00:00Thank you. The chair now recognizes Representative King Hines for five minutes.
00:05First of all, thank you to all of you for appearing before us today. Thank you for your
00:10service, and I just have to say, man, go women power, because just phenomenal women appearing
00:17before this committee. I come from the Northern Marianas, where access to service is very limited.
00:24We don't have a CBOC, and I think people are going to get sick of me saying that,
00:28because I'm going to say it over and over again until we actually do get access to care,
00:33which is why, you know, looking at community care programs is very important to me because of that
00:42reason. Now, one of the things that I'm hearing from all of you is that things could be better
00:48with regards to the way we deliver this programs. There are gaps. Dr. Mops, is it Mops? You spoke
00:57of, in your written testimony that you submitted, you talked about a comprehensive metrics system
01:08that needs to be put in place. Can you just kind of dive into that a little bit? Because I'm looking
01:14for opportunities to improve to ensure that some of these challenges and gaps that we're talking about
01:20and hearing about today are actually addressed in the legislation and that we can improve the system.
01:30And thank you very much for that question. I think this is critically important, and I am certainly
01:34a advocate for the, not the either or, but the and. We have to have both a strong VA and strong
01:39community care. And as part of that, the GAO has provided extensive recommendations regarding the
01:44opportunity to improve oversight and accountability around community care. And in particular, some of
01:50the things that have been mentioned here do need to be improved upon. The ability to track scheduling
01:54performance, for example, metrics aligned with those timeframes are imperative, meaningful accountability
01:59around those metrics. And then, for example, the VA's referral coordination initiative, which was meant to
02:04streamline specialty care, has suffered from somewhat inconsistent implementation, unclear guidance about
02:10its use and inadequate performance metrics. So I would simply say that the work has been done around
02:16assessing VA community care opportunities for improvement. And I would just say that we should
02:20be looking very extensively at the recommendations provided by GAO in order to enhance them.
02:26Thank you for that. And this is a question to you, Dr. Hunter, because I do agree. I'm an attorney by
02:32practice. And, you know, when you appear before in front of a jury, you have to submit data evidence,
02:38right? But sometimes the anecdote does win. And too often, as a matter of fact, in the community that I come
02:45from, these stories are what I hear every single time I meet with constituents. And for as long as I've sat
02:53in this committee in this last seven months, these are the stories that we hear. And so, you know,
03:01you spoke of some of the gaps to include accessibility to record keeping and being able to have a more
03:12seamless process whereby there's a little bit more accountability with regards to the program itself.
03:20Can you give us suggestions as to how we can improve the current situation?
03:26Thank you so much for that. Because, you know, again, we understand that this isn't a either or,
03:31that's not how this should be characterized. It's a yes and, but we really need to improve
03:34the coordination side of community care so it is held to some of the same standards that VA care is.
03:40And so, if we're thinking about the coordination piece, there are a few things that can be done.
03:45One is there needs to be some more deliberate looking into some of the VA modernization and the
03:52enterprise systems that are being rolled out. This work is sort of early on preliminary.
03:57We are really excited to work with the committee to better understand and ensure that the electronic
04:04health care record system is being rolled out in an appropriate manner that allows for better
04:10coordination. Because right now what we're seeing far too often is that the VA, where there are very
04:15well-coordinated records kept, is not able to communicate well with community providers and things
04:20are falling through the cracks. We are not getting full care plans. We are not able
04:24to ensure that veterans are receiving the same standard and quality of care. And so, first,
04:30making sure that process is going well, as well as ensuring oversight and enforcement of the quality
04:37standards and training that are required of our community care providers. The Mission Act said that
04:42needed to happen, but according to multiple independent medical associations, there is not yet a published
04:50transparent standard for what community care needs to meet or what sort of records need to be provided
04:56back to the VA care teams to ensure the comprehensive continuity of care. And so, in those two areas,
05:02I think there's a lot of room to be done and I think this committee is is primed to be able to
05:08engage in that and that sort of oversight. Thank you. I'm out of time. I yield my time. I yield back.
Comments