Despite decades-long concerns over deficiencies and management, state-run VA homes were nonetheless harder hit by the COVID-19 pandemic than homes run by the VA itself, Politico reports, as "antiquated" and "dilapidated" centers without direct control from the federal agency struggled to keep the lid on infection by themselves.
In fact, the death rate in the "dangerously decentralized" state-run facilities was more than double that of those managed directly by the VA, Politico writes. Former Veterans Affairs Secretary David Shulkin called the system a "hodgepodge."
So how might it be reformed? Even if some of the homes are state-run, the VA itself is the only agency that could share information regarding facility quality on its website, which it recently began doing after complaints from the Government Accountability Office. Still, Rep. Mark Takano (D-Calif.), chair of the House Veterans Affairs committee, is considering legislation "to broaden [Centers for Medicare/Medicaid Services] oversight, set standards for construction and renovation and require the homes to be run by licensed long-term care administrators," Politico writes.
Other advocates want Congress to address the "fundamental gaps" in regulation and oversight between states, the federal government, and contractors brought in to conduct an annual safety inspection of the state-run homes. "We think it was a mistake years ago that we were not put under purview of the state health department. We're not afraid of scrutiny," said Joel Kintsel, executive director of the Oklahoma Department of Veteran Affairs.
Former VA Secretary Shulkin added that he'd love to see state and federal agencies hold a "policy summit" to plot the path ahead, given there will be more veterans in need of care in the not-so-distant future. He said, "How do we do better for vets? How do we work together? This fragmented system is not a secret." Read more at Politico.