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Hon. Jerry F. Costello, a Representative in Congress from the State of Illinois

Chairmen Mitchell and members of the Subcommittee on Oversight and Investigations, I would like to thank you for giving me the opportunity to be a part of this hearing addressing the issue of ensuring the quality of healthcare practices within the Veterans Health Administration (VHA). 

First, I want to give my condolences to the families affected by the tragedy at the Marion VA Medical Center, including the wife of Mr. Robert Shank III, Mrs. Katrina Shank, who is here today to testify. 

As the representative of the congressional district which includes Marion, Illinois, I know that much of the staff at the Medical Center does good work providing healthcare for Veterans.  For this reason I am all the more troubled that faulty leadership at the Medical Center and significant institutional problems have resulted in the tragic deaths of at least nine individuals in the past two years and in significant health problems for numerous others.  The system has failed these veterans, and their families, who have given a part of their lives to the service of this country.  While it is too late to help these veterans, we must make sure that these problems are corrected to restore the integrity of the VHA system.

The report addresses four major problems that were found at the facility:  quality management, the credentialing process, the privileging process, and a lack of leadership by senior staff.  In all of these cases there was a combination of exceedingly poor management in parts of the facility and a lack of sufficient, system wide rules ensuring checks on the quality of health care.  As such, both the Marion VAMC’s practices and VA Department rules relating to quality healthcare assurance need to be reviewed and strengthened accordingly.  In addition, while the credentialing of health care providers can be viewed as a problem of the health care system as a whole, there is much that the VHA can do to address this problem.

While I am pleased that the VA discovered and investigated the problems at the Marion VAMC, this must be the first step in reevaluating and reforming fundamental procedures in the VHA.  Representatives Shimkus, Mitchell, Whitfield and I have recently introduced legislation to address many of these issues.  The Veteran’s Health Care Quality Improvement Act would:

  1. require greater disclosure of a physician’s history of malpractice lawsuits and status of being licensed
  2. establish within the VA, as well as in each Veterans Integrated Services Network (VISN), a Quality Assurance Officer responsible for ensuring quality healthcare is provided
  3. require a complete review of VA policies and procedures which ensure quality care

While I will work to enact this legislation into law, it is seriously troubling that these controls were not already standard practice within the VHA.

As these investigations demonstrate, there clearly needs to be a substantial revamping of the credentialing and privileging processes, as well as other institutional changes within the VHA to assure quality healthcare.  I look forward to the panel’s testimony regarding their investigations.  I also hope to hear suggestions of how reliable controls can be implemented in our medical centers and outpatient clinics so that our Veterans receive the quality healthcare that their country owes them. 

Mr. Chairman, I again thank the Subcommittee for allowing me to participate today, and I look forward to the testimony of the witnesses.