Grassley made his request of the General Accounting Office, which serves as the investigative arm of Congress. He was joined by 12 other members of Congress who share his concern about the way the system affects health care services available to veterans in rural states.
The Department of Veterans Affairs began implementing what's known as VERA ? or the Veterans Equitable Resource Allocation system ? in 1997 to comply with legislation that required the VA to provide veterans equitable access to care.
Grassley said that while some reallocation of resources was necessary when Congress reformed the system at that time, "it appears today that VERA doesn't account for the basic overhead costs of running a medical facility or the costs of serving all of America's veterans." As a result, even though Congress has increased funding for VA health care more than 23 percent since 1996, veterans facilities in the Midwest and Northeast need supplemental funds to stay open for the second year in a row.
In a letter sent to the GAO comptroller today, Grassley and the others said that the beginning of VERA's fifth year is a good time to evaluate whether the system is achieving more equitable resource allocation.
"When VERA was designed, the goal was to make sure all veterans got the same quality of care no matter where they lived," Grassley said. "The concern now is whether the VA accurately factors in the difficulties and high cost of providing health care services in rural areas of the country."
Grassley said this worry is based on a recent conclusion by the VA that the cost of caring for rural veterans is less expensive than urban veterans. The finding was based on the services rural VISNs currently provide which are limited because of budget restrictions. The VA also may have failed to consider that veterans in urban areas have access to more services, and that rural areas have low utilization of health care services because people will often forego care rather than travel long distances.
Today, the members of Congress who signed the letter with Grassley asked the GAO to:
» identify improvements that could be made,» comment on VERA's effect on health care for rural veterans,» determine the relationship of enrollment to resource allocation, and» describe the circumstances in certain parts of the country that have led the VA to seek supplemental funding for the regions, which are organized by the VA into VISNs, or Veterans Integrated Services Networks.
The GAO has not done a complete review of VERA since the system was first implemented.
During the last year, Grassley has been pressing the VA to direct a fair share of resources to VISN 14, which includes Iowa, and use all possible options to meet the budgetary shortfalls facing VA facilities in Des Moines, Knoxville and Iowa City. Most recently, he has been working to get the VA to release supplemental funds that were approved for the network more than four months ago.
