It's 159 pages! I think this is what to mine from the strata of verbiage:
(Public Law 113–146; 38 U.S.C. 1701 note) * * * * * * * Title I. Improvement of Access to Care from Non- Department of Veterans Affairs Providers SEC. 101. EXPANDED AVAILABILITY OF HOSPITAL CARE AND MEDICAL SERVICES FOR VETERANS THROUGH THE USE OF AGREE- MENTS WITH NON-DEPARTMENT OF VETERANS AFFAIRS ENTITIES.
Possibly the Find tool (CTL F) will facilitate wading through the sea of words.
This one is not all that encouraging:
159 (p) AUTHORITY TO FURNISH CARE AND SERVICES.— The Secretary may not use the authority under this section to furnish care and services after December 31, 2018.
But this one looks better (bottom of page 159):
1) IN GENERAL .—There is authorized to be appropriated, and is appropriated, to the Secretary of Veterans Affairs, out of any funds in the Treasury not otherwise appropriated $10,000,000,000 to be deposited in the Veterans Choice Fund established by subsection (a). Such funds shall be available for obligation or expenditure without fiscal year limitation, and only for the program created under section 101 (or for hospital care and medical services pursuant ø
Happy hunting. to subsection (c)(3) ¿ to paragraphs (3) and (4) of subsection (c) of this section). * * * * *
From the above: "From the WH's perspective: They agreed to work with Shulkin on fixing his staff problems. But both times they talked, he went directly to the media and declared victory. In the view of senior officials, there's a difference between discretely and professionally handling staffing issues and publicly embarrassing and firing supporters of the president. Kelly agreed to help Shulkin with the former, and Shulkin keeps trying to do the latter."
A simple and effective resolution of Shulkin's problems with his staff is to fire Shulkin.
A simple and effective resolution of Shulkin's problems with his staff is to fire Shulkin.
This appears to be in the works as well as a host of additional folks after yesterday's house cleaning. Its getting pretty crazy at the VA and the big Bus (omnibus) that this bill needs to get on is coming soon.
As this all relates to OPK's BRLI its hard to understand for sure exactly how the Shulkin or the Trump approach would be different, but it appears to be this. What Shulkin wants and presumably what the VA's current RFP and vendor bids are against is the smaller plan in that outside care options will be available but in a more limited way than what Trump wants.
The biggest veterans issue before lawmakers now — and one of the behind-the-scenes fights within the administration — pertains to the overhaul of numerous VA community care programs into a single, more flexible, easier-to-use system allowing some veterans to see private sector doctors for a variety of ailments and injuries.
Both the House and Senate have multi-billion-dollar plans under consideration that would ease eligibility rules for the outside care but still keep a critical management role in place for VA administrators.
Conservative groups and some political appointees within the White House have complained the idea doesn’t live up to Trump’s past promises of full “choice” for veterans, and have pushed for even more freedom for medical appointments outside the existing VA system.
Both Senate Veterans’ Affairs Committee Chairman Johnny Isakson, R-Geogia, and House Veterans’ Affairs Committee Chairman Phil Roe, R-Tennessee, said they are open to the idea, and negotiations are ongoing.
Those negotiations had been focused on the nuances of the legislation in recent months, with debate over issues like how many private-sector medical appointments veterans could have paid for before additional authorizations were needed from VA managers.
Presumably the more private-sector medical appointments veterans could have paid for before additional authorizations were needed from VA managers could mean more lab testing via the Choice program as well. I think and hope all this pressure will force a cutting of the deal for the purpose of getting this in the omnibus. Govt appropriations run out in 9 days and at this point no one is talking shutdown.
A massive spending deal that Congress struggled to resolve by Tuesday morning purportedly contains extensive reforms for the Department of Veterans Affairs, including an overhaul to the controversial and much-debated Veterans Choice program.
Lawmakers are working on a $1.3 trillion deal that would fund federal agencies through the end of the fiscal year, which ends Sept. 30. It was uncertain Tuesday morning when Congress would unveil or vote on the spending bill. They face a Friday deadline or else trigger a partial government shutdown.
Negotiators worked late into Monday night, delayed by several hot-button initiatives vying to be tacked onto the bill as policy riders. According to multiple news reports, lawmakers hadn’t settled on proposed changes to Affordable Health Care, funding for President Donald Trump’s proposed border wall, a path to citizenship for recipients of Deferred Action for Childhood Arrivals, or DACA, and other issues that could potentially be included.
As the debate continued Tuesday, eight major veterans organizations were fighting for VA reforms to survive the negotiations.
The American Legion, Veterans of Foreign Wars, AMVETS, Disabled American Veterans, Paralyzed Veterans of America, Vietnam Veterans of America, Wounded Warrior Project and Military Officers Association of America called this moment a “historic opportunity” to pass multiple VA reforms at once.
Besides revamping the Choice program, the spending bill contains a gradual expansion of caregiver benefits to veterans injured before the 9/11 terrorist attacks, they said. It would also create a systematic review of VA infrastructure, with the intention of disposing of aging and underused facilities nationwide.
“Although this veterans legislation has only recently been shared with our organizations, it is based on months and months of consultation with our organizations and many other stakeholders,” they wrote Monday in a letter to congressional leaders. “While not perfect, we believe that this legislation represents a fair compromise that will help to strengthen veterans’ health care for future generations, while ensuring that caregivers of veterans of all generations get the support they deserve.”
The reforms were each previously introduced in Congress as separate bills, but all of them have been deadlocked in recent months. If they fail to pass as part of the spending bill, which creates a fast-track for approval, it’s uncertain when Congress would take them up again.
The leading pro-private sector voice, a conservative group called Concerned Veterans For America (CVA), has conducted polls showing vets also favor reforms and care choice, but even CVA’s director, Dan Caldwell, recognizes full-on privatization is a third rail in veterans politics: “We think you shouldn’t dismantle the VA, you shouldn’t privatize the VA, but it should be integrated better with the private sector and Choice should be part of that,” he told USA Today last August.
Still, Caldwell and his group are pushing a Republican bill they helped craft, The Veterans Empowerment Act, that calls for the “termination of functions of the Veterans Health Administration directly related to the furnishing of hospital care, medical services, and other health care.” (“It’s not terminating the VA,” Caldwell said in an interview with Task & Purpose. “The legal language is such that it would turn it into a non-profit corporation, but it would still have a government charter. It wouldn’t be run by Kaiser or another big insurance company, it just would restructure the VA so it can do things a private healthcare system can without being constrained by red tape.”)
Here is another article that lambasts the "conservative" desire to privatize completely driven by the Koch bros.
Clearly as the omnibus opportunity approaches and surely will pass in some form things are reaching a fever pitch. What does either approach mean for VACO? It appears VACO's bid against the RFP that is out represents Shulkin's approach that could have more or less veterans covered based on milage from a VA center. All that is negotiable etc. However this other group, per the article, that Koch is supporting states:
Rumors of threats to Shulkin's job security come amid a flurry of changes in major positions in the Trump White House, including at the head of the State Department and the CIA. While initially Trump supported his VA chief enthusiastically, he recently scolded Shulkin at a meeting, Axios reported on March 11.
During the meeting he took the unusual step of calling former Koch associate Peter Hegseth (now a Fox News pundit) to discuss how best to privatize the agency. Hegseth, former CEO of CVA, was strongly considered for the post during the transition -- an ominous sign for Shulkin, who is seen as too moderate by many conservatives in the White House.
"If Trump picks Hegseth, it's going to be war," Paul Rieckhoff, executive director of Iraq and Afghanistan Veterans of America (IAVA), told The New York Times during the Trump transition.