The U.S. House of Representatives is considering a $81.6 billion funding bill to cover a broad range of VA and DoD health care needs. Following a period of tight budgets, the proposed bill increases spending by $1.8 billion, but it is $1.2 billion below the budget request from President Obama. The Military Construction and Veterans Affairs and Related Agencies Appropriations Act provides $260 million for upgrading the VA electronic health record system (EHR) and $304 million for construction and alterations for new or existing military medical facilities.
The house bill earmarks $52.5 billion for VA health care services, including $7.8 billion for mental health care services; $164 million for suicide prevention activities; $284 million for traumatic brain injury treatment; $7.2 billion for homeless veterans treatment, services, housing, and job training; and $250 million for rural health initiatives.
Although the bill provides funding to improve the Veterans Information Systems and Technology Architecture (VistA) system, the bill also includes language that restricts that funding until the VA has certified interoperability of the system with the DoD. The bill also requires the VA to meet certain milestones with respect to functionality and management. Still how fast the VA will move on the VistA upgrade remains to be seen. LaVerne Council, VA chief information officer told a March 2, 2016 House appropriations committee that the VA will “take a step back and look at what we really need to have an EHR and a health care system do.”
The development of a new DoD EHR system is progressing, according to Chris Miller, program executive officer, Defense Healthcare Management Systems. In a Senate hearing, he told committee members that the DoD has made significant progress and is not rolling out the Joint Legacy Viewer, which “provides an integrated display of DoD, VA, and TRICARE network provider data for clinicians and other users.”
Miller told the committee that predeployment testing of the new EHR is nearing completion, and the system will undergo contractor testing through December 2016. “The new EHR represents a fundamental business transformation within DoD, and the bulk of our work moving forward is making sure our end-users and the DoD community as a whole are prepared to begin using this system once it comes online.”
The Surgeon Generals of the Air Force, Army, and Navy also testified before the U.S. Senate Committee on Appropriations. According to Lieutenant General Mark A. Ediger, Air Force Surgeon General Veterans Choice Act led to decline in referrals to military facilities. In addition, all 3 Surgeons General expressed frustration with the continuing high rates of tobacco used among active-duty service members and the lack of success of tobacco cessation efforts.