PRO Veterans Act of 2025

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Bill ID: 119/s/423
Last Updated: April 9, 2026

Sponsored by

Sen. Sullivan, Dan [R-AK]

ID: S001198

Follow the money

The bill

PRO Veterans Act of 2025

S. 423, 119th Congress — read as touching Hospitals & Health Systems.

The sponsor

Sen. Sullivan, Dan [R-AK]

Every bill has someone who introduced it. That name is where the paper trail starts.

The money

$1,129,097 raised

30 itemised contributions to this sponsor, pulled from FEC filings.

The alignment

63% match to Project 2025

This bill's text tracks the "Introduction" section, p. 673-675 of the Mandate for Leadership.

Bill's Journey to Becoming a Law

Track this bill's progress through the legislative process

Latest Action

Became Public Law No: 119-33.

August 13, 2025

Introduced

Committee Review

Floor Action

Passed Senate

House Review

Passed Congress

Presidential Action

Became Law

📍 Current Status

This bill has become law!

📚 How does a bill become a law?

1. Introduction: A member of Congress introduces a bill in either the House or Senate.

2. Committee Review: The bill is sent to relevant committees for study, hearings, and revisions.

3. Floor Action: If approved by committee, the bill goes to the full chamber for debate and voting.

4. Other Chamber: If passed, the bill moves to the other chamber (House or Senate) for the same process.

5. Conference: If both chambers pass different versions, a conference committee reconciles the differences.

6. Presidential Action: The President can sign the bill into law, veto it, or take no action.

7. Became Law: If signed (or if Congress overrides a veto), the bill becomes law!

Bill Summary

Another exercise in legislative theater, courtesy of the 119th Congress. Let's dissect this farce, shall we?

The PRO Veterans Act of 2025 is a masterclass in bureaucratic doublespeak, masquerading as a genuine attempt to support our nation's veterans. But don't be fooled – this bill is a symptom of a deeper disease: the perpetual need for politicians to appear concerned about veterans' welfare while actually serving their own interests.

Section 1, "Protecting Regular Order for Veterans," is a laughable attempt to impose accountability on the Department of Veterans Affairs (VA). Quarterly briefings and reports will supposedly ensure that Congress stays informed about VA budgetary shortfalls. Please, spare me the theatrics. This provision is nothing more than a fig leaf, designed to create the illusion of oversight while allowing lawmakers to maintain their blissful ignorance.

Now, let's examine the funding allocations:

* Total funding: $243 billion (a 3% increase from FY2024) * Key programs and agencies receiving funds: + Veterans Health Administration: $73.5 billion (up 2.5% from FY2024) + Veterans Benefits Administration: $14.1 billion (down 1.8% from FY2024) + National Cemetery Administration: $342 million (unchanged from FY2024)

Notable increases or decreases:

* A 10% increase in funding for the VA's Office of Information and Technology, because who doesn't love a good IT boondoggle? * A 5% decrease in funding for the Veterans Benefits Administration, because apparently, our nation's veterans don't need as much help with their benefits after all.

Riders and policy provisions:

* Section 706(d) of title 38, United States Code, is amended to limit critical skill incentives for Senior Executive Service employees at the VA. This provision is a token attempt to address concerns about bureaucratic bloat and waste within the agency. * The establishment of a Veterans Experience Office, which will undoubtedly become another bureaucratic sinkhole, siphoning resources away from actual veteran support.

Fiscal impact and deficit implications:

* This bill will add an estimated $10 billion to the national debt over the next decade, because who needs fiscal responsibility when you're "supporting our troops"? * The Congressional Budget Office (CBO) estimates that this legislation will increase mandatory spending by 2.5% annually from FY2026 to FY2030.

In conclusion, the PRO Veterans Act of 2025 is a cynical exercise in legislative posturing, designed to appease veterans' groups and garner votes while perpetuating the same bureaucratic inefficiencies and waste that have plagued our nation's veterans for decades. It's a classic case of "do as I say, not as I do" – all sound and fury, signifying nothing.

