Murkowski Efforts Bring VA Officials to Alaska on Care Concerns

Senator’s Advocacy and Initiative Brings VA Attention to “Hierarchy of Care”

Due to Senator Lisa Murkowski’s recent intervention, senior officials from the Veterans Health Administration and the Office of the Assistant Secretary of Defense for Health Affairs in Washington, D.C. are currently in Alaska to determine whether existing Alaska VA healthcare delivery partnerships in Anchorage, Fairbanks, Wasilla and rural Alaska must change due to last year’s passage of the Veterans Access and Choice Accountability Act of 2014.

In recent years, the Alaska VA healthcare system has entered into partnerships with numerous community providers to address gaps in veterans’ healthcare delivery in both urban and rural Alaska. Many of these partnerships were created in response to Senator Murkowski’s “Care Closer to Home Initiative” which allowed care to be purchased from community providers in veterans’ home communities, instead of sending them to the Lower 48 for medical treatments. 

Additionally, the VA also established partnerships with components of the Alaska Native healthcare system to deliver care in rural Alaska where the closest VA health center is an airline flight away, after years of advocacy by Murkowski.

During a Memorial Day state work period tour of the DOD/VA joint venture hospital on Joint Base Elmendorf Richardson in Anchorage, Murkowski was informed that new “Hierarchy of Care” guidelines issued by VA headquarters are being interpreted to halt the VA from referring patients to existing sharing partners such as the JBER Hospital, Southcentral Foundation and Tanana Chiefs Conference except in urgent and emergency cases.

Instead, veterans now must use the new “Choice Card” to procure care on their own pursuant to the 2014 legislation. Every veteran in Alaska registered for healthcare is eligible for a Choice Card since the VA does not maintain its own full service hospital in the state, but the Choice Card comes with onerous strings attached for both patients and providers.

This information from hospital staff led Senator Murkowski to send a letter (attached) to VA Secretary Bob McDonald in late May, reading:

This news could not come at a worse time given that the VA was recently forced to close the two procedure rooms at its “new” Anchorage outpatient facility due to defects in the ventilation system. The joint venture hospital is the backup. The situation also threatens to undermine proactive steps taken by Alaska VA to address staffing shortages in Anchorage and in its Community Based Outpatient Clinics through sharing arrangements with tribal health partners such as the Southcentral Foundation in Wasilla.

Moreover, under the “Hierarchy for Purchased Care” directive, I am led to believe that Alaska VA may not enter into new sharing agreements to address extreme staff turnover in Fairbanks or address continuing problems in Wasilla. Cumulatively these developments could result in the return of waitlists at Alaska VA healthcare facilities.

The senior officials visiting Alaska will meet with state and tribal health officials and congressional delegation staff tomorrow morning.  Murkowski has asked for a full briefing on the team’s findings as soon as possible.