My TLDR summary is that there are some ideas in the document that seem good, some that probably need more research, and some that are scary.
I have summarized the document by section. There are some statement that were difficult to understand so I tried to summarize as best I could. They want to improve care and response times for veterans, but they insist on getting rid of coverages for abortion or transgender surgeries. They also are really pushing to outsource Veterans care to local health and community care organizations. They want to outsource more positions, and cut down on Union employees and replace civil service employees. There is also a suggestion of creating new executive positions that will not be able to be replaced by another administration, and creating new laws to prevent another administration from undoing their changes.
Overview
States that the VA must be Veteran Centric. Claims that under Biden the VA has been more interested in Unionization, Equity and Inclusion, and providing access to abortion. To quote, “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
Seems thorough
Veterans Health Administration (VHA)
Needed Reforms
Get rid of any clinical directives that are not in line with Conservative Principles, specifically Abortion and Gender Reassignment Surgery, which “both follow the Left’s pernicious trend of abusing the role of government to further its own agenda.”
Focus on shifting demographics.
If possible, get Congress to pass legislation to prevent future administrations from changing rules and regulations.
Create a Veterans Bill of Rights to ensure that veterans are automatically told of their eligibility for community care.
Require public reporting to ensure standards of care are met.
Increase referrals from VA Medical Centers to private sector and community care to improve the overall patient experience.
Budget
Conduct independent audits.
Review aging infrastructure (buildings) that are old or under-utilized because of location.
Expand use of Community Based Care.
Set up partnerships between the VA and local health care systems to reduce costs.
Personnel
Extend the term of the Under Secretary for Health (USH) to five years and allow reappointment to protect USH from political transitions. And establish a Senior Executive Service (SES) position of VHA Care System Chief Information (CIO), selected by and reporting to the chief of the VHA Care System with a dotted line to the VA CIO.
Identify new workflow process to bring wait times for veterans who need care into compliance by increasing number of patients seen per day, adding hours in the evening or weekend, using Telehealth, and increasing pay as needed to attract talent.
Hire health care retirees and veterans.
Consider a VA Tuition Assistance program with the understanding that workers will work in understaffed areas.
Conduct a high-priority assessment of Electronic Health Record (EHR) transition delays and functionality problems. Need to implement this in coordination with the DOD.
Veterans Benefits Administration (VBA)
Needed Reforms
Reduce complexity of Benefits and streamline process especially with Disability claims.
Identify performance targets and develop process to complete disability claims in 30 days.
Outsource disability examinations to outside health care providers.
Increase automation.
Reduce fraud.
Budget
Change the VA’s Schedule for Rating Disabilities (VASRD) , which determines what disabilities are covered. Agent Orange and Toxic Burn Pit exposures have greatly increased the costs for disabilities, so find ways to reduce these costs. They are very careful not to go into specifics on this, beyond saying that they want to revise disability rating awards for future claimants while preserving them
Fully or partially for existing claimants.
Increase IT budgets.
Personnel
Use more contractors to “free” federal employees to perform other duties.
Improve acquisition of workforce to hire more contractors.
Outsource more to private companies.
Human Resources and Administration (HRA)
Needed Reforms
Rescind all delegations of authority made by previous administration. I am guessing this means getting rid of all the Biden appointees.
Transfer all career Senior Executive Leaders out of PA and PAS positions on the first day to ensure “political controla” of the VA.
Reduce hybrid and wfh work.
Budget
Expedite acquisition of new Human Resources information technology System (HRIT).
Increase pay ranges in non-medical jobs such as IT, acquisition and economists.
Personnel
Foster culture of veteran driven and flexible and agile workplace.
Ensure senior leaders (SES) set proper example
Have a “fully vetted roster of candidates” to assume key positions before formal nominations are made.
Increase the number and utilization of Limited Term Appointment Senior Executive Service positions for up to three years to work on special projects.
Identify which mid- and senior-level managers are willing to accept and support these changes.
Ensure that White House communicate labor reform agenda immediately and issue executive orders on civil service reform.
Anticipate and be proactive on legal challenges from labor, be aware of when labor contracts end and have a clear strategy to get what “leadership’ wants from a new contract.
Work with Congress to sunset the Office of Accountability and Whistleblower Protection (OAWP).
and decouple HRA and the Office of Security and Preparedness (OSP) because of duplicate and overlapping functions.
Of all the chapters this one seems to be the least radical although the author attacks unions, and pushes to privatize some services. In Connecticut we have many examples of how badly privatization has worked just ask the family of the nurse who was brutally murdered in Willimantic?!? Thank you Nancy for your good work.
As a veteran some items are already out sourced to very bad Drs etc, for me with a injury while in service I am still waiting for care and they sent me to a chiropractor instead of an Orthopedic. I tried to get a hearing exam and they want me to travel out of state etc. The need to add VA services and do they not realize the older generation is mostly men still they need more female services. NOLA has a great new building CT needs one and not just in Orange West haven..