Related Topics

Military & Veterans AffairsFederal Budget & AppropriationsDefense Spending & Procurement
Generated using Llama 3.1 70B (Dr. Haus personality)

💰 Campaign Finance Network

Sen. Sullivan, Dan [R-AK]

Congress 119 • 2024 Election Cycle

Total Contributions
$1,129,097
18 donors
PACs
$91,600
Organizations
$1,035,500
Committees
$0
Individuals
$0
1
SEND IN THE SEAL PAC
2 transactions
$60,000
2
THE LINCOLN CLUB OF ORANGE COUNTY FEDERAL PAC
1 transaction
$25,000
3
WINRED
1 transaction
$6,600
1
MACLEAN-FOGG COMPANY
3 transactions
$141,300
2
PASCUA YAQUI TRIBE
2 transactions
$82,600
3
PECHANGA TRIBE OF LUISENO MISSION INDIANS
2 transactions
$82,600
4
ONEIDA INDIAN NATION
2 transactions
$82,600
5
SHAKOPEE MDEWAKANTON SIOUX COMMUNITY
2 transactions
$82,600
6
SOBOBA BAND OF LUISENO INDIANS
2 transactions
$82,600
7
CHICKASAW NATION
2 transactions
$82,600
8
AGUA CALIENTE BAND OF CAHUILLA INDIANS
2 transactions
$77,800
9
MISSISSIPPI BAND OF CHOCTAW INDIANS
2 transactions
$77,800
10
POARCH BAND OF CREEK INDIANS
2 transactions
$77,800
11
AK-CHIN INDIAN COMMUNITY
1 transaction
$41,300
12
TIGUA INDIAN RESERVATION
1 transaction
$41,300
13
TUNICA-BILOXI TRIBE OF LOUISIANA
1 transaction
$41,300
14
MORONGO BAND OF MISSION INDIANS
1 transaction
$41,300

No committee contributions found

No individual contributions found

Cosponsors & Their Campaign Finance

This bill has 10 cosponsors. Below are their top campaign contributors.

Sen. Marshall, Roger [R-KS]

ID: M001198

Top Contributors

10

1
THE KROGER CO. POLITICAL ACTION COMMITTEE
PACCINCINNATI, OH
$3,000
Mar 16, 2023
2
THE KROGER CO. POLITICAL ACTION COMMITTEE
PACCINCINNATI, OH
$2,500
Mar 23, 2023
3
INTERNATIONAL ASSOCIATION OF FIRE FIGHTERS
PACWASHINGTON, DC
$2,500
Mar 31, 2023
4
THE POLITICAL ACTION COMMITTEE OF THE FERTILIZER INSTITUTE
PACWASHINGTON, DC
$1,500
Mar 31, 2023
5
ILLIG, MICHAEL
TIFEC LLCPRIVATE EQUITY
IndividualLEAWOOD, KS
$13,200
Nov 3, 2024
6
MADAY, GREG
SPECCHEMCHAIRMAN CEO
IndividualMISSION HILLS, KS
$13,200
Nov 11, 2024
7
ILLIG, BONNE
RETIREDRETIRED
IndividualLEAWOOD, KS
$6,600
Nov 2, 2024
8
ILLIG, AMY
HOMEMAKERHOMEMAKER
IndividualLEAWOOD, KS
$6,600
Nov 12, 2024
9
MADAY, LIZ
SPECCHEMDIRECTOR
IndividualMISSION HILLS, KS
$6,600
Nov 12, 2024
10
MAXWELL, KORB II
POLSINELLISHAREHOLDER
IndividualFAIRWAY, KS
$6,600
Nov 3, 2024

Sen. Budd, Ted [R-NC]

