House lawmakers seek higher pay for VA radiation specialists treating vets with cancer

The Department of Veterans Affairs will be able to offer higher salaries to radiation specialists who treat veterans with cancer, if a bipartisan bill makes it through Congress.

Two top lawmakers on the House VA Committee are reintroducing a bill that would set a higher pay cap for therapeutic medical physicists (TMPs) working at the VA.

The VA Therapeutic Medical Physicist Pay Cap Relief Act would raise the current pay cap for TMPs, and allow the department to pay them up to $280,340 a year.

Congressional staffers said the VA can currently pay TMPs a maximum salary of $195,000.

The bill would also move TMPs from their current “hybrid” Title 38 designation, under the Veterans Health Administration’s pay system, and would give them full Title 38 status.

Technology Modernization Subcommittee Ranking Member Sheila Cherfilus-McCormick (D-Fla.) and Oversight and Investigations Subcommittee Chairwoman Jen Kiggans (R-Va.) are introducing the bill.

The American Society for Radiation Oncology and the American Association of Physicists in Medicine endorse the bill.

Sen. Tim Kaine (D-Va.) introduced similar legislation in January 2020.

Congressional staffers told Federal News Network that the bill seeks to narrow a growing pay gap between what these radiation specialists earn at the VA and in the private sector.

“It’s a much more competitive pay raise. They’d be able to retain their current TMPs, and then also hopefully hire more TMPs,” a congressional staffer said.

Staffers said a board-certified TMP with a Ph.D. and 10-14 years of experience earns an average salary of $233,000 in the private sector.

Over the past 15 years, TMP salaries have increased in the private sector. During that period, radiation therapy has become more sophisticated and more common in cancer treatment.

“These are highly trained people. This is precision medicine, using things like radiation technology. It’s like, instead of cutting out an entire section of cancer, it’s how do we target specific cells?” a staffer said.

But TMPs at the VA are making about $40,000 on average less than their private-sector counterparts, staffers said, and the VA is offering salaries as low as $100,385 for vacant TMP positions.

Staffers said the bill would allow the VA to increase retention and become a more attractive employer for TMPs. The bill, they added, would also provide higher-quality care for veterans.

“If you’re dealing with recruitment and retention issues, and folks are leaving the VA because they’re finding better paying jobs in the private sector, this turnover is going to lead to a decrease in the quality of care that vets are receiving —inconsistent radiology practices, which could threaten patient safety,” a staffer said.

Staffers also expect the VA will need to staff up with TMPs under the PACT Act, which expands VA health care eligibility for veterans exposed to toxic substances during their military service.

The VA has designed 20 cancers and diseases as “presumptive conditions,” meaning veterans under the PACT Act don’t need to prove that their service caused the condition.

“After the PACT Act, there’s going to be a greater need for in-house TMPs to meet that need,” a staffer said.

Staffers said lower pay, combined with a lengthy hiring process, makes it difficult for the VA to recruit these in-demand specialists. They estimated TMPs might need to wait four-to-six months to start work at the VA, but might only take four weeks to onboard at a private hospital or health care system.

“That’s part of our overarching concern — it’s difficult to get hired through VHA, but people really want to work there. People want to give back to the veteran community,” the staffer said. “Anything we could do to make working at the VA easier and better for people, it’s something we want to do.”

Staffers also expect higher salaries under the bill would reduce a high rate of turnover for TMPs. They said that in the spring of 2023, the VA saw a TMP turnover rate exceeding 25%.

“That metric speaks to the lack of quality care that veterans could be receiving from TMPs, and what this legislation hopes to alleviate,” a staffer said.

To make up for these staffing shortages,  congressional staffers say the Veterans Health Administration has been outsourcing this work to contractors — and paying them higher rates.

Staffers said the VA would reduce overall costs if they could offer higher salaries to federal employees in TMP positions

“Long-term, [it’s] lowering costs for the VA and makes it more efficient, providing more quality care to our vets,” a staffer said.

VA estimated that a similar proposal back in fiscal 2019 would have saved the department $45 million over 10 years.

Staffers said that of the 111 total TMP positions across the entire VA medical system, 63 of them are full-time federal employees at the VA, and 48 positions are contracting staff. Another 13 TMP positions are vacant.

“It speaks to the point of basically trying to alleviate the issue with the VA relying on more expensive contractors, and instead hiring positions in-house,” a staffer said.

VA’s top human resources officials support another bipartisan bill that would raise pay caps for VA medical professionals.

The VA CAREERS Act, introduced in January by Senate VA Committee Chairman Jon Tester (D-Mont.) and Sen. John Boozman (R-Ark.) would set higher base pay caps for VA physicians, podiatrists, optometrists and dentists.

Jessica Bonjorni, the head of human capital management at the Veterans Health Administration, told the Senate VA Committee in March that the current pay caps are a constraint for the VA, especially for high-cost-of-living areas and for specialties such as cardiology, neurology and radiology.

Base pay for physicians, dentists and podiatrists in several specialties is currently capped at $400,000 — the current annual salary of the president.

“This is a smaller bill on the whole, but ultimately, in the grand scheme, we want to have good people working at the VA, because veterans liked their care at the VA,” a staffer said about the TMP Pay Cap Relief Act.

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