Hearing of the Health Subcommittee of the House Veterans' Affairs Committee - Optimizing Care for Veterans with Prosthetics: An Update


By:  Ann Marie Buerkle
Date: July 31, 2012
Location: Washington, DC

Good morning and welcome to today's Subcommittee on Health Hearing, "Optimizing Care for Veterans with Prosthetics: An Update."

Today's hearing is a continuation of a discussion we began almost three months ago when this Subcommittee heard from veterans with amputations, members of our veterans service organizations (VSOs), and officials from the Department of Veterans Affairs (VA) to review VA's capability of delivering state-of-the-art prosthetic care to veterans with amputations and the impact of VA's planned prosthetic procurement reforms.

These reforms will, among other things, take prosthetic purchasing authority away from prosthetic specialists and transfer it to contracting officers.

As our veterans so eloquently described in May, prosthetic care is unlike any other care that VA provides and, when we make the mistake of treating it as such, no less than the daily and ongoing functioning and quality of limb of our veterans is at stake.

I was very troubled to hear our veterans voice such strong opposition to the proposed procurement reforms, arguing forcefully that they would lead to substantial delays in care for veterans with amputations and clinical judgments regarding veterans needs being overridden by individuals with little to no experience in prosthetic care.

In mid-June - following our hearing - I sent a letter, along with Ranking Member Michaud, to the Secretary requesting that the Department respond to a number of questions and provide certain materials regarding the strategy, plans, and criteria used to consider, develop, design, implement, and evaluate the proposed reforms and the pilot programs that preceded them.
Our goal was to understand the analysis VA employed to develop the reforms and what was behind the decision that this was the best idea for our veterans, especially those who have experienced loss of life as a result of service to our country.

Sadly, the Department's response -- which came a week after the deadline requested in our letter -- did not provide the information or the level of detail we asked for and did nothing to assure me that the plan would be effective or that our veterans concerns were unfounded.

To the contrary, a close review of the materials VA provided leads me to believe that the reforms were developed without careful and thorough consideration. It leads me to believe they were developed without sufficient input from veterans themselves, veteran service organization advocates, or other stakeholders.

It leads me to believe that they were developed and implemented, after being tested for a very short time, at a small number of locations, with very limited feedback. It leads me to believe they were developed without adequately measuring their impact on patient care. It leads me to believe they were developed without safeguards in place to ensure veterans and clinician's wishes are respected and timeliness goals are met.

It is concerning that VA would move forward with instituting large-scale changes that so directly impact veteran patients in this way. If my concerns are groundless -- and I hope that they are -- I want VA, in explicit detail, to explain why.

During our last hearing, our veterans and VSOs spoke loud and clear. Now it is time for VA to do the same.

Again, I thank you all for joining us this afternoon. I now recognize our Ranking Member, Mr. Michaud [ME-SHOW] for any remarks he may have.

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