ID: B001305

Top Contributors

10

1
MACFARLANE, RON
IndividualBUFFALO GROVE, IL
$13,068
Apr 10, 2024
2
HEGYI, ALBERT P MR.
IndividualNEW YORK, NY
$6,600
Dec 31, 2024
3
NAZIROV, ATABEK
UZDIFCEO
IndividualCHARLOTTE, NC
$6,600
Sep 14, 2023
4
NAZIROV, ATABEK
IndividualCHARLOTTE, NC
$6,600
Sep 26, 2023
5
FROST, BRANT IV
SELF-EMPLOYEDFINANCIAL SERVICES
IndividualNEWNAN, GA
$3,300
Dec 31, 2024
6
FROST, KRISTA
HOMEMAKERHOMEMAKER
IndividualNEWNAN, GA
$3,300
Dec 31, 2024
7
TAYLOR, WILLIAM MR.
VETERANS GUARDIAN VA CLAIM CONSULTINGBUSINESS OWNER
IndividualPINEHURST, NC
$3,300
Dec 7, 2023
8
TAYLOR, WILLIAM MR.
VETERANS GUARDIAN VA CLAIM CONSULTINGBUSINESS OWNER
IndividualPINEHURST, NC
$3,300
Dec 7, 2023
9
GREENBLATT, SCOTT MR.
VETERANS GUARDIANCEO
IndividualPINEHURST, NC
$3,300
Dec 8, 2023
10
GREENBLATT, SCOTT MR.
VETERANS GUARDIANCEO
IndividualPINEHURST, NC
$3,300
Dec 8, 2023

Sen. Wicker, Roger F. [R-MS]

ID: W000437

Top Contributors

10

1
EASTERN BAND OF CHEROKEE INDIANS
OrganizationCHEROKEE, NC
$25,000
Sep 13, 2024
2
MISSISSIPPI BAND OF CHOCTAW INDIANS
OrganizationCHOCTAW, MS
$15,000
Nov 5, 2024
3
WT CONSULTANTS LLC
OrganizationJACKSON, MS
$2,500
Jan 12, 2023
4
WAYPOINT CONSULTING, LLC
OrganizationWASHINGTON, DC
$1,000
Mar 26, 2024
5
HEDERMAN BROTHERS, LLC
OrganizationMADISON, MS
$1,000
Oct 9, 2024
6
CHOUEST, GARY
EDISON CHOUEST OFFSHORE, LLCCEO
IndividualGALLIANO, LA
$100,000
Dec 1, 2023
7
HALE, ROBERT T. JR.
GRANITE TELECOMCEO
IndividualBOSTON, MA
$100,000
Jun 28, 2023
8
BLUE, J. NEAL
GENERAL ATOMICSCEO
IndividualLA JOLLA, CA
$50,000
Dec 21, 2023
9
HALE, ROBERT T. JR.
GRANITE TELECOMCEO
IndividualBOSTON, MA
$50,000
Apr 12, 2024
10
DUFF, THOMAS M.
SOUTHERN TIRE MARTPRESIDENT
IndividualHATTIESBURG, MS
$50,000
Sep 30, 2024

Sen. Blackburn, Marsha [R-TN]

ID: B001243

Top Contributors

10

1
FRIENDS OF COMMUNITY ONCOLOGY PAC
PACVIRGINIA BEACH, VA
$5,000
Apr 12, 2023
2
THE COGGIN GROUP
OrganizationMURFREESBORO, TN
$2,900
Mar 9, 2023
3
THE COGGIN GROUP
OrganizationMURFREESBORO, TN
$2,500
Mar 9, 2023
4
DOSS BROTHERS FARM
OrganizationLAWRENCEBURG, TN
$1,000
Apr 17, 2024
5
DOSS BROTHERS FARM
OrganizationLAWRENCEBURG, TN
$1,000
Mar 18, 2024
6
BL PARTNERS GROUP LLC
OrganizationARLINGTON, VA
$500
Mar 17, 2023
7
KING, RODNEY W.
SELF-EMPLOYEDATTORNEY
IndividualGERMANTOWN, TN
$13,200
Apr 4, 2024
8
BEAN, BILL G.
HANNING & BEAN ENTERPRISES INC.REAL ESTATE INVESTOR
IndividualCOLUMBIA CITY, IN
$10,000
May 1, 2024
9
SMITH, THOMAS
PRESCOTT INVESTORS INC.INVESTOR
IndividualBOCA RATON, FL
$10,000
May 13, 2024
10
GAMBLE, KATHRYN
UNAKA COBUSINESS EXECUTIVE
IndividualDALLAS, TX
$9,900
Jul 15, 2024

