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Sens. Moran, Tester, King, Collins and McCain Call on VA Secretary Gibson for Answers

Rural Veterans' Health Care Access Program in Danger of Cancelation

WASHINGTON, D.C. – U.S. Senator Jerry Moran (R-Kan.), a member of the Senate Veterans’ Affairs Committee, has asked acting Secretary of the Department of Veterans Affairs (VA) Sloan Gibson to explain why the VA is not being straightforward with Congress about the future of the Access Received Closer to Home (ARCH) program, which rural veterans rely on for access to timely, quality health care. While the VA continues to tell Members of Congress that no decision has been made about the future of the successful pilot program, which expires in September 2014, sources tell Sen. Moran that the national program director for ARCH directed the five pilot sites several months ago to begin contacting veterans who participate in ARCH to let them know the program would be ending. The letter to Sec. Gibson is cosigned by U.S. Senators Jon Tester (D-Mont.), Angus King (I-Maine), Susan Collins (R-Maine) and John McCain (R-Ariz.).

“For reasons we do not understand, the Veterans Health Administration (VHA) is choosing – at VHA’s own initiative – to end this successful program despite the more than 90 percent satisfaction rate communicated by veterans…” Sens. Moran, Tester, King, Collins and McCain wrote to Sec. Gibson. “All along, the VHA gave us the impression that they were waiting on analysis about the success of ARCH to inform their decision about extending the program – this is a misleading storyline at best. We are deeply disappointed by this breach of trust because those who suffer from this recklessness are veterans.”

Since 2011, the ARCH pilot program has been operating in five rural sites – Caribou, Maine; Farmville, Virginia; Pratt, Kansas; Flagstaff, Arizona; and Billings, Montana – offering rural veterans the opportunity to access health care services from community providers if they reside at least one hour from a VA medical center or Community Based Outpatient Clinic (CBOC). Veterans are overwhelmingly satisfied with this program and the medical services they are receiving, which falls directly in line with the VA’s recent statements that the Department is working to “accelerate access to care” for veterans across the country. It is becoming clear that VHA made plans months ago to dismantle the program, not seek extension of the contracts, and not offer access to services that veterans have come to appreciate and rely upon.   

The senators wrote, “Instead of continuing to work with patients and connecting them with providers in their local area, VA employees at these pilot sites were directed to report weekly to VHA regarding alternate plans to send veterans back to VA facilities. For example, an 82 year old veteran who relies on ARCH is concerned about his canceled services and the prospect of again having to drive 4 hours with his oxygen tank for monthly visits at a VA medical center. What is also troubling about this situation is that the VHA made an intentional decision not to inform Congress about their plans to discontinue and not extend this program.” 

This week the Senate approved the Veterans’ Access to Care through Choice, Accountability and Transparency Act of 2014 and on May 22, 2014, the Senate Appropriations Committee approved legislation directing the VA to continue providing medical care through ARCH in fiscal year 2015 using existing authorities. In light of these legislative actions, Sens. Moran, Tester, King, Collins and McCain call on Sec. Gibson to take control of VHA’s actions to dismantle ARCH and make certain that veterans who are currently receiving medical services through ARCH will continue to receive that care.

Please find the full text of the letter below:

The Honorable Sloan Gibson

Acting Secretary

Veterans Affairs Department

810 Vermont Ave, N. W.

Washington, D.C. 20420

Dear Secretary Gibson,

This week the Senate approved the Veterans’ Access to Care through Choice, Accountability and Transparency Act of 2014.  We hope that negotiations with the House will move quickly and that the president will soon sign a bill into law.  As a result, we expect that the Department of Veterans Affairs will soon provide veterans with the choice to access timely, quality health care from non-VA providers –a necessary choice because of the burden of travel and long wait-times that veterans experience across the country.

While the legislative process continues, we want to make certain that veterans who are currently receiving medical care through the Access Received Closer to Home (ARCH) Program do not experience a lapse in access to this care. You have the authority to extend contracted medical services under Title 38, Sec 1703 and we are seeking your immediate action to halt the Veterans Health Administration (VHA) in their efforts to discontinue the ARCH medical care services which currently benefit several thousand rural veterans in our states.

Since 2011, the ARCH pilot program has been operating in five rural sites – Caribou, Maine, Farmville, Virginia, Pratt, Kansas, Flagstaff, Arizona, and Billings and Anaconda, Montana – offering rural veterans the opportunity to access health care services from community providers if they reside at least one hour from a VA medical center or Community Based Outpatient Clinic (CBOC). Veterans are overwhelmingly satisfied with this program and the medical services they are receiving, which falls directly in line with your agency initiative to “accelerate access to care” for veterans across the country. Yet, we’ve come to learn that the VHA made plans months ago to dismantle the program, not seek extension of the contracts, and not offer access to services that veterans have come to appreciate and rely upon.   

On March 26, 2014, the VHA directed VA employees at the five pilot sites to begin contacting veterans who participate in ARCH to inform them that the program is ending. Instead of continuing to work with patients and connecting them with providers in their local area, VA employees at these pilot sites were directed to report weekly to VHA regarding alternate plans to send veterans back to VA facilities. What is also troubling about this situation is that the VHA made an intentional decision not to inform Congress about its plans to discontinue this program. 

During the Senate Veterans’ Affairs Committee hearing on March 12, 2014, then-Secretary Shinseki stated that he would share a report that detailed the operations of ARCH and recommendations on the future of the program with Members of the Committee. In fact, the Secretary stated the report would be on his desk “by sunset” in order to make certain that information was then provided to the Committee. Weeks passed and Secretary Shinseki did not provide the report or any insight regarding the future of ARCH. As such, staff requested a briefing and delivery of the report as promised by the Secretary, which resulted in a meeting on April 11, 2014, with the Office of Rural Health Director Gina Capra, along with other VHA officials who participated by conference call. Unfortunately, the VA yet again failed to deliver the report as anticipated or provide any insight as to a decision regarding the future of the ARCH program, which they indicated was still pending senior leadership review.

We now know that VHA did, in fact, make a decision and took steps in March to communicate to veterans they would be severing ties with their currently contracted non-VA providers. For reasons we do not understand, the VHA is choosing – at VHA’s own initiative - to end this successful program despite the over 90 percent satisfaction rate communicated by veterans in survey results and independently assessed by Altarum. All along, the VHA gave us the impression that it was waiting on analysis about the success of ARCH to inform its decision about extending the program. We are deeply disappointed by this breach of trust because those who suffer from this recklessness are veterans.

On May 22, 2014, the Senate Appropriations Committee approved legislation directing the VA to continue providing medical care through ARCH in Fiscal Year 2015 using existing authorities.  In light of this legislative action and the Senate passage of the Veterans’ Access to Care through Choice, Accountability and Transparency Act of 2014, we strongly urge you stop VHA’s plans to dismantle ARCH and make certain that veterans who are currently receiving medical services through ARCH will continue to receive that care.

We would appreciate a timely response within fourteen days. 

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