U.S. Senator Richard Burr (R-NC) introduced the Veterans Integrated Service Network (VISN) Reorganization Act of 2013, a bill designed to streamline the regional administrative offices of the Veterans Health Administration so that our focus returns to getting care to our veterans. The bill would combine the current 21 VISNs into 12 VISNs to reallocate and better target funds to improve the quality and consistency of health care for our nation's war heroes.
"The bureaucracy of our veterans' health care system has become so bloated that our nation's veterans are suffering as a result," Senator Burr said. "By reducing the number of administrative offices and reallocating staff and resources to our VA medical centers in the field, we can provide our nation's veterans and their families with the quality care they deserve."
In 1995, Dr. Kenneth Kizer, former Undersecretary of Health for the Department of Veterans Affairs (VA), submitted a plan to Congress to restructure the Veterans Health Administration (VHA) with the intent of providing a "patients first" focus. This plan led to the creation of the VISN, a new structure designed to serve as the basic budgetary and planning units of the veterans' health care system. Each VISN would act as the operational arm of the VHA, handling all budget, management and oversight decisions for the VA medical centers located within its geographic boundaries and allocating resources where they are needed most. This structure was intended to take the budgetary decision-making powers away from the centralized VHA and empower VISNs with the independence to decide how best to provide care for the veterans in their region. It was also hoped that the health care centers, no longer weighed down by budgetary concerns, would be able to concentrate their efforts on enhancing veterans' access to better quality care.
VHA, however, has significantly strayed from its initial goal of using VISNs as focal points for budgetary concerns, and patient care is suffering as a result. The VISNs are now bloated with staff who perform functions that have little to do with budget, management or oversight, let alone health care for veterans. In fact, VISN headquarters have grown well beyond the 220 total staff envisioned by Dr. Kizer to a total of 1,340 staff in 2011, siphoning precious dollars away from actual health care for veterans. In addition, VHA has not kept up with the significant shift in veteran demographics to see where veterans are getting their care and how they can design VISN geographic boundaries to best serve the veterans who are seeking care.
By consolidating the geographic boundaries of 9 VISNs, this bill would restore their "patients-first" purpose. Each of the 12 VISNs would have no more than 65 full-time employees focused solely on budget, management and oversight in order to alleviate the strain of these functions on the VA medical centers. In addition, VA employees at the VISNs whose positions do not deal with the budget would be transferred to other positions within the VA where their talents may be put to better use. This bill would also instruct VA to conduct a review and assessment of the current VISN structure and operations every three years and report any recommendations for changes to the Senate and House Committees on Veterans Affairs.
U.S. Senator Tom Coburn (R- OK) is an original co-sponsor.