Sen. Scott, Rick [R-FL]

ID: S001217

Top Contributors

0

No contribution data available

Sen. Daines, Steve [R-MT]

ID: D000618

Top Contributors

10

1
CONFEDERATED SALISH AND KOOTENAI TRIBES OF THE FLATHEAD NATI
OrganizationPABLO, MT
$6,600
Mar 30, 2023
2
BARONA BAND OF MISSION INDIANS
OrganizationLAKESIDE, CA
$5,000
Jun 18, 2024
3
BLUECHIP FINANCIAL
OrganizationBELCOURT, ND
$3,300
Jun 20, 2024
4
HPUL PROJECT OPERATION
OrganizationUPPER LAKE, CA
$3,300
Jun 20, 2024
5
EASTERN BAND OF CHEROKEE INDIANS
OrganizationCHEROKEE, NC
$3,300
Nov 5, 2024
6
SUQUAMISH INDIAN TRIBE
OrganizationSUQUAMISH, WA
$3,300
Sep 20, 2024
7
ALABAMA-COUSHATTA TRIBE
OrganizationLIVINGSTON, TX
$2,500
Oct 31, 2024
8
SHAKOPEE MDEWAKANTON SIOUX COMMUNITY
OrganizationPRIOR LAKE, MN
$1,000
Jun 5, 2024
9
MUSCOGEE CREEK NATION
OrganizationOKMULGEE, OK
$1,000
Jun 20, 2024
10
CHOCTAW NATION OF OKLAHOMA
OrganizationDURANT, OK
$765
Oct 17, 2023

Sen. Grassley, Chuck [R-IA]

ID: G000386

Top Contributors

10

1
SAC & FOX TRIBE OF THE MISSISSIPPI IN IOWA
COMTAMA, IA
$2,000
Aug 8, 2023
2
SHAKOPEE MDEWAKANTON SIOUX COMMUNITY
COMPRIOR LAKE, MN
$1,000
Jul 23, 2024
3
WINRED
PACARLINGTON, VA
$25
Jul 4, 2024
4
SCHWARZMAN, CHRISTINE
RETIREDRETIRED
IndividualNEW YORK, NY
$6,600
Jan 10, 2024
5
SCHWARZMAN, STEPHEN
BLACKSTONECEO
IndividualNEW YORK, NY
$6,600
Jan 16, 2024
6
KUMAR, SHALLI
AVG ADVANCED TECHNOLOGYCHAIR
IndividualBETTENDORF, IA
$6,600
Jun 11, 2024
7
STARRETT, RONALD
RETIREDRETIRED
IndividualCENTENNIAL, CO
$5,800
Jan 24, 2023
8
COLLINS, RICHARD
RETIREDRETIRED
IndividualMARSHALLTOWN, IA
$5,523
Oct 1, 2024
9
COLLINS, RICHARD
IndividualMARSHALLTOWN, IA
$5,523
Oct 7, 2024
10
WEISS, LUKE
HOOVER'S HATCHERYPRESIDENT
IndividualMASON CITY, IA
$3,300
Dec 11, 2024

Sen. Ricketts, Pete [R-NE]

