A sweeping omnibus package aimed at overhauling the Veterans Affairs Department is gaining ground on Capitol Hill.

Sens. Johnny Isakson (R-Ga.) and Richard Blumenthal (D-Conn.) introduced the Veterans First Act on Aprils 28. The bill will create a “new VA” through a “very important and very effective and very direct piece of legislation,” Isakson  said.

“This is a little bit like fixing the plane while you’re flying it,” Blumenthal said during a press conference at the Capitol. “This system can be and must be improved, and this measure will help advance its efficiency and its fairness. That’s the real lesson here. We are learning from experience, we are learning from the problems that have arisen in the existing system and we’re making it better. And there may well be a need to make it better still. This may not be the last word, but the point is we have to go forward and make sure that there is strict accountability, not just in the rules but in the culture.”

The VA has maintained a place in headlines and the national spotlight for issues related from accountability of senior executives to patient wait times to whistleblower investigations.

According to the Senate Committee on Veterans’ Affairs, there is about $4 billion in spending and roughly the same amount in offsets for the bill. Isakson, who is the chairman of the committee, said he did not have a topline number immediately available, but paying for the bill would come from a combination “of the legislation itself, as well as some other things that aren’t as expensive as we once thought they were, rolled together to see to it that we can get them paid for, as well as some creative work that the ranking member [Blumenthal] and I have done to do that.”

A giant step forward

The Veterans First Act comes less than two years after the Veterans Access, Choice and Accountability (or Choice) Act, and senators backing the new bill acknowledged that the omnibus would address the beleaguered law.

“The Choice Act has been rolled out; a rocky roll out,” said Sen. Jon Tester (D-Mont.). “It hasn’t worked very well quite frankly, and I’m being generous. This bill is going to take a giant step forward to help to fix the Choice Act. It’s going to make the VA work better for our veterans. It’s going to be much more user-friendly for those veterans who have care outside the VA.”

In March, VA Secretary Bob McDonald told a Senate subcommittee the Veterans Choice Program — part of the overarching Choice Act — needed an overhaul. The Choice Program lets veterans seek medical care outside the VA when certain conditions are met.

“We have to modernize and clarify VA’s purchase care authorities to preserve veterans’ access to timely community care everywhere in the country,” he said. “We need to return to all the things we had before Choice. It was well-intended. But it was non-choice. It created a single entry point called a third-party administrator where you handed the veteran a phone number. I know that doesn’t work.”

The bill also would designate the VA under the Choice Program to be the primary payer for conditions not related to service.

Sen. Mike Rounds (R-S.D.) said the provision puts the responsibility “back on the VA where it should have been all along.”

“This fixes an issue that was affecting veterans across the nation by forcing them to pay unnecessary deductibles, which in some cases was thousands of dollars for their care, when they used the private sector,” he said.

Making the system ‘better and fairer’

Another area addressed within the Veterans First Act is senior executive disciplinary actions.

Late last year the demotions of two senior executives involved in a relocation program within VA led to a months-long cycle of disciplinary actions, appeals and eventual reinstatements. The case was a catalyst for reconsidering how the agency can hire and fire its senior executives.

“That would never happen again under this bill for senior executive management,” Isakson said, adding the bill would require “full due process, but full accountability, to see to it that somebody who doesn’t do right by our veterans or is not carrying out the intent of their job, is held accountable including to the extent of their job if that’s what it takes.”

Currently, all senior leaders have a right to appeal disciplinary actions to the Merit Systems Protection Board. But under the Veterans First Act, the VA Secretary would have the final word for health care and medical center executives.

“This is one of the central goals to improve the rules and standards compatible due process, so as to shorten some of the times, provide clarity and specificity, so as to eliminate some of the grounds for appeal,” Blumenthal said. “Enforcement is key here and a system that is riddled with vagueness and lengthy times can’t be enforced expeditiously. This bill remedies some of those kinds of lapses or problems in the current system to make it work better and fairer.”

No fear for whistleblowers

Recently, the Office of Special Counsel found major flaws with the Veterans Affairs Inspector General’s investigations of three separate cases of whistleblower allegations.

The Veterans First Act would create an Office of Accountability and Whistleblower Protection, which would be led by a presidentially appointed director.

The director’s job would be to work with OSC as well as the VA Inspector General on whistleblower cases, as well as provide annual reports to Congress on the office’s activities.

The bill also would require biannual training for every VA employee on whistleblower disclosures and protections.

“The vast majority of VA working men and women come to their jobs, do them well, care for veterans — in fact many of them are veterans themselves — and some of them become whistleblowers,” Blumenthal said. “This measure assures that every veteran who works for the VA, every member of the VA staff, everyone who works on behalf of veterans, is treated fairly and that they can report issues of wrongdoing without any fear of retaliation or revenge.”

Looking ahead

Isakson said the new legislative package is a sign that “we’re perfecting the process to see to it that what they promised in 2014 is now the reality in 2016.”

Included within the nearly 400-page legislation is:

• A requirement that VA launch a pilot program for benefits appeals.
• The expansion of the VA’s definition of homeless to include those fleeing a residence due to domestic violence.
• The allowance of more flexible work hours for VA physicians and physician assistants.
• The ability of survivors of a deceased veteran to apply for benefits without filing a formal claim.
• A requirement for schools that receive Post-9/11 GI Bill payments to provide annual reports to the VA on the academic progress of veteran students.

Isakson said the leaders of both congressional chambers are aware of the legislation. He also added that the package is not a competitor to the Care Veterans Deserve Act of 2016, which a handful of Republican senators, including John McCain (R-Ariz.), introduced a day earlier.

Rep. Jeff Miller (R-Fla ), chairman of the Committee on Veterans Affairs, called the omnibus “a positive development.”

“If what Sens. Isakson and Blumenthal are working on passes the Senate, I look forward to immediately engaging in conference committee negotiations in order to move a VA reform package to the president’s desk,” he said in a statement.

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