

The Department of Veterans Affairs (VA) is responsible for ensuring quality care for spinal cord injury and disorder (SCI/D) veterans. According to VA’s SCI/D Registry, there are currently 22,721 living SCI/D veterans, 97% of these veterans received VA care in the past 12 months. This high percentage is a testament to the significant level of responsibility VA has in caring for SCI/D veterans.

For this reason, I was honored to recently hold an oversight hearing on VA’s care for SCI/D veterans to ensure that VA is meeting this community of veterans’ needs. I am incredibly disappointed, however, that you did not send a witness to our recent hearing from the SCI/D System of Care despite my explicit request to do so. This is the third time the department has substituted its judgement for mine and not fulfilled my requests for witnesses. I am disappointed, yet not surprised, that VA’s witness’ lack of specific knowledge regarding SCI/D programs, has necessitated this letter and the enclosed questions.

Given the Paralyzed Veterans of America’s (PVA) and I AM ALS’s fulsome participation, the hearing proved that SCI/D veterans have unique needs that require care which can only be provided by specially trained providers. Yet, at the hearing it was revealed that VA’s SCI/D units are chronically understaffed. Regardless of whether the provider vacancy rate is 9%, as VA testified, or 30%, as PVA testified, VA Medical Centers’ (VAMC) are allegedly pulling providers off the SCI/D units to fill staffing vacancies in other departments. That is unacceptable.

Your staff have told me that your VAMCs have the appropriate number of staff necessary to provide care to veterans. If this is true, it seems misguided that specialized, irreplaceable staff are being pulled away from SCI/D patients to fill gaps that VA Central Office (VACO) believes don’t exist.
In addition to staffing, VA needs to look at other ways to reduce burdens on its facilities. Home and community-based services provide opportunities for SCI/D veterans to receive care where they live instead of in a facility. This is why I believe that the passage of H.R. 8371, the Senator Elizabeth Dole 21st Century Healthcare and Benefits Improvement Act is critical. This bipartisan bill would provide VA with the authority needed to provide home and community-based services as well as give caregivers access to the necessary support they need to take care of their veteran.

Please provide, no later than Monday, July 22, 2024, answers to the enclosed questions, including copies of all responsive documents. When producing documents, please do not alter them in any way, including but not limited to the application of redactions or a watermark. Additionally, digital copies should be provided in a format enabling their printing and copying by the House Committee on Veterans’ Affairs. Thank you for your attention to this issue. Please do not hesitate to have your staff contact my staff with questions.



Cc: The Honorable Mark Takano, Ranking Member

Enclosure: Supplemental SCI/D Questions

Supplemental SCI/D Questions for VA

1. During FY23 and FY24 how many missed medical appointments for SCI/D veterans are the result of VA transportation issues?
a. What is the cost to VA of these missed appointments?
2. Does VA include nursing staff in the 9% vacancy rate for clinical staff in the SCI/D System?
a. If not, what is the vacancy rate for nurses in the SCI/D System?
b. Are the number of VA providers in SCI/D centers and units in compliance with VHA Directive 1176?
3. Are VA providers screening all SCI/D veterans for mobility intervention and walking aid eligibility?
4. How does VA account for the 13-bed shortage in operational long-term care SCI/D beds (a discrepancy highlighted by VHA Directive 1176 and data provided by VA)?
5. What is VA’s budget in FY24 for the Highly Rural Transportation Grant Program?
a. How many veterans use this program?
6. How are the tier qualifications determined for VA’s Program of Comprehensive Assistance for Family Caregivers?
7. Are all of VA’s mobile medical units wheelchair accessible?
8. What oversight and specialized training does Medical Disability Examination Office (MDEO) do to ensure that contracted examiners are competent to perform disability compensation examinations on veterans with complex spinal cord injuries and disorders, and to ensure that contracted examiners do not cause injury during the examination?
9. When a contracted exam facility is exempt from ADA and OSHA requirements under law, what does MDEO do to ensure that contracted exam vendors provide paralyzed and catastrophically disabled veterans accessible disability compensation facilities?
10. Provide a detailed explanation for how MDEO ensures that contract exam vendors identify veterans who require accessible facilities and schedule them accordingly?
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