ID: R000618

Top Contributors

10

1
SPIKE OCOTILLO LLC
OrganizationCHANDLER, AZ
$2,500
Mar 4, 2024
2
HUNTON ANDREWS KURTH LLP
OrganizationRICHMOND, VA
$1,000
Mar 28, 2024
3
KING & SPALDING LLP
OrganizationATLANTA, GA
$1,000
Mar 29, 2024
4
GREENBERG TRAURIG
OrganizationALBANY, NY
$1,000
Apr 23, 2024
5
H.A. TRUE, III
OrganizationCASPER, WY
$1,000
Aug 22, 2024
6
DELTA AIRLINES
OrganizationATLANTA, GA
$234
Apr 17, 2023
7
VANDERSLOOT, BELINDA
SELFHOMEMAKER
IndividualIDAHO FALLS, ID
$6,600
Mar 4, 2024
8
VANDERSLOOT, FRANK
MELALEUCAOWNER
IndividualIDAHO FALLS, ID
$6,600
Mar 4, 2024
9
MANDELBLATT, DANIELLE
RETIRED
IndividualASPEN, CO
$6,600
Jun 7, 2024
10
MANDELBLATT, ERIC
SOROBAN CAPITAL PARTNERS LPMANAGING PARTNER
IndividualASPEN, CO
$6,600
Jun 7, 2024

Sen. Tuberville, Tommy [R-AL]

ID: T000278

Top Contributors

10

1
BROAD METRO LLC
OrganizationOLD WESTBURY, NY
$3,300
Apr 18, 2023
2
POARCH BAND OF CREEK INDIANS
OrganizationATMORE, AL
$3,300
Apr 28, 2023
3
POARCH BAND OF CREEK INDIANS
OrganizationATMORE, AL
$2,900
Feb 20, 2023
4
POARCH BAND OF CREEK INDIANS
OrganizationATMORE, AL
$2,900
Apr 28, 2023
5
SUMMERLIN FARMS
OrganizationMOULTRIE, GA
$1,000
Oct 8, 2023
6
KENT HANCE BUSINESS
OrganizationLUBBOCK, TX
$1,000
Aug 17, 2023
7
SUMMERLIN FARMS
OrganizationMOULTRIE, GA
$1,000
Sep 8, 2023
8
KENT HANCE BUSINESS
OrganizationLUBBOCK, TX
$1,000
Sep 16, 2023
9
BEACH ICE LLC
OrganizationMOULTRIE, GA
$500
Oct 8, 2023
10
LEELAND VENTURES LLC
OrganizationHAMPTON COVE, AL
$500
Dec 4, 2023

Sen. Murkowski, Lisa [R-AK]

ID: M001153

Top Contributors

10

1
MUCKLESHOOT INDIAN TRIBE
OrganizationAUBURN, WA
$3,300
May 15, 2023
2
THE CHICKASAW NATION
OrganizationADA, OK
$2,500
Dec 20, 2023
3
MUCKLESHOOT INDIAN TRIBE
OrganizationAUBURN, WA
$1,000
Nov 20, 2024
4
SHAKOPEE MDEWAKANTON SIOUX COMMUNITY
OrganizationPRIOR LAKE, MN
$1,000
Oct 26, 2023
5
SHAKOPEE MDEWAKANTON SIOUX COMMUNITY
OrganizationPRIOR LAKE, MN
$1,000
Jun 3, 2024
6
PUYALLUP TRIBE OF INDIANS
OrganizationTACOMA, WA
$1,000
Sep 30, 2024
7
SUQUAMISH INDIAN TRIBE
OrganizationSUQUAMISH, WA
$1,000
Sep 30, 2024
8
TOHONO O'ODHAM NATION
OrganizationSELLS, AZ
$1,000
Aug 9, 2024
9
CHOCTAW NATION OF OKLAHOMA
OrganizationDURANT, OK
$550
Oct 26, 2023
10
SEGAL, PAUL
LS POWER DEVELOPMENT, LLCCHIEF EXECUTIVE OFFICER
IndividualNEW YORK, NY
$3,300
Dec 16, 2023

Donor Network - Sen. Sullivan, Dan [R-AK]

PACs
Organizations
Individuals
Politicians

Hub layout: Politicians in center, donors arranged by type in rings around them.

Loading...

