The leader of the health care arm of the Department of Veterans Affairs told Capitol Hill lawmakers Friday that while VA has seen major success in vaccinating veterans during the pandemic, challenges remain.
"We are now approaching the last mile of this pandemic," Acting VA Undersecretary for Health Dr. Richard Stone told members of the House Appropriations subpanel on military construction and Veterans Affairs.
VA has vaccinated more than 1 million veterans with at least one dose along with hundreds of thousands of its staff and other federal essential workers, but limited vaccine supplies are standing in the way of the department and the millions of other veterans who need vaccines. As supplies remain scarce, Stone said the department is focused on vaccinating the most vulnerable veterans -- older vets, those with health conditions that put them at higher risk for virus complications and frontline workers, he said.
VA also faces significant challenges reaching all veterans who want or need a vaccine, Stone said, particularly those in rural or remote areas.
"Nobody has done this before. This has been a tough one," Stone said. "We are not doing as well with rural veterans and reaching them as we would like to. We need to do better with highly rural. This is a tough, herculean effort to get where we need to be."
Some of the strategies VA is using to reach those veterans includes partnering with local organizations, deploying mobile medical centers and using smaller aircraft to fly vaccines to remote areas. Recently, Stone said VA used a smaller plane to fly to an Alaskan island to vaccinate 50 veterans. VA is also working with the State Department to get vaccines to veterans who live in the Philipines, Stone said, where some healthcare workers have yet to receive vaccines.
Lawmakers including subcommittee Chairwoman Rep. Debbie Wasserman-Schultz, D-Florida, wanted to know how VA plans to provide vaccines to veterans who are not enrolled in or eligible for VA care.
Under current conditions, Stone said VA doesn't have enough vaccines or resources to vaccinate veterans who aren't eligible for care. But in areas of the country where higher-risk veterans are declining the vaccine, the department is enrolling eligible veterans "on the spot" to put more vaccines in more arms. In New York, Stone said, as many as 1,000 high-risk veterans have refused the vaccine.
Those refusals are more common in rural communities across all age groups, said Dr. Kameron Matthews, assistant undersecretary for health for clinical services.
About 9.3 million veterans are enrolled in VA care of the about 18.5 million veterans in America, Stone said. The department has been allotted about 6 million vaccine doses for veterans so far, along with about 400,000 for VA staff and 25,000 for Homeland Security staff VA is vaccinating as part of its Fourth Mission. VA is receiving those vaccines in shipments of about 140,000 doses per week, though some of those shipments have been delayed recently due to severe winter storms across the country.
"I have virtually no first doses left today," Stone told lawmakers. "They are in veterans' arms."
In coming months, Stone said VA expects some 7 million complete vaccine doses.
While some veterans are refusing the vaccine, Stone said veterans of color have a higher acceptance rate, good news for a population found to be at higher risk at VA and among non-veterans.
"In communities of color we're actually exceeding what we are in the white population of America," Stone said. "I'm really pleased at how Black and Hispanic veterans are accepting the vaccine."
As the pandemic raged and VA was forced to limit in-person appointments, exams, procedures and treatments, a backlog of care grew. As conditions improve, Stone said the department will need more resources to reduce that backlog. When veterans' care is delayed, they can face worsening health conditions and more complex treatment needs, all of which will require more funding, he added.
"We need to recognize that there may be another pandemic," Stone said. "There may be a variant. And we need to prepare ourselves."
That's where the Biden Administration's American Rescue Plan comes in, he said. That plan allocates an additional about $17 billion in funding to VA, the majority for healthcare costs. Last year Congress provided VA an additional nearly $20 billion for pandemic response, and some lawmakers have taken issue with Biden's plan to provide billions more when about half of the 2020 funds have yet to be exhausted.
VA's massive healthcare system -- the largest in the United States -- also needs a robust supply of personal protective equipment such as N95 masks, gowns and gloves. Currently, VA has an about 180-day supply of N95 masks necessary for staff to treat COVID-19 patients, and the department needs a continued six-month supply on hand to be proof against the supply chain interruptions and shortages it experienced in 2020.
Veterans "come to us as a safety net," Stone said, adding that during the pandemic VA has seen an increase in veterans seeking health care after losing their jobs, housing assistance and other aid.
"This has been some of the toughest work I've done," Stone said, "including combat."
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