{"id":24498,"date":"2018-05-23T13:08:52","date_gmt":"2018-05-23T13:08:52","guid":{"rendered":"https:\/\/one.sightlinemg.com\/federaltimes\/uncategorized\/2018\/05\/23\/lawmakers-eye-more-dramatic-management-changes-within-va\/"},"modified":"2026-08-08T03:18:07","modified_gmt":"2026-08-08T03:18:07","slug":"lawmakers-eye-more-dramatic-management-changes-within-va","status":"publish","type":"post","link":"https:\/\/one.sightlinemg.com\/federaltimes\/congress\/2018\/05\/23\/lawmakers-eye-more-dramatic-management-changes-within-va\/","title":{"rendered":"Lawmakers eye more dramatic management changes at VA"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">WASHINGTON \u2014 House lawmakers on Tuesday hinted at <a href=\"https:\/\/www.militarytimes.com\/veterans\/2018\/05\/21\/wilkies-va-nomination-raises-more-short-term-department-leadership-questions\/\" title=\"\" class=\"\" target=\"_blank\">continued dramatic shake-ups at Veterans Affairs<\/a> in months to come, this time taking aim at the department\u2019s health management structure for a complete overhaul.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Republicans and Democrats on the House Veterans\u2019 Affairs Committee said they see the potential for massive changes within VA\u2019s existing system of <a href=\"https:\/\/www.militarytimes.com\/veterans\/2018\/03\/07\/va-secretary-promises-more-leadership-changes-following-another-rebuke-from-investigators\/\" title=\"\" class=\"\" target=\"_blank\">Veterans Integrated Service Networks<\/a>, a series of 18 regional administrative overlays to the veterans health system. Several said it may be time to get rid of the outdated management model.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u201cThe VISNs are due for an overhaul,\u201d said committee chairman <a href=\"http:\/\/caucus.militarytimes.com\/speaker\/phil-roe\/#.WwVije4vyUk\" title=\"\" class=\"\" target=\"_blank\">Rep. Phil Roe, R-Tenn<\/a>. \u201cThey should be the fail-safe mechanism when a medical center goes off course. Unfortunately, too many of them seem to be afflicted with a case of learned bureaucratic helplessness.\u201d<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The idea is one that has been proposed by veterans groups and lawmakers in the past, but could have extra momentum this year given the massive veterans health care changes currently moving through Congress.<\/p>\n\n\n\t<aside class=\"smg-interstitial-link wp-block-smg-interstitial-link\">\n\t\t<a href=\"https:\/\/one.sightlinemg.com\/militarytimes\/veterans\/2018\/05\/16\/sweeping-veterans-policy-bill-passed-overwhelmingly-in-the-house\/\" class=\"smg-interstitial-link__inner\">\n\t\t\t\t\t\t\t<div class=\"smg-interstitial-link__media\">\n\t\t\t\t\t<img loading=\"lazy\" decoding=\"async\" width=\"300\" height=\"196\" src=\"https:\/\/one.sightlinemg.com\/wp-content\/uploads\/2026\/08\/AP_16190749319719.jpg.jpg?w=300\" class=\"smg-interstitial-link__image wp-post-image\" alt=\"\" \/>\t\t\t\t<\/div>\n\t\t\t\t\t\t<div class=\"smg-interstitial-link__content\">\n\t\t\t\t<span class=\"smg-interstitial-link__kicker\">Related<\/span>\n\t\t\t\t<h3 class=\"smg-interstitial-link__title\">Sweeping veterans policy bill passed overwhelmingly in the House<\/h3>\n\t\t\t\t\t\t\t\t\t<p class=\"smg-interstitial-link__excerpt\">The VA Mission Act, expected to be taken up quickly in the Senate, includes new community care rules, a caregiver stipend expansion and more.<\/p>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/a>\n\t<\/aside>\n\t\n\n\n<p class=\"wp-block-paragraph\">The Senate is expected to finalize a $52 billion veterans legislative package on Wednesday that includes new rules for medical care coverage outside the VA system. In addition, President Donald Trump has repeatedly promised to cut waste and abuse within the federal ranks, and create a more customer-friendly veterans department.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">VA officials are already undergoing a review of the department\u2019s existing management organization, prompted by problems with VISN leadership in recent years.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In March, then VA Secretary David Shulkin ordered the dismissal of several regional directors and new investigations into three of the department\u2019s 18 VISN operations following issues with ineffective management within those offices.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The networks were created in an effort by department officials to decentralize budgeting, planning and oversight for hospitals and clinics in regions across the country.