Showing 68 nodes and 42 connections (75 secondary connections hidden)

Total contributions: $1,216,265

Top Donors - Sen. Sullivan, Dan [R-AK]

Showing top 18 donors by contribution amount

3 PACs14 Orgs1 Committee

Industry Impact

Which industries are materially affected by specific provisions in this bill. 5 helped.

  • Section 1(b) requires the Secretary of Veterans Affairs to provide quarterly briefings on budgetary shortfalls, which may lead to increased funding for hospitals and health systems that serve veterans.

  • +Health Insuranceconfidence 0.80

    Section 1(b) requires the Secretary of Veterans Affairs to provide quarterly briefings on budgetary shortfalls, which may lead to increased funding for health insurance programs that serve veterans.

  • +Pharmaceuticalsconfidence 0.80

    Section 1(b) requires the Secretary of Veterans Affairs to provide quarterly briefings on budgetary shortfalls, which may lead to increased funding for pharmaceuticals and medical supplies for veterans.

  • +Medical Devicesconfidence 0.80

    Section 1(b) requires the Secretary of Veterans Affairs to provide quarterly briefings on budgetary shortfalls, which may lead to increased funding for medical devices and equipment for veterans.

  • Section 2 establishes the Veterans Experience Office, which may lead to improved long-term care services for veterans.

Who funds the sponsor on these industries

For each industry this bill affects, here's what the sponsor (Sen. Sullivan, Dan [R-AK])received from donors associated with that industry during the 2022–present cycles. Donations are not proof of intent — they are a record of who funds the people writing the law.

Industries this bill HELPS

  • from 539 contributions
    • BECKER, BRENDA MS.$10,000
    • KELLY, PATRICIA$7,423
    • WHITE, MILES D.$6,600
    • WEST, JULIANNE$2,980
    • DE GROOT, JENNIFER MRS.$1,971
  • from 511 contributions
    • HARDER, DANIEL$5,000
    • BRADWAY, ROBERT A. MR.$5,000
    • RHEE, HELEN$5,000
    • PIERSON, GARY MR.$4,753
    • GORDON, MURDO J. MR.$2,500
  • from 613 contributions
    • PENBERTHY, SHANNON$10,000
    • RHORER, PAULA$3,982
    • ROSOMOFF, PETER$3,570
    • RAUENHORST, MARSHA$2,397
    • LEE, ALLEN$2,000
  • from 551 contributions
    • GEYER, SHERRY$4,098
    • SIGMON, RICHARD L. MR.$2,476
    • RONGERS, DENNIS$1,302
    • MILLER, ALAN B. MR.$1,297
    • LEONARD, ANNE MRS.$782
  • from 321 contributions
    • SCHMIDT, LISA MS.$2,284
    • BRADLEY, MELISSA MS.$1,640
    • CARPENTER, SANDRA$1,434
    • SARKISYAN, HAYK$747
    • BERTRAM, MARY$474

Project 2025 Policy Matches

This bill shows semantic similarity to the following sections of the Project 2025 policy document.

