Lawmakers reach agreement on stalled VA accountability bill

Congressional Republicans and Democrats have reached agreement on a long-stalled bill to make it easier for the Department of Veterans Affairs to fire its employees, part of an accountability effort touted by President Donald Trump.

The deal announced Thursday could smooth the way for final passage on an issue that had been in limbo since the 2014 wait-time scandal at the Phoenix VA medical center. As many as 40 veterans died while waiting months for appointments as VA employees created secret waiting lists and other falsehoods to cover up delays.

The bipartisan deal on Capitol Hill followed a fresh warning from the VA inspector general of continuing patient safety problems at another facility, the VA medical center in Washington D.C. After uncovering serious problems there last month, the IG's "rapid response" team visited the facility again on Wednesday and found at least two new instances in which patients were "placed at unnecessary risk."

In one case, they found a patient prepped for vascular surgery in an operating room, under anesthesia, whose surgery was postponed because "the surgeon did not have a particular sterile instrument necessary to perform the surgery." The team also found "surgical instruments that had color stains of unknown origin in sterile packs," according to the IG's letter sent to the VA. The VA last month had provided assurances of immediate action to fix problems.

VA Secretary David Shulkin told senators at a hearing that he had no concerns about patient safety and that the auditors' visit revealed a process "that works" -- doctors stopping a procedure when they identified a potential risk. But Shulkin agreed legislation was needed to help improve the VA. "In the cases we need to make changes in management, today I just don't have that ability to do it," he said.

The Senate measure softens portions of a bill that had passed the House in March, which Democrats criticized as unfairly harsh on workers. Sens. Jon Tester of Montana and Johnny Isakson of Georgia, the top Democrat and the Republican chair on the Senate Veterans' Affairs Committee, worked to make modifications that in part would give VA employees added time to appeal disciplinary actions.

House Veterans Affairs' Committee Chairman Phil Roe, sponsor of the House bill, said he would support the revisions.

"To fully reform the VA and provide our nation's veterans with the quality care they were promised and deserve, we must ensure the department can efficiently dismiss employees who are not able or willing to do their jobs," said Sen. Marco Rubio, R-Fla., the bill's lead sponsor.

It comes after Trump last month signed an executive order to create a VA Office of Accountability and Whistleblower Protection, with an aim of identifying "barriers" that make it difficult for the VA to fire or reassign bad managers or employees.

The GOP-controlled House previously approved an accountability bill mostly along party lines.

The Senate bill adopts several portions of a bipartisan Isakson bill from last year, including a longer appeal process than provided in the House bill — 180 days vs. 45 days, though workers would not be paid during that appeal. VA executives would be held to a tougher standard than rank-and-file employees for discipline. The Senate bill also codifies into law the VA accountability office created under Trump's order, but with changes to give the head of the office more independent authority and require the office to submit regular updates to Congress.

Conservative groups praised the legislation.

"These new measures will disincentivize bad behavior within the VA and further protect those who bravely expose wrongdoing," said Dan Caldwell, policy director of Concerned Veterans for America, pointing to a "toxic culture" at VA.

The agreement comes in a week in which Senate Democrats are standing apart from Trump on a separate issue affecting veterans, the GOP bill passed by the House to repeal and replace the nation's health care law. Sen. Tammy Duckworth, D-Ill., warned the House measure would strip away explicit protections to ensure that as many as 8 million veterans who are eligible for VA care but opt to use private insurance would still receive tax credits. A group of GOP senators is now working to craft their own health bill.

Congress has had difficulty coming to agreement on an accountability bill after the Phoenix VA scandal. A 2014 law gave the VA greater power to discipline executives, but the department stopped using that authority after the Obama Justice Department deemed it likely unconstitutional. This week, a federal appeals court temporarily overturned the VA firing of Phoenix VA hospital director Sharon Helman over the wait-time scandal, saying she deserved more time to appeal her case.

Critics have complained that few employees were fired for various VA malfeasance, including rising cases of opioid drug theft, first reported by The Associated Press.