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Today, that level of middle managers has swelled to about 1,000 employees. Critics have questioned whether they\u2019re creating more efficiency for the health system or simply creating more bureaucracy.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u201cStriking the proper balance between authority and flexibility can be difficult,\u201d said Rep. Julia Brownley, D-Calif., following a Tuesday\u2019s committee hearing on the issue.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u201cNot only do we need to ensure the VISN governance structure empowers its leaders to act in veterans\u2019 best interest when problems arise, we also have to ensure VISN leadership is held accountable when they fail to act in veterans\u2019 best interest.\u201d<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">That includes multiple reports that problems at veterans hospitals in New Hampshire, Massachusetts, Arizona and Washington, D.C. in recent years were overlooked or ignored by VISN officials, whose job is supposed to include oversight and correction of their local medical centers.<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1200\" height=\"919\" src=\"\/wp-content\/uploads\/2026\/08\/AP_395435336029.jpg.jpg\" alt=\"\" class=\"wp-image-73894\" srcset=\"https:\/\/one.sightlinemg.com\/wp-content\/uploads\/2026\/08\/AP_395435336029.jpg.jpg 1200w, https:\/\/one.sightlinemg.com\/wp-content\/uploads\/2026\/08\/AP_395435336029.jpg.jpg?resize=300,230 300w, https:\/\/one.sightlinemg.com\/wp-content\/uploads\/2026\/08\/AP_395435336029.jpg.jpg?resize=768,588 768w, https:\/\/one.sightlinemg.com\/wp-content\/uploads\/2026\/08\/AP_395435336029.jpg.jpg?resize=1024,784 1024w\" sizes=\"auto, (max-width: 1200px) 100vw, 1200px\" \/><figcaption class=\"wp-element-caption\">People line up to get prescriptions filled at the  pharmacy in the Sacramento Veterans Affairs Medical Center in Rancho Cordova, Calif., on April 2, 2015. (Rich Pedroncelli\/AP)<\/figcaption><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Carolyn Clancy, executive in charge of the veterans health administration, acknowledged the complexity of the current system has meant that responsibilities among regional officials and medical center staff \u201chas not always been clear.\u201d<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">But she said current department leaders have a stated goal \u201cto streamline business practices and ensure clearly defined roles \u2026 so that we are functioning in a way that is more efficient, produces better results and accountability.\u201d<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Officials at the VA Inspector General\u2019s office told lawmakers they still haven\u2019t seen evidence of that, and lawmakers said they remain skeptical.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">VA officials have planned a report on possible reforms to the VISN due on July 1. Brownley said if that isn\u2019t accompanied by an outline for significant changes within the current management structure, she\u2019ll be disappointed.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u201cWe are tired of receiving reports,\u201d she said. \u201cWe are sick of inaction.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Is the department&#8217;s system of regional middle managers the next item on Congress&#8217; chopping block?<\/p>\n","protected":false},"author":7,"featured_media":36095,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_yoast_wpseo_meta-robots-noindex":"","_yoast_wpseo_meta-robots-nofollow":"","_yoast_wpseo_canonical":"","_acf":"","_yoast_wpseo_primary_category":38,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","_smg_distribution_targets":[]},"categories":[104,38,106,31,33,9],"tags":[],"coauthors":[3294],"class_list":["post-24498","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-acquisition-update","category-congress","category-daily-brief","category-home","category-newsletters","category-federal-oversight"],"acf":{"subheadline":"","legacy_arc_id":"M6LFSDOD2ZAL5P3IZCSIOW7E4I","arc_canonical_url":"\/veterans\/2018\/05\/23\/lawmakers-eye-more-dramatic-management-changes-within-va\/","remove_feature_photo":false,"is_sponsored":false,"subtype":"","redirect_url":"","disable_inline_ads":false,"native_logo_pretext":"Presented 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