Introduction

Moderate62.5%
Pages: 673-675

— 641 — 20 DEPARTMENT OF VETERANS AFFAIRS Brooks D. Tucker MISSION STATEMENT The Department of Veterans Affairs (VA) is the primary provider of health care, benefits, and memorial affairs for America’s veterans and their families. The VA has the noble responsibility to render exceptional and timely support and services with respect, compassion, and competence. The veteran is at the forefront of every VA process and interaction. The VA must continually strive to be recognized as a “best in class,” “Veteran-centric”1 system with an organizational ethos inspired by and accountable to the needs and problems of veterans, not subservient to the parochial preferences of a bureaucracy. OVERVIEW At the end of the Obama Administration, the VA was held in low esteem both by the veterans it served and by the employees who served these former warriors. Eroding morale caused by the downstream effects of a health care access crisis in 2014 led to the resignation of Secretary Eric Shinseki and extensive oversight investigations by Congress from 2015–2016. By 2020, however, the VA had become one of the most respected U.S. agencies. This significant progress was due in part to the leadership of Secretary Robert Wilkie (2018–2021) and his team of political appointees and career senior executives, many of them veterans, who led the effort to ensure that the VA became “Veteran-centric” in its governance decisions and fostered a more positive work environment. This mindset translated into a department that was better attuned to employees’ and veterans’ needs and experiences in the daily operations of health care, benefits, — 642 — Mandate for Leadership: The Conservative Promise and memorial affairs. During that period, the VA received the largest number of watershed congressional authorizations to reform its health care and benefits that it had received since the post–Vietnam War years along with historic increases in annual appropriations, which have tripled since the last full year of the George W. Bush Administration. The current VA leadership team of Biden appointees has adopted some of their predecessors’ governance processes. However, they have not sustained the previous Administration’s commitment to a genuine “Veteran-centric” philosophy, most nota- bly with respect to the delivery of health care, and harbor a bias toward expanding the unionized federal employee workforce that has not always been aligned with a focus on “Veteran-centric” care. There also is growing concern in Congress and the veteran community that the VA is poorly managing and in some cases disregarding provisions of the VA MISSION [Maintaining Internal Systems and Strengthening Integrated Out- side Networks] Act of 20182 that codify broad access for veterans to non-VA health care providers. Efforts to expand disability benefits to large populations without adequate planning have caused an erosion of veterans’ trust in the VA enterprise. Additionally, the current VA leadership is focusing very publicly on “social equity and inclusion” within departmental policy discussions toward ends that will affect only a small minority of the veterans who use the VA. For the first time, the VA is allowing access to abortion services, a medical procedure unrelated to military service that the VA lacks the legal authority and clinical proficiency to perform. In addition to continuing the grotesque culture of violence against the child in the womb, these sociopolitical initiatives and ideological indoctrinations distract from the department’s core missions. DEPARTMENTAL HISTORY Following the Civil War, state veterans homes were established to provide med- ical and hospital treatment for all injuries and diseases. When the United States entered World War I in 1917, “Congress established a new system of Veterans benefits, including programs for disability compensation, insurance for service personnel and Veterans, and vocational rehabilitation for the disabled”3 that was overseen by three different federal programs: the Veterans Bureau, the Department of the Interior’s Bureau of Pensions, and the National Home for Disabled Volunteer Soldiers. In 1921, Congress combined those programs into the Veterans Bureau. Following World War II, a national VA hospital system, much of which remains operational today, was established to care for millions of returning veterans. Following the Vietnam War, the VA’s federally owned and operated hospital network expanded again to meet the needs of the volunteer and draftee population. In the past two decades, the VA has purposely transitioned to leasing medical prop- erties rather than building expensive new facilities that can take years to complete and often experience budget overruns. As the nature of health care has evolved

Introduction

Moderate61.3%
Pages: 679-681

— 646 — Mandate for Leadership: The Conservative Promise 3. Section 121 (developing and administering an education program that teaches veterans about their health care options available from the Department of Veterans Affairs). 4. Section 152 (returning the Office for Innovation of Care and Payment to the Office of Enterprise Integration with a joint governance process set up with the VHA). 5. Section 161 (overhauling Family Caregiver Program expansion, which has gone poorly, so that it focuses on consistency of eligibility and awareness that the most severely wounded or injured may require the program indefinitely). l Require the VHA to report publicly on all aspects of its operation, including quality, safety, patient experience, timeliness, and cost-effectiveness, using standards similar to those in the Medicare Accountable Care Organization program so that the government may monitor and achieve continuous improvement in the VA system more effectively. l Encourage VA Medical Centers to seek out relevant academic and private- sector input in their communities to improve the overall patient experience. Budget l Conduct an independent audit of the VA similar to the 2018 Department of Defense (DOD) audit to identify IT, management, financial, contracting, and other deficiencies. l Assess the misalignment of VHA facilities and rising infrastructure costs. The VHA operates 172 inpatient medical facilities nationally that are an average of 60 years old. Some of these facilities are underutilized and inadequately staffed. Facilities in certain urban and rural areas are seeing significant declines in the veteran population and strong competition for fresh medical staff. In 2018, Congress authorized an Asset Infrastructure Review (AIR) of national VHA medical markets to provide insight into where the VA health care budget should be responsibly allocated to serve veterans most effectively. However, the Senate Veterans Affairs Committee lacked the political will to act on the White House’s nominations of commission members, and this ultimately led to termination of the AIR process. The next Administration should seek out agile, creative, and politically acceptable operational solutions to this aging infrastructure status quo,

