Rep. Lee Joins Senator Casey, Rep. Deluzio Call on Veterans Affairs Pittsburgh Healthcare System (VAPHS) to Address Long-Standing Problems

**FOR IMMEDIATE RELEASE**

January 16, 2023 

CONTACT: Emilia Rowland, Emilia.Rowland@mail.house.gov

Rep. Lee Joins Senator Casey, Rep. Deluzio Call on Veterans Affairs Pittsburgh Healthcare System (VAPHS) to Address Long-Standing Problems

[PITTSBURGH, PA] — Today, Congresswoman Summer Lee (PA-12), Senator Bob Casey (D-PA) and Rep. Chris Deluzio (PA-17) called on the Veterans Affairs Pittsburgh Healthcare System (VAPHS) to address chronic staffing shortages, open a new outpatient clinic in Monroeville, and ameliorate the structural issues at the 70-year old University Drive Hospital.

Congresswoman Lee said, “I appreciate the efforts by Director Koenig to improve VAPHS and address some of its most pressing needs. However, VAPHS was one of only nine VA Medical Centers and Healthcare Systems out of 114 to receive a one-star rating from the recent Center for Medicare & Medicaid Services (CMS) ratings and has serious structural problems that need to be addressed. Our veterans sacrificed their livelihoods to serve our country and deserve high-quality, world-class health care when they return home. It is unacceptable that our veterans are forced to receive healthcare from a hospital that is understaffed and lacks sufficient  resources, such as -accessible vehicles, they need. I implore Director Koenig to answer our questions and recommit himself to ensuring that Western PA’s veterans receive the best health care possible.”

Background:

• VAPHS serves over 84,000 veterans annually.
• Ever since a Legionnaires outbreak in 2012, VAPHS has shuffled through six medical system directors in five years, with Director Koenig having served since 2019 (Source).
• VAPHS remains short-handed in several key disciplines, including Registered Nursing, behavioral health, Medical Support Assistance, and housekeeping.
• VAPHS was one of only nine VA Medical Centers and Health Care Systems out of 114 to receive a one-star rating from the recent Center for Medicare & Medicaid Services ratings. While this is the first year that the VA received ratings on the same scale as non-VA health providers, this indicates that there is room for improvement in delivering quality healthcare services to the region’s veterans. On October 10, a veteran died by suicide at the H. John Heinz III VA Medical Center (Source). 

Letter text:

January 11, 2024 

Donald Koenig 

Director 

VA Pittsburgh Healthcare System 

University Drive C 

Pittsburgh, PA 15240-1003 

Dear Director Koenig:

Thank you for your work at the Veterans Affairs Pittsburgh Healthcare System (VAPHS) over the last four and half years.  Starting the role, you were the sixth medical system director to rotate through VAPHS in five years, following the aftermath of the 2012 Legionnaires’ outbreak.[1]  That turnover rate demonstrates the challenges of running a health system operating at the VA’s highest complexity level and serving over 84,000 veterans annually.[2] We appreciate your efforts to improve VAPHS and address some of its pressing needs, including chronic staffing shortages, opening a new outpatient clinic in Monroeville, and the critical structural issues at the 70-year old University Drive hospital.

Despite these efforts, challenges remain—some unique to VAPHS and others related to the VA health care system as a whole—degrading the system’s ability to provide the vital care both needed and expected by the region’s veterans. Addressing the barriers to this vital care, including the VAPHS’s shortage of vans for veteran transportation, inconsistent communication between VAPHS management, line leaders, and frontline workers, and uncertain security measures to protect and inform veterans and employees, will ultimately produce the end-results desired by us and you—a health system providing high-quality care and services to its veterans.

First, although hiring and retention have improved significantly over the last year, we have heard that it consistently takes significant time to post for the hiring of positions, even when management becomes aware of a future need. Additionally, we have heard that, even with the flexibility and incentives provided by PACT Act authorities, VAPHS remains short-handed in several key disciplines, including: Registered Nursing, behavioral health, Medical Support Assistance, and housekeeping. To address these hiring-related concerns, we ask that you develop a system to track the amount of time between VA management becoming aware of a talent need and VA posting a position to hire to address that need and keep us apprised of this information quarterly. We also ask that you identify the causes of your remaining talent shortfalls and actions to address those shortfalls as well as limitations imposed by current VA authorities.

Second, VAPHS was one of only nine VA Medical Centers and Healthcare Systems out of 114 rated to receive a one-star rating from the recent Centers for Medicare & Medicaid Services (CMS) ratings. We realize this year was the first that VA received ratings on the same scale as non-VA health providers, that certain priority metrics do not correlate equivalently due to differing incentive structures at the VA (versus the private sector), and that these metrics provided a dated view of VAPHS’s performance. However, we remain concerned by the ratings and have high expectations for improvement over the current rating period. Please let us know what steps you are taking to improve upon the one-star rating and the degree of improvement that you expect VAPHS to reasonably achieve over the next round of ratings.

Third, we understand that you do not have sufficient vehicles, including handicap-accessible vehicles, to transport veterans to and from appointments and to fulfill other needs across VAPHS. We understand many older vehicles are no longer fit for service and the nationwide microchip shortage has significantly delayed access to replacement vehicles. We encourage you to explore all possible pathways to restoring VAPHS’s ability to provide transportation services to all those veterans in need and ask that you reach out to our offices if you believe that we can support you in this regard.

Fourth, on October 10, a veteran died by suicide at the H. John Heinz III VA Medical Center.[3] We know you have already conducted a thorough investigation of the incident and are continuing to identify and enact security reforms to avoid a future suicide. We have heard from employees at the facility that communication surrounding the incident and the after-action review left room for improvement. We ask that you personally provide a briefing to our offices on the suicide’s circumstances, VAPHS’s root cause analysis and assessment of its security measures, changes made following the analysis and assessment to prevent another suicide from occurring at VAPHS, and, through this entire process, VAPHS’s communications to employees.

Lastly, we have heard that the consistency of communications and quality of relationships between VAPHS management, service line leadership, and union leadership have not yet returned to pre-2017 levels. Your lack of timely and responsive communications with our offices about pressing challenges facing your health system amplifies our concerns. If we find it difficult to get to the bottom of issues involving VAPHS, front-line employees likely face insurmountable challenges. One particular opportunity for improvement we see is the reinstatement of a Labor Management Forum (LMF) at the VAPHS level. We encourage you to restart this forum at the VAPHS level and use it to seek input on VAPHS improvements and align key stakeholders on current and future initiatives, including those enabled by the PACT Act.

We hope you take our suggestions seriously and appreciate your continued partnership in providing the best care available to the veterans of southwestern Pennsylvania and nationwide.

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Since taking office in January, Lee, who serves on the House Oversight Committee and Space, Science and Technology Committee, has delivered historic levels of federal investment totaling nearly $1 Billion brought back to Western PA, including over $200 million for infrastructure, over $50 million for affordable transit, and over $500 million to keep clean energy manufacturing at home in Pennsylvania. These investments will help improve Western Pennsylvania’s infrastructure and transit, ensure cleaner air and drinking water, lower housing costs, fund research institutions, fuel clean manufacturing, fund STEM innovation and entrepreneurship, boost workforce development, and create thousands of good paying union jobs.  Lee and her team have also delivered casework and constituent services to over 1,380 constituents with issues ranging from helping our seniors and disabled community access Medicare and social security to helping folks secure housing and helping families with immigration support and passports. 

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