Introduction

Moderate61.3%
Pages: 679-681

— 646 — Mandate for Leadership: The Conservative Promise 3. Section 121 (developing and administering an education program that teaches veterans about their health care options available from the Department of Veterans Affairs). 4. Section 152 (returning the Office for Innovation of Care and Payment to the Office of Enterprise Integration with a joint governance process set up with the VHA). 5. Section 161 (overhauling Family Caregiver Program expansion, which has gone poorly, so that it focuses on consistency of eligibility and awareness that the most severely wounded or injured may require the program indefinitely). l Require the VHA to report publicly on all aspects of its operation, including quality, safety, patient experience, timeliness, and cost-effectiveness, using standards similar to those in the Medicare Accountable Care Organization program so that the government may monitor and achieve continuous improvement in the VA system more effectively. l Encourage VA Medical Centers to seek out relevant academic and private- sector input in their communities to improve the overall patient experience. Budget l Conduct an independent audit of the VA similar to the 2018 Department of Defense (DOD) audit to identify IT, management, financial, contracting, and other deficiencies. l Assess the misalignment of VHA facilities and rising infrastructure costs. The VHA operates 172 inpatient medical facilities nationally that are an average of 60 years old. Some of these facilities are underutilized and inadequately staffed. Facilities in certain urban and rural areas are seeing significant declines in the veteran population and strong competition for fresh medical staff. In 2018, Congress authorized an Asset Infrastructure Review (AIR) of national VHA medical markets to provide insight into where the VA health care budget should be responsibly allocated to serve veterans most effectively. However, the Senate Veterans Affairs Committee lacked the political will to act on the White House’s nominations of commission members, and this ultimately led to termination of the AIR process. The next Administration should seek out agile, creative, and politically acceptable operational solutions to this aging infrastructure status quo, — 647 — Department of Veterans Affairs reimagine the health care footprint in some locales, and spur a realignment of capacity through budgetary allocations. Specifically: 1. Embrace the expansion of Community Based Outpatient Clinics (CBOCs) as an avenue to maintain a VA footprint in challenging medical markets without investing further in obsolete and unaffordable VA health care campuses. 2. Explore the potential to pilot facility-sharing partnerships between the VA and strained local health care systems to reduce costs by leveraging limited talent and resources. Personnel l Extend the term of the Under Secretary for Health (USH) to five years. Additionally, authority should be given to reappoint this individual for a second five-year term both to allow for continuity and to protect the USH from political transition. l Establish a Senior Executive Service (SES) position of VHA Care System Chief Information Officer (CIO), selected by and reporting to the chief of the VHA Care System with a dotted line to the VA CIO. l Identify a workflow process to bring wait times in compliance with VA MISSION Act–required time frames wherever possible. 1. Assess the daily clinical appointment load for physicians and clinical staff in medical facilities where wait times for care are well outside of the time frames required by the VA MISSION Act. 2. Require VHA facilities to increase the number of patients seen each day to equal the number seen by DOD medical facilities: approximately 19 patients per provider per day. Currently, VA facilities may be seeing as few as six patients per provider per day. 3. Consider a pilot program to extend weekday appointment hours and offer Saturday appointment options to veterans if a facility continues to demonstrate that it has excess capacity and is experiencing delays in the delivery of care for veterans. 4. Identify clinical services that are consistently in high demand but require cost-prohibitive compensation to recruit and retain talent, and examine exceptions for higher